Remember with me. You are a young child—in your elementary years—and you find yourself in an ice-cream shop. Let’s call it Baskin Robbins for the sake of nostalgia. You can barely see over the freezers but as you gaze up and down the line at all the different flavors to choose from, your excitement and childlike wonder is interrupted by… stress. You feel that flicker of overwhelm becoming increasingly more intrusive because you know you have to narrow it down and that you have to order and that people are waiting on you and that you want it ALL but that you can’t possibly have all 31 flavors and…

Phew. Still with me? Now, imagine that there were only ever just 3 flavors. How does this change the way you would feel peering over the freezers? How might your decision-making process feel different? Many parents in early intervention may empathize with this young child’s anxiety around making decisions from a multitude of possibilities.

So Many Important Decisions

While we, as service coordinators and providers, place parent engagement and empowerment at the forefront of our practices, it may be prudent to consider how this can be felt from the parent’s perspective. For example, the development of the IFSP (especially right after assessment for service planning) might evoke a sense of uncertainty from parents. How? Hearing the assessment report and being asked to participate in the child outcome summary process using may elicit a range of emotions on the grief spectrum. Denial, sadness, anger, rejection, guilt, shame, and hopelessness are a few of the emotions that parents may feel, especially when hearing their child be described by strangers in an unexpected way. By the same token, parents who received the news they were expecting (i.e. that their child qualifies for the program) may be trying to reconcile feelings of being validated and heard with guilt for being “right” about something they did not want to be “right” about. Nonetheless, grief counseling suggests that important decisions should be avoided while someone is experiencing grief.

Similarly, discussing a joint plan with a provider at the beginning or end of a session might do the same. Parents may question themselves: Who’s to say I’m the expert? Am I picking the right thing to work on? What if I tell her what I really want and it’s the wrong answer? What if I’m wasting the time I have with the provider by picking the “wrong” thing to work on? Surely, we all can empathize with this hesitancy when it comes to wanting to make the best decisions on behalf of those we love. Our task is to help parents feel confident in their own ability to make those decisions, eventually without our help.

Where Do We Start?

Use active listening at all times to capture the essence of the parent’s message. What things have they kept mentioning? What are they saying would make life easier for them? What stresses do they mention over and over? What are things that bring them joy? Think about some other ways to engage in and practice active listening with those in your personal circle.

Use cues from the parent during your interactions with them to guide conversations about what things would be helpful to address. Maybe you notice that the dad has repeatedly mentioned that he cuts his 33-month-old son’s food up into very small pieces when asked about meal-time. Perhaps the mom has intentionally turned the TV on and situated the baby in front of it before giving him the bottle. You may notice a parent look nervously towards the back of the house where her other children are during your meetings. Maybe the dad prefers to stand at the kitchen counter during sessions rather than in the same area as you or the child. What questions could you ask after noticing some of these cues from parents?  How can you tailor your questions to get more clarity about these behaviors’ driving forces?  

Make sure you understood them correctly. Use reflective and judgement-free language to flesh out concepts they’re sharing with which you may be unfamiliar. Use phrases such as “I’m hearing…; you mentioned…; I thought I heard something about…; it seems like ___ is very important to you…; can you tell me more about what _____means and/or looks like in your daily life…; would you like to share more about ____…, etc.” Active listening may involve jotting down notes, which can be referenced before the next meeting with the family.

Got It. Now what?

It is the responsibility of the service coordinators and providers to scaffold decision-making as warranting situations arise to help the family feel confident and at ease, not only with the decisions they are tasked to make in those moments, but also with the process of how to critically and confidently think them through.

Share your thoughts below in chat!

Be sure to check out the first post this series:

Get the Backstory: Validating and Valuing Family Input

The post Baskin Robbins: How Do I Decide? appeared first on Early Intervention Strategies for Success.

Imagine: you are sharing your deepest wishes with a trusted friend. You are sharing a cup of coffee on the couch and you feel led to begin a conversation about your goals for the coming New Year. You share your regrets from the past year and your hopes and dreams about how you envision this New Year. You are deep in thought and passionate about articulating these ambitions out loud. Your friend’s response, much to your surprise, is superficially supportive. You sense judgement but you can’t put your finger on it. Why is she being short? Why does her smile look fake? Does she realize her eyebrows just did that? You begin to wonder what her thoughts are and to feel… Vulnerable. Embarrassed. Insecure.

