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Early Intervention

The first three years of a child’s life are widely regarded as the most important period for development.

For some children, early limitations aren't easily overcome with time alone. Developmental delay means that a child may acquire skills more slowly or to a lesser degree. When children require extra help in these early years, support such as Occupational therapy, Physiotherapy, or Speech Therapy is known as early intervention.

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Early Intervention - What is it?

A typical baby’s development

The first three years of a child’s life are widely regarded as the most important period for development1. During this time, their nervous and sensory systems, muscles, joints, thoughts, and actions begin to mature and work together.

Typically, skills develop in a smooth, sequential progression. Each skill lays the foundation for the next, more complex one. For example, a baby will learn to hold up their head before they can sit. They will swipe at toys before learning to open their hand and grasp them. They will focus on nearby objects before learning to turn their head and eyes to follow something in motion.

When development is delayed

For some children, early limitations aren't easily overcome with time alone. Developmental delay means that a child may acquire skills more slowly or to a lesser degree.

However, it's important to remember that the sequence of development generally remains the same. Head control still precedes independent sitting. Swiping comes before grasping. Focusing up close comes before tracking moving objects.

The brain’s ability to change

At birth, a baby’s brain is still developing. It grows, forms new connections, and even has the capacity to reorganize itself. In some cases, healthy brain cells can take over the function of damaged ones. This remarkable ability is called neural plasticity or neuroplasticity.

However, this capacity decreases as the brain matures. That’s one reason why early years are so critical for children, especially those who need extra support.

The Benefits to Children and Families

We now understand why the first years are so important for development. But the brain doesn’t form these connections on its own, it also needs training and practice.

When children require extra help in these early years, support such as Occupational therapy, Physiotherapy, or Speech Therapy is known as early intervention.

Extensive research supports early intervention, highlighting its benefits for both children and their families. Its main goals are to:

Enhance cognitive outcomes

Improve motor and communication skills

Minimize the risk of secondary complications

Support parent and caregiver well-being

Strengthen bonding and interaction between parent and child

Parents and Therapists in Partnership

Therapists play a key role in assessing development and recommending helpful activities. But since parents and caregivers are with the child 24/7, they are essential partners in the intervention process.

Research shows that early intervention programs that actively involve parents tend to have greater impact on children’s development [7]. When families and therapists work together toward shared goals, children are more likely to reach their potential.

Playing with a Purpose

All this talk of therapy and intervention may sound serious, but at its heart, early intervention is simply play with a purpose.

Children with developmental delays learn through play, just like any child. In fact, they're often more engaged and motivated when they're having fun. Whether you’re a parent, grandparent, sibling, or friend, you can support a child’s development just by understanding why certain activities are helpful and how to make them enjoyable.

The Five Play Positions to Support Motor Development

Some children may prefer certain positions, while others may need to avoid specific ones for medical reasons. Always consult with your therapist to determine what’s best, especially if your child’s muscles are tight (high tone) or floppy (low tone), or if certain positions cause discomfort. There are five key positions that help promote motor skills:

1. Supine (back lying)

2. Prone (tummy lying)

3. Side-lying

4. Sitting

5. Kneeling

Transitions: Moving Between Positions

Transitions are the movements children use to shift from one position to another - like rolling from tummy to back. To transition successfully, a child needs to shift their weight, support themselves, and move another part of their body.

Therapists may recommend activities that specifically help develop transition skills.

Position vs. Activity: Finding the Right Balance

Both the position your child is in and the activity you choose matter. But your child’s ability in that position affects how challenging the activity should be.

For example, if sitting is difficult, your child will use most of their energy just to stay upright - so choose a simpler activity. If your goal involves a complex activity, choose an easier position or offer more support. This way, your child can participate successfully without becoming overwhelmed or too tired.

Here is a brief overview of each position and ideas of activities to complete in each position:

Supine (back lying)

Supine or back lying is one of the most fundamental developmental positions. When your child lies on their back, their body is symmetrically supported by the surface, allowing for a sense of security and stability.

This position provides an ideal foundation for developing essential physical, cognitive, and sensory skills, which are the building blocks for more complex movements and milestones down the line.

Prone (tummy lying)

Tummy time is especially important for children with developmental delays, as their back muscles are often weaker and need extra support to strengthen. While it can be challenging, especially for younger babies, helping your child feel comfortable and enjoy the position is more important than achieving specific tasks.

Side-lying

Side-lying is a supportive position that helps children with developmental delays explore and use both sides of their body, especially when tummy or back lying is too difficult. It’s particularly useful for children with uneven muscle tone or strong reflexes, as it supports fine motor, cognitive, and sensory development.

Sitting

Sitting is a key developmental milestone, supported by earlier motor skills like bringing hands and feet to the middle of the body while lying down. These early movements help build the postural control and coordination needed for sitting.

Kneeling

Kneeling is an important developmental position that strengthens muscles and helps children move between sitting, crawling, and standing. Different types of kneeling (like low, high, half, and four-point kneeling) support a variety of motor skills and are often used in therapy and play.

What do I do now?

If you're reading this and feeling unsure about what to do next, you're not alone. Many parents feel overwhelmed when they notice their child developing differently or more slowly than expected. The most important thing to remember is: you're not powerless, and you're not on your own. Here are some simple steps you can take right now:

  • 1. Talk to a Professional

    If you have concerns about your child’s development, speak with your GP, health visitor or paediatrician. They can guide you through assessments and referrals if needed and connect you with early intervention services.

  • 2. Start Observing

    Keep a notebook or use your phone to jot down what your child is doing and what they find tricky. Taking videos or photos is also helpful to visually explain any of your concerns. This will help professionals understand your child’s needs and guide the best support.

  • 3. Ask for an Assessment

    Early intervention services can assess your child’s physical, cognitive, and communication development. You don’t need a diagnosis to access support, just the recognition that your child might benefit from some extra help.

  • 4. Get Involved in Early Intervention

    If your child is referred for early intervention, great! These programs often involve Physiotherapists, Occupational Therapists, and Speech Therapists. You’ll be part of the process, learning how to support your child through play and daily routines.

  • 5. Start Small, at Home

    You don’t need to wait for appointments to begin helping your child. Simple things like tummy time, side-lying play, or helping your child reach for a toy in sitting position can make a big difference, especially when done regularly and with purpose.

  • 6. Lean on Support

    This journey can be emotional. Reach out to parent support groups, therapists, or family members. You are doing the best you can and that’s enough for your child.

The F-Words

In 2011, Dr. Rosenbaum and Dr. Gorter published a groundbreaking paper titled "The 'F-words' in Childhood Disability: I swear this is how we should think!". In it, they introduced six key “F-words” that reframe how we think about childhood disability: Functioning, Family, Fitness, Fun, Friends, and Future. These simple yet powerful words encourage parents, children, and therapists to focus on strengths and possibilities and on what a child CAN do, rather than what they find difficult. This positive, practical approach supports meaningful, family-centred goal setting and helps children thrive in their own unique ways. To help families use this framework, we’ve created a poster explaining each of the F-words and a goal-setting sheet to support collaborative planning at home or in therapy.

To learn more about the F-words and how this approach is changing the way we think about childhood disability, the CanChild website is a great place to start.

Join The Firefly Mailing List For More Support For Parents

What's Next?

Follow the PAM Wheel - A practical, visual, and easy-to-use tool to help families and therapy teams manage a child’s postural and activity equipment throughout the day.

Toileting

Bathing and Showering

Walking
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