Early Intervention Strategies for Success

Sharing What Works in Supporting Infants & Toddlers and the Families in Early Intervention

 

Your tire just went flat. You pull over to the side of the road, in the middle of nowhere, to try to accomplish something you’ve Goethe quote: Everything is hard before it is easy.never done before. No, it’s not call AAA…you’re going to change the tire yourself. Thank goodness you have a good signal out here because you use your phone to look up a YouTube video on changing tires first. You also read through your owner’s manual for instructions. Once you’ve watched an example and read step-by-step instructions, you should be ready, right? Wrong. First, just getting the tire out of your trunk is an ordeal, then getting the jack hooked up is challenging. You fit the wrench to the lug nuts and go to turn them (which looked easy when the guy in the video did it) but yours seem to have been put on by Superman. They are so tight you have to stand on the wrench to get them loose. After about 45 min of trying, you finally get the tire changed, put the old tire in the trunk, and get back in the driver’s seat. You slowly pull away, thinking “I have no idea if I really did that right.” Whew!

So what’s the problem with this learning opportunity? You just struggled through a brand new experience, having never done it before. It was stressful, scary and SO different from how easy it looked on the video. Now, compare this experience with that of families in early intervention. They often have plenty of opportunities to watch someone who is very skilled intervene with their children and it looks so easy. They can read a handout which makes intervention sound easy too. Then, the service provider leaves the home and they have to use the same strategy they just watched, but now they have to do it without support. The parent has no previous experience with the strategy and isn’t sure how to adapt the strategy if it doesn’t work. Imagine how frustrating this could be, having watched someone do it successfully and then not being able to get it to work. What could make the difference here, between a frustrated parent and one that feels confident with using a strategy between visits?

Adult Learning Principles #3: Adults learn best through actively participating and practicing what they are learning.

Adults learn best through experience, through feeling and doing a new task with support and feedback from others. We need to try it out, problem-solve in the moment if something goes south, and reflect on our practice. Practicing a new task engages multiple senses, which stimulates multiple neural pathways that support memory. It is through active practice and participation that we really learn HOW to do something, and helping caregivers learn HOW to use intervention strategies is what EI is all about.

In a fascinating meta-analysis of four adult learning methods, Trivette, Dunst, Hamby, & O’Herin (2009) (PDF, New Window) found that active participation was a key feature of adult learning that contributed to positive outcomes for the learner. Getting the caregiver actively involved in all aspects of the EI visit is more likely to result in confidence with using intervention strategies between visits. Let’s think about how we can do this!

How Can We Use This Principle?

Think of the intervention visit as a practice session for the caregiver – This is a big shift in thinking for many of us. Keep your eye on the prize – EI should build the capacity of the caregiver to interact with the child in ways that enhance development during and between visits so practice during visits will prepare families for real life between visits!

Explain to the parent why his/her participation during the visit is key – You set the tone for how visits work so you can help families understand the importance of their active participation. Talk about how EI visits work, what the expectations are and who will do what from the very first contacts with families. They often don’t know what to do during visits so you can support their participation and help them understand how the visit works.

Always follow modeling with practice – If you demonstrate a strategy, talk to the parent about what you’re doing and why, then turn the activity over to the parent so he/she can take the lead. Build practice time into each visit.

Have and show confidence in the parent’s abilities – After all, he/she is going to be there with the child for many many more hours than you are. The parent can do intervention well with the child; he/she might need to do it differently from how you do it and that’s okay. Your one-hour-a-week doesn’t change a child’s development…the parent’s interactions with the child do that.

Consider Two Examples:

Think about these two examples and the different experiences for the family.Baby drinking bottle in woman's arms

Example #1: Jenna is worried about how her son, Trent, is drinking from a bottle. He takes 45 min each feeding and often falls asleep. When he feeds, she notices a steady stream of formula dribbling out of the corner of his mouth. When she asks the OT, Elaine, about this, Elaine asks if she can feed Trent. While she feeds Trent, Elaine talks with Jenna about how to hold the bottle, how to hold Trent’s cheeks to help him suck, and how to position him to make feeding easier. Trent takes the bottle in about 25 min with much less spillage. While Jenna is happy that Trent can do it, she feels really bad that she can’t feed her son like Elaine can. When Elaine leaves, a few hours later Trent gets hungry and when Jenna tries to do what she watched Elaine do, it just doesn’t work and she starts to cry.

