In a nutshell…

For a long time we believed that young children with disabilities learned best in 1:1 sessions with specialists. Individualized therapy in special places or special programs for children with disabilities was the “gold” standard. Therapists and teachers worked hard; teaching developmental steps sequentially, isolating skill sets, task analyzing. However, recent research about early learning indicates that young children do not learn “better” with experts in special programs or isolated settings. They learn best within familiar activities and with familiar adults. The IDEA mandate to provide EI services in natural and inclusive environments came about BECAUSE of this research on young children’s learning. It was a call to capitalize on the natural teaching/learning opportunities within those environments. Changes in EI practices in response to these requirements have been slow to evolve. While many of our services now occur in natural and inclusive environments, there is still a propensity to provide 1:1 “therapeutic” services during set aside times, using decontextualized activities.

It is time for us to fully embrace early learning research and the mandate for natural learning opportunities. Providing services in natural and inclusive environments means using the learning opportunities in everyday routines and activities in which children and families participate at home and preschool. It means embracing the fact children learn best when they are DOING what they need and want to do. The skills needed by children are best identified from analysis of the skills needed within daily activities and routines. If we are to maximize learning within natural activities, the services we provide must directly influence the routines and activities the child participates in every day. Since we cannot be with the child every day, this means shifting our attention from children alone during visits to shared attention on children and the adults in children’s lives. The essence of EI is our ability to provide young children with disabilities and their families the supports necessary to engage in their daily routines and activities across settings. Traditional therapies are no longer the “gold” standard for our programs.

Key principles to consider…

  1. Children learn best when engaged with people and things that are familiar to them. EI services means supporting children to fully engage and be independent in the activities they need and want to do. Everyday life provides children a multitude of opportunities to develop, practice and generalize skills across a variety of settings and activities.
  2. Service delivery is not just about location: natural means everyday routines and activities. Asking care providers to replicate decontextualized activities or asking families to set aside certain times in the day to “work” on specific skills is not natural. Children with delays/disabilities benefit from special attention to routine learning opportunities that occur during daily life.
  3. Evidence of new skills within everyday activities is the most appropriate measure of EI effectiveness. Children are practicing skills every day within naturally occurring learning opportunities. If their practice is to be effective, we must find ways to support the adults in children’s lives to positively impact these “practice” learning opportunities.

Why are using natural learning opportunities so important?

Capitalizing on natural learning opportunities within the child and family’s everyday environments reflects the core mission of EI. Using and supporting natural learning opportunities allows children to develop to their fullest potential and to live life more fully within their families and their communities. And, when it is all said and done, it is the law.


NDE/NDHHS: The EI Practitioner’s Guide, March 2018

Return to Routines-Based Home Visits