A Parent’s Perspective

Now, imagine that instead of talking to a dear friend, you are talking to a complete stranger in an intake meeting, no coffee involved. Instead of freely sharing your priorities for the New Year, you are being asked to name priorities you have for your most precious hope in the world—your child.

Will I be judged for what’s important to my family and me? Was that the right thing to say? Is that the kind of answer they’re looking for? Geez, I have so many I can’t even put them in order. I need help sorting this out in my head and I am entirely overwhelmed but I don’t want the lady to think I don’t care if I am too vague. Is it okay to breastfeed in here?

These are just some of the thoughts that ran through my head as a parent as I began the early intervention process with my, then, 8 month old. Some deep reflection led me to the following conclusion: From my team, I needed my priorities validated and valued so that I could begin to trust them and their input into our lives.

Building Rapport, Being Curious, and Cultivating Relationships

As service coordinators and providers, it is our job to give up control for the sake of building rapport and trust so that deeper and more meaningful impacts can be achieved during the entire early intervention journey. You might be thinking, But, I don’t control interactions! I help the family with guiding questions to get them to a point where both the clinical/developmental priorities and family priorities are aligned. We have all been there. It can be challenging to reconcile the priorities that are indicated through family and formal assessments with what the family is sharing as their priorities. However, a family’s priorities can and should be discussed informally, too, starting with the first contact you have with them.

To ponder: What barriers to active listening and getting the backstory have you experienced in your relationships and interactions with families?

How?

Be genuinely curious about families, their daily lives, and their backgrounds. Ask for the sake of truly learning, and not documenting. Repeat back what you hear them say often to check that you are understanding their meaning. Validate them when you sense uncertainty, stress, or when they share about topics that are clearly close to their hearts. Use your intuition. Ask open ended questions—not the kind that indicates you are checking off a list, but the kind you would ask when something someone has just said has genuinely sparked your interest. Once you have a truer understanding of where a person is coming from, you can begin to introduce how early intervention can help facilitate and highlight these priorities in the family’s life using the family’s everyday routines and priorities.

To ponder: How might these initial and ongoing interactions inform your practice as you continue to cultivate a relationship with the family throughout the EI process?

So, where does that leave us? For anyone, the first step to making changes is acknowledging that change would bring an added benefit to your quality of life. Seeking help, self-referring, taking a random number that the PCP handed them and calling, showing up to appointments, answering the phone to unknown numbers– these are all indications that a family is open to change. As providers and service coordinators, the most important part of our job is to cultivate relationships that are conducive to productive and meaningful change. We begin that cultivation that by simply listening— getting the backstory so that you can truly walk alongside the family as they continue developing the rest of their early intervention narrative.   

Share with us! What are your go-to questions/conversation-starters that you have in your toolbox to help you ease into this informal approach of getting the backstory?

Micaela is a former early intervention service coordinator and developmental services provider. She holds a master’s degree in Early Childhood and Family Development and her passion is helping families astound themselves with all they can achieve. She is, most importantly, the mother of a beautiful little boy. She and her family have been receiving the support and services of EI since her son was 7 months old. Micaela and her husband are excited to be welcoming a little girl into the world this spring. Through this blog series, Micaela hopes to merge the distinct perspectives of a parent, a service coordinator, and a provider into a unique cultivation of meaningful insight and conversation.

The post Get the Backstory: Validating and Valuing Family Input appeared first on Early Intervention Strategies for Success.

Raise your hand if facilitating transition from early intervention (EI) has been challenging for you or your staff?

Rest assured, you are not alone! We, on the professional development team, consistently hear from service coordinators (especially newbies) and local EI system managers that transition is daunting. They tell us that they or their staff struggle with managing the timelines, filling out the IFSP transition pages, scheduling the meetings, and generally keeping all of the requirements in mind. EI practitioners want to make sure the process works well for families, and as you know, transition is federally monitored so it is very common to feel pressure to “do it right.” To help you help your staff, or help yourself, ensure smooth transitions, we’ve developed a new Transition from Early Intervention Learning Path.

What is a Learning Path?

Learning Paths are small collections of curated activities that focus on an EI topic. To learn about the topic, learners complete each activity on the path. Activities might include reading an article, completing an online module, watching a video, etc. Once the learner completes the learning path, he/she takes a final quiz to earn a certificate documenting the professional development hours earned.

We have several learning paths available now – two on Autism Spectrum Disorder and five on functional assessment. In this post, we’re going to focus on our newest learning path on transition and talk about how to use it with your staff, whether you are meeting in-person or virtually.

