SovNews_Winter 2015 - Sovereign Pediatric Therapy

Winter 2015
Sovereign Pediatric Therapy
active participation of families in the therapeutic process
by embedding intervention strategies into family routines.
It is the parents who provide the real early intervention by
creatively adapting their child care methods to facilitate the
development of their child, while balancing the needs of the
rest of their family.
Early Intervention and
Pediatric Outpatient Clinics:
Working Together to Meet the Needs of
Infants and Toddlers in Our Community
Advantages of Illinois’ Early Intervention Program
By Debra J. Denniger OTD, OTR/L
When children under the age of three are in need of extra
support service, the question arises as to what is the best
environment or setting to receive these services. Should you
pursue outpatient therapy at a pediatric clinic, should you
contact The Early Intervention Program, or should you do
both? There are good therapists in both systems. A good
pediatric therapist, regardless of the setting, will be skilled
in the nuances of
typical and atypical
development and will
give consideration
to family values and
routines as part of the
therapy process. A
good therapist will also
make suggestions on
how to facilitate the
child’s development
based on your values,
routine and resources.
However, there are differences within these two systems.
This article will attempt to highlight the advantages, as well
as the differences, of both systems.
Illinois’ Early Intervention Program
The mission of the Illinois Early Intervention Program is
to assure that families who have infants and toddlers,
birth to three, with diagnosed disabilities, developmental
delays or substantial risk of significant delays receive
resources and supports that assist them in maximizing
their child’s development, while respecting the diversity
of families and communities. A referral to The Early
Intervention Program is initiated by contacting the local
Child and Family Connections (CFC) office, which is the
Department of Human Services (DHS) local regional intake
entity responsible for insuring that all referrals to the Early
Intervention Program receive a timely response and are
handled in a professional and family-centered manner. The
focus of the Early Intervention Program is to encourage the
To find the local CFC office serving your area, please visit:
Therapy typically takes place in the home or daycare
center which tends to be not only convenient, but
it also facilitates the incorporation of therapeutic
recommendations into your daily routine utilizing the
toys, furniture, and/or other items naturally occurring in
your home.
Evaluations include a multidisciplinary team format, or
that of individual service providers of different disciplines.
Therapy however is often transdisciplinary, where a team
member may work on all goals written on the child’s plan
of care.
Developmental Therapy: Children who qualify receive
developmental therapy (in addition to other identified
therapies), which is usually not covered by insurance and
therefore often not available in outpatient pediatric Clinics.
Service Coordination: Each child referred to early
intervention is assigned a service coordinator who helps
to manage their case. This person is a valuable resource
and assists parents with navigating through the early
intervention process and will coordinate with you and your
team of therapists on your behalf. The service coordinator
assists the parent with the transition process from early
intervention to early childhood (preschool) when the child
turns three years old.
Limitations of Illinois’ Early Intervention Program
Qualifying for services: A child must have a qualifying
medical diagnosis or must have at least a 30% delay in
one developmental area (developmental areas are gross
motor, fine motor, cognitive, language, social and self-help)
to quality for services.
Timing and initiation of therapy services: It sometimes
takes up to a month or longer for therapy services to
be initiated, particularly in disciplines where there is a
shortage of qualified providers such as occupational
therapists, physical therapists and speech-language
A family fee may be required: Monthly family fee
contribution may be required and is based on the family’s
income using a sliding scale.
Sovereign Pediatric Therapy – Focused on Results
Pediatric Outpatient Clinics
Most pediatric outpatient clinics bill
your medical insurance and therefore
operate from medical model of service
delivery. In most instances, medical
insurance will pay for a therapy
evaluation, regardless if it is for
physical therapy (PT), occupational
therapy (OT), or speech therapy (ST).
Coverage for actual therapy services
beyond that varies greatly depending on your insurance
plan and the specific service being recommended. Because
medical insurance is intended to provide coverage for a
medical need, the medical need for therapy service must
be clearly documented in the evaluation provided by the
therapist. For those without therapy coverage, or with very
limited therapy coverage, discounts or a reduced fee are
usually offered for those paying at the time of service.
Advantages of Pediatric Outpatient Therapy
Short Wait Time: There is usually little to no wait for
services to be initiated. Therapy evaluations and treatment
can usually be scheduled within one week of receiving the
initial call or inquiry.
Eligibility: Eligibility is based on having an identified need
that can be met through participation in therapy and not
based on a percentage of delay. Clinic therapy is an ideal
option for those children with a mild, but treatable, condition
which does not qualify for early intervention service.
Variety of Equipment: Children seen for therapy within
the clinic generally have access to a greater variety of
equipment and supplies not readily available within most
homes. Examples include the use of suspended equipment
and specialized swings, walkers, or scooters.
Teaming Facilitated: When your child receives therapy in
more than one discipline at a clinic, therapists have greater
access to each other to discuss immediate concerns and
questions. Multidisciplinary teaming between the child’s
treating therapists occurs frequently because the child’s
therapists are all on-site together.
Limitations of Pediatric Outpatient Therapy
Eligibility: Services are provided based on therapy
insurance coverage for a medical need or for those who
have the ability to pay for services. Clinics vary in their
payment options, but many offer reduced rates for
payment at time of service. Some have sliding fees based
on income.
Want to share this News Brief with your
co-workers or friends? Visit our website at and click the Pediatric
Clinics tab at the top of our home page. See
the informational topics available and click the
links for past issues of News Brief.
Do you have questions or concerns regarding your child’s
development? Sovereign Pediatric Therapy offers free
screenings. Call any office to schedule an appointment.
Pediatric outpatient clinics can vary greatly one from
another; therefore parents are encouraged to contact the
clinic they are considering to find out their philosophy of
care and any important policies that may impact you such
as payment, cancellation, or scheduling policies. It is also
recommended that you visit any clinic you are considering to
be sure it is the right fit for you and your child.
Early Intervention and Outpatient
Clinics Working Together
Local CFC offices often work together
with pediatric outpatient clinics to meet
the needs of children in the community.
CFCs often utilize the services of
pediatric outpatient clinics that employ
early intervention credentialed therapists
to provide services in the child’s natural
environment (usually the home).
Occasionally, clinic-based services can
be approved by The Early Intervention
Program when a therapy provider for
the child cannot be scheduled in a
timely manner. There are also situations
where parents wish to pursue additional
therapy services for their child beyond
what has been approved by The Early Intervention Program.
If this is approved by your physician and determined to be in
the best interest for your child, early intervention therapists
and clinic therapists will team together to coordinate
therapeutic interventions.
To provide children with the highest quality therapy
for achieving independence while empowering parents to
further enhance their child’s function. This is achieved by
utilizing a holistic, eclectic, individual-based approach.
*Special thanks to CFC #15 for their review and contribution to this News Brief.
*Information regarding the Illinois’ Early Intervention Program was also gathered from the Illinois Department of Human Services Website
Is Sovereign Pediatric the right clinic for you? Please call any
of our offices and schedule a visit with one of our staff who
will be happy to answer any of your questions.
2835 N Sheffield Ave
Suite 401
Chicago, IL 60657
Crystal Lake
390 E Congress Pky
Unit A
Crystal Lake, IL 60014
Sovereign Pediatric Therapy – Focused on Results
1315 Macom Dr
Suite 103
Naperville, IL 60564