Thanks for the great questions. The daily routines you’ll use will depend on what the child and parent like to do or what routines are challenging for them. To encourage communication and engagement during routines they enjoy and routines that occur often, I’d encourage you to look for opportunities to help the parent be playful with the child during the day. For instance, playful interactions can happen during the dressing routine in the morning, during snacks and mealtimes, when getting in the car to go run errands, while working in the garden – during whatever the family likes to do. You can use your expertise to help the parent recognize these opportunities and embed intervention in them. For example, the parent could prompt the child to say “open” to get in the car. The parent could get down on the child’s level, model “open” with an expectant voice, then wait a few seconds for the child to respond. If the child says anything like “open” or gazes at the parent, the parent responds with “Open! I’ll open the door!” and lets the child climb in the car. This same strategy could be used to open snack bags, open doors, etc. If the parent can use this strategy frequently throughout her day, her child will learn to use a sound, his eye gaze, or the word “open” to communicate. He’ll get much more practice doing it than he will if you are the only one working on it with him during your visit.

Look for daily routines that are challenging for the parent too. Ask her what’s hard about her day, then try to join that routine to help her problem-solve how to improve it or how to get the child to communicate during it. If meals are hard, then observe a regular mealtime, ask the parent what it would look like if the routine was going well, then work together to come up with a strategy or two. Coach the parent as she practices the strategy. You might have to model it first with the child, but always encourage the parent to practice it after she’s watched you and you’ve explained what you’re doing. Coach her to practice it during the actual routine, then work with her to plan for how she’ll use the same strategy when you’re not there.

I hope these examples help. Check out these posts for more info:
https://veipd.org/earlyintervention/teaching-early-turn-taking-engagement-skills-an-example/
https://veipd.org/earlyintervention/being-playful-vs-playing-with-toys-whats-the-difference/
https://veipd.org/earlyintervention/which-activity-is-really-routines-based/
https://veipd.org/earlyintervention/6-specific-questions-to-ask-when-exploring-family-routines/

I completely agree, Allison, that focusing on routines can be much more productive and meaningful. When we can help reduce stress, rather than adding to it, we are doing our jobs well! What kinds of activities have you used to help families with decreasing the stress level during the morning “get out the door” routine?

What fantastic insights, Sarah! I’m so glad you shared them! Yes, I agree that not playing can be both harder and easier. It’s hard not to jump in and “do” because we know we can and we’re usually pretty good at it. I love how you observed, gave positive feedback, and shared suggestions and ideas. Like you, I’m usually full of ideas so it can be challenging to focus them and not give too many. Lots of suggestions aren’t necessarily helpful if they overwhelm the receiver, so taking it a little slower than how fast my brain could crank them out was often a good idea for me. You’re exactly right, though, that the suggestions that the mother can use everyday are much more likely to be used repeatedly throughout the week!