A Four-Step Plan for Staff Development

Here are four steps you can use or adapt when helping your staff brush up on their knowledge about transition from EI:

1. Open a discussion about transition during a staff meeting.

Before your staff start the learning path, pull them together for a virtual or in-person meeting about transition or add this to your staff meeting agenda. Use open-ended questions to facilitate a discussion that airs out the challenges and makes room for successes and strategies. Be open to hearing what your staff still need to know. Here are some examples of guiding questions:

• What’s going well this year with transition?
• What do you find challenging about transition? Why?
• What questions do you have about facilitating transition?
• What does a successful, smooth transition look like?
• What tools and strategies are you using now for successful transitions?

2. Guide your staff through the Transition Learning Path.

Introduce your staff to the transition learning path by taking them on a web tour during the meeting, or email them the link to the path with instructions for what to do. To familiarize yourself, take a moment now and visit the Transition Learning Path. Review the six activities, then come back here for more ideas for how to continue the learning process.

Here are some options for how to help your staff move through the path:

• Have staff do one activity before each staff meeting for the next 6-7 meetings
• Convene a special transition discussion group to do each activity together then discuss
• Give staff a deadline to complete the learning path then get together to discuss using specific guiding questions
• Identify staff partners to work through the path together by completing activities and coming together regularly to meet, then pull the whole group together to discuss and share insights.

Or, if you are an individual service coordinator or service provider, you can complete the path on your own. I recommend completing the activities across several sessions rather than trying to knock it all out in one afternoon. The path results in a certificate documenting four professional development hours (after completing a knowledge check) so you will get the most out of it by absorbing the content across time.

3. Continue the learning with a Transition Learning Byte.

Learning across time is always more effective than learning from a single event or resource. The nature of the learning paths encourages learning across time, but you can extend the conversation even further by using the Shooting the Transition Hoop Learning Byte. Learning Bytes are staff meeting activities on a variety of EI topics. The purpose of the transition learning byte is to guide learners as they review key things to remember about transition and reflect on how they can use this information in their daily work with children and families. This could be an activity you do after a group discussion about what was learned from the learning path as a way to debrief. Or, use this learning byte two weeks or a month later to refresh and revisit transition.

4. Revisit the Transition from Early Intervention Services to Part B Preschool Special Education Performance Checklist in 3 months.

Another idea to stretch the conversation and continue the learning would be to use the Transition Performance Checklist multiple times. It is included as an activity on the learning path, but you could have your staff complete it again three months down the road as a self-assessment, either during a group meeting, at supervision, or during peer observations.

Transition is an ongoing process that is so important to ensuring families leave EI with confidence. Whether your staff includes service coordinators, service providers, or both, all EI practitioners can benefit from an understanding of the process. If you want more information or resources about transition, be sure to visit the VA Early Intervention Professional Development Center site’s Transition topic page.

How could YOU use the new Transition Learning Path?

Share your ideas in the comments below!

Resource Highlight: Transition Tutorials

This 4-part series of video tutorials is part of the learning path but can be very useful to staff on their own. These tutorials explain how to complete the transition section of VA’s IFSP and additional requirements in the process:

• Transition:  A Series of Family Decisions 
• Transition: Developing the Plan and Documenting the Steps 
• Transition in Action: Scenarios
• Transition Conference Requirements 

Look for the tutorials on the VEIPD Transition topic page, under the eLearning tab!

The post Resource Alert! – Check Out the New Transition Learning Path appeared first on Early Intervention Strategies for Success.

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.

The presence of an engaged service coordinator who understands the role and skillfully conducts the  many responsibilities of the position ensures a well-coordinated approach to EI service delivery. It is widely acknowledged in the EI field that families have the right to high-quality, individualized EI services; our field must commit to including service coordination in this acknowledgement by ensuring that the professionals who provide this service receive the attention, understanding, respect, and resources they need and deserve. (DEC and ITCA, 2020, p 10)

Wow. This quote is from the summary of the Service Coordination and Early Intervention – Division for Early Childhood (DEC) and IDEA Infant & Toddler Coordinators Association (ITCA) Joint Position Statement which was recently released in December 2020. It’s a powerful message for our field that’s intended to help us leave behind the unfortunate idea of service coordinators as simply paper pushers. It signals to leaders, administrators, and team members, including families, that service coordinators (SCs) are vitally important professionals who play key roles in the delivery of quality early intervention (EI). It’s about time. I’m proud to have been a part of the development of this statement and eager to spread the word.

