The HEP Approach utilizes key principles of enriched environment models and brain plasticity. The therapists and family collaborate during the intervention process to offer permanent, ongoing, personal ized environmental stimulation to promote the child's active exploration and participation. Acrucial component of the HEP Approach is enhancing parenting self-efficacy to create en riched environmental conditions in the home and on an ongoing basis across environments.

The HEPApproach intervention and clinical reasoning process follow a systematic order based on the data-driven decision-making model. There are 11 phases to the HEP Approach process. Phase 1 involves referral to the program. Phase 2 includes a meeting with the family to introduce them to the HEP Approach. Phase 3 is a comprehensive assessment of the child and family systems. Phase 4 is the identification of family and child strengths and challenges based on the assessment. Phase 5 involves formulating hypotheses about how underlying factors or systems impact the child's challenge areas. Phases 6 and 7 include collaborative goal setting and outcome measure identification with the family. Phase 8 is intervention planning. Phase 9 implements the intervention through an individualized process that generally involves four steps that prioritize different areas of need (e.g., self-regulation and homeostasis of the child, adaptation of the physical and social home environment to support succes

A 24-item Likert-type questionnaire was developed by the researcher to evaluate the feasibility, acceptability, satisfaction level, and safety of the intervention. The questionnaire items were grouped under four main categories: feasibility (items 1-7), acceptability (items 8-12), satisfaction (items 13-19), and safety (items 20-24). The five-point Likert-type scale included response options ranging from 1 (Strongly Disagree) to 5 (Strongly Agree).

Goal Attainment Scaling (GAS) is one of the most frequently recommended goal-setting methods used in clinical and research settings to measure changes that occur during and after an intervention. Research has shown that GAS is a reliable tool for children with developmental challenges.

GAS is a scale used to evaluate the extent to which individually set goals-established at the beginning of the intervention-are achieved, providing subjective information related to the infant's specific needs. The scale uses a five-point rating system ranging from -2 to +2 to score goal attainment. A score of 0 represents the expected level of performance; -1 indicates slightly below expectations, and -2 indicates much lower than expected. Similarly, +1 reflects slightly above expectations, and +2 represents much better than expected performance. The scores are converted into standardized scores for analysis, and T-scores are used as outcome measures for the targeted goals.