EI therapists and teachers must wear a face covering during the entire course of EI service delivery.
Therapists and teachers may use alternate face coverings (such as face shields that are transparent at or around the mouth) for therapies or interventions that require visualization of the movement of the lips and mouth (for example, speech therapy). These alternate coverings may also be used for children (for example, hearing impaired) who benefit from being able to see more of the therapist or teacher’s face.
Everyone who will be part of the session and is over the age of 2 years must wear a face covering if they can medically tolerate one.
The child who is receiving EI services is not required to wear a face covering during sessions.
EI services require that therapists and teachers interact with children and families in close proximity, making physical distancing difficult or impossible to maintain.
Anyone who is not participating in the session, group or office visit must maintain at least 6 feet of physical distance.
Make sure that child, caregiver and staff groupings are as static as possible by having the same group or individuals consistently interact with the same therapist or teacher.
Provider must maintain a staffing plan that does not require employees to “float” between different classrooms or groups of children, unless such rotation is necessary to safely supervise the children due to unforeseen circumstances (such as staff absence).
If there is time allocated for children to rest during the day (for example, naptime), the provider should place children at least 6 feet apart and head-to-toe for the duration of rest, when possible.
Follow appropriate physical distancing requirements, including posting physical distancing markers using tape or signs that denote 6 feet of spacing between locations that are commonly used and other applicable areas. Limit the size of gatherings, support healthy hand hygiene, and restrict nonessential visitors, volunteers, and activities involving other groups at the same time.
All EI providers, regardless of settings, must work to reinforce and put plans in place to make sure that:
All parents, caregivers and children participating in the session wash their hands for at least 20 seconds using soap and water before and after the session and upon entry into a center-based or facility location.
All therapists and teachers wash their hands for 20 seconds using soap and water or use an alcohol-based hand sanitizer that is at least 60% alcohol before and after each session.
It is recommended that therapists and teachers who practice more hands-on therapeutic approaches put on gloves and leave them on for the entire session.
If gloves must be replaced for some reason during the session (for example, contact with stool or excessive body fluids such as saliva, mucus, vomit or urine), remove them, wash hands as described above, and put on a new pair of gloves.
Leave gloves on until the end of the session. Remove by grasping the inside of the wrist end and pulling inside-out over your fingers, then discard into a plastic bag or lined trash can. Use alcohol-based hand sanitizer containing at least 60% alcohol or wash hands with soap and water for 20 seconds after removing gloves.
Please note that wearing gloves does not take the place of thorough hand-washing.
Home-based and community-based settings:
The practice of bringing toys or other materials into multiple homes and community-based settings during in-person EI service delivery has the potential to spread COVID-19 or other viral or bacterial infections. Therefore, until further notice, it is prohibited to bring materials and toys from outside into home-based and community-based settings.
Eliminating the practice of bringing toys and other materials into home- based and community-based settings aligns with best practices in EI service delivery. Furthermore, teletherapy has demonstrated that providers can successfully use the materials, toys and objects already in a family’s home for therapeutic purposes during a session. See NYC Department of Health Using Materials Found in the Home/Community During Early Intervention Sessions by Developmental Milestone (Forthcoming) to support therapists and teachers who have not yet made this transition, or have questions about this best practice.
ii. Center and Facility-Based Settings (Please refer to Happy Dragon Health and safety plan)
These settings follow the NYC Health Department’s COVID-19: General Guidance for Cleaning and Disinfection for Non-Health Care Settings.
Therapists, teachers, families and staff implement ongoing self-screening prior to the session to determine whether they or anyone else who intends to participate in the session. And also, on the day of the visit, before the therapist or teacher enters the home or as part of a coordinated facility intake process, determine whether the child or anyone in the household:
Has COVID-19 symptoms, such as fever, cough, shortness of breath or difficulty breathing, chills, muscle pain, sore throat, new loss of taste or smell, etc.
Has tested positive for COVID-19 in the past 14 days
Has been told by a health care provider or the NYC Test & Trace Corps to remain home due to being exposed to COVID-19
If the answer to any of these questions is YES, the sessions should be rescheduled at least 14 days out or those sessions can be delivered via teletherapy (if the parent or guardian has signed consent for the use of teletherapy).
It is critical to continue obtaining parent and guardian signature on the Consent for the Use of Telehealth During the Declared State of Emergency for COVID-19 to allow for flexibility in cases where a member of the household or the treating team becomes sick, or the parent and treating team is interested in keeping the option to shift back to teletherapy seamlessly.
If a child is sent home due to concerns about COVID-19 or home- based sessions are cancelled, the center or therapist should call the family the night before services are scheduled to restart to confirm that it is safe to resume.