A Joint Call to Action

The statement was written, reviewed, and finalized as a collaboration between DEC and ITCA. It represents the voice and beliefs of EI professionals from multiple disciplines who are members of DEC and Part C coordinators across the country. Together, these groups came to the conclusion that we needed a strong Call to Action in support of service coordinators and specific information about the knowledge, skills, beliefs, expertise, roles, and responsibilities of professionals who provide service coordination to encourage consistency across our field.

What Can You Do?

Let’s break down the four recommendations in the Call to Action and consider how to move the dial forward.

#1: States and local programs should review and align current competencies to the indicators in the Knowledge and Skills for Service Coordinators (KSSC) document.

In an appendix, the KSSC outlines six knowledge and skill areas that are essential for service coordinators, including: infant and toddler development, family-centered practices, leadership and teaming, coordination of services, transition, and professionalism. Take some time to read it and compare it to guidance or competencies your program uses when hiring and training SCs. If you don’t have program-level competencies, consider adopting these.

#2: Leaders who hire, supervise, and mentor service coordinators must have a thorough understanding of the expertise and needs of these professionals. This understanding is essential to ensure that compensation aligns with the level of responsibility expected of service coordinators. Service coordinators also should have appropriate administrative support, reflective supervision, and resources to successfully manage the workload, navigate changes in policies and procedures, and, most importantly, partner with families.  

This recommendation focuses on leadership and administrative support, which traditionally varies greatly across EI programs. If you are a leader, be honest with yourself and reflect on what you understand. Can you specifically explain what the SCs in your program do and what they need? If you find holes in your knowledge or how your program functions, make a plan to address them starting today. A few ideas:

• Ask your SCs what they need and how your program can meet this recommendation, then work together to set goals.
• Schedule regular meetings with service coordinators to touch base, identify needs, and collaborate toward goals.
• Provide specific info about policy changes and what they mean. Invite input and be flexible when you can.
• Check in regularly about workloads.
• Be available for regular planned and unplanned reflective supervision.

#3: States and programs must consider multiple factors when determining workload size to ensure that service coordinators can manage the roles and responsibilities outlined in this joint position statement. The factors to consider include (1) the number of families served per service coordinator, (2) the varying levels of need experienced by families, (3) the model of service coordination implemented in the state/program, (4) the need for administrative support and supervision, and (5) the level of responsibility, educational background, and any specific expertise required of service coordinators in a given state or program.

This recommendation strongly encourages programs to use a multi-factorial view when determining workloads for service coordinators, rather than simply relying on “caseload” numbers which often fail to reflect the complexity and individualized nature of the work. If you are a leader, take a hard look at how your program operates, check in with your staff, and make adjustments to make the work more manageable. If you are a service coordinator, examine your workload and talk with your supervisor about what is going well and where you need support. Bring your creative ideas to the meeting and work together to tackle this recommendation. You might not be able to change the number of referrals coming in, but there are often smaller changes that can be made to improve the situation.

#4. Additional research is needed to identify recommended practices specific to service coordination, which could be guided by the KSSC document. Research also needs to address how these practices would be implemented with families and how service coordinators would be trained to use these practices during preservice and inservice training.

This might sound like a recommendation for academics, but academics need EI programs to work with to conduct research. Reach out to your local university to initiate conversations about research and service coordination. Encourage faculty to share the position statement with their students. Building partnerships with faculty not only benefits the students you may share during field placements, but could also have a positive impact on the field if you work together to learn more about best practices.  

I encourage you to take the time to read the full position statement and share it (or the Executive Summary) with at least two other people. Share it with your staff or with colleagues, other SCs, contractor agencies, leadership, families, and higher education faculty. Start thinking about how you can use it in your program or state.

Let’s answer the call for action by dedicating some intentional time and energy to our service coordinators. They deserve it.

How can you use the position statement in your program? Who will you share it with?

The post Call to Action! Service Coordination and Early Intervention – DEC/ITCA Position Statement appeared first on Early Intervention Strategies for Success.

An important and ongoing part of a service coordinator’s job is gathering information from families about their child and how that child fits into the daily routines of their life. This information ebbs and flows, changing as children and parents develop together over time. By gaining insight into these routines service coordinators can facilitate an IFSP rich with meaningful outcomes and goals and can aim to provide services that best meet the needs of the child and family. Come walk a mile with me as we step through a day in the life of a family. Simple though it may seem, let’s start in the very beginning…

It’s time to wake up.

