In this episode, Dr. Mona and special education lawyer Amanda Selogie dive into the critical role of early intervention in childhood development. They break down the realities families face today, including navigating insurance, dealing with staff shortages, and facing lengthy evaluation waitlists. They emphasize how accessing developmental support early lays the foundation for inclusive education. This ensures children of all abilities have an equal opportunity to thrive alongside their peers when entering the school system.

We discuss:

• Defining Early Intervention: Amanda Selogie explains how services support babies and preschoolers with developmental delays or specific diagnoses before they enter the school system.

• Cost and Coverage: The guests discuss how initial developmental evaluations are typically free through state agencies, while ongoing therapy services can sometimes carry out-of-pocket costs or insurance copays.

• Systemic Roadblocks: The conversation addresses how pandemic-related burnout has caused severe provider shortages and extensive waitlists, particularly affecting families in rural areas.

• Kindergarten Readiness: Dr. Mona and Amanda highlight how early support prevents children from falling behind behaviorally and being prematurely excluded from general education classrooms.

• Inclusive Education: The episode concludes by showcasing how fully integrated classrooms foster empathy and lifelong acceptance among all children.

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00;00;00;04 – 00;00;19;29

Dr. Mona

Welcome back to the follow up. It’s Doctor Mona, and this is a series on the PedsDocTalk podcast, where we revisit a past episode in less time than it takes for you to be on hold with an insurance company asking if your child’s speech therapy is covered. Tell me how I know. I deal with this all the time with my patients.

 

00;00;20;01 – 00;00;42;05

Dr. Mona

That’s a whole other conversation for another day, but I’m rerunning this one about early intervention, what it is, why it’s important, how to get services. Because we talk a lot about feeding, sleep and behavior on the show and on my platform. But development is the piece that ties it all together. Development and behavior go hand in hand. And here’s the thing parenting advice isn’t one size fits all.

 

00;00;42;10 – 00;01;04;10

Dr. Mona

What works for your child depends on where they are developmentally. So if your child isn’t hitting certain milestones, there’s real support out there. It’s called early intervention in the United States. And in this episode, I talk with special education lawyer Amanda Logie about what it is, how to access it, and what the equivalent can look like in other countries.

 

00;01;04;13 – 00;01;25;22

Dr. Mona

Remember, if you like this conversation, download the full episode. Download this one anytime you download it helps the show grow. Leave a review and share it on your social and tag the PedsDocTalk podcast and PedsDocTalk when you do. Let’s get into this follow up.

 

00;01;25;25 – 00;01;29;17

Dr. Mona

What is early intervention and why is it important that parents know about it?

 

00;01;29;19 – 00;02;00;29

Amanda Selogie 

Yeah, so early intervention is a very broad term. It’s used to describe the services and supports that are available to young children. So we’re talking babies infant free school age usually who might need more support. And the most common way people I think think about it is children with developmental delays and disabilities at an early age. So usually pediatricians and other providers kind of recommend referrals to families to get quote unquote early intervention when there’s a diagnosis.

 

00;02;01;00 – 00;02;27;24

Amanda Selogie 

So whether it’s from birth, a cerebral palsy, Down’s syndrome, or it’s a year into their life when they are diagnosed with speech delay or autism diagnosis on the spectrum, that’s kind of like that. First go to, we’re going to send you a referral for early intervention because early intervention allows you to get started earlier than just going into school, because we know we don’t have universal preschool in this country yet.

 

00;02;27;24 – 00;02;51;18

Amanda Selogie 

So the first time many kids are exposed to school, especially low income families, is kindergarten. So the idea that these children really need more support to learn new skills to overcome challenges and increase their successes once they get to school. So it’s usually this birth to 3 or 5 year range is usually what we’re talking about with early intervention.

 

00;02;51;21 – 00;03;09;10

Dr. Mona

So the evaluation itself, like just say a family wants to get their child evaluated. Is there a cost to that or does that depend. And also what are the cost of services like if they do qualify for speech therapy as an example, does that also just depend on state insurance coverage and things like that?

 

00;03;09;12 – 00;03;29;10

Amanda Selogie 

Yeah. So most of these agencies that are arms or connected to the state are usually going to be free, both the evaluation and the services. There’s nonprofits that do developmental screens for free for families. And I know that there are organizations across the country that do this. So sometimes the evaluation part, it’s a little bit easier to access free assessments.

 

00;03;29;10 – 00;03;50;28

Amanda Selogie 

It’s the services that may not always be free. If so, you go to these agencies and they say, okay, you qualify for ten hours of speech therapy a year. And you’re like, well, what if my child needs it? Once a week? There’s only two weeks in a year. That’s not going to be enough. And even insurance companies may pay the majority, but there’s still a copay.

