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Early intervention for children with disabilities meets growing need in Cuyahoga County

Everly Fisher plays with a puzzle during her early intervention session through the Cuyahoga County Board of Developmental Disabilities. Devan Adley, speech language pathologist, and Jessica Fisher, Everly's mother, prompt the toddler to take the pieces in and out of the puzzle.
Kelly Krabill
/
Ideastream Public Media
Everly Fisher plays with a puzzle during her early intervention session through the Cuyahoga County Board of Developmental Disabilities. Devan Adley, speech language pathologist, and Jessica Fisher, Everly's mother, prompt the toddler to take the pieces in and out of the puzzle.

More children from birth to age three with disabilities or developmental delays are qualifying for early intervention services through Cuyahoga County. The increase is also statewide. Locally, the Cuyahoga County Board of Developmental Disabilities has been meeting the need by expanding its resources.

Since 2016, early intervention in Cuyahoga County has increased by 41%, according to Lori Mago, the division manager of assistive technology and children’s services for the Cuyahoga DD.

“That number tends to tick up from month to month,” Mago said. “It’s been a steady uptick really since COVID. Since maybe fall of 2021. We started coming out of COVID. People felt more comfortable.”

In Strongsville, Everly Fisher, who goes by the nickname Evie, started the program in October of 2022. Her mother, Jessica Fisher, and speech language pathologist for early intervention from the Cuyahoga DD, Devan Adley, work together to help Evie identify animal shapes in a peg puzzle as part of her therapy.

Evie has a speech delay. Her mother noticed it early on.

“I’d say around a year when she wasn’t saying mom, dad, ball,” Jessica said. “That was my first kind of clue. She also did some other things. She does some hand movements.”

This led to testing and a diagnosis of autism. Jessica said she recognized signs in her daughter because her oldest child also has autism. She requested early intervention services for Evie from Bright Beginnings, the intake provider for the Cuyahoga DD's early intervention program. Bright Beginnings receives a child’s referral and if approved, the county board provides staffing for services.

Early intervention is a statewide system in Ohio where coordinated services such as speech language pathology and physical therapy are provided to children from birth to age three who have disabilities or developmental delays, according to the Ohio Department of Developmental Disabilities website. The program happens at home during the child’s daily routine.

“She’s been imitating vocalization so much more,” said Adley, as she counted the number of puzzle pieces to Evie. “We have gotten a couple simple words out of her.”

Devan Adley, speech language pathologist from the Cuyahoga County Board of Developmental Disabilities, repeats foundational sounds to 2-year-old Everly Fisher during her early intervention session.
Kely Krabill
/
Ideastream Public Media
Devan Adley, speech language pathologist from the Cuyahoga County Board of Developmental Disabilities, repeats foundational sounds to 2-year-old Everly Fisher during her early intervention session.

There are a few ways children can qualify for services. The Ohio DODD has a list of approved diagnoses for early intervention such as autism, hearing loss or Down syndrome, said Erin Wladyka, early intervention manager for Cuyahoga County DD. A family member, caregiver, childcare center or medical provider can start the referral process with Bright Beginnings where a skills assessment is conducted for the child.

Katie Parker, early intervention manager for Cuyahoga County at Bright Beginnings, said that children were not as engaged with other peers, such as in a daycare setting, during the early stages of the pandemic, so more kids have shown signs of delay. More families are seeking early intervention services because the program changed from a classroom-based approach to an evidence-based, at-home approach. And, more families like the services coming to their home.

“The intervention happens when the provider is not present," Parker said. "So, it’s giving and coaching the caregiver with the strategies and skills to practice them in their daily routines.”

The switch to an evidence-based approach using natural environments from a classroom-based approach began in 2012. In Cuyahoga County, less than 1,000 kids were served before the change. Now, there are more than 1,600, Mago said.

Across Ohio, children served in early intervention increased by 15% from 2021 to 2022. Kimberly Hauck, director of the Ohio DODD, said the state has promoted the evidence-based approach.

“We actually right now are at historic numbers,” Hauck said. “Above what we typically would see even before the pandemic.”

Mago said her team has hired more staff for Cuyahoga County to try to keep up with the growth, but the Ohio DODD has also helped.

“We do have other resources and things throughout the state that we can use in addition to our own services and supports to help meet the needs,” Mago said.

“When Devan comes, every day’s different,” Jessica said as she held up a communication board at Evie's eye level so she could choose a snack.

“We might work on pictures and try to do some communication with pictures on snack options,” Jessica said.

Adley calls it alternative augmentative communication, which is a way to communicate that replaces speaking. Evie uses pictures of food to tell her parents which snack she wants.

Mago said the Cuyahoga DD wants to partner with more local providers for services and hire additional staff to help meet the growing need.

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Kelly Krabill is a multiple media journalist at Ideastream Public Media. Her work includes photography and videography. Her radio and web reporting covers a wide range of topics across Northeast Ohio.