Making decisions about service delivery in early childhood programs.

PURPOSE This article presents a rationale for specialized services personnel to use fluid models of service delivery and explains how specialized services personnel make decisions about the blend of service delivery methods that will best serve a child. METHOD The literature on occupational therapy, physical therapy, and speech-language pathology service delivery in early childhood programs is reviewed, synthesized, and applied to current practice. The literature explains that direct and consultative services provide unique benefits to children and should be flexibly scheduled based on each child's current priorities. Flexible service delivery models allow therapists to meet the evolving needs of children within dynamic environments. CONCLUSION To establish fluid service delivery models, therapists need to (a) plan collaboratively with teachers so that the model selected meets the teacher's preferences, (b) design flexible scheduling systems that emphasize inclusive practice, and (c) maintain precise documentation about when and how services are provided.