Example #2:  When Elaine hears about Jenna’s struggle, Elaine asks if she can watch Jenna feed Trent. After watching for a few minutes, Elaine and Jenna talk about how to help Trent feed more successfully. Elaine coaches Jenna in how to position Trent, how to hold his cheeks while she feeds him the bottle, and how to angle the bottle to help him suck most efficiently. Elaine even puts her hands over Jenna’s sometimes to help Jenna feel the proper positioning. After receiving Elaine’s support, Jenna practices feeding Trent the rest of his bottle while Elaine watches. Elaine gives Jenna a few more pointers, then they talk about how feeding went when Trent is done. Jenna feels nervous about trying these techniques when Elaine leaves but she feels like she can do it since she’s had some practice.

As you’ve read, example #2 offered Jenna the opportunity to practice feeding her son while using strategies and getting immediate feedback and support from Elaine. One of the best results of example #2 and the biggest differences between examples is Jenna’s feelings of confidence. We want families to feel prepared and confident with learning and using strategies when we aren’t there – and practice during the visit is likely to be a key to making this happen!

What strategies do you use now to encourage families to be active participants during visits?

What do you do when families are reluctant to practice using strategies while you’re there?

Share your tips for implementing this adult learning principle in the comments below!


Be sure to check out the other posts about adult learning principles:

Adult Learning Principle #1: Making Intervention Immediately Relevant

Adult Learning Principle #2: Linking New Learning to Prior Knowledge

Adult Learning Principle #4: Practicing Intervention Strategies in Real-Time

Adult Learning Principle #5: Feedback is How We Grow

8 comments on “Adult Learning Principle #3: Active Practice and Participation are Key!

  • Beth Tolley says:

    Thank you! The changing the tire example makes this principle so clear – as do the examples with Jenna and Trent! This makes such great sense!

    Reply
    • Thanks Beth! I’m so glad you thought so! We all use this principle in our everyday lives all the time…I think many of us use it during intervention too and don’t recognize it’s importance. Practice IS so important! 🙂

      Reply
  • Amy Cocorikis says:

    Having read this and shared it recently in several PD activities – there is specific phrasing in this article that has created so many “aha moments” I had to share! “They often have plenty of opportunities to watch someone who is very skilled intervene with their children and it looks so easy. They can read a handout which makes intervention sound easy too.” “Imagine how frustrating this could be, having watched someone do it successfully and then not being able to get it to work.” People responded very strongly to the image that this created…Lots of folks felt good about our use of modeling during visits, and our creative home programming ideas, but when we considered that any of our families could be left feeling this way, it opened up a whole other level of reflection! Thanks!

    Reply
    • That’s wonderful to hear, Amy! Thinking about what comes next, after we model, is so important and for me, was really easy NOT to think about, especially before I had the experience of my son receiving EI. It wasn’t that I didn’t care, I just assumed that my modeling was sufficient. I’m always so excited to hear about how you use our blogs and about the incredible reflections your groups share. Your reflective practice groups sound like they really are making a difference! Keep up the fantastic work and please keep sharing your groups’ insights!

      Reply
  • Nathan Travis says:

    Dana,
    As always, you rock! Thanks so much! Excellent analogy! Great article. I will be using it as a launching pad to start discussions w/my parents that don’t always feel really comfortable engaging in suggestions/ideas (that they even come up with which are great!) in our therapy visits. Thanks again!

    Nathan

    Reply
    • Thanks Nathan! The whole practice and participation thing made perfect sense to me as I reflected on how much I struggled with changing my first tire (and maybe my second one too…). I’d love to know how it goes when you use the analogy with parents. Hope to see you at CCSS this summer!

      Reply
  • Michelle says:

    This article really struck home- the whole image of changing the tire and frustration with that task makes the point to me as a provider to how frustrated a task as “eating” or “changing a diaper and the child moving against you” can be and how important it is to step back, take a deep breathe and ask the questions of what have you tried and show me how to help work together.
    -Encouraging, model and show to help build the confidence for the parent/child relationship in those identified difficult situations/tasks.

    Reply

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