Early social and emotional development includes the ability for young children to “form close and secure adult and peer relationships; experience, regulate, and express emotions in socially and culturally appropriate ways; and explore the environment and learn — all in the context of family, community, and culture” (Yates et al., 2008, p. 2). This describes the way infants and toddlers understand and communicate their emotions to build healthy relationships with those closest to them.

When you think about social and emotional development, all of the words above may come to mind. Each word is a critical component of social and emotional development. In early intervention, all practitioners play a key role in supporting the emotional well-being of every young child and their family.

Why and What You Can Do

“Social and emotional experiences with primary caregivers as well as interactions with other children and adults early in life set the stage for future academic and personal outcomes, and undergird other areas of development” (Darling-Churchill & Lippman, 2016, p. 2). You have a unique opportunity to nurture the connection between the caregiver and child and promote successful outcomes for each child you serve.

Here are eleven easy strategies you can implement to support social and emotional development:

1. Boost the parents’ confidence. This is a hard time for many parents. Parents may feel responsible for their child’s developmental delay. Building their confidence empowers them to feel competent. When someone feels good, it makes them happy. This helps promote positive parent-child interactions.

2. Support the child’s self-esteem. Children tend to avoid difficult tasks. After all, nobody likes failing. Boosting a child’s self-esteem gives him/her confidence to explore and try new things.

3. You can never give too much information. Explain what you are doing and why you are doing it. This helps parents understand the reasoning behind the intervention strategies you suggest or model.” Give parents plenty of opportunities to ask questions.

4. Focus on increasing positive parent-child interactions. Many children may resist demands placed on them. A positive parent-child interaction removes the feeling of a demand and makes the interaction playful and fun. It enhances the bond between the caregiver and child.

5. Read cues and intervene before a child is in his/her red zone. There are four stress responses a child may experience: Green zone, red zone, blue zone, or combo zone. Click here to read the checklist that identifies different behaviors associated with each zone. Positive emotions are associated with the green zone and negative emotions are associated with the other stress responses. Children are more likely to come back and stay in the green zone when parents are attuned to their moods and feelings. Becoming a detective for your child’s stress cues can be a great tool to improve attunement.

6. Model the behaviors you wish to see. We can help parents learn to model behaviors they want to see in their children as they grow into adults. Children learn how to manage big feelings in large part by watching their adults manage big feelings.

7. Explain the importance of comfort. Comfort is a big part of secure attachment. So often parents get mixed messages about comfort from society – sometimes it seems as if comfort is the same as creating a weak child. We can bust that myth by sharing the information we know about the role of comfort in early brain development.

8. Provide structure and routine. Routines are the safe walls around a child’s day. There is no RIGHT kind of routine but whatever it is, the more predictable for the child, the better. Routines that are repetitive for a child help them make sense of the world. They will always have another chance to practice the things they struggle with most.

9. Use positive behavior supports. A positive and proactive approach to supporting behaviors helps reduce parental stress and increase positive behaviors in children as they aim to please their parents. These strategies decrease reactivity and should be individualized for each child and situation.

10. Label emotions. Language is a major learning tool for children and during the young toddler and preschool years, we learn and use language as a way of making sense of the world. Putting words to feelings helps children learn that feelings are generally transient and aren’t a permanent state of being. This is something we should be regularly talking about with our parents.

11. Increase parent responsiveness. Parent responsiveness nurtures a safe, secure attachment allowing a child to explore and thrive in their environment as the child becomes more resilient and independent. Wonder with the parents about what their child may be feeling or thinking so they can respond in an intentional and positive way. 

What challenges or barriers do you face as an early interventionist supporting social and emotional development?

What other strategies would you add to support each child’s social and emotional development?

Additional Resources:

DEC Child Social-Emotional Competence Checklist

Supporting Social and Emotional Development: What ALL Early Interventionists Can Do Handout

References

Darling-Churchill, & Lippman, L. (2016). Early childhood social and emotional development: Advancing the field of measurement. Journal of Applied Developmental Psychology, 45, 1–7. https://doi.org/10.1016/j.appdev.2016.02.002 

Yates, T., Ostrosky, M., Cheatham, G., Fettig, A., Shaffer, L., & Santos, R. (2008). Research synthesis on screening and assessing social–emotional competence. Retrieved from Center on the Social Emotional Foundations for Early Learning http://csefel.vanderbilt.edu/documents/rs_screening_assessment.pdf

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Despite not being able to meet in person, tele-intervention (telehealth) has brought new opportunities to think about how we are talking about the child outcome summary process. Let’s be completely honest. Tele-intervention forces us to use good teaming practices because there cannot be any side conversations among professionals and everyone is only able to see and hear the same information. This helps us think outside of the box to ensure that all team members have the exact same information so caregivers can make the best decisions for their child.

