Years ago when my son and I were receiving EI for his torticollis, I found myself surprised about how hard it was to remember to use the strategies that the PT and I practiced during our visits. She taught me to use TAMO techniques and positioning strategies and shared other ideas that I was eager to use. When she left, I found that the day would pass and I would have forgotten to use what I learned…this was especially surprising given that I WAS an early interventionist.
My experience occurred years ago, but I’ve recently heard families and providers talking about this same issue – how to help families use strategies between visits, how to make it easier on them to help their children be successful. It’s not easy providing support when you (the service provider) aren’t there, is it?
When I was on the receiving end of EI, I found that I had to problem-solve how to help myself remember what to do between visits. After plotting out our daily routine and when I could use the strategies we had developed during the PT sessions, I still struggled with remembering them during the day. I found that the day would pass with lots of diaper changes, errands, playtime, and time at the sitter (while I worked part-time) and poof…it would be 7pm and I had only stretched my son once. I felt like I was definitely not up for the mommy-of-the-year award at the ends of those days.
My Grand Plan
So I came up with a grand plan to help me remember…sticky notes. Yes, the best idea I had was to use sticky notes. I posted sticky notes everywhere – by the changing table, in our play area, in the kitchen, in the car, in my son’s room, in the bathroom, everywhere. Without these visual reminders, my sleep-deprived brain just couldn’t keep up. This simple strategy did help me get into a new routine of embedding the strategies into what I already did and eventually they became no-brainers. Getting there was the hard part.
There is some research from Dunst and his colleagues that found that families appreciate visual reminders, something they can post on the frig to remember what to do between visits. We can help families think about their routines. We can join routines to help families practice using strategies. What can we do, then, to support them when we aren’t there?
So here’s my question to you…
What do you do now to help parents and caregivers remember to use the strategies developed during visits??
Share your ideas so we can help families think beyond sticky notes!
See this posts for more ideas about supporting families between visits:
Who is the Focus of your Visit? – Adult Learning & Early Intervention
Great article, Dana! In trainings, we actually talk about “fridgeable strategies”!! In addition to your post its, folks are trying mini picture schedules in different rooms of the house that show parents step by step how to embed a strategy. Some have also purchased write on/wipe off wall clings from office supply stores and placed them in different spots in a family’s home. As part of the home visit, the parent and provider determine what strategies worked, how best to incorporate them into different routines, and then jot down the reminders in the spaces those routines take place!
Fantastic ideas, Amy! I would imagine that the wall clings are pretty inexpensive? Whether a wall cling, picture schedule, sticky notes or other idea works for a family could be determined during that planning process, just how you described it. Do you/your providers have a preference about whether or not the parent is the actual one writing the strategy down at the end of the visit, or if it’s the provider? What do you think?
I think at this point, most practitioners are writing out the strategies as part of their “home program”, but I love the idea of giving the family the option…we do talk about finding out what kinds of “learners” parents and caregivers are so we can tailor our coaching strategies. I know I am a “note taker”, so I’m sure some parents might like the idea too! I’m going to share this with a FB group of Developmental Therapists..we have “work it out Wednesdays” where we post a question or challenge and folks weigh in with ideas! Thanks!
Great…let us know if your fb users have any more great ideas!
Sticky notes?! What a fun-tabulous idea! Thank you for sharing. I’m going to see if that will help some of my families!
Sometimes simple is good! Except for when the baby tries to eat the sticky notes… 🙂
We had a lively discussion about using sticky notes and we’ll be offering it to families who want to give it a try. Currently we’ve been experimenting with the Next Steps form (Dr. Robin McWilliam). We put it onto 1/2 sheet NCR as a reminder of 3 things: what was done today, what will be done UNTIL the next visit (largest and most important area on the sheet), and what will be done during the next visit. It is used with about 1/2 of our families….mostly with success. The sticky notes and wall clings are intriguing ideas! Thank you.
Could you tell me where you found the Next Steps form? I am a new SLP in EI, fresh outta grad school. 🙂 Currently, I am using sticky notes and a Comfort/Success rating. I typically target one technique a week. Start by modeling technique, have Mom give it a try, give feedback, ask for feedback and leave her with reminders (frigables). That form sounds truly useful! I would love to give it a try!
Great question, Becky! Hopefully David can reply to share the Next Steps form he’s using. I checked the latest book by Robin McWilliam (Routines-Based Early Intervention) and didn’t see the plan but the book could certainly be a great resource.
In the past, I’ve created my own handout that I used at the end of each visit. It had a column for the strategy the family wanted to try (where we wrote a detailed “how to” description), who will try to use it, and what we expect to happen (how we hope the child will respond, etc.). I’d also write in a Plan B for if the strategy didn’t work between visits. I only wrote 1-2 strategies each week and the parent chose which ones to try. Then I would start the next visit by touching base on the plan to see how it went between visits. It worked really well.
Another resource that might help is Dathan Rush’s and M’Lisa Shelden’s Coaching in Early Childhood handbook and website (www.fipp.org). They have lots of info about using a “joint plan” like this as part of a coaching style of interacting with families. Hope this is helpful. Good luck!
Following a training from Dr McWilliam in Montana last year we took his Next Steps form and revised it for our local use. It is a very simple form with the family’s name, date, early interventionist’s name and phone number, and spaces to write 3 things:
* WHAT WE DID TODAY – a summary of what was done, discussed, and covered at today’s visit.
* WHAT WE WILL DO UNTIL THE NEXT VISIT – the things that were agreed to work on, from today until the next visit. This is the most important piece…..the actual intervention!
* WHAT WE WILL DO ON THE NEXT VISIT – the plan for our next visit.
This form is printed on duplicate NCR paper so the family can have their copy (usually posted on the fridge) and the early interventionist has a copy for reference and part of the confidential record.
Dana, I can send you a couple versions of the form if you would like to forward them to Becky. Some of our folks prefer the 1/2 sheet version and others use the full sheet.
At our program we typically leave a copy of our contact note (similar to that format – with a summary of the visit and the home activity strategies) on each visit. Recently, as part of my goal of becoming even better with coaching/teaching families, I have started asking at the end of the visit, as I am writing my note – asking the families “okay, so what strategies should I be writing down here on this note?” Whereas before, of course we talk about, practice, etc etc the strategies during the visit, I used to just write them down on the note before I leave. I’ve found that just in the few times that I’ve been asking families before I write – it’s been a process of self-discovery, as I had found that the families don’t necessarily get the same information as I was trying to convey during the visit, and the things that are important to them to work on, and will fit into their routines, are not always what I was ‘going to write’ 🙂 I’ve also found too that the families I have started to do this with, are following through much better!
I love it that by asking that simple question, you are facilitating the parent’s learning process. How exciting that they are more able to use what they are learning because of it too! Thanks for sharing your process, Jennifer!
Sorry about the typos!!! That’s really embarrassing on my part 🙁
What typos? All fixed! 🙂
hehe thanks! 🙂
That’s a great idea, Jennifer. Our early interventionists will be very interested in learning about your strategy for “syncing” up the intervention between the parent and professional. Thanks for sharing!