Yes, great point Stacy! It can be intimidating! I hope that someday we will have more consistency across the field in who provides special instruction because I really think that would help us feel more like the specialists we are and help others see us that way. It always makes me sad to think of SI as a last resort kind of service. There really is so much value in what a highly qualified special instructor/developmental service provider can do!

This is my view also! The description of being a generalist surrounded by specialists is spot on. I work in a state with a team-based collaborative coaching model and it has taken some work to figure out how to best use special instruction. I also know that different teams do things differently, even within the same organization, and in some places SI is sort of the last choice service. Then again, although I have a Master’s, many SI’s don’t. It is easy to feel like they don’t have anything to contribute in a room full of CCC’s, OTs and doctoral PT’s.

You really summed the situation up perfectly, Jeff. I think it is that idea of educators as “generalists” that is both an incredible strength of our knowledge base and part of what makes our position on the EI team so fuzzy. When our workgroup was developing language for the special instruction position statement, we talked at length about the use of the term “generalist” – agreeing that our knowledge about global development and how it overlaps is key, but worrying that the term could seem so broad, as if educators don’t have a specialty. We decided that we are also specialists, with our knowledge and skills crossing all areas of development so that intervention strategies and support are well-integrated into a holistic picture of the child in the context of the family. We absolutely DO need our team members, and it is in that collaboration that we are all most effective. It is a tough subject, and I’m so excited too that there are conversations going on about this important role!

Also, as an educator surrounded by specialists, it is easy to find my identity lost in the generality of my field. I am a generalist in all five areas of development and so, often begin to wonder how I fit in. Don’t get me wrong. I know the value of my field and my job, but comparatively, it does seem to get lost (in my mind) among some of the other specialized disciplines. It is encouraging to hear that there are efforts to delineate the field more clearly. I appreciate your efforts in doing so. Thanks for addressing the issue, Dana.

Completely agree, Cheryl. Without standards, the role IS variable because of such different backgrounds, training, experience, and even knowledge of what being a special instructor/developmental therapist really means. Ugh – that real quote you mention is so misleading to families. We all bring different competencies and skills to the table and we need each other. I have always thought that role sharing (between professionals and even between the parent and professional) is such a key to holistic intervention. As a special instructor, yes, I should hopefully be able to implement strategies used by a PT or OT with the therapists’ support but that doesn’t mean that I am a substitute for their expertise. Not having standards for special instructors muddies the waters – for all of us!

You make some great (and scary) points. I agree that how special instruction (DI) is used really does vary from program to program, and I think that abiguity is likely due to the lack of a clear definition for this role and who is qualified to do it. We certainly found that to be the case on our workgroup (we had reps from 11 states). The definition in the federal law really doesn’t provide much guidance. I believe, as it sounds like you do, that the service provider who has the most appropriate expertise to support the family in addressing the IFSP outcomes should provide the service listed on the IFSP. The decision about which service or service provider is recommended should NEVER be based on a program’s financial situation. I’m really hoping that this new position statement starts conversations about this role in states and local programs to help us reflect on and fix some of the things you mentioned. As you also mentioned, there are well-qualified, knowledgeable special instructors out there. I have always taken this position – if it was MY child, I would want the best qualified, most knowledgeable person helping me with his development. Families in EI deserve no less.

By the way, the appendix in the position statement is a table that lists what special instruction is and is not. We didn’t specifically address when to recommended it because that is an individualized, team decision. Our workgroup did acknowledge that it’s awfully hard to make a good recommendation when team members aren’t really clear on the role of special instruction, or don’t have faith in the knowledge and skills of the special instructors on their teams because the folks in these roles maybe don’t necessarily have a consistent background or bank of competencies and skills. It’s a challenging situation and there is definitely more work to be done. Thanks for sharing your soapbox! 🙂

What I find is that the use of DI varies depending upon the council, and that in some cases, services from DI have been used in place of service providers that other team members or the parents feel would be better suited to the child.

For instance, I’ve arrived at homes where parents show me target words developed by the DI that are developmentally inappropriate and way too difficult. I’ve been part of teams where the DI is working on feeding with little to no knowledge of the mechanics of feeding, why the child may be having difficulty, how to manage textures, sensory issues, or how to look for possible aspiration or penetration. I’m aware of instances where a child with congenital/hand issues was working on dressing with a DI where an OT would be more appropriate for current and future development due to those congenital issues. In some instances, the parent has asked for more SLP services which were available, and were offered DI services instead.

Depending upon the council, I’ve heard that DI has been encouraged to “save money” – I don’t know how that works, so maybe it’s so and maybe not. Two of the three councils I’ve been involved with do not use DI in general.

Just as there are things a DI knows and can do that I do not/cannot, there are things I know and can do that they do not/cannot. Having said that, I work alongside some very talented DIs who are dedicated, knowledgeable, great team members. At a time when the Commonwealth is moving away from more specialized personnel to a Primary/”Preferred” Provider model, time will tell. It would be great to have guidelines as to when DI is and isn’t warranted, instead of, “Well, we’ll just put developmental services in instead of (fill in the blank.)”

Thanks so much, Jodi! I visited your blog – thanks for letting me know about it! You have some great stuff on there! I love the idea of establishing a PLN on Twitter too. Honestly, I’m new to Twitter but will do my best to remember to use #earlyedsped. We’ll also be tweeting from our project’s new account (veipd) too. I couldn’t agree more about the importance of the special instructor’s role and having high expectations! Having a common language and understanding about this role was definitely a goal of our workgroup in writing the position statement!