After completing tele-assessments, I have experienced great success incorporating the caregivers in the Child Outcomes Summary (COS) discussion. The COS process summarizes a child’s functional development in three child outcome areas: positive social-emotional skills (including social relationships), acquire and use knowledge and skills (including early language/communication), and use of appropriate behaviors to meet their needs. The Decision Tree can be a helpful tool to facilitate the COS process.

All caregivers participate in the COS discussion using the Decision Tree. This includes deciding with the team which rating statement represents their child’s functioning compared to other kids of the same age. (Click here for more information about the Decision Tree and Virginia’s COS Process). Before even going through the process, it is most helpful to discuss who will facilitate the discussion with the caregiver and the rest of the team members. This includes sharing the screen to show the Decision Tree.   This can be the service coordinator or a provider. Here are 6 steps you can use throughout the process that I have found beneficial.

6 Steps for Engaging Caregivers during the COS Process

1. Explain the caregiver’s role as a team member.

This is an important step. Caregivers need to understand their role in the process and how they can participate. When they are unsure of what to do, they may be more reluctant to participate. Encourage their voices by involving them throughout process, giving thorough explanations, and asking open-ended questions to receive more in-depth answers.

2. Explain each outcome area and the use of the Decision Tree.

The second page of the Decision Tree shows the Infant & Toddler Connection of Virginia Child Outcomes Summary handout. This handout was specifically designed to support the caregiver’s understanding of the process. It is helpful to send this handout to caregivers prior to the meeting and share the screen with the document pulled up while discussing and highlighting different outcome areas. This will also encourage caregivers’ participation when they fully understand what is being discussed and why.

3. Discuss each outcome area with individualized examples.

During the Assessment for Service Planning, the team discusses functional development within each outcome area based on parent report, observation, clinical opinion, etc. Functional child development focuses on what matters in the family’s daily life, showing how the child is engaging, initiating, and participating throughout their day. It has little meaning to a caregiver if a child can stack blocks, so a functional example would be, “During bath time, Sydney enjoys lining her plastic blocks on the bathtub ledge before knocking them off and laughing. Her mother commented Sydney enjoys playing this game the entire time.” Embedding functional information like this contributes rich examples to the Decision Tree discussion that help all team members understand the child’s abilities and needs. During the discussion, it is also helpful to share the screen to show each outcome area on the IFSP as it is discussed. Screen sharing gives the parent the opportunity to follow along.

4. Review typical functional development.

This is an important step and not to be missed. It truly helps each team member, including the caregiver, understand what is typical for the child’s age within that given child outcome area. This will help each team member understand whether or not the child has “age-expected” functional skills. Utilize your resources for typical development. This can include a combination of resources such as the Act Early Milestones, Functional Development, Age-Expected Snapshots of Development, etc. Again, sharing the screen to show this information and/or sending the info prior to the meeting is beneficial to all team members.

5. Use the Decision Tree discussing each question and prompt.

Again, sharing the screen and/or sending the Decision Tree to the family prior to the meeting can be really helpful. Screen sharing allows each team member (including the caregivers) to look at the same information and follow along accordingly. Ask each question out loud for each decision point. Pause for discussion or examples. When choosing between two items at the decision point, read it and reflect with the caregiver and other team members about specific examples to reach an agreement on the best possible choice. By this point, caregivers should feel empowered to help make the best decision based on the information given to them and understand the importance of their voice.

6. Decide as a team the best statement.

Everyone has a voice. Check in with each person to make sure everyone is in agreement including the caregiver. Discuss specific examples if there is a difference of opinion at any given point in time.

Please note: When I share my screen, I already have these resources pulled up and ready to share as they are discussed: Decision Tree and the Infant & Toddler Connection of Virginia Child Outcomes Summary handout, the child’s IFSP, and information about typical functional development (See #4 above).

What are your top tips to engage families during the Child Outcome Summary Process?

How do you help facilitate the discussion?

Share your tips and ideas by leaving a comment below!

For more information about the COS process and the Decision Tree, check out these resources:

Decision Tree Tutorial

Virginia’s Child Outcomes Booklet: Team Engagement in the Child Outcomes Summary Process

The Decision Tree: A Tool for Teaming and Family Engagement – Parts I and II

ECTA COS Completion: When Teams Can’t Meet in Person

Extra! Extra! Read All About….Integrating the Decision Tree

Logan is Not a Number! – Explaining the Child Outcomes Process

COS Completion – When Teams Can’t Meet in Person

The post Successfully Engaging Caregivers in the Child Outcomes Summary Process Virtually appeared first on Early Intervention Strategies for Success.

We are all in this together. Early interventionists are exploring and learning new telehealth options. For many, this may mean learning new technology platforms, navigating limited wifi access, and simultaneously focusing on providing exceptional service delivery through telehealth. Teleflections©, a new resource, provide reflections from early interventionists who share their own experiences including their successes and challenges. Each week new videos are posted.

