We’re really good, in early intervention, at the “what ifs…” – especially when it comes to adopting new practices. When a practice feels unfamiliar or even contrary to how we were trained, it’s so easy to jump to the “what ifs” and feel like there are many reasons not to use the new information. Often, though, with a little creative problem-solving and an open mind, the “what ifs…” can be managed and our practices can grow!
Here are two common “what ifs…” that I’ve heard when interventionists are trying to think about using routines-based practices with families:
What if I can’t be there when the routine naturally happens?
Maybe the target routine occurs when the child attends the church nursery on Sundays or during bath time at 7:30pm. Whenever you can, joining the child and family during the actual routine is the best way to provide support, but when you can’t be there, it doesn’t mean that you can’t support that routine. Here are 4 strategies to try when this happens:
- Ask the parent to describe the routine, focusing on what happens before, during and after the routine.
- Find out about what the parent does, what the child does, what others do during this routine.
- Ask more thought-provoking questions about what the parent has tried and why, what she thinks & feels about the routine, why she thinks the child does what he does, what she thinks she’d like to change and why.
- Go back over the routine together and develop a step-by-step plan for how to embed strategies into the routine to achieve the parent’s goal. Write the plan down.
Here’s a real example:
Micah disliked bath time. I’d been giving his grandmother general “have you tried this…” kinds of strategies for weeks that were just not working. I wasn’t able to join bath time because it happened before bedtime each evening. Finally I recognized that I really didn’t know much about how bath time worked for this specific family, so I asked the grandmother to describe it to me, starting from what happened leading up to Micah’s bath, how he was bathed, and what happened afterwards. We talked it through and came to the joint conclusion that he loved being in the water. Because he had very limited language but strong cognition, he knew he eventually had to get out of the water, which usually lead to a struggle, so he had started resisting bath time before even getting in the tub. Micah couldn’t communicate that he wanted to stay in the water so he cried instead.
After lots of joint-problem solving, his grandmother decided to give him several verbal warnings about bath time ending soon, instead of just snatching him up out of the water, then pull the plug on the water after the last warning. They also worked on simple words and signs like “all done.” She tried these relatively simple strategies and Micah got out of the tub without crying for the first time. Without the water, the tub wasn’t as fun anymore and, in fact, was kind of chilly so he was ready for his towel. The problem of this routine was solved, even though I couldn’t be there. Once bath time was enjoyable, it became a great place for learning opportunities too. Win-win all around!
What if the family doesn’t have any routines?
Yikes. This question is really a judgment on the part of the interventionist and indicates the need to step back and reflect on what we think about families. Routines are things families do during the day that take many different forms. Some families have lots of routines and activities, like going to child care, running errands, swimming, or reading books together. Other families have fewer routines that they recognize and may struggle to answer questions about them. Still others may be just beginning to set new routines after the birth of a new baby or a recent move.
By getting to know families and finding out about what they like to do or would like to do, we can discover their routines with them. It is not their responsibility to have “routines” that look the way we want them to look. Routines belong to families, not to us. Maybe the family’s main routine is watching TV during the day. If that’s what they do, then that’s where you start. Be careful not to assume that families don’t have routines just because their routines don’t look like yours.
The “what ifs” are everywhere.
Think about them, run them by your colleagues, find solutions…but don’t let them stop you. Use the “what ifs” as stepping stones to help you get better at what you do.
What other “what ifs…” can you think of? How would you answer this one: “What if the parent is used to me working with the child and doesn’t want to use strategies during other routines?”
Share your thoughts and your answer to this one in the comments below!