Frequently Asked Questions

In the states where intervention in natural learning environments is working, how are they interpreting the definition of NE?

All states are to define natural environments according to the federal definition in IDEA, Part C. Natural environments are home and community locations in which children would naturally be if they did not have a disability. If it is created for children with disabilities or they only attend because they have a disability, it is not a natural learning environment.

Why do early intervention services need to take place exclusively in home instead of the center? Is there research to support the fact that we can't do it that way?

IDEA, Part C defines natural environments as places where children would be if they did not have a disability. This may include homes, community locations, and early childhood programs, all of which are available to all families. The question is not merely where the supports are provided, but also how we provide them.

Even if services provided in a center or provider office are delivered in a way that supports family learning & involvement, doesn't the research point to these locations as inherently not completely a NE?

Therapy clinics and practitioner offices are not considered natural environments. Regardless of how hard we try, we are providing decontextualized interventions, which are not supported by the research on how children learn. Children learn best when they learn in context and have multiple opportunities to practice the skills and abilities throughout their day. The generalization research indicates that it is much easier to generalize newly learned skills when they are learned within the context of meaningful, functional activities as they happen naturally versus setting up contrived situations in a clinic or office.

If you have a playgroup (Language group) that encourages family (parents/grand parents) and sibling participation at the center, would that meet the natural environment guidelines?

In order for a play group to be considered a natural learning environment it should be a group that was not created for the purposes of therapy. It should be a group that children who are typically developing would naturally attend. Developing groups with peer models and/or allowing siblings to attend would not be consistent. In most cases, groups or other opportunities for child interaction occur within the community. If this is a priority of the parent, the early intervention service coordinator and/or practitioner should facilitate the child's/family's involvement in those types of learning opportunities. This may include attending with the parent and child to identify ways with the parent can promote the child's participation in ways that have development-enhancing qualities.

If a center-based program has a preschool open to the public as a whole and incorporates the learning philosophies discussed today into individualized treatment, would it be considered to be a natural environment?

A center-based preschool program in which children who are typically developing attend and the ratio of children who are typically developing to children with disabilities is similar to that ratio in the general community, this could be a natural learning environment for the child with a disability. "Individualized treatment," however, should occur within the context of the naturally planned and occurring activities in the preschool classroom and the role of the EI practitioner should be to support the preschool teacher in promoting the child's participation in the classroom activities rather than the practitioner using a pull-out model, which would be considered decontextualized intervention.

If we agree that it is the family's involvement in embedding activities into daily routines that is the essential part of NE, is there a reason why the coaching sessions can't take place at the center as well as in the NE?

We are not talking about having the parent embed therapy activities into their existing routine and activities. We are talking about recognizing and using their typical activities as opportunities for child participation in learning opportunities that have development enhancing qualities. We are not limiting these activities to working on only one skill or area of development, but rather allowing for participation in the activity and interactions with the adults in the environment to promote multiple skills as they would happen and be learned naturally.

Is a child care program that is the same building with a group therapy within early intervention considered a natural learning environment?


If a development group joins typically developing peers in a gross motor room at a therapy clinic for 20 minutes of a 90 minute group time, is the class time inclusive? How much of the time needs to be inclusive?

No. The group should not be one created by the early intervention program or practitioner that includes token peer models for the purposes of targeted children to get their therapy. The entire group activity should be one in which children in the community may participate together for fun, enjoyment, and learning.

How many children are needed to be able to be a NE? If no children are present in church/McDonald's/park, is it a NE?

A natural environment is where children would be if they do not have a disability. Children without disabilities go to church, McDonald's, and the park. They do not go to therapy clinics, agencies that exist solely for persons with disabilities, or centers designed specifically for persons with specific diagnoses.

If a parent asks to go to a center-based program, can they be denied that request?

Parents can go to any center-based program, therapy clinic, medical program, or therapy provider they choose. The question is whether or not this falls under the provisions of IDEA, Part C, which require that supports be provided in natural learning environments.

How do we embed natural environment therapy practices into our therapy when children live in homes with virtually no toys or books?

The first place to start, regardless of the resources of the family, is getting an understanding of how the child spends his or her time. What does the child do? Who is the child with? Where does the child go? What are the parents/caregivers doing during the child's day? This is the beginning of the assessment process to identify the child's existing (and desired) activity settings. Once this occurs, and the practitioner discovers the family has no toys or books, then it is the responsibility of the practitioner to identify what the child is currently using as play objects (i.e., pots, pans, empty containers, rocks, sticks, sand, etc.). The practitioner then can support the caregivers in maximizing the child's enjoyment of what play objects do exist. If the family is interested in obtaining other objects for the child to play with, then the practitioner is responsible for assisting the family in identifying resources to obtain them (i.e., toy lending resources, public libraries, garage sales, Goodwill, budgeting to purchase toys, etc.). Most often a family's lack of resources that match what we feel is important for a child to have becomes the issue. Our responsibility is to support the family with what they have, where they are, and sharing information that matches their priorities.

What is your stance on (providing, suggesting?) toys if parents are looking for recommendation?

If parents ask for suggestions for specific toys, practitioners may provide suggestions; however, suggestions should be made based on child/family interests and keeping in mind how the toy will promote the child's participation in play opportunities versus working directly on a targeted skill. Discuss the multiple learning opportunities that toys can provide.

What exactly do I do with a child who watches TV all day and maybe has a few broken toys and the parent does not see lack of play skills as a concern? What do I do with this child if I bring no toys? I am a developmental therapist who is supposed to be working on cognitive, self-help & social outcomes as well as speech & motor outcomes?

Watching television and playing with his/her toys (broken our not) are activity settings that provide multiple learning opportunities. They may not be consistent with your values and beliefs to what young children do during the day, but if these are the interests of the child and parent, our responsibility is to talk with the parent about how to use what they have and support the parent in identifying multiple learning opportunities that could come from using what is present in their environment. It is easy to take in a bag of toys, but more challenging to explore real life options for many families. We must remember that learning takes place when we are not there, too, so we have to use what they have available and accessible to them to give the child more practice in using existing skills and developing new abilities. Toy bag treatment sessions are decontextualized interventions that do not promote functional skill use and learning in natural settings.

What's wrong with bringing (or giving) toys for families to use to enhance skills?

This is all about enhancing parent capacity, which includes accessing resources. Also, would the child typically play with a therapy ball? If no, it's not contextualized. The purpose of your visit is not to "perform," but rather to engage the parent about what's happening or could be happening when you are not there that has development-enhancing possibilities.

What about the houses we go into, where the houses are dirty and not conducive to therapy?

More often than not, this is an issue of our values versus the family's values. In order to be truly family-centered, we have to acknowledge that different families have different lifestyles and different standards of tidiness. If it is an abusive or neglectful situation, we are mandated reporters. If it's not abuse or neglect, we need to look closely at our own values. The fact is that is where that child lives. We need to support the family in promoting the child's developing in their natural environment.