There are a variety of ways to access the Teleflections© series. Follow us on:

• Facebook
• Instagram
• Twitter
• YouTube (Teleflections© Playlist)

During this time of uncertainty, it helps to normalize our experiences and laugh (maybe sometimes cry) about them together. You can also check out the COVID-19 and EI Tele-Intervention Updates page for the latest resources.

Let’s take a look at some of the recent Teleflections©.

In Teleflections© 2, Julie Vaughn (SLP) was honestly states, “I won’t lie. It’s not my thing. It’s just not my thing, but I am making the best of it. I have learned a lot this week about computers and technology.” Coming out soon, Julie shares a new video with her successful update on how she has grown over the past two weeks. This is something new and we have to give ourselves time and patience as we all learn together.

In Teleflections© 4, Missy Rose (PT) shares her experiences as a physical therapist who relies on her hands to gain information about a child. Make sure you do not miss her fancy doll she uses to support families learning different positioning techniques. Many of us are nervous about not being in the home, but we are all learning we can still coach families to support their child’s development in naturally occurring routines and activities. We have even heard so many successes about coaching families and seeing a larger variety of routines as we navigate this together.

In Teleflections© 5, Stacie Jackson (LSM and SC) shares her experience waking up at 3:45 the morning of her first intake. It is safe to say many of us have experienced restlessness or disrupted sleep. After all, we’re all experiencing similar responses together.

The latest Teleflections© 6, Dana Carroll (OT) shares her experience from a mother who was really nervous at first. Dana describes the mother as being “over the moon” by the end of the session. Many families may be worried about how they will continue to support their child’s development during this time and it is a great way to remind them that we are all in this together.

Check out Teleflection©s by following our social media. We would love to hear about your experiences.

What has been your biggest success (or challenge)?

Share your experiences in the chat below!

The post Introducing Teleflections©: We Are All in This Together appeared first on Early Intervention Strategies for Success.

We all have times when we leave visits feeling like it went great because we were able to successfully engage the caregiver. Other times, we leave visits feeling defeated and wondering what we could have done differently or if the caregiver may not be completely on board with early intervention yet. Honestly, there are a multitude of reasons we make this assumption and it may be far from the truth. Maybe we need to listen better, build a stronger rapport, or simply do a better job providing information by being more intentional and reflective with the caregiver about his or her beliefs and interactions with the child. Caregivers are equipped with their own knowledge and expectations of the world (and early intervention) and we have to respect that as we provide support. With that said, we also want to help caregivers learn so that they can use intervention strategies successfully with their children. This can be a careful dance.

Creating Cognitive Dissonance

This is where we bring in our secret weapon as we help caregivers reflect on (and possibly change) how they promote their child’s development. One strategy we can use to facilitate this reflection is called creating cognitive dissonance.

Learn more about cognitive dissonance. The article states:

“According to cognitive dissonance theory, there is a tendency for individuals to seek consistency among their cognitions (i.e., beliefs, opinions). When there is an inconsistency between attitudes or behaviors (dissonance), something must change to eliminate the dissonance. In the case of a discrepancy between attitudes and behavior, it is most likely that the attitude will change to accommodate the behavior.”

In other words, cognitive dissonance creates a conflict in your brain where you engage in a behavior that does not reflect your actual beliefs. When people are in a state of cognitive dissonance, there is an urge to resolve the conflict. This happens quite frequently when people are faced with making decisions.

How You Can Create Cognitive Dissonance to Help Caregivers Learn

Let’s visit Natasha to see how she implements this strategy in practice. 

Natasha provides services to Christine (mother) and Sebastian (father) and their two-year-old, Isaiah. Isaiah has very few words. He tends to get frustrated frequently which really upsets his parents. Isaiah’s parents have both have expressed the stress it places on them as a family. Natasha has observed Isaiah becoming emotionally overwhelmed when he wants to communicate a message to his parents, but they do not understand him. 

Natasha has approached Christine and Sebastian about using sign language. When she brought it up initially, they were adamant against sign language because they want him talking. Natasha wanted to discuss using sign language again, but decided to be more intentional and reflective with Christine and Sebastian. Here is how the conversation went:

Natasha: How are Isaiah’s tantrums today?

Christine: It has been really bad. I know he is trying to tell me something, but it takes me so long to figure out what he wants. By the time I do, he has already spiraled out of control. 

Sebastian: Today, he wanted more cereal and we thought he wanted a drink. 

Natasha: What do you think is causing these outbursts?

Christine: It is definitely when we do not understand. When I can figure it out right away, he is fine. 

Sebastian: It is like he is frustrated when he cannot talk.

Natasha: Tell me if I understand you correctly. He is getting frustrated when you do not understand him.

Christine and Sebastian (simultaneously): Yes!

Natasha: I wonder what we can do to help eliminate some of that frustration while he is building his vocabulary.