There’s so much information that can be gained by simple, open-ended questions about how a child moves through his/her day. Does a child wake up like a ray of sun or a storm cloud? Does the 7-day forecast call for sunshine or partly cloudy skies? Ask questions about what constitutes a child’s daily routines. Also ask how that child is participating in their day within those routines. If a child starts their day in tears, does it continue to pour or are there rainbows?

Little Sammy wakes up with the sun with tears in his eyes. He calls out “mommy” while sitting in his toddler bed. After a few minutes of snuggles he’s ready to start the day. When his mom asks what he wants to wear today he pulls open the dresser drawer and says “Paw Patrol” while pulling out his shirt. He lays down on the bed in anticipation of having his diaper changed. He grabs it and says “peepee.” As soon as he is dressed and dry he runs out the door calling out for “daddy” and tells him he’s ready for “a snack” (aka breakfast). He pulls over the kitchen stool to the pantry. He gives a “bar” to dad for help opening the package.

This small part of Sammy’s morning routine alone contains a wealth of information. He has a healthy attachment to his parents. He is growing in independence. Sammy recognizes the routines in his day and participates in dressing. He is showing early signs of readiness for toilet training. Sammy calls out to his family by name. He is using words to tell others what he needs and to identify when he needs help. He is using nice problem solving to figure out how to get something himself. What other things can we ascertain about Sammy from the first 15 minutes of his day?

The days are long, but the years are short.

Most of us are probably familiar with this little adage but unless you are still in those days, then it can be all too easy to forget just how long the days can be. As the family talks about the ins and outs of their daily routines, ask follow-up questions about the child’s likes and dislikes, what do they love to play with and how do they play with it, and what happens when it’s time to stop doing that activity. Are there times of the day the family dreads? The family’s answers can provide a valuable insight into what direction to take with the providers as you plan for the assessment and segues smoothly into the conversation about the family’s concerns and priorities. It can also help you identify challenges within the day the family might not recognize as a challenge.

Service Coordinator: Does your son take a nap?

Mom: Yes, after lunch.

Service Coordinator: How long are his naps?

Mom: Usually about an hour and a half.

In this interaction we’ve established that Sammy takes a nap but a few follow-up questions might reveal that Sammy can easily take up to an hour (or more) to fall asleep and will only stay asleep with his mom next to him. It’s a challenge and frustration for his mom because she doesn’t have that time free to get a few things done around the house. Meanwhile, at daycare he’s the only child in the room that doesn’t nap. His teachers have given up rubbing his back and he now spends the 2 hours lying still in his cot not allowed to talk or move. He has come to associate daycare with being forced to lie still for 2 hours and now drop-off has become a challenge, filled with tears and begging not to go. Take a moment to reflect on how you frame questions to families about their child’s routines. Challenge yourself to think more reflectively and capture the quality of the routines.

Pulling it all together.

The benefits of delving more deeply into daily routines and activities during the development of the IFSP are numerous. Those benefits include a broader knowledge of the child’s natural environments and possible locations for services to take place in the future, capturing challenging moments in the day that might not have been reported at the initial referral, and identifying naturally-occurring routines that can be used to develop richer, more meaningful outcomes and goals for the child and family, only to name a few. Empathy and open-mindedness are useful tools that will enable you to meet a family where they are. Using those tools to gather information from families about their child and how their child fits into the daily routines of their life lends itself naturally to capturing a true picture of a child’s development and functioning that enables us to move beyond our assessment tools. Early intervention supports and services are bound to be more successful when they’re meaningful to the family and embedded naturally into the child’s daily activities and routines.

While we walk alongside a family in the direction of their rainbow, what questions can you ask to better understand how to walk a mile in their shoes?

Share your ideas in the comments below.

Kimberly Morse, MS, CFCS-HDFS, EIP, lives and works in Chesapeake, VA. She holds a BA in Psychology and MS in Child Development and Family Relations. She began working in Early Intervention for the State of North Carolina in December of 2008. She relocated with her family to Virginia in 2015 and resumed working in Early Intervention first through the Infant and Toddler Connection of Norfolk and currently through the Infant and Toddler Connection of Chesapeake. Kimberly and her husband Matthew have 2 little boys, ages 2 and 6. Days spent as their mother are filled with loving memories, a few tears, and a healthy dose of humility and perspective. Kimberly can be reached at kimberly.morse@chesapeakeibh.net.

