Partnering With Physical Therapists and Speech-Language Pathologists in Early Childhood to Promote Access to Assistive Technology for a Child With Medical Complexity

Noah is an 18-month-old boy with Rubinstein-Taybi syndrome, diagnosed at 3 months through genetic testing that revealed a cyclic adenosine monophosphate response element-binding protein (CREBBP) variant. At 7 months, Noah was socially engaged, smiling and responding to familiar caregivers, but his motor differences were evident: limited head control, frequent fisting of his hands, difficulty grasping objects because of syndactyly, the need for assistance with rolling, and difficulty tolerating time on his stomach.By 9 months, Noah was referred to Part C Early Intervention services and began occupational and physical therapy. With support, he was developing postural control and reaching skills. Still, his opportunities for exploration and communication remained largely dependent on adult facilitation. At this point, Noah did not have independent or reliable ways to move across his environment or consistent methods for communication to share his wants, needs, or make choices.The central challenge in this case: How can pediatric clinicians and therapists partner to bring assistive technology into the lives of children, like Noah, at the right time?