EarlySteps provides services to families with infants and toddlers aged 0-3 years who have a medical condition likely to result in a developmental delay, or who have developmental delays. Services include occupational therapy, physical therapy, speech therapy, nutrition services, social work services, special instruction, vision services, behavioral therapy, etc. These services are usually provided in the child's natural environment, such as the child's home, or the child's daycare.

On March 22, 2020, Louisiana governor John Bel Edwards announced a statewide shelter in place order. This order stated "people should not go to work unless providing essential services." Services such as occupational therapy, physical therapy, speech therapy, etc were deemed essential. However, as of March 24, 2020, EarlySteps completely terminated home/community-based services, and has since only allowed the use of teletherapy for service delivery. Teletherapy uses FaceTime, Zoom, or similar communication options that allow audio and video interaction between the provider and the family. Since the termination of direct (in person) services, and the transition to exclusive teletherapy service delivery, many families and children are now being negatively impacted.

One issue is that teletherapy requires both the family and provider to have access to internet connection, and/or mobile data, as well as a smartphone, tablet, computer, and/or laptop. Unfortunately, not all families have easy access to these (whether due to home location, no transportation to access places with these, financial limitations, etc). Thus, some children have been unable to receive services at all since this transition.

Another prominent, and more prevalent issue is that many children have been unable to adapt to teletherapy. 0-3 year olds do not have the attention span to stay actively engaged with therapy through a screen. Parents are not trained in how to properly provide their children with physical therapy and are being asked to maneuver their child in place of the therapist. Children that used to receive different services for an hour weekly (per service), now may receive up to 30 minutes, at best, until they begin to lose engagement. Many others it has not worked for at all, and so have been without therapy for 6 months. It's also important for therapists, especially with therapies such as physical and occupational, to be there in person to physically manipulate the child's movements theirselves, and thus show the parents proper form for exercises and activities for them to continue to work on outside of therapy. Teletherapy completely removes this ability, causing many therapies to almost be impossible to adequately provide in many cases.

While the initial response to switch to teletherapy when COVID first hit may have been understandable, this has now gone on for 6 months, and the teletherapy only service delivery is severely effecting the development of many children within EarlySteps. 0-3 is a crucial time in children's overall development. Many children are going with little to no therapy, and not making any progress towards developmental milestones. Some are  regressing in their development. These therapies have been deemed as essential services from the beginning, and other agencies like those within home health and outpatient centers, are providing direct therapy to clients. Home health care for elderly patients was not interrupted.  

EarlySteps needs to begin offering home, and community based direct services again for therapy, on a case by case basis. It should be up to the families, and the therapy providers to determine the best avenue for service delivery. If both family, and therapist are comfortable with direct services, and believe it to be in the best interest for the child, then they should have the option available.  The blanket practice of teletherapy only is not sustainable, and is causing EarlySteps children and families to suffer because of it. Please sign this petition to call for EarlySteps to immediately begin offering direct home, and community based services again, along with teletherapy, and to be determined on a case by case basis between the family and therapy provider!