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Logan’s annual IFSP review is underway and you are excited to celebrate his progress. You’ve been working with his family for a year so you’ve seen the steady pace at which Logan continues to develop. When he first entered early intervention, he was only two months old and doing most of the things a two-month-old needed to do. Now that he’s 14 months old, his delays appear more significant but you want his parents to remain hopeful so you and your colleagues explain the assessment results, celebrating his gains and acknowledging the next skills to come.

When the team discusses the child outcomes summary process, the service coordinator uses the Decision Tree (PDF, New Window) as a guide. Because of his age and slow but steady progress, Logan is showing very early skills when compared to his same age peers, which sounds very different from the discussion the team had last year. You want to help Logan’s parents understand why this is, but then another team members drops this question:

“So what do we think? Is Logan a 1 or a 2 now?”

“OMG,” you think, “Logan is NOT a number!” Now what do you do?

Children are Not Numbers on the Decision Tree

This is an important point that ALL team members need to understand. The discussion about the child outcomes and the Decision Tree (PDF, New Window) should never include labeling a child with a number. It should be about using the information you have to make an informed decision as a team that describes Logan’s development according to the three global child outcomes (“global” because these are outcomes we’d like to see for all children during their early childhood years).

During the meeting, the team describes the child’s development using summary statements on the Decision Tree, not numbers (see the Child Outcomes Booklet (PDF, New Window) for more info). The numbers on the Decision Tree can be thought of as categories that describe skill development related to the child outcomes – not categories of children. For example, “Category 1” includes a summary statement (or description) that tells us that Logan has “very early skills in this area. This means that [Logan] has the skills we would expect for a much younger child.” This does NOT mean that “Logan is a 1.” While the service coordinator does have to report a number for each outcome in documentation back at the office, and these numbers are referred to as “child ratings” according to the Office of Special Education Programs (OSEP), it’s a really good idea to let go of the idea that the child outcomes discussion results in a number for the child. Let. It. Go.

Here’s why: If you hold this belief, even an underlying belief in linking a child to a number, then you will convey this belief to the family. No parent wants their infant or toddler rated or numbered. It can be hard enough for a parent to hear the age equivalency scores from the assessment tool. Parents must be involved in the child outcomes discussion, and we want them to understand the process – a process that, admittedly, can be hard to explain.

The Words You Use Matter – Tips for Developing Your Script

The words you use to explain this process matter. Yes, some parents may be mentally exhausted by the time you get to this discussion, but that does not mean you should sugarcoat it, skip it, or hurry through it, which can be tempting to do. It can also be tempting to let the professional team members discuss the process without much explanation for the parent. To avoid this, try these tips:

1. Write down a sample script for how you can explain the process to all team members (including and especially the parent) without assigning the child a number, then let a colleague read it and give you feedback.
2. Read it out loud to yourself and see how it sounds.
3. Listen to how others explain the process and “borrow” their words.
4. Ask families who are already enrolled in your program what they understood about the child outcomes discussion from their initial or annual IFSP meeting.

Here’s a big one: Dig in a bit and reflect – Are you the team member who asked about a child’s “number” at an assessment or IFSP meeting? If you are, then it’s a good thing to recognize that now and commit to a change in thinking for your next assessment or IFSP meeting.

There is No Need to Pick a Number at the Meeting

How you explain the process will likely differ from your colleague’s script and that’s okay. The words you use may change a bit with each meeting depending on your style, the team with whom you work, the family’s understanding and learning needs, etc. The important point here is to think about the message you (and your team members) convey with the child outcomes process. There is no need to “pick a number” for a child during the meeting, but there is a need to be accurate, respectful, and sensitive while helping all team members understand, participate in the process, and identify summary statements to describe the child’s development.

Open the door for this discussion with your team members using the questions here, or share your thoughts by adding a comment below:

How do you explain the child outcomes discussion process to families? What are your go-to phrases to help all team members understand?

If a team member tries to pick a number at the meeting, what could you say in response?

For more information, check out these resources:

Virginia’s Child Outcomes Booklet (PDF, New Window)

Virginia’s System for Determining Child Progress (OSEP Child Outcomes)

Decision Tree Tutorial Video

The post Logan is Not a Number! – Explaining the Child Outcomes Process appeared first on Early Intervention Strategies for Success.