 

00;03;50;28 – 00;04;09;24

Amanda Selogie 

So it’s not always going to be free. There are avenues to get free services, especially for low income families, but it’s not like a guaranteed thing. But when you get to the 3 to 5 year range and older, that’s when it should be entirely free because it is covered by the school district. So that’s where the change usually lies.

 

00;04;09;24 – 00;04;17;21

Amanda Selogie 

And we see a lot more kiddos that need the services between 3 and 5 because they didn’t get it earlier on, mostly because of cost and access.

 

00;04;17;23 – 00;04;36;01

Dr. Mona

Do you see like there’s been reports of families feeling like there’s a long wait list or wait times? Or is it really that as long as you call, you keep calling, you get on the assessment list that you should be able to get an evaluation in a timely manner? Because we know that development is important early on, which is why we want them to get evaluated.

 

00;04;36;04 – 00;05;03;02

Amanda Selogie 

Yeah, I mean, we are seeing real wait times. I mean, it’s gotten better probably six months. But you know, we work with a lot of providers and we have a lot of providers on like our podcast that we talked to about this. And unfortunately, there was a lot of burnout and Covid and a lot of people left the field or they switched or they completely changed careers, whether it was because of, you know, needing to be able to pay for expenses or just the burnout.

 

00;05;03;02 – 00;05;33;01

Amanda Selogie 

And we are seeing a lot of staff shortages across the board from public agencies, school districts to private agencies. And so, because school districts and regional centers and these early intervention services, they’re having shortages. They’re having to then reach out to private organizations to fulfill their contracts, which then makes the private agencies even more fall. We’re in southern California, and I’ve I had a family that wanted ABA therapy, behavioral therapy.

 

00;05;33;01 – 00;05;57;18

Amanda Selogie 

You know, I could throw a rock and I could find five. But in rural parts of the state and the country, that’s not the case. So even if a family is told, hey, you just keep calling more and more places, they may not find someone except for someone who’s two hours away. And if they’re going to go two hours away for therapy, is that beneficial for their one and a half year old to sit in the car for four hours to get a service, it may not be feasible.

 

00;05;57;20 – 00;06;13;15

Dr. Mona

Well, yeah. I mean, we’re talking so much about just all the different steps that it takes to get the services versus recognizing that you need services. I think that’s such an important role in education for families on what is, you know, what we expect to be typical in terms of age and what’s going on with your child’s development.

 

00;06;13;20 – 00;06;31;08

Dr. Mona

And that’s a lot on clinicians. And then obviously getting the services set up, getting the evaluation, obviously getting them, you know, tied into whatever they need. And you mentioned that it is something that ends up in the school system. You know, part of me, I’m in health care. I see the stuff is so important to me. As you know, this is why I wanted you to come on.

 

00;06;31;08 – 00;06;57;02

Dr. Mona

Like early childhood education and early childhood development. And I’m talking that first five years. Let’s even, like the first six years. Okay? You’re in California. I’m in Florida. It’s so stressful that a lot of it is dependent on where you live in this country and to a large degree. And I’m speaking like I’m in Florida where I have autistic children, and getting them in to ABA or getting them into just even an evaluation, it takes forever.

 

00;06;57;02 – 00;07;13;08

Dr. Mona

And it’s not the parents. Sometimes it’s literally like the waitlist, like moms have told me that, oh, I’m on a waitlist at some, you know, there’s a school nearby in our area that does work with a lot of autistic families, and it’s so frustrating because I’m like, they need the support, but there really is such a barrier to that.

 

00;07;13;08 – 00;07;36;21

Dr. Mona

And putting it on the school system too. I know that they have so much going on. You know, there’s so much that they’re evaluating and with low funds, and I’ve always felt like we just need way more resources and way more funding to this entire area. And I know you agree, and I know we’ve chatted about, you know, the state differences and stuff, but this is so important so that parents know how to advocate for themselves and how to push if they need the help.

 

00;07;36;28 – 00;07;58;28

Amanda Selogie 

Yeah. And I mean, when we touch on why is it so important? It’s not just that kids ages birth to five. That’s when so much development occurs. But it’s also the goal is to get your child ready for school, too. And that’s the piece that I think there’s a lot on social media right now about kindergarten readiness and what you need to do.

 

00;07;58;28 – 00;08;21;18

Amanda Selogie 

And I’m not talking about getting your kid ready for kindergarten so that they can be reading and writing. That’s not what I’m talking about. Being able to have your child be in an inclusive environment, because what we see happen so often is that a child who could have should have received services at one or 2 or 3, and didn’t they enter kindergarten?

 

00;08;21;22 – 00;08;42;21

Amanda Selogie 

They struggle. And the school district says, your child is so behind, they’re not accessing or they’re having behaviors, so they’re having to remove from the class. Maybe they’re getting suspended, which that’s a whole other topic. Myself, a kindergartner getting suspended. But that happens. Yeah, these are happening. And the school district then says, you know, your child really can’t be in this environment.

