Do you have a child enrolled in early intervention? Yes
No
What is your zip code?
How would you describe your child's racial background? American Indian or Alaska Native
Black or African American
Native Hawaiian or other Pacific Islander
Asian
White
Prefer not to answer
What is your child's ethnicity? Hispanic or Latino Not Hispanic or Latino Prefer not to answer
What is the age of your child receiving EI services? 0-6 months 7-12 months 13-18 months 19-24 months 25-31 months 32-36 months
Are you receiving Live Video Visits (Teletherapy)? Yes
No
I used to
Are you receiving phone consultations? Yes
No
Why did you choose not to receive Live Video Visits (LVVs)? (check all that apply) I don't have access to technology
I don't have access to wifi/internet
My family is overwhelmed / there is too much going on in my home right now.
LVVs weren't offered
I prefer to receive services in person
LVVs were too difficult to fit into our family's schedule
I anticipated it would be difficult to keep my child engaged during LVVs.
I have concerns about the family fee
Other
If other, please explain.
Why did you stop receiving LVVs? (check all that apply) I didn't feel comfortable participating in LVVs.
I didn't feel like my child was engaged during LVVs.
It was difficult to keep my child in front of the screen for the LVVs.
I didn't have good wifi/internet connection.
I didn't have enough data to access the LVVs.
I decided to wait for face to face services.
I didn't feel LVVs were beneficial.
I didn't feel the activities/strategies discussed with me during LVVs were helpful.
I didn't feel the activities/strategies used with my child during LVVs were helpful.
It was too difficult to manage the LVVs with our family routines.
Other
If other, please explain.
How many live video visits occurred?
What services do you currently receive through Early Intervention? Developmental Therapist
Developmental Therapist Hearing
Developmental Therapist Orientation and Mobility
Developmental Therapist Vision
Board Certified Behavior Analyst
Interpreters
Translators
Nurse
Nutritionist
Occupational Therapist
Occupational Therapy Assistant
Physical Therapist
Physical Therapy Assistant
Service Coordinator
Licensed Social Worker
Social Work Assistant
Licensed Professional Counselor
Psychology Assistant
Speech-Language Pathologist
Speech-Language Pathologist Assistant
How beneficial are the LVVs with the service coordinator? Very Beneficial
Somewhat Beneficial
Neutral
Not Beneficial
How beneficial are the LVVs with the developmental therapist? Very Beneficial
Somewhat Beneficial
Neutral
Not Beneficial
How beneficial are the LVVs with the developmental therapist - hearing? Very Beneficial
Somewhat Beneficial
Neutral
Not Beneficial
How beneficial are the LVVs with the developmental therapist - orientation and mobility? Very Beneficial
Somewhat Beneficial
Neutral
Not Beneficial
How beneficial are the LVVs with the developmental therapist - vision? Very Beneficial
Somewhat Beneficial
Neutral
Not Beneficial
How beneficial are the LVVs with the behavior analyst? Very Beneficial
Somewhat Beneficial
Neutral
Not Beneficial
How beneficial are the LVVs with the interpreter? Very Beneficial
Somewhat Beneficial
Neutral
Not Beneficial
How beneficial are the LVVs with the translator? Very Beneficial
Somewhat Beneficial
Neutral
Not Beneficial
How beneficial are the LVVs with the nurse? Very Beneficial
Somewhat Beneficial
Neutral
Not Beneficial
How beneficial are the LVVs with the nutritionist? Very Beneficial
Somewhat Beneficial
Neutral
Not Beneficial
How beneficial are the LVVs with the occupational therapist? Very Beneficial
Somewhat Beneficial
Neutral
Not Beneficial
How beneficial are the LVVs with the occupational therapy assistant? Very Beneficial
Somewhat Beneficial
Neutral
Not Beneficial
How beneficial are the LVVs with the physical therapist? Very Beneficial
Somewhat Beneficial
Neutral
Not Beneficial
How beneficial are the LVVs with the physical therapy assistant? Very Beneficial
Somewhat Beneficial
Neutral
Not Beneficial
How beneficial are the LVVs with the clinical social worker? Very Beneficial
Somewhat Beneficial
Neutral
Not Beneficial
How beneficial are the LVVs with the social work assistant? Very Beneficial
Somewhat Beneficial
Neutral
Not Beneficial
How beneficial are the LVVs with the professional counselor? Very Beneficial
Somewhat Beneficial
Neutral
Not Beneficial
How beneficial are the LVVs with the psychology assistant? Very Beneficial
Somewhat Beneficial
Neutral
Not Beneficial
How beneficial are the LVVs with the speech language pathologist? Very Beneficial
Somewhat Beneficial
Neutral
Not Beneficial
How beneficial are the LVVs with the speech language pathologist assistant? Very Beneficial
Somewhat Beneficial
Neutral
Not Beneficial
Did you have to purchase additional data to access your LVVs? Yes
No
Did you have to purchase or borrow a new device to access your LVVs? Yes
No
Did you incur any additional costs to participate in LVVs? Yes
No
If yes, please explain.
What would you be more comfortable with? Live Video Visits
Face-to-Face Visits
Are you comfortable having providers come back into your home? Yes
No
When EI providers do come to your home, what personal protective equipment / safety considerations are important to you? (check all that apply) My provider must wear a mask
My provider must wear a gown
My provider must wash their hands before and after the visit
My provider must test their temperature before the visit
My provider must be screened for exposure
Other
If other, please explain.
What are your expectations for EI providers that may visit your home after COVID-19 restrictions are lifted?
Would you like to share anything else with us?
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