DEAR ERI COMMUNITY:I am an experienced OT (37 years) working in Early Childhood Intervention working in the home. Our program really wants us to use what is in the home and in the childâ€™s natural environment. I have a 23 month old child who is in Spanish speaking family (so I work through an interpreter). He is extremely shy (fearful of all change)and will not interact with me at all. The way I treat is giving the mother ideas and then she tries them with him. The interpreter is an ECI Early Intervention Specialist who can also interact with the child and get him to do some of the things I suggest. He did not walk until 19 months. He never tolerated tummy time and even after he crawled he would not get on the floor to look for a toy under the bed, etc. He is an over responsive sensory avoider, extremely posturally insecure, moderate hearing loss, balance and motor planning are very poor. We have made lots of improvements and he will now get on the floor and look for a toy that rolls under furniture, get on a jumping horse and bounce, sit on a donut gym ball and play with toys, runs in the house but not the yard or playground, climbs on and off furniture, allows Mom and Dad to bounce him on their knees as long as it is not too aggressive and kicks a ball. I have left a few things in the home to work with (Rody Jumping Horse and Donut Ball). I am needing some new ideas in the challenging case.