Sebastian: I am not sure anymore.

Natasha: I know previously, we talked about using some signs and you were not sure if it would help. Sign language can be a bridge to using words. It is used as a strategy to help reduce frustration so you can understand what Isaiah wants and model the appropriate words. I want to be clear, though, that sign language is always used with words. Once Isaiah is confident using his words, he will stop using the signs because he will replace them with words. It sounds like you really want to reduce his frustration (parent belief?). What would you think about trying a couple signs and seeing how it goes (behavior)?

Christine (pausing in thought): …..I do want to help Isaiah learn to talk. 

Sebastian: I guess we were worried he would never talk and only sign. 

Christine: I see what you are saying. I think we can try sign language if it will help him.

Natasha: It is something to try. If it does not help, we can try something else.

I am sure many of you have encountered a situation like this. Natasha created cognitive dissonance in her discussion with Christine and Sebastian by having them reflect on their beliefs versus behavior. When we create cognitive dissonance, caregivers must reflect on their beliefs and decide whether or not they will change their behavior. 

What are some other situations where creating cognitive dissonance may be helpful?

Add your ideas in the comments below!

The post Creating Cognitive Dissonance as a Learning Strategy appeared first on Early Intervention Strategies for Success.

Tantrums are a normal part of every young child’s life. If we are honest, we throw our own “tantrums” as adults. When working with young children, especially those with a language delay, we have to understand that tantrums are a mode of communication when emotions become overwhelming. Marci Melzer offers five steps to handle tantrums with late talkers. 

Watch the video here and we will explore each step. 

Children under three are driven by emotions and not logic (Prencipe & Zelazo, 2005). Think about this statement and what it means for the families you serve. Often, a parent’s expectations for a child’s behavior may be unrealistically high for the child’s developmental age. Further, tantrums are stressful for the caregiver and the child. In order to access the frontal lobe (top brain) to make good decisions, the reactive part of the brain (bottom brain) needs to calm to access the top functions of the brain. The caregiver needs to be calm to make good decisions on how to react and support the child. The child needs to be calm in order to learn. This is why each of the steps Marci Melzer provides can be helpful. Let’s discuss each step.

Step 1: Acknowledge and react as if the child was injured.

Marci describes this as the “stop, drop, and roll” method. This is where a tantrum first sparks and you need to put out the fire by providing an empathetic response. “You have to give that tantrum the same kind of attention as if was an accident or illness because in your child’s heart, in their feelings, they feel the same when they want a cookie and they can’t have it as they do when they are running and skin their knee and get hurt physically.” The difference is the empathetic response given by the caregiver in both situations. The child feels the same because both situations are out of their control and they are communicating those feelings. You would give the tantrum the same response of love in both situations (cookie before dinner vs falling and getting hurt). Both instances are “bummer situations.” Once you respond and the child knows you care about the message he/she is communicating, you move to the next step. 

Step 2: Understand the message the child is trying to tell you.

In this step, the caregiver is calm and can access his/her frontal lobe to problem-solve what message the child is trying to tell him/her. Every behavior is communicating a message (hungry, too loud, attention). 

Step 3: Be a language facilitator and translate the message.

The caregiver now becomes the language facilitator for the child by helping to find the words to express the message. Supporting the caregiver to model the words the child is trying to communicate is key. “You deal with the behavior with hugs and cuddles, but you translate this communication into words” (for example, modeling “all done” instead of throwing a cup off the high chair). Marci makes a good point; most caregivers are already translating their child’s language in their heads (“Oh…he is hungry). It is a matter of modeling the language for the child, but step four takes that a bit further.

Step 4: Model the message in words the child can process.

Most children in early intervention are late talkers. This is where we want to make sure that we are modeling the language on the child’s level. This may be a single word or short phrase. It is important to make sure the child is calm and engaged or go back to step 1. After you model the message when the child can process and understand, move to the final step.

Step 5: Make sure the child is ready to move on.

This is all about empowering the child. You acknowledge the feelings and calm the child, understand and translate the message, make sure the child understands the replacement behavior, and then check in with your child and make sure he/she is ready to move on with the next thing to do (such as help make dinner). 

A big mistake many caregivers make is redirecting or distracting without going through and acknowledging all five steps. Without going through each step, children not learning how to handle the big emotions they feel inside. This type of facilitation shows it is okay to have big feelings and how to properly deal with them over time. Remember, children under three react based off their emotions. It is not until after age three where logic starts to be used and there are a lot of emotions children feel as they learn to walk, talk, and interact with others.  

How do you support caregivers in understanding their children’s behaviors in your program?

How do you communicate typical development for children to caregivers?

Share any successful strategies you have in your tool bag.

Reference: Prencipe, A. & Zelazo, P.D. (2005). Development of affective decision making for self and other: Evidence for the integration of first- and third-person perspectives. Psychological Science, 16, 501-505.

