Date of Submission


Degree Type


Degree Name

Doctor of Psychology (PsyD)



Department Chair

Arthur Freeman, Ed.D., ABPP

First Advisor

Stuart Badner, Psy.D., Chairperson

Second Advisor

Steven Godin, Ph.D.

Third Advisor

Elizabeth Gosch, Ph.D.


The Early Intervention program in Pennsylvania has within its design, provision to provide a range of at least sixteen support services to eligible infants, toddlers and their families. State mandated early intervention programs in Pennsylvania offer services to premature, underweight, medically fragile or chronically ill babies, infants with identified disabilities or developmental delays, adolescent parents, depressed parents, parents who are unprepared or overwhelmed by the care of a baby, and parents at social or emotional risk in the caregiving role. The overall intention of the Early Intervention Program is to reduce the risk of developmental dysfunction and delay and to enhance the emotional well-being of children and families. These services and supports were designed to address specific outcomes that are identified by families, physicians and other significant people in the families' lives. Many of the services provided to eligible families address cognitive, physical and communication delays. However, in practice many of the unique social, emotional and behavioral needs faced by children and parents are not being met. The participants of this study consisted of 228 case managers working in the Early Intervention Birth to Three Service Coordination Unit at county mental health/mental retardation programs in Pennsylvania. The 35 counties that granted permission for their case managers to be included in the study were: Adams, Allegheny, Beaver, Berks, Bradford, Bucks, Cameron, Carbon, Chester, Clinton, Columbia, Dauphin, Elk, Erie, Fayette, Lackawanna, Lancaster, Lehigh, Luzerne, Lycoming, McKean, Montgomery, Montour, Monroe, Northampton, Philadelphia, Pike, Snyder, Schuylkill, Sullivan, Susquehanna, Union, Wayne, Wyoming, and York. These counties represented 25 county joinders and included the four regions of Pennsylvania. This study identified 1) the types of Early Intervention services parents are requesting from case managers in the birth-to-three Early Intervention system in Pennsylvania, 2) explored case managers perceived level of need for services on their caseloads for the birth-to-three Early Intervention system in Pennsylvania, 3) evaluated the actual frequency of services being provided in the birth-to-three Early Intervention system in Pennsylvania, 4) explored case managers' confidence level for being able to coordinate services for the 16 identified services and document them on the Individualized Family Service Plan, 5) identified barriers that may prevent services from being rendered, and 6) looked to what extent population density, county caseload size, and defined regions within Pennsylvania impacted on the actual frequency of Early Intervention services being provided. This study is relevant because it identifies challenging issues families and case managers face on a daily basis, as well as the services that are critical for comprehensive and collaborative service delivery. Additionally, suggestions were made as to how to improve access to psychology services which could benefit the Early Intervention Program in Pennsylvania by meeting the unmet needs of the families.