 

00;08;42;21 – 00;09;03;06

Amanda Selogie 

They need to be pulled to a special day class. They need to be pulled to a separate setting. And what happens to that child when they are just starting their educational experience, and they are being completely excluded from the general population and the general education environment. They are being taken away from the equal opportunity to learn. That is really important for our kiddos.

 

00;09;03;06 – 00;09;28;07

Amanda Selogie 

And so when we look at early intervention, a lot of what we’re looking at and kind of when we have clients and when we have families we’re working with and we’re trying to get them the right services, a lot of it is that eye of how can we get a lot of these underlying skills. This is skills that are a little bit easier for most families to teach their kids that these kids with developmental or any other type of a disability, they have an extra hurdle.

 

00;09;28;13 – 00;09;50;23

Amanda Selogie 

How can we get them up there to where they can access that general education kindergarten the minute they step through their school district doors, because the minute they get pulled to a separate classroom, it becomes more challenging every day they are in there to get them back to an inclusive setting. So we’re looking at it from the eye of wanting to give kids an opportunity to learn the same way as their peers.

 

00;09;50;25 – 00;10;03;29

Dr. Mona

Well, I was just going to ask about inclusive education. Obviously, your project, your nonprofit about inclusive education project. I think you already alluded to it. But why is this so important? If there’s anything else you want to add, why is inclusive education necessary for children?

 

00;10;04;04 – 00;10;33;24

Amanda Selogie 

So inclusive education really benefits us all. It benefits everybody. It benefits the child living with a disability. It benefits their peers, the adults, our communities, because it doesn’t just encourage these equal opportunities and equity, but it also encourages understanding and acceptance of differences. So which unfortunately is something that many adults in this country have trouble with. And we ask why they have trouble with it because they weren’t taught.

 

00;10;33;24 – 00;10;53;00

Amanda Selogie 

That is kindergartners unfortunately. So the school that I worked at before I went to law school was a full inclusion school, meaning that it was a public charter school where 20% of their population was kids with disabilities, and they were fully included in the general education environment. If they needed Aids, they had Aids, they needed speech therapy, they had it.

 

00;10;53;03 – 00;11;14;07

Amanda Selogie 

The goal was to have them in the general education class as much as possible, and it was one of those 1 in 1,000,000 schools. It was amazing to see that not only were the kids that I worked with were supported the way that they should be, but their peers, the students with disabilities, weren’t students with disabilities. To them, they were their friends.

 

00;11;14;09 – 00;11;41;28

Amanda Selogie 

They weren’t anything different because they learned from kindergarten on that they were just one of their peers, that there was nothing different about them. They were on this special bus. They weren’t on in this special class. They weren’t a special education student. It was. And the amount of just amazing things I saw in this school of these peers who I worked with, a little boy who had Down’s syndrome and when he needed a little break, a sensory break from the classroom, we pull him out.

 

00;11;41;28 – 00;12;03;06

Amanda Selogie 

And he loved basketball, so he would get to choose a peer to play basketball with him for, you know, what was like three minutes. So it wasn’t a huge time out of the classroom. And the kids loved playing with him. They fought over who got to help him in class and outside of class because they not only accepted him, but they understood him as their peer.

 

00;12;03;07 – 00;12;23;09

Amanda Selogie 

They didn’t see him different, and I can only imagine because that was so many years ago. These all of these kids that I worked with are now adults, and I can imagine that they are much more accepting adults than peers who, you know, when I was in school, I remember there being two kids with autism who were at my school.

 

00;12;23;09 – 00;12;44;28

Amanda Selogie 

That’s the only ones I knew of, and they were in a separate class. And the only reason I even knew that they existed was because once a week for one hour, they came into our class and we rotated sitting next to them. That was all. Yeah, all we were taught. So this inclusive education is the first time when kids are exposed to maybe people who are different.

 

00;12;45;00 – 00;13;10;15

Amanda Selogie 

And if we can teach them at an early age, we’re not having to backtrack and have as many problems as I think we see with employers not being accepting disabilities from having former presidents who think it’s okay to make fun of people who are disabled, you know, we have a lot of problems with not accepting each other. And I think this is where it all begins.

 

00;13;10;18 – 00;13;32;02

Dr. Mona

And that’s your follow up. Just a small dose of the real, relatable and eye opening conversations we love to have here. If you smiled, nodded, or had an moment, go ahead and download, follow and share this episode with a friend. Let’s grow this village together for more everyday parenting wins and real talk. Hang out with us on Instagram at the PedsDocTalk podcast.

 

00;13;32;04 – 00;13;47;16

Dr. Mona

Want more? Dive into the full episode and more at PedsDocTalk.com. Because parenting is better with support. And remember, consistency is key. Humor is medicine and follow ups are everything. I’m Doctor Mona. See you next time for your next dose.