Where are your practices on the traditional vs. participation-based continuum?
Wherever you are on the continuum, take some time to examine the similarities and differences between the two interventions, reflect on your own practices, and plan for how to evolve your work to a more evidence-based approach. This brief provides a summary of research by Campbell & Sawyer (2007), who examined videotaped intervention visits to determine differences between traditional and participation-based intervention. One significant finding: parents and children are more engaged in general, and with each other, when intervention focused on the child’s participation in daily routines, rather than targeting missing skills. When parents and children are engaged, intervention is more likely to be meaningful, useful, and successful. Read on to learn more about how you can use participation-based intervention practices in your work with families.
Source: Campbell, P. H., & Sawyer, L. B. (2007). Supporting learning opportunities in natural settings through participation-based services (PDF, New Window). Journal of Early Intervention, 29(4), 287-305.
Research: What Do We Know?
The authors of this study examined 50 videotapes of “typical” visits from early interventionists from a variety of disciplines. Videos were analyzed using the Natural Environments Rating Scale (NERS) and the Home Visiting Observation Form (HVOF) to determine differences between traditional and participation-based intervention. Traditional intervention included learning activities planned by the interventionist that targeted specific skills, with the interventionist working directly with the child. In contrast, participation-based intervention focused on helping the child participate in naturally occurring learning opportunities and teaching caregivers how to interact with their children using intervention strategies to support participation. Strategies were incorporated into family routines and activities because they provided the context for the child’s participation. A primary differences between the two types of intervention were what roles the interventionist and the caregiver played in the service. The authors provide a detailed table in the article comparing the two types of intervention (p. 290).
Based on the review of the videotaped visits, the authors concluded that more visits showed traditional practices (70%!) than participation-based practices, which is consistent with other EI literature. Despite what we know from the literature – that traditional practices are not most effective – they persist. When participation-based practices were used, children were more frequently rated as “very engaged” and the child or parent was more likely to be the leader of the activity. The interventionist acted more frequently as a facilitator with the parent-child-interventionist triad rather than providing more direct, child-focused intervention. Interventionists providing participation-based intervention engaged in more observation, used more modeling and verbal support, and focused more on the parent-child interaction. There was more caregiver involvement in general and more interaction with the child, with less time spent in a more passive role. In both types of intervention, materials in the home were used and play provided the context of triadic interactions between the parent, child, and provider. There was, however, a statistically significant difference between what occurred during traditional and participation-based intervention.
Practice: How Can You Use What You Know?
What practices can you start using to provide more participation-based intervention? Here are a few to get you started:
Videotape a few of visits – Use a similar method as was used in this study. Videotape a few visits (with parent permission) then compare your work with the table on pg 290 in the article. Reflect on whether your practices are more traditional or participation-based and why. This could be done individually, with a supervisor or mentor, or as a group staff development activity.
Step back and let them lead – Let go of your plan for the visit and let the parent and child lead. Try this with new families, or explain to a family you have a relationship with that you’d like to try something different. Keep the IFSP outcomes in mind and look for opportunities for learning and participation in whatever routine you find yourself in.
Spend more time actively observing – This was an important difference between the two approaches. Rather than “doing,” spend more time watching. Use what you learn from watching to provide guidance and support to help the parent adapt the routine so that the child can learn from it.
Focus on caregiver-child interactions – That’s where learning happens. Shift your focus from what you think YOU need to what the PARENT can learn to do.
Let go of assessment skills – What we learn at the assessment is important, but don’t let it be the guide for your intervention. Look at the bigger picture. How do children learn to use a pincer grasp in everyday life? Yes, the child isn’t standing in the middle of the floor for 5 seconds, so how can she learn this kind of balance while helping her dad rake leaves? Keep your eye on the prize – learning while participating in real life.
Where are you on the continuum? If your practices are more traditional, what’s your next step for becoming more participation-based? If you already focus on participation, what advice to you have for others?