Connecticut Birth to Three Services & Supports

The Connecticut Birth to Three system promotes the use of the following the  research supported practices:  Natural Learning Environment practices, Coaching as a style of interaction, and Primary Service Provider approach to teaming.

Primary Service Provider approach to teaming

In order to support and build capacity in parents, our system values a Primary Service Provider (PSP) approach to teaming.  This means that every child and every family have a full team supporting and available to them, but one person functions as the primary support for the family. As described by Rush & Shelden (1), a Primary Service Provider approach to teaming includes:

  • an established team consisting of multiple disciplines
  • meeting regularly and selecting one member to act as the PSP to the family
  • using coaching as an interaction style with parents, caregivers and other team members
  • strengthening parents confidence and competence in promoting child learning and development
  • supporting  parents competence in obtaining desired supports and resources
  • providing all services and supports within the natural learning opportunities/activities of the family

“The primary service provider approach to teaming is used in early intervention to support families of infants and toddlers in achieving the outcomes established in the Individualized Family Service Plan (IFSP). Using this approach, a team of professionals work together to provide assessment, intervention, consultation, and education in order to support children, families, and caregivers.  One member of the team, serving as the primary service provider (PSP), functions as the primary liaison between the family and other team members. The PSP receives consultation from the other team members and may use adult learning strategies, eg, coaching, as a way to interact with and teach other team members, including the family and caregivers”.(2)

The PSP is chosen with input from the whole team including the parent, based on who is the best match for the child and family.   The “use of a primary service provider/primary coach minimizes the negative consequences of having multiple and or changing practitioners “. (3) Support  found in research includes:

  •  A 2004 national report by Bruder and Dunst on helpfulness of early intervention, 96% of the time parents with one provider rated him or her helpful , 77 % of the time parents with two providers rated them as helpful, and 69 % of the time parents with three or more providers rated them as helpful. (4)
  • Parent and family well-being was positively affected by a family-centered early intervention approach and negatively affected by  early intervention service intensity.(5)
  • A review of literature  found that families with multiple providers showed increased parental stress and  confusion.  Also noted was that  having multiple providers resulted in a significant number of families having unmet needs , especially for children with severe disabilities. (6)
  • A study of 190 infants and families receiving 1 year of Early Intervention services reported that parents had less parental stress with one providers vs. multiple providers.  Of significant interest was that the developmental outcomes for these infants was also better when served by a single provider vs. multiple providers. (7)
  • A pilot study by Shelden and Rush looked at an experimental group of children and families receiving Early Intervention services based on Primary Service Provider teaming using a coaching interaction style vs. a control group receiving services from multiple independent providers.  The results showed that children and families receiving PSP/coaching received less service hours and still met IFSP outcomes more often than did the control group.  Children in both groups showed developmental progress with no  differences in the amount of progress noted between the groups. (8)

1 Shelden, M. L., Rush D. D. (2013) The Early Intervention Teaming Handbook: The Primary Service Provider Approach. Baltimore, MD: Paul H. Brookes Co. (p. 12)

2 Early Intervention Special Interest Group of the Section on Pediatrics, APTA (2013) Fact Sheet: Using a Primary Service Provider Approach to TeamingAlexandria, VA: Section on Pediatrics, APTA.

3 CaseTools (2009)Checklist for Implementing a Primary-Coach Approach to Teaming  http://fipp.org/static/media/uploads/casetools/casetool_vol5_no1.pdf   (p.2)

4 Bruder M.B. & Dunst, C.J. (2004) Outcome Interview Data Report.

5 Dunst C. J., Hamby D. W., Brookfield J. (2007) Modeling the Effects of Early Childhood Intervention Variables on Parent and Family Well-Being. Journal of Applied Quantitative Methods, 2(3), 268-288.

6 Sloper, P., & Turner, S. (1992). Service Needs of Families of Children With Severe Physical Disability. Child: Care, Health and Development, 18(5), 259-282.

7 Shonkoff, J.P., Hauser-Cram, P., Krauss, M.W., & Upshur, C.C. (1992) Development of Infants With Disabilities and Their Families: Implications for Theory and Service Delivery. Monographs of the Society for Research and Child Development, 57(6), 1-163

8 Shelden, M.L., Rush D.D. (2013) A Pilot Study of the Use of Geographically Based Early Intervention Teams Using a Primary Service Provider Approach to Teaming in The Early Intervention Teaming handbook: The Primary Service Provider Approach. Baltimore, MD: Paul H. Brookes Co. (p. 40)

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Resources and Information

Fact Sheet Primary Service Provider Approach to Teaming

Primary Service Provider Looks Like/Doesn’t Look Like

Primary Service Provider Video – Panel Discussion through APTA Early Intervention Special interest Group – January 15, 2013

FIPP Case in Point. Characteristics of a Primary Coach Approach to Teaming in Early Childhood Programs

FIPP Case Tools: Checklist for Implementing a Primary Coach Approach to Teaming

FIPP Guidelines for Team Meetings When Using a Primary-Coach Approach to Teaming Practices

FIPP Case Tools: Worksheet for Selecting the Most Likely Primary Service Provider

FIPP Case Tools: Joint Visit Planning Tool When Using a Primary Service Provider Approach to Teaming

FIPP Case Tools: Individual Family Staffing Report for Sharing Information and Planning During Team Meeting

Fact Sheet: Using a Primary Service Provider Approach to TeamingAlexandria, VA: Section on Pediatrics, APTA.