Early Intervention Strategies for Success

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  • Do’s & Don’ts for Managing an Unclean Environment(current)

Visiting all kinds of environments is one of the things that I’ve always loved about early intervention. No two days or two visits are ever the same. Magnifying Glass Highlighting the Word DoAlong with this flexibility comes the unpredictable nature of the environments in which we find ourselves. You can easily drive from one home that is pristine to another that is unclean (by your own standards). One of the lessons that every interventionist eventually learns is that one family’s perspective on cleanliness and their living conditions may be very different from another’s. This is not to say that one is more right than the other, or to say that the early interventionist has the most accurate perspective. It’s just a reality of the work we do that we must adjust to different environments and do so without judgment.

One Interventionist, Two Home Environments

Consider these real-life examples:

Jessica looks at her schedule for the day and remembers that she is visiting with Sam and Reggie’s families. Sam’s family lives in an upstairs apartment in an older townhouse. She knows that the entrance to the townhouse is always completely dark so she takes a flashlight with her. The steps leading up to the townhouse are slippery from use and there is often a strong garbage smell. The family’s apartment is uncluttered but the carpet is well-worn and dirty, despite Sam’s grandmother’s repeated attempts to clean it. She keeps their living space as tidy as possible, but struggles with cockroaches because her downstairs neighbors and the landlord refuse to treat the house. After visiting with Sam’s family, Jessica drives to Reggie’s home, which is in an affluent neighborhood near the university. Reggie has a fully equipped playroom and several pets. During visits, Jessica has often seen the dogs having accidents on the dark carpet and there is a strong urine smell in the home. Reggie’s mom often apologizes, saying she can’t keep up with the dogs and with Reggie. Jessica, Reggie and his mom typically spend time in the playroom or his bedroom, but in both places they struggle to find a place to sit as the floor and bed are usually piled with clothing and scattered toys.

DO’s and DON’Ts

Both of these environments reflect challenges related to cleanliness. Both families are probably doing their best to keep their homes clean, but both environments have the potential to make a visitor to the home uncomfortable. If you were to walk into either home, here are a few do’s and don’ts for managing yourself and the situation:

DO remember that you are guest in the family’s home. Be respectful and do your best to adjust. Like Sam’s grandmother, the family may be doing the best they can in their given situation.

DON’T make or share judgments about the living situation, unless you have real health or safety concerns. Try to ignore the challenges in the environment as must as possible. If you must address concerns, do so in a respectful manner and be specific about how your concern relates to the child’s health or safety (i.e., “I’m worried about the cockroaches too because of Sam’s asthma.”)

DO dress appropriately so that you don’t have to worry about your clothing getting messy. Keep a change of clothes in the car if needed – if, for instance, you, like Jessica, know that it is quite likely that you will sit in a wet spot or get messy during the visit.

DON’T request that families clean up when you come. Also don’t cover the surface you are sitting on or bring a blanket to avoid the floor. I’ve actually heard stories about providers who have brought a carpet square for themselves only or told a family to clean up a corner of the room for the visit – yikes. Remember that intervention doesn’t just have to take place on the floor (PDF, New Window).

DO your best to get to know the family and make them comfortable. If they feel like you are judging them and their home, then it is unlikely that you will build a strong rapport. Building the parent-provider partnership is pivotal to successful intervention.

DON’T ignore your own discomfort, though. While it is our responsibility to be flexible and meet families wherever they are, we are also individuals with our own feelings too. If you are in an environment that makes you uncomfortable, talk to your supervisor for guidance. The truth is that it is impossible to only see families in pristine environments so you must learn to adjust and do so in a respectful manner. However, if there is an environment where you don’t feel safe, then let someone know.

What strategies do you use when you encounter an unclean environment? What advice would you have for a new early interventionist in this situation?

3 comments on “Do’s & Don’ts for Managing an Unclean Environment

  • Belkis Negron,PT says:

    I have been to many homes that have all kinds of bugs and have been bitten by them. I try to schedule those visits on the same day, change clothes and socks between visits and do all that laundry as soon as I get home, making sure the dryer is on high temperature. It isnt easy. I not only worry about bringing the bugs to my house, but also between homes. These are measures that should be followed with all homes, even very clean ones may have them.

    • Great suggestions, Belkis! You make a good point about being careful not to transport bugs from one home to the next. It sounds challenging to change clothes several times in the same day but I can see how it can be an effective strategy. It makes me think about toy bags too – stopping the spread of an infestation by not bringing a toy bag from a home to your car or to the next home is another reason to leave the toys at the office.


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