Changing Colors: The Blog of Spectrum Pediatrics

August 24, 2015

Early Intervention: Why Do We Ask So Many Questions?

By: Lauren Foster, OTD/OTRL
  • Coaching practices are considered “best practices” for families of children with special needs. In fact, the state of Virginia mandates that early intervention services are delivered via coaching.
  • What is coaching? According to Rush and Shelden (2011), coaching is an interactive process that promotes a caregiver’s ability to support a child’s participation in everyday experiences & interactions across settings.
  • Coaches and caregivers partner to analyze problems and develop interventions that the family uses throughout their day.

So what’s with all those questions we ask during early intervention visits?

In coaching, therapists or “coaches” use reflective questions to help caregivers gain insights into a problem or situation. By asking open-ended questions, the coach and caregiver can dig deeper into a problem. Evidence suggests that when solutions grow out of the caregiver’s ideas, children perform better and caregivers feel more empowered (Dunn et al., 2012).babies playing

  • In traditional therapy, a therapist will develop a plan for the caregiver and give specific intervention instructions to the family. In coaching, the coach and caregiver will develop a plan together.
  • Instead of telling the caregiver what to do, the coach invites the caregivers to be part of treatment planning.
  • In the coaching model, the coach guides the caregiver to develop his or her own plan.

baby thinking homeDuring a “coaching” session, therapists help caregivers identify what is most important to the family, what strategies parents have already tried, analyze factors that contribute to participation, develop a plan of action, and determine what next step fit best within the family’s life.

Literature suggests that when parents identify their own problems and come up with their own solutions, not only are they more likely to follow through with their plans but they feel more confident to tackle future problems and feel less stressed doing so (Dunn, Cox, Foster, Mische-Lawson & Tanquary, 2012; Foster, Dunn, Mische-Lawson, 2012). Ultimately, the goal of early intervention is to help children participate in their daily activities while simultaneously helping caregivers feel confident in their decisions.


Dunn, W., Cox, J., Foster, L., Mische-Lawson, L., & Tanquaray, J. (2012). Impact of an integrated intervention on parental competence and children’s participation for children with autism. American Journal of Occupational Therapy 36(5), 520-528.

Foster, L., Dunn, W., & Mische-Lawson, L. (2012 – online). Coaching mothers of children with autism: A qualitative study for occupational therapy practice. Physical and Occupational Therapy in Pediatrics.

McWilliam, R. A. (2010). Working with families of young children with special needs. New York, NY: Guilford Press.

Rush, D. & Shelden, M. (2011). The Early Childhood Coaching Handbook. Baltimore, MD: Brookes Publishing.

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