During the Advancing Comprehensive Early Childhood Intervention Conference in Lisbon, Portugal, September 2–5, professor and founder and director of Nurture Connection David W. Willis, MD, FAACP, attended what he called “a glorious presentation” about Illinois’ Early Intervention Training Program (EITP), which supports professionals working with families with children from birth to three years old. Back in the States, Dr. Willis, who is a professor of pediatrics and psychiatry at Georgetown University, sat down with two other Nurture Connection leaders for a virtual meeting with the presenter and EITP director, Susan Connor, to learn more about it and how its leaders have incorporated the principles of Early Relational Health.
Parents often welcome a new baby with great joy, but the early months can also bring stress and uncertainty. Some newborns cry for long stretches or wake frequently through the night, leaving parents exhausted. A parent may notice that their baby struggles with feeding, becomes upset during daily routines like dressing or bathing, or seems slower to reach milestones such as rolling over, sitting, or talking. When concerns arise about development or about the growing bond with their baby, families can connect with early intervention specialists who partner with them to build on their strengths and support their child’s development.
In this issue, we feature the Early Intervention Training Program (EITP) in Urbana-Champaign, Illinois, a professional development program that supports providers across the Illinois Early Intervention System. Like programs in all 50 states and territories, Illinois Early Intervention accepts referrals from many sources, including families, physicians, childcare providers, and social services and early learning programs. Illinois emphasizes family-centered practices, and it has the added benefit of offering a cutting-edge early intervention training program based on respect for family strengths and wisdom and grounded in the importance of relationships.
The Emerging Connection to Early Relational Health
Susan Connor is the director of Illinois’ Early Intervention Training Program (EITP), a professional development program that supports the workforce within the state’s early intervention system. Early intervention emerged from decades of advocacy by the disability community and federal legislation, beginning in the 1970s, aimed at improving services for young children with developmental delays and disabilities. The program began in 2002 as part of United Cerebral Palsy of Greater Chicago and moved to the University of Illinois at Urbana-Champaign in 2013. Now based in the Special Education Department of the College of Education, EITP provides training and technical assistance to early intervention professionals who support thousands of families across Illinois each year. The Illinois Early Intervention System serves between 25,000 and 27,000 families on any given day. Last year alone, Connor says, more than 3,000 early intervention professionals participated in EITP training events. The program is funded through the Illinois Department of Human Services.
“Over the last 10 to 15 years, the information on brain development has just exploded,” Connor noted in a 2024 interview. “We didn’t used to train on brain development, but it’s a big piece of what we train on now. We have been fortunate in Illinois in that some of the leaders and pioneers in our state have put us in a really fantastic position as an early intervention program.”
Early intervention programs support strong relationships between caregivers and young children, and serve as an extraordinary opportunity for the promotion of Early Relational Health (ERH), she shares.
“Our current leadership is steadfast in elevating family voices, inviting families and preparing them to be able to participate in working groups that shape recommendations to the system,” Connor says. “It has also been intentional in utilizing what we know around early brain development and the connections that are made when children are within strong, supportive, nurturing early relationships.
“This has really allowed us, as the training program for the State of Illinois, to utilize our resources and meet our deliverables with a lot of the Early Relational Health principles built in,” she adds.
Connor, who is also the principal investigator for EITP, has worked for the program since 2004 and served as its director since 2014. As a mother of three girls and part of a close Midwestern family with eight brothers and sisters, she is passionate, she says, about helping early intervention professionals “provide supports that are truly individualized and family centered.”
One of the most important parts of EITP is helping early intervention professionals build on family strengths and support resilience. In the program’s interactions with early intervention professionals, Connor says, “we hear daily examples of how they are shifting their approach with families to an approach that focuses on strengthening families’ capacity to support their child’s development, with a recognition that families already have a lot of strengths to build on.”
That hasn’t always been the case, she notes. “This is a big shift from a more traditional, deficit-based approach that many [early intervention specialists] were trained in, where the focus is on the developmental delays.”
(Above) Members of Illinois’ Early Intervention Training Program (EITP) attend a recent conference in Oregon.
Early intervention specialists in the Illinois program, she says, take a family’-strengths approach “to cocreate strategies with families that feel doable within their busy lives.”
This is especially true of a practice called “serve and return,” a natural back-and-forth exchange between a baby and their parent or caregiver that is key to early development. It’s an interaction “served” by the baby, such as making sounds, glancing toward the parent, or showing interest in something, which is “returned” by the caregiver verbally or with gestures and eye contact.
Other strategies, she says, include parents tuning into their babies’ cues, “noticing what their babies are noticing, smiling or laughing back when their baby smiles or laughs, taking advantage of those regular rhythms or routines that happen often and creating connection opportunities within them, or just being physically close to their baby.”
Learning How to “Read” Your Infant
One developmental therapist, Connor says, talked about working with a mother who felt unsure how to “read” her infant. The therapist and mother practiced getting on the floor, slowing down, noticing the baby’s gaze, and waiting for the child to respond. With more practice, she says, the mom was confident her baby felt more secure and connected.
Connor is gratified that when using an ERH approach that builds on a family’s strengths, early intervention professionals report a remarkable difference in their feelings about work. Among other things, they report feeling more connected to the families they support and a deep satisfaction as parents experience success and joy with their child. They also notice less stress in parent-child interactions.
