Early childhood is full of transitions, one of the most important being from home to preschool. But for children who receive services under the Individuals with Disabilities Education Act (IDEA), it's an even bigger jump. Getting that transition right is crucial to the child's ongoing success.

Part C of IDEA provides early intervention (EI) services to children from birth through age 3. Often the services are provided in the home. When a child turns 3, he transitions to Part B special education pre-

school services or another program, such as Head Start, depending on eligibility and family preferences. At least 90 days before the child's third birthday, the lead early intervention agency must convene a conference with parents and the local education agency (under Part B) to discuss services for which the child is eligible and how the transition will take place.

IDEA requires states to establish policies and procedures to ensure a smooth transition from Part C to Part B, and the U.S. Department of Education's Office of Special Education Programs monitors how well states meet those requirements via annual performance reports. Despite these safeguards, the transition can be stressful.

"Early intervention. is very family centered," said Christine Myers, PhD, OTR, who practiced in EI in Florida and now teaches early childhood courses as an assistant professor in the OT program at Eastern Kentucky University (EKU) in Richmond. "Therapists get to know the families well; it's very personalized. Then all of a sudden the child turns 3, and everything changes. The child is going into the school environment, where services are more child centered and focused on academics. That is a big change for families."

It's no surprise, then, that with such an extensive program and so many factors to consider, there will be bumps in the road for at least a few families. Thanks to ongoing research and very invested parties on all sides of the issue, more is being learned about how to make the transition as smooth as possible.

Timing the Transition

It's common for many children to be identified to receive Part C services around age 2. That leaves little time for families to come to grips with their children's conditions and needs-not to mention the complex web of services, regulations and people involved in service delivery-before the providers and location of services change.

Further, depending on the date of the child's birthday, there may be a gap between when the child turns 3 and when he is able to enter preschool. How that gap is handled differs from state to state.

"In the mid-nineties, the Office of Special Education Programs developed a policy allowing the state Part C program to serve children after the age of three, and for the Part B Section 619 Program to serve two-year-old children. States were required to develop a state-level policy before proceeding with the flexible service-delivery practice. The policy was designed to provide flexibility, particularly for children who might have summer birthdays," explained Kathy Whaley, technical assistance specialist at the National Early Childhood Technical Assistance Center (NECTAC). Based at the University of North Carolina, NECTAC is funded by OSEP to provide technical assistance to the states and territories as they implement the early childhood provisions of IDEA.

To help bridge the gap during the summer for some youngsters in her county in Kentucky, Myers has started an extremely innovative program in collaboration with preschool, Head Start and Part C representatives. Level-1 fieldwork students from EKU work with the children on preschool-oriented social and behavioral skills such as standing in line, washing hands before

a snack, sharing and turn-taking. At the same time, the children's parents partici-pate in a support group run by one of Myers' colleagues to help them address questions and cope with stressors related to the transition process.

When IDEA was reauthorized in 2004, the new version of the law offered states another transition option as well. They could continue Part C services for children after age 3 until the children are eligible for kindergarten. Children would not receive services in a Part B preschool program but instead would continue in the early intervention program, with the same providers, through age 5. So far, however, not a single state is pursuing this option. A few states have sought more information, but too much about the option remains unclear, most notably its funding.

"In order for Part C to serve children for a longer period of time, you have to have money," said Lynne Kahn, NECTAC director and principal investigator. "It is not clear where the money would come from. It's not clear whose  responsibility it is."

Part of the reason funding isn't clear is because no regulations for IDEA 2004 Part C exist. When Congress passes a law, the related government agency-in this case the Department of Education-promulgates the rules on how the law should be carried out. Proposed rules were issued in 2007 and went through comment and review periods. Draft final regulations had been released last year but were withdrawn in January when the presidential administration changed.

Talking the Transition

The National Early Childhood Transition Center (NECTC) has conducted a number of surveys on transition experiences as children move from early intervention to preschool. Among their findings: "Families rarely identified the service coordinator as the primary provider," explains NECTC principal investigator Beth Rous, EdD. "I don't think they are making it clear what the purpose of the transition process is."

Rous said service providers need to do more to collaborate, especially in home-based EI services where provider visits often don't overlap. "Providers still aren't talking enough... What we are finding is that it's not the [specific state's] requirements that make the difference, it is how the providers implement the requirements."

Luckily, this is a place where OTs can step in and take action to increase communication, plan ahead and thereby ease family stress in the transition process.

• Start talking to families about the transition as soon as EI services begin. "Tell them, 'I am your therapist. I am here to help address your needs and your child's needs right now; but eventually you are going to move into a new system, and we are going to work on preparing you and your child for that move,'" suggested Myers, who spent two years as a research assistant at NECTC. Try to anticipate the child's needs as he transitions. For example, a child who needs sensory supports at home will likely need similar supports in the classroom. Early planning can help the preschool have those supports in place when the child starts school, rather than waiting for the preschool therapist to reassess.

• When the transition-planning meeting occurs, be there. Parents also can elect to have a Part C representative attend the first IEP meeting; offer to play that role. The EI therapist also could meet with the preschool teacher once the child is assigned to the school or attend with parents if they choose to visit the preschool classroom, to make suggestions in a consultative role.

"If we are a part of the child's life, we really should try to be there," Myers affirmed.

• If you work in the preschool that receives the child into Part B services, make yourself known and available to parents. "Parents are used to having that connection with their EI service providers; so when that connection is taken away, they feel like they are in no-man's-land," she added. "It is hard enough saying goodbye to their child, but they also are losing that connection with their provider."

Once the child is added to your caseload, make a point to contact the parents by phone. You also can attend a school open house or be present when the parents pick up the child to introduce yourself. Give parents a way to contact you.

And don't forget that the transition process is ongoing. It starts long before the child turns 3 and continues well after his first day of preschool.

The Bright Side

"The whole concept that families are unhappy [once the child gets to preschool] is really not true," Rous said. "Once families get settled, they are satisfied with their experiences."

Surveys by the NECTC have found that after the child moves into Part B, families report slightly higher levels of quality of life and quality of services. They also are satisfied with the level of involvement they have and do not indicate they feel overburdened by the transition process.

As more research helps lawmakers and administrators align rules and laws with evidence-based best practices, implementation of transition processes should continue to improve. In the meantime, OTs can work individually with families to make the transitions as smooth as possible.

The first transition, from EI to preschool, "really sets the stage for every transition this child is going to have," Myers concluded. With each subsequent transition, "so many of the same issues are going to come back. If we can make this a positive, smooth experience for the family, it is really going to set the stage for how they view transitions in the future."

Jill Glomstad is ADVANCE managing editor.

Resources

• IDEA 2004 (U.S. Department of Education): http://idea.ed.gov/explore/home

• The National Early Childhood Technical Assistance Center: www.nectac.org

• The National Early Childhood Transition Center: www.hdi.uky.edu/NECTC/Home.aspx

•"Transition in Early Intervention: The State of the Evidence and Best Practices": NECTC recently assembled a presentation compiling a list of 21 recommended practices as well as over 1000 individual strategies providers can implement. The presentation is available on the NECTC Web site (www.hdi.uky.edu/NECTC/Home.aspx, click Publications, then Presentations and scroll down to "Other Completed Presentations"); a Webinar and Web-based tool will be available later this year.