Abstract
This case study is intended to help occupational therapists gain an appreciation for how collaboration can support effective service delivery in other cultures through cross-cultural awareness of Asian and Pacific Islanders' practices in the Commonwealth of the Northern Mariana Islands. Therapists use clinical reasoning to identify hierarchical skill acquisition for the child and consider the family's cultural values when developing an individualized family service plan and an individualized education plan. Early intervention and early childhood special education programs collaborate to provide smooth transitions and carryover of outcomes. Developing cultural competency may enhance occupational therapy services for families and children at ages birth to 5. Furthermore, the purpose is to understand different cultural contexts and encourage professionals to blend the family's priorities with the clinician's expertise to implement optimal service delivery for children in special education.