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Drew Dudley believes every person has changed someone’s life not by doing something extraordinary but rather through the everyday simple actions of being a leader. These actions can be so small a person may not even recall it in his or her memory. Mr. Dudley presents this inspiring Ted Talk on everyday leadership.

Take 6 minutes to hear his story:

“We have made leadership something bigger than us.”

Drew Dudley is right. If we relate leadership to only changing the world, maybe we need to redefine it. Drew Dudley worries “sometimes we spend so much time celebrating amazing things that hardly anybody can do, that we’ve convinced ourselves those are the only things worth celebrating.” The truth is there are moments that occur every day that define you as a true leader. Awareness and intention to understand the power of our own light can help us recognize what Mr. Dudley calls “lollipop moments.” Those moments are what makes us leaders.

“A lollipop moment is a moment someone said something and did something that made your life fundamentally better.”

Take a moment to pause and reflect on this statement. Who has impacted your life by simply saying or doing something? How have you impacted others?

It’s possible we do not always realize the power of our own words and actions in everyday moments. One day, I remember I was leaving the soccer field. A mother approached me and asked if I remembered her. She looked very familiar and then I recalled working with the family in early intervention. This mother gave me an update on her child and thanked me for supporting them. She told me she often thinks of the impact I made on them by providing the foundation for her, her husband and grandparents to help her son continue to grow in his journey. Wow! I was speechless. I did not realize the power of my influence on this family.

These are moments we have all experienced and never realized it……..a lollipop moment. This mother just found an opportunity to thank me for it.

Drew Dudley challenges us to “redefine leadership about lollipop moments. How many we create? How many we acknowledge? How many of them we pay forward? How many we say thank you for?” I am accepting this challenge and will remain aware of the opportunities to create lollipop moments with families. I will acknowledge the power I hold as a leader. I will model characteristics of a great leader daily during my visits and when working with my team members. I will thank others when they say or do something that impacts change in my life.

Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that frightens us. -Marianne Williamson

Please feel free to share your own lollipop moment when someone has impacted your life or thanked you for impacting their life.

What were your first thoughts after watching this video?

The post Everyday Leadership: Redefining Leadership in Lollipop Moments appeared first on Early Intervention Strategies for Success.

Have you heard the news? Assessment teams all over Virginia are integrating the Decision Tree (PDF, New Window) into practice (Drum Roll Please). The Decision Tree is a tool used for teaming and family engagement during the child outcomes summary process.

Let’s imagine that a team from Collaboration County is successfully using the Decision Tree. What might this look like? Keep reading to find out.

Let me introduce you to the team as we check in with them prior to, during, and after their assessment for service planning (ASP).

Margaret – Local System Manager (LSM)
Khadijah – Service Coordinator (SC)
Anika – Speech Therapist (ST)
Charles – Educator (Ed)
Parent – Marisol (Tyler’s Mother)

Before reading about this team’s example below, print the Key Tips handout (PDF, New Window). Highlight the tips you see as the team implements the Decision Tree.

Prior to the ASP

At the staff meeting, Margaret (LSM) introduced the new Decision Tree to the team and handed them a copy. She helped the team familiarize themselves with the Decision Tree by facilitating a discussion using a scenario-based Learning Byte (PDF, New Window). Margaret divided the team into pairs.

Khadijah (SC) practiced facilitating the discussion on Social/Emotional Skills, including social relationships with Anika (ST). Khadijah explained what is expected in this area for a 28 month old child. She discussed some specific examples when prompted on the Decision Tree. Khadijah asked Anika for additional input. Khadijah did not feel comfortable at first, but began to feel more familiar with the flow of the Decision Tree. Anika (ST) took a turn and practiced as well. Anika and Khadijah quickly realized the importance of gathering information about a child’s development and participation across all settings and situations in order to be successful implementing the Decision Tree.

Margaret (LSM) reflected with her staff on the activity and provided time to ask questions and support each other through this process. Everyone loves how the Decision Tree engages the caregiver as an integral member of the team.

After the meeting, Khadijah (SC), Anika (ST), and Charles (Ed) discussed who would facilitate the child outcomes summary discussion at their next assessment with Tyler and his family. Khadijah (SC) agreed with her team to facilitate the discussion.

During the Meeting

During the assessment for service planning, Charles (Ed) helped to ensure team members asked a variety of open-ended questions that included how the child participated throughout several settings and routines. When it was time to discuss the three outcome areas, Khadijah (SC) showed Marisol, Tyler’s mom, the handout on the Infant & Toddler Connection of Virginia Child Outcomes Summary Process as she explained what the three child outcomes entail. Anika (ST) noticed Marisol’s eyebrows furrowed. She asked Tyler’s mom, “What questions do you have for us?” After answering questions, Khadijah continued to facilitate the discussion in each child outcome area. Anika (ST) and Charles (Ed) each provided specific examples of the child’s strengths and areas of growth. Marisol added individualized examples of Tyler’s functional skills within different routines like waking up and going to the grocery store.