“Sometimes a therapist will get a [proud] text between visits where the parent is sharing something the child did!” Connor reports.
Validating Parents’ Experiences
The way that early intervention professionals approach parents is also important, Connor says. “Focus first on listening and validating the parent’s experience and story — believe them! Emphasize there is no ‘right way’ to parent, only ways that match their child and family. Use warm, nonjudgmental language and curiosity when you are unfamiliar with what a family is sharing (perhaps it’s a different culture or just an experience that you yourself never had).” Look for strengths, then highlight and celebrate them, she advises, because “it can be easy to get stuck in the things that aren’t going that well yet.”
She also shares a quote from one of the EITP trainers about the value of the program. “When we model slowing down, listening, reflecting, taking another’s perspective . . . the intent is that the professionals feel what it’s like to be in a supportive learning relationship. The parallel process is powerful: When adults feel seen and supported, they naturally pass that same attunement on to the parents and children they support.”
Connor encourages trainees to acknowledge and normalize the stress, fatigue, and uncertainty many parents experience. “Connect them with other parents who have walked a similar path, because parenting is hard,” she says, adding that it’s also crucial to share hope and avoid pressure. “Ask what parents are hoping to see happen and support them in creating a plan that helps them move toward those hopes and dreams. In doing this, avoid placing the professional’s hopes on the family, [since] they are often very different.”
Early interventionists “meet parents where they are” and reflect on their own biases, as childrearing is inextricably bound up with culture, Connor notes. They help parents understand child development and what behaviors are typical, even if frustrating, for toddlers, she says, as well as how to use emotional literacy practices to help toddlers name, understand, and express feelings.
Practicing co-regulation, in fact, minimizes the chance that parents and professionals will move toward more punishment-based responses or strategies, she adds. Early interventionists help parents “reflect on their own stressors and history and how these things can sometimes influence the way they respond to behaviors that feel more challenging to them.” Finally, Connor says, they help parents “ensure they always have strategies in place to keep the child safe.”
“We’ve been doing this work in Illinois in fits and starts for many years. . . . Sometimes it was framed as dyadic relationships, sometimes as social-emotional development, sometimes as infant and early childhood mental health. We didn’t really call it Early Relational Health. We have been fortunate in Illinois in that the leaders and pioneers in our state have been advancing this work for years, which has positioned our early intervention system well to embrace Early Relational Health.”
— Susan Connor, Ed M, Director & Principal Investigator, Early Intervention Training Program at the University of Illinois
Sharing What’s Not Working — and What Is
Asked about difficulties, Connor says that “one of our greatest challenges continues to be supporting a workforce that is experiencing high demands, workforce shortages, lack of competitive pay and benefits, and significant stress as they work to meet the increasing emotional and developmental needs of families. Our early interventionists are deeply committed to families, but they need ongoing support, reflective spaces, and adequate system infrastructure to sustain this work.”
“Currently, our system has not received cutbacks in funding,” she adds. “However, our workforce compensation has not seen regular, consistent increases over the years, and therefore has not kept up with the market or the increased costs of living.”
The most gratifying part of this early relational work, Connor says, is witnessing transformation in families, in early intervention personnel who support them, and in systems. She recalls a story from a physical therapist about a father who found his baby’s crying during feeding and diapering stressful, even unnerving. She coached him instead to look at those everyday routines as opportunities for connection. They jointly created a few strategies that the father felt might help, such as using gentle touch, noticing and copying facial expressions, and putting a rolled-up towel in the high chair for greater support. After trying them out, the father was gratified to find the changes “actually made those times of day much more enjoyable and less stressful.”
“Hearing a parent share how their early intervention experience supported them or made a difference, hearing a provider share that they feel renewed in their purpose, are making a paradigm shift, or are experiencing successes with their families,” Connor reflects — “these moments mean a lot.”
Tips for Working with Families in Early Intervention
The anecdotes that EITP’s Susan Connor shared with Nurture Connection reflect some of the common practices used by family-centered early intervention programs. Here’s her summary of the tips:
– Find out what the caregiver has already tried — what has worked and not worked.
– Find out what the caregiver thinks might work or might not work.
– Cocreate strategies with the caregiver rather than telling the caregiver what will work.
– Model strategies that allow for supported practice of strategies, which can be adjusted as needed.
Common examples of specific strategies include:
– Observe/watch, wait, and wonder together: This approach slows interactions down and creates space for caregiver observations and thoughts: What do you think (the baby or toddler) is doing there? What has his attention?
– Serve-and-return strategies that help parents notice and respond to their child’s signals: He is really looking at your face and moves his head when you move yours — have you noticed that before?
– Co-regulation strategies, such as using a soft voice, rocking, or deep breathing, when the baby is distressed
– Using daily routines (feeding, diapering, hanging-out time, travel time, bathtime) as natural opportunities for connection
– Video, with consent: Offer to video some of the parent’s or caregiver’s interactions so they can “see” those moments of connection, joy, and success and rewatch strategies to help them remember what it looked like.
Through these types of strategies and approaches, parents — who are the most important relationship in their child’s life — build confidence and experience in their caregiving.
