Young children with special needs and their families often experience transitions across multiple environments in the early childhood years. Many transitions are identified as stressful for children and families. In the present study, a series of focus groups involving administrators, practitioners, and family members were held around the United States to identify transition practices that have been implemented effectively for children, families, staff, administrators, and communities. Two major themes emerged from the data: critical interagency variables, defined as strategies that support an interagency process involving multiple parties; and transition practices and activities, defined as practices that address child, family, staff, program, and community-specific activities. Outcomes from these focus groups included identification of transition strategies for young children with special needs that are considered valuable by parents, providers, and administrators and that are consistent with theoretical frameworks described in the transition literature.

Education and ongoing assessment of skin integrity and the use of devices that minimize pressure at the tracheostomy-skin interface effectively reduce TRPU even among a population of children at high risk. These interventions can be integrated into daily workflow and result in sustained effect.

The complexity of the early intervention to preschool transition process has been highlighted in the early childhood literature; however, the role of independent therapy providers in transition planning has not been described specifically. The present study used survey research methods to gather information about the transition practices of 103 independently contracted therapists providing early intervention services in Kentucky. Results provide preliminary data regarding the ways in which therapists working as independent contractors participate in the transition process. Working with families, attending meetings, and communicating with receiving therapists were the most commonly reported strategies for participation, yet barriers to participation such as lack of time and decreased support from service coordinators also were identified. Most therapists reported participating fully in the transition process despite having received minimal training specifically related to early childhood transitions. Implications for future research and practice include: comparing transition involvement between therapists working as independent contractors and those employed by hospitals or therapy companies, exploring service coordinators' and families' perspectives about the role of therapists in transition, and examining how specialized training supports transition outcomes.

Although limited by a small sample, the study provides an initial description of occupational therapists' participation in early childhood transitions.

Therapists providing early intervention services within the home environment may benefit from the theory in their creation and modeling of naturalistic interventions with infants and families.