During the discussion, Tyler began to cry and Marisol stated he was probably hungry. Khadijah (SC) asked Marisol if she would like to move the meeting to the kitchen while Tyler ate a snack. Marisol agreed this would be best before continuing to help her focus on the discussion. Khadijah (SC) showed the team the Decision Tree to thoughtfully reflect on each question. Marisol contributed specific examples of Tyler’s abilities and activities along with Anika (ST) and Charles (Ed) until they agreed on a statement to describe Tyler’s functional behaviors compared to his same aged peers.

After the Meeting

Khadijah, Anika, and Charles left the home and met back up at a coffee shop. They reflected on what went well. They agreed each of them provide a different perspective and supported to the family throughout. Changing rooms to finish the discussion helped satisfy Tyler when he was hungry and engage Marisol in the discussion. Team members provided support to each other throughout the process.

Khadijah, Anika, and Charles identified ways they could grow as a team. Khadijah (SC) reflects that her explanation to Marisol on the child outcomes summary process could have been more detailed to help Marisol understand and feel comfortable participating. Charles (Ed) wants to write down examples within routines and settings so he does not forget as they discuss each area. Anika (ST) showed Charles the tool she utilizes called the Assessment for Service Planning Notes Template. Anika (ST) wants to practice asking more open-ended questions around routines.

At the next staff meeting, Margaret (LSM) reflected with her staff on how implementation of the Decision Tree was going. It was a rich discussion filled with what has been going well and how her staff would like to improve.

You heard it here first folks. The Collaboration County team is engaging families and utilizing strong teaming and collaboration throughout the child outcomes summary process.

How do you implement the Decision Tree in your locality?

What ways do you enhance your teaming process?

What strategies do you use to engage the family in the child outcomes summary process?

The post Extra! Extra! Read All About…Integrating the Decision Tree appeared first on Early Intervention Strategies for Success.

Think about the following perspectives during the Assessment for Service Planning and IFSP development process:

Team Members Arrive

SC: I arrive to facilitate the assessment for service planning and IFSP development for Jacoby. I meet Franklin, occupational therapist, and Maria, developmental specialist. We all walk in and I introduce Marilyn and Kevin (Jacoby’s mother and father) to Franklin and Maria.

Family: I open the door and immediately feel intimidated and outnumbered as Tamira, our service coordinator, walks in with two other people. She introduces them, but I already forgot their name and discipline. I am not even sure what they do exactly.

Assessment

SC: I begin to explain what to expect over the next couple of hours. I update the team and check in with the Marilyn and Kevin on any new updates or concerns. Franklin and Maria begin the assessment for service planning, engaging Marilyn and Kevin in questions and Jacoby in play. This is going to take a long time. Jacoby keeps running away. I have a lot of paperwork to get signed and we still need to develop the IFSP.

Family: Jacoby runs away the moment he sees everyone. I hope he cooperates throughout the visit. I am feeling anxious about what to expect. They are asking us a lot of questions. Maybe I should have been paying more attention to Jacoby because I do not know all the answers. I really wish Jacoby would sit down and play with them. He is getting fussy. I bet he wants a snack. I guess he will have to wait.

IFSP Development

SC: I facilitate the IFSP development. When we begin to write outcomes, I begin the discussion by asking Marilyn and Kevin, “What would you like to see Jacoby doing?” 

Family: Jacoby is really becoming upset right now. They are the experts. Just tell me what to do.

Remember the Family Perspective

Assessment for service planning and IFSP development are complex processes which require several tasks be completed by the EI team (including the family). Juggling these tasks can lead all team members to feel some level of stress or anxiety. Parents may feel unsure about what to expect. They may also feel anxious about how to manage their child’s participation and care during the meeting. Marilyn and Kevin were hoping to find answers, support, and future guidance on how to help Jacoby. Tamira, Franklin, and Maria have set tasks to complete during this time and are hoping to complete everything in a timely manner. How can Tamira, Franklin, and Maria provide support to Marilyn and Kevin during this time? Here are some easy tips to support parents.

Be mindful. Before going in the home, take a couple deep breaths and reflect on what this visit means to the family. It can be easy to forget about the parents’ perspective. Remember, the words and actions within each family interaction can impact their perspective of early intervention. Remain aware of feelings that lose focus on the family such as thinking, “I need to hurry before my next visit.” Hurrying may make parents feel unimportant and unheard. Mindfulness allows professionals to be conscious of the caregiver’s feelings and needs.

Check-in periodically with families. Throughout the process, pay attention to the caregiver’s nonverbal cues. Check-in to see if they need a break or have any questions. Caregivers may need a moment to feed their child, change their child’s diaper, use the restroom, or simply step away to quietly process all of the information given. Caregivers may feel like they will interrupt the process. Let caregivers know it is okay to take a break if needed.

Explain. Explain. Explain. Explain what you are doing and why you are doing it. Try not to use acronyms or jargon that may be unfamiliar to the family. Read a caregiver’s nonverbal cues while you explain to see if you need to pause and check for understanding.

In the scenario above, Kevin and Marilyn are experiencing an array of emotions. They are looking to the early interventionists for guidance and understanding. Tamira, Franklin, and Maria can support the family by being mindful, checking in with them, and explaining the process to alleviate some of the family’s worries.

How do you stay focused and present during your interactions with families? 

What are some strategies you use to check-in with families?

What could Tamira, Franklin, and/or Maria do to ease Kevin and Marilyn’s worries throughout the visit?

What other tips would you add to support families?

Add your tips and strategies to the comments below!

The post Don’t Forget the Family’s Perspective appeared first on Early Intervention Strategies for Success.

Rosemary, speech therapist, has been seeing Caleb for five months and it is time for his annual IFSP next month. She is worried she does not have enough information to provide developmental age ranges for the annual IFSP. According to the practice manual (Chapter 6, page 2), ongoing assessment is defined as:

“Assessment that occurs as a routine part of service delivery based on observation of the child’s functioning and skills across all developmental domains and indicator areas. The purpose of ongoing assessment is to give the provider and the IFSP team, including the family, information on the child’s progress on the IFSP outcomes and short-term goals being addressed by the current activities and to assist in identify any emerging concerns in other areas of development. No assessment tool is required; but, when needed, the service provider may use an assessment tool as a reference point, especially for areas of development outside his/her area of expertise.”

Rosemary reflects back on past visits and reads her progress notes. She pulls out the initial protocol (or assessment form) used for Caleb and updates it accordingly. Rosemary begins to feel more confident as she realizes she has seen Caleb performing during a variety of activities and routines including the park, car, grocery store, meals, and playtime with his brother and family. Rosemary realizes she has more than enough information to update Caleb’s progress in the three child outcome areas. She also uses the protocol as an anchor tool to provide developmental ranges as part of ongoing assessment.

A Deeper Look at the Definition of Ongoing Assessment

When you read the state’s definition, what key words related to the process of ongoing assessment do you notice?

Observation, functioning, progress, and emerging concerns are key words to ongoing assessment. Ongoing assessment is the continuous observation process you use to monitor a child’s progress, notice any emerging concerns, and discuss them with your team as needed. When we look at the whole child’s development across time, we are ensuring we are monitoring progress and routinely individualizing services throughout the process.

Three Strategies to Improve Ongoing Assessment Practices

Ongoing assessment is something you are probably already doing during each visit with the family. Here are some simple tips to feel confident before your next annual IFSP review.

• Document ongoing assessment in your contact notes. Contact notes should clearly reflect a child’s progress since ongoing assessment is a part of the contact note requirements (page 9) (PDF, New Window). Sometimes, there will not be as much progress week to week, but it is still important to document what the family and child did (current progress), so that progress will be clearer when something happens in the future. Ongoing assessment helps you identify progress towards IFSP outcomes/short-term goals and also any new functional skills in the three child outcome areas. Updates about progress in the three outcome areas are fundamental information that should be documented in your contact note.
• Read your records before your next visit. We can easily get in the routine of just going from visit to visit. A simple glance over your last contact note may help guide you during your discussions with families. Check in with the family and compare what you learn to your protocols. Some service providers regularly update their protocols throughout the time they see a child. This helps providers think about the whole child versus just their specialized area. You might also want to review the IFSP narrative and note differences in the child’s skills since the IFSP was developed. What has changed? What other activities or routines do you want to observe?
• Visit the family within different routines and activities including going out in the community. This will help you observe skills in a variety of settings. Observing the child in a variety of settings will help you ensure the information you gather during ongoing assessment is not only accurate, but also identifies learning opportunities throughout the child’s early intervention experience.

In the scenario above, Rosemary was able to see other ways Caleb was functioning. She walked with the family to the car to see what strategies Caleb’s mom was already using to help Caleb communicate. She observed them talking about the weather when they walked outside and using words like “up” when he was climbing into the car. However, there was so much more going on than just using words. Caleb walked down the steps holding his mom’s hand and transitioned from the grass to the sidewalk when she told him to “stop” and “come here” as he tried to run to the tree in the middle of the yard. There was a neighbor outside and Caleb waved after seeing his mom wave at the neighbor. Once he was in his seat, he wanted to try to buckle himself which was a puzzle all on its own. Caleb was determined and able to use his fingers to push the buckle down. He was focused and proud of himself once he did this on his own.

Rosemary realizes ongoing assessment occurs naturally. She has integrated this as a standard practice by documenting ongoing assessment in her contact notes, reviewing records before her visit, and seeing families within different routines and activities. She has all of the information she needs about Caleb’s communication and other areas of development and is ready to update the IFSP.

What practices do you find helpful during ongoing assessment?

Please share any tips you may have in your local program.

For more information, please check out:

Decision Tree Seeds for Success: Functional Assessment is Not the Same Thing as Testing (PDF, New Window)

The post Ongoing Assessment Occurs Naturally appeared first on Early Intervention Strategies for Success.

Assessments continue to evolve in a variety of settings including the medical and educational fields. Though these assessments look and feel different, there is one very large commonality.  True individualization is ultimately valued. As we move toward conducting functional assessments, we have to learn how to gather information differently. Rather than interviewing the parent straight from the assessment tool, going item by item, we know that we can gather richer information by having a conversation with the parent about the child’s daily life. Sure, we still need to observe the child and complete the items on the protocols, but these conversations help us relate what we observe to the child’s everyday life – his/her functional development. This helps us individualize assessment, and provide services, in a meaningful, functional way.

What does a functional assessment look like?

One simple way is to start with the parents’ concerns and any new updates, including medical information, since the intake. This is a fantastic role for the service coordinator because they have the information from the intake and can explain what the parents can expect during the assessment process.

Then, begin to ask open-ended questions with the start of a child’s day to bedtime, covering sleep, mealtime, playtime with others and self, naps, community outings, bath time, car rides, and any other relevant routines to the family. This will help trigger any concerns about the child’s day the caregiver may have previously forgotten. Analyzing the caregiver’s responses to the questions can lead into deeper questions and discussion. Try to wait to complete any protocols until the majority of the questions have been asked and the play is completed. This will help the parent feel more open to discussing details of their personal life. This is a vulnerable time and listening and observing help make this process more comfortable. Take a few minutes after the assessment to take the protocols out and complete them prior to reporting out in the three outcome areas. This may feel uncomfortable at first, not having the protocols in front of you. Practicing and understanding the reasoning behind the questions in protocols helps this become a more natural process.

Here are some practical strategies to move toward functional assessment.

1. Ask open-ended questions centered on a child’s day.

The key is to ask open-ended questions during an assessment that are centered on a child’s routines and activities to gain meaningful information. Open-ended questions strengthen the relationship with the caregiver because we are actively listening and creating rich conversations in order to understand the whole picture of the child’s development within the context of the family’s life. We see the meaning behind the child’s behaviors versus simply identifying behaviors. Consider these questions: What do yes or no answers from an assessment tool really tell us about the child? Can these questions feel intimidating to parents? How can we truly gain a deeper understanding of the dynamics that affect a child’s development? Understanding the dynamics surrounding a child’s life is essential.

Please follow this link (PDF, New Window) for an example of how a functional assessment might flow, including examples of open-ended questions to ask.

2. Teaming

Functional assessments still include observation, clinical opinion, parent report, and any protocols. Each locality may be set up differently, in terms of who conducts assessment, what tools are used, etc. As long as the teams are communicating information, this should still look similar across localities. The service coordinator facilitates the assessment and supports the family and providers throughout the process. One of the service providers may focus on asking open-ended questions while the other provider facilitates play with the child.

One strategy to increase teaming is to communicate each person’s role in the assessment. After the assessment, discuss what went well and areas to grow. It is important to not be judgmental as this is a learning process for all of us. Communication is the most effective way to build stronger teams. Respect the perspective each person brings to the table and ensure everyone participates in the assessment. Remember, parents play a huge role in our team.

3. Practice makes perfect.

Incorporating functional assessment into your existing assessment process is easier than expected with practice. Each locality has different processes that need to be individualized to serve the same purpose of a functional assessment. How can we gain a clear picture of a child’s life in order to help provide quality services? Some providers may have set assessment slots that provide a multitude of opportunities to practice and strengthen their knowledge and confidence in conducting functional assessments.

Practice during assessments by asking more open-ended questions and relying less on the protocols being in front of you. During assessments, practice viewing development from a functional perspective looking at how the child will use skills to be successful in his daily life. Role-playing is another way to practice with a colleague. Take turns asking questions as the provider while the other acts as the caregiver.

Every assessment has different variables that may add additional stressors such as a barking dog or siblings. The functional assessment process gains rich information while providing opportunities to consider each child’s interests and family dynamics. In the end, we gain an understanding of the child’s personality, relationship to the caregivers and other people, temperament, learning style, and participation in daily routines and activities. Functional assessments are thorough and help us to receive valuable information to help us create a truly individualized plan for each child.

I would love to hear your own strategies for functional assessments.  Please share your tips on completing functional assessments in your locality.

What are some of your favorite strategies to ask open-ended questions, practice, and/or collaborate as a team?

What are some challenges you encounter when implementing functional assessments?

The post Enhancing Quality Functional Assessments for Each Individual Family appeared first on Early Intervention Strategies for Success.