Complex Medical Needs and Homelessness: A Case Study of the Natural Environment

Infants and toddlers with complex medical needs are likely to receive early intervention (EI) services, which take place in children’s natural environments (NEs). Little is known about the NE of children with complex medical needs or how their EI services are implemented in consideration of their intersectional identities. In this case study, we explored the NE of one child with complex medical needs who was experiencing homelessness and how his EI services were embedded in his NE. We used multiple qualitative methods, including observations, interviews, document review, auto-photography, and photo-elicitation. Using thematic analysis, we developed five themes from the data: (a) description of the child’s NE, (b) the family’s planning and intentionality, (c) positivity and acceptance, (d) family expertise versus provider expertise, and (e) a continuum of practices. Implications relate to practices that align with a family’s unique circumstances and the need for research that addresses a family’s intersectional experiences navigating disability.