Pennsylvania Practitioner Forms & Links

Billing Forms

Bucks County Practitioners Materials

Checklists for Providing/Receiving Early Intervention Supports in Child Care Settings

 

Chester County Practitioners

Computer Help

DE STATE Practitioners Information; forms; materials, etc. for Practitioners serving Delaware STATE children and families.

Delaware County Practitioners &materials applicable only to Delaware Early Intervention Practitioners

Early Childhood Mental Health Resources

When we talk about “early childhood mental health,” we are referring to the positive results of intervening early before problems develop into something more serious. Simply put, early childhood mental health is the same as healthy social and emotional development in young children, encompassing things like learning to express and regulate emotions, forming close and secure personal relationships, and exploring and learning about their environment.

  • Infant-Toddler Temperament Tool - Infant Version The Infant Toddler Temperament Tool includes a short online survey that allows parents and caregivers of infants and toddlers to recognize and explore their own temperament traits and those of a child for which they provide care. The IT3 generates results which support parents and caregivers in understanding how adult and child similarities and differences in temperament traits may affect “goodness of fit.” Along with these results, the IT3 generates simple best practice tips adults can use to foster the unique temperament of each child within their care.
  • Infant-Toddler Temperament Tool - Toddler Version The Infant Toddler Temperament Tool includes a short online survey that allows parents and caregivers of infants and toddlers to recognize and explore their own temperament traits and those of a child for which they provide care. The IT3 generates results which support parents and caregivers in understanding how adult and child similarities and differences in temperament traits may affect “goodness of fit.” Along with these results, the IT3 generates simple best practice tips adults can use to foster the unique temperament of each child within their care.

Incident Management

Ounce/ECO Materials Developmental Profiles and ECO

Philadelphia Practitioners &materials applicable only to Philadelphia Early Intervention Practitioners

  • Assessment of Family Activities & Routines  This questionnaire will help providers get a picture of a child’s typical performance in everyday family activities/routines. The best way to use the form is as a guideline for an interview or conversation with the caregiver(s). When used as an interview/conversation guideline, the provider makes sure that s/he learns about how each activity/routine occurs in the household, the child’s participation in the activity/routine, and the extent to which caregiver(s) are satisfied with the child’s participation. An example can be found at http://jeffline.tju.edu/cfsrp/pbs.html.
  • Caregiver-Child Interaction Plan (CCIP) This form is designed to assist practitioners and caregivers in analyzing challenging routines in a step-by-step process. Together, the team can then develop strategies that will improve the routines. To view an example, copy and paste http://jeffline.tju.edu/cfsrp/pdfs/Caregiver%20Child%20Interaction%20Plan%20Example.pdf into your internet browser's address bar and then hit enter.
  • Quarterly Review Form - Single Service Provider This is the contact form for Single Service Provider Quarterly Reviews.
  • Request for IFSP Team Meeting Outside of QRM Schedule Guidelines for requesting a team meeting outside of a regularly scheduled quarterly review meeting. Also included is the actual request form itself.
  • Service Agreement Form Famly - Provider service agreement form
  • Service Agreement Form - Spanish
  • Service Support Plan - Instructions
  • Team-based Service Delivery Approaches in Pediatric Practice APTA article regarding importance of PTs working collaboratively with other disciplines. The choice of team approach should be based on the needs of the child and family.14 The recommended—and generally accepted—approaches of teaming are interdisciplinary and transdisciplinary. However, there has been a recent shift toward the recommendation and use of transdisciplinary teaming, particularly in early intervention settings.
  • Training Matrix – Annual Requirements (Philadelphia County) Included is a detailed outline of state regulations, training requirements, courses, and mandated credits.
  • Training Matrix – New Practitioner (Philadelphia County) Included is a detailed outline of state regulations, training requirements, courses, and mandated credits.
  • Visual Progress Monitoring Data Collection
  • Warm Resource Line The warm line provides resource information to early intervention service providers in the birth-to-three system about supports and services that families can access in the community. The Warm Line is staffed by Family Support Coordinators from ChildLink.

Practitioner Materials

Progress Monitoring

Sunny Days PA Employee Materials

Teaching & Learning Collaborative (TLC)

  • 2015-16 TLC Training Handbook The following document includes information for Provider Competency classes for 2014 - 2015. If you have any question regarding training please contact Maureen Cimochowski at 610-449-1600 Ext. 120 (mkearney@sunnydays.com).
  • Assessment of Family Activities & Routines  This questionnaire will help providers get a picture of a child’s typical performance in everyday family activities/routines. The best way to use the form is as a guideline for an interview or conversation with the caregiver(s). When used as an interview/conversation guideline, the provider makes sure that s/he learns about how each activity/routine occurs in the household, the child’s participation in the activity/routine, and the extent to which caregiver(s) are satisfied with the child’s participation. An example can be found at http://jeffline.tju.edu/cfsrp/pbs.html.A
  • Caregiver-Child Interaction Plan (CCIP) This form is designed to assist practitioners and caregivers in analyzing challenging routines in a step-by-step process. Together, the team can then develop strategies that will improve the routines. To view an example, copy and paste http://jeffline.tju.edu/cfsrp/pdfs/Caregiver%20Child%20Interaction%20Plan%20Example.pdf into your internet browser's address bar and then hit enter.
      

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