Alice (service coordinator) joins Jodie (therapist) on an intervention visit to see Max and his mother. When they walk into the home, Jodie reminds Max’s mother that Alice is here and says, “She’s just here to do the paperwork.” Alice keeps the smile on her face as she greets the family, but inside is cringing and thinking, “Wait, did she really just say that?!”

Ever Been in Alice’s Shoes?

Ever had a moment like this during a visit? Maybe a colleague described your job in a less-than-professional light? Or a parent introduced you to someone else in a way that left you feeling like he or she really didn’t understand what you do? Unfortunately, this is not an uncommon occurrence for many service coordinators when their team members struggle to understand their role or the importance of service coordination.

Understanding the Service Coordinator’s Role

Service coordinators are valuable team members who lead early intervention (EI) teams. They bring unique expertise to the team that is often misunderstood. It is easier to recognize how a physical therapist brings expertise about motor development or how a speech-language pathologist brings expertise in communication. We tell families all the time that they bring expertise about their child, their daily routines, and how their family works. Because the role of service coordinator is unique to EI, it can be less obvious what that role brings. Other team members may see the service coordinator as primarily a “paper-pusher” responsible for documentation and getting forms signed. (In fact, many service coordinators have reported this.) Or, perhaps, families may see the service coordinator as the voice on the phone who calls each month to ask how things are going. If that is all they see or hear, then you can undersatnd how it can be hard to really understand the role of a service coordinator and the value in this work. Because the service coordinator role is less familiar, it’s really important for program supervisors, and service coordinators themselves, to help others understand what they do.

Tips for Helping Others Understand the Value of Your Role

Make Sure YOU Know Your Own Value – If you are a service coordinator, make sure you can articulate what you bring to the team. Write it down. Come up with a phrase you can use when faced with situations like the one described above. Embrace your role and its importance. What you think about yourself will shine through, especially when you first meet parents (PDF, New Window) and other team members. Here’s how Alice explained her role when she first met Max’s family:

Example: I’m your service coordinator, which means I am the person who will guide you through the early intervention process. I’m also a resource for you when you want to learn about what’s available in the community to help you and your child. I make sure that your EI services are addressing what’s important to you. I’ll check in regularly to see how things are going and I’m here for you to ask questions anytime.

If you’re the supervisor, make sure you can explain the roles of all of your staff and that you educate new staff, contractors, and community partners so they understand the value of all team members.

Explain Your Role Using the Three Family Outcomes – I heard this tip on a service coordination webinar and it’s a great one. Describe your role to families and others in terms of the three Office of Special Education (OSEP) family outcomes, which include helping families: 1) know their rights; 2) effectively communicate their child’s needs; and 3) help their child develop and learn. Here’s another example of how Alice could explain her role using the family outcomes:

Example: It’s my job to make sure you are aware of your rights as a parent involved in our program. I am also here to help you communicate with the rest of the team anything you want to share, including what you think your child and family need, what’s important to you, and what you would like to accomplish by being in our program. We will work together, with other members of your EI team, to make sure you are learning ways to encourage your child’s development throughout the day.

Speak Up and Share Your Value – Don’t be afraid to speak up and share your value. Try not to take it personally when someone incorrectly explains what you do; most likely, the jab was unintentional. If you find yourself in Alice’s shoes, speak up! Use a friendly, professional tone of voice and remind the provider and family of what you do. When you speak up, you educate everyone present, which can be a wonderful thing. Here’s what Alice could say in this situation:

Example: Yes, we do have some paperwork to do but I’m here for more than that. I’m looking forward to seeing how Max is doing with learning to sit up on his own. I also love seeing how physical therapy is going and talking with you both about any updates or changes needed to Max’s IFSP. I’m responsible for making sure that EI services are working for your family and that you are getting what you and Max need. If there are any questions, I’m here to help with that too.

Show Your Value – This is an important one. Demonstrate the value you bring to the team, to the visit, and to any interactions with the family and other team members. Be fully present when joining visits. Get involved, share ideas, make observations, and offer feedback. This always needs to be balanced with avoiding “taking over” or disrupting the visit, but you have valuable insight to share. You know about child development too. You are an expert in the EI process. You demonstrate your value when you actively participate, guide the EI team, and do what you say you will do, meaning that you follow through on your commitments. What you do, as well as what you say, shapes what others know about your work!

How do you share and show your value as a service coordinator?

How would you handle the situation described above? What would you do or say to help your team members understand your role?

Share you insights in the comments below!

