Maybe you’ve felt this before…you are on a visit and it’s the parent’s turn to practice using an intervention strategy. Perhaps you just modeled it, or you and the parent came up with an idea and want to give it a try. When you ask the parent if she’d like to try it, she averts her gaze and answers “I guess so,” with an uncomfortable look on her face. Perhaps when the parent tries to engage her child, you sense her discomfort then too. In turn, you feel uncomfortable and wonder…what do I do?

Early intervention is all about building a parent’s capacity to facilitate her child’s development. In the best case scenario, the parent is eager to learn, confident with engaging her child, and interested in trying new things. In the worst case scenario, the parent doesn’t even want you in the home. In reality, most parents are somewhere in between, on a looooong continuum of parent-child engagement, comfort level, interest and readiness.

5 Strategies for Responding to Discomfort

As an early interventionist, you work hard to build rapport and trust and get to know the family in a way that lays the foundation for how you’ll work together. Again, that’s easier sometimes than others. A key aspect of getting to know families really involves being responsive – responsive to their needs, interests, priorities, and feelings. Responsivity is a critical skill to use in the situation described above.

Here are 5 responsive strategies to help you manage discomfort:

Acknowledge what you sense – Ask the parent how she feels as soon as you sense discomfort. Be specific: “I’m wondering if you’re feeling a little uncomfortable?” or “How do you feel about using that strategy?” You could be wrong about what you sense, but you won’t know until you ask. Let her know that how she feels is okay and that she can decide whether or not to proceed – give her the choice.

Ask her how that felt – After trying the strategy, check in again. Be specific: “How comfortable are you with that strategy? How did that feel? What did you think about that?” Be responsive to her answer and make it safe for her to be honest. Don’t insist on using a strategy just because you think it’s a good one. If a parent feels uncomfortable, she’s less likely to use that strategy when you aren’t there.

Ask if she would like to do something differently – Invite the parent’s input and problem-solve together. Maybe she has an idea of how to tweak the strategy or situation to make it easier or more comfortable. Flexibility is a hallmark of good early intervention.

Try to build on what she and her child already do – Before even introducing a new strategy, find out what they already do or have already tried. Observe the parent and child first doing what they naturally do. Model the strategy first, if that helps the parent. Brainstorm how the strategy might be used during the activity, then coach the parent in how to use it during a familiar interaction. Seize the opportunities as they happen and be sure to provide feedback when the parent uses the strategy successfully. Remember your role as a facilitator of the parent’s learning too.

Step back, reassess, and consider options – Sometimes you and the parent have to try a strategy to figure out it’s not the right one. Use the conversation to help you reassess whether or not the strategy is appropriate for the child, parent, and situation. If it is and the parent is okay, then proceed. If not, step back and reassess. There is always another route to the outcome so be open to it.

How Much Discomfort is Okay?

Now, this raises the question of how much discomfort is acceptable? To me, the answer lies in your conversations with families. EI can push parents out of their comfort zone as they learn to use new strategies with their children. It can be uncomfortable to try something new with an unpredictable toddler in front of someone who is perceived as having expertise. The trick here is to have the courage to acknowledge the discomfort and talk about it so you and the parent can figure out what to do next. Options might include tweaking the strategy, modeling it again for the parent, trying it again a few times, letting the parent try it between visits on her own, or simply ditching the strategy all together…and all of these options are okay. Being responsive to what the parent is feeling will help you know what to do next.

What do you do when a parent seems uncomfortable? 

Share your experiences and strategies in the comments below!

The post The Parent Seems Uncomfortable…What Do You Do? appeared first on Early Intervention Strategies for Success.

Pop Quiz: What is the activity that families report in the literature as the most helpful thing that happens on EI visits?

Answer: Problem-solving

Are you surprised? It makes so much sense when you think about how much you talk with families about their challenges – teaching the 18 month old to sit in the grocery chart, understanding a toddler who uses elaborate jargon and no true words, helping an infant feed without aspiration, etc. Being a resource for families is an important part of what we do. However, being a resource does NOT mean that we have all of the answers. Giving answers isn’t the same thing as problem-solving.

Consider this Scenario

Jason asks Camilla (the occupational therapist) how to help his daughter, