The outcomes have been written, so now it’s time to determine services. The team sorts through possibilities for Arnold, a two year old with global developmental delays, and his family. Multiple team members recommend multiple services, then Winnie, the service coordinator, suggests they consider a primary service provider (PSP). The team decides that Patrick, the physical therapist, is the most appropriate choice for the PSP. The speech-language pathologist will provide monthly support to both Patrick and Arnold’s family. Other professional team members will also be available for support if needed in the future. The IFSP is signed and everyone goes on their way.
In the car, Patrick wonders what being the primary service provider really means…is he supposed to be the speech therapist, educator, and occupational therapist all rolled into one? Isn’t that expecting more of him than what he can do under his license?
What It Means To Be a Primary Service Provider
Understanding just what it means to be a primary service provider is important for all early interventionists. Let’s think about what being a PSP IS and what it ISN’T:
The PSP is the team member who will be the family’s primary contact for EI services. This means that, while there may be more than one service listed on the IFSP, the PSP is the person who will see the family most often.
The PSP is a collaborative partner who keeps in touch with other providers on the team. The PSP stays in regular contact with all team members, including the service coordinator, to keep everyone updated on progress and family questions.
The PSP is the team member who helps the family address the child’s development from a holistic perspective. One of the hallmarks, and great benefits, of using this approach is that the PSP takes a holistic view of development. The child is not viewed from a discipline-specific or domain-specific perspective – meaning that we don’t compartmentalize the child into developmental pieces. For example, we don’t only address motor skills during a physical therapy visit or communication skills during speech therapy. Instead, Patrick will help the family find ways to address Arnold’s communication and movement during daily activities. He might join the family while they prepare for lunch, helping Arnold’s mother prompt him to use words to request a food choice, then coaching her on how to help Arnold carry his plate to the sink. The PSP helps the family and all team members consider how all aspects of development intersect during the child’s everyday life.
The PSP is not a lone wolf. The PSP practices with the support of other team members. The PSP is not expected to intervene on developmental concerns that he or she is not comfortable addressing. For example, if a developmental services (DS) provider is asked to be the PSP with a child who has global delays and feeding concerns, but the provider has no training in feeding, then using the PSP approach may not be appropriate. OR, that DS provider isn’t the right choice to be the PSP for that child. However, if the DS provider is comfortable monitoring feeding with the support of an OT who joins visits on a regular basis, then it could work well.
The PSP is not the lone decision maker. Just because Patrick is the PSP, this does not give him liberty to make service decisions by himself. He is still part of a team that includes Arnold’s family, Winnie (SC), and the SLP. Decisions regarding the frequency, intensity, type, or end of services are made by the team, with Patrick as an important participant.
With the support of his team, Patrick settles into his role. He realizes that he is an early interventionist first – and an early interventionist is someone who sees the child as a whole and the family as providing the context for the child’s learning. He is an early interventionist with specialized training and expertise in physical therapy. He is an asset to his team, bringing his knowledge and experience and sharing his expertise in a way that builds the family’s capacity to encourage Arnold’s development. As the PSP, he also shares his expertise with other team members so that the team works as a unit to support the family. His role is rich, holistic, and responsive and he is ready.
How do you describe what a primary service provider IS and ISN’T?
When do you use a PSP approach and how do you know when it’s working well?
Share your experiences in the comments below!