Check out these two videos about the importance of service coordination:

How Service Coordinators Support Service Providers

The Importance of Service Coordination

The post Service Coordinators: Speak Up and Share Your Value! appeared first on Early Intervention Strategies for Success.

Transition is a hefty topic here in Virginia, and I bet it’s probably a hefty topic in other states as well. Transition, and all of the requirements that go along with it, can be overwhelming to all members of the IFSP team. In VA, we often hear from service coordinators that transition is hard – hard to remember all of the steps involved, hard to complete the documentation accurately, hard to manage timelines, and hard to collaborate with receiving programs. For service providers (and service coordinators too), it can be hard to let families go. For families, transition can be a scary time of moving from the known to the unknown and learning to trust someone new with their child. Despite the challenges, we hope that in the end, transition is smooth and results in children and families moving to the next environment where they will be supported and successful.

That all sounds great, but how do you do it? What does smooth and successful transition look like?

A Flexible and Focused Journey

Answering those questions is tricky because transition should be an individualized process. It should be flexible but focused, with the journey being as important as the destination. We often think of transition as the journey from Part C early intervention (EI) to Part B early childhood special education preschool services. The DEC Recommended Practices on transition remind us to think more broadly. Transition in EI includes any change in environment, such as a preemie’s move from the NICU to home or a two year old’s move from home-based EI services to classroom-based preschool under Part B, Early Head Start, a local church preschool, or child care center.

DEC Recommended Practices: Transition

Transition often represents a big change for the family, so what we, as EI practitioners, do before, during, and after that change really matters. Let’s consider the two recommended practices and how what you do impacts what successful transition looks like.

TR1. Practitioners in sending and receiving programs exchange information before, during, and after transition about practices most likely to support the child’s successful adjustment and positive outcomes.

As we see in this practice, it matters what we do before, during, and after the journey:

Before transition: Exchanging information when preparing for transition might look like a service coordinator sharing the IFSP and evaluation information with the receiving program (with parent permission) at the point of referral. It might look like the parent sharing a homemade booklet about her child with the IEP team so they can learn who her child really is. 

During transition: Imagine the speech therapist from the EI program talking with the receiving preschool teacher about how best to support the child’s communication starting the first day of school. Or, the EI physical therapist (PT) working closely with the receiving program’s PT to ensure the new program has the appropriate equipment so the child has the stability he needs to participate in group activities. 

After transition: Even though the child will be discharged from the EI program just before transition, wouldn’t it be great if the receiving program staff could still reach out to the EI practitioners with questions about how to help the child adjust to the new environment? Similarly, the EI staff could reach out to the family to check in on the child’s adjustment and offer support, even just over the phone. Staying in touch, even though the child is no longer receiving EI services, would be a wonderful way to facilitate that seamless transition. 

TR2. Practitioners use a variety of planned and timely strategies with the child and family before, during, and after the transition to support successful adjustment and positive outcomes for both the child and family.

Implementing this practice reminds us that transition should be well-planned and coordinated. For a service coordinator, this might look like closely monitoring required timelines for Part B referral, which in Virginia includes referring children by April 1st (or earlier in some localities) to ensure that eligible children start preschool the first day of the next school year. Service coordinators also ensure that transition planning occurs at least 90 days but not more than 9 months prior to the anticipated date of transition. Transition conferences are held so families can learn about their options and plan accordingly.

During the transition process, the service coordinator and other providers can help families prepare and provide needed information to the receiving programs (such as proof of residency). They may attend eligibility or IEP meetings with families for support. Service coordinators and providers can check in regularly with families about the process, answer questions, and link families with other parents who have been through the process. 

Providers can help children and families prepare for the new environment by working together on outcomes to help the child be successful. Examples of this could include teaching the child to use an AAC device to communicate more clearly with others, helping the child learn to use a gait trainer to maneuver around obstacles in a busy setting, assisting the parent in finding opportunities for the child to learn to play near other children, or encouraging the family to teach the child to hang up a jacket, carry his backpack, or help clean up after lunch. 

What transition looks like and how the journey unfolds will be different for each child and family. What we do, as EI practitioners, before, during, and after transition can help make sure the process is a positive one that prepares children (and their parents) to be successful wherever they go next.

What is one of the most important things you can do to help families prepare for transition?

How do you support families during and after transition? 

Share how you implement the transition practices in the comments below!

To read more about how to implement other DEC Recommended Practices, be sure to check out the rest of this series by searching for “DEC Recommended Practices” using the search feature at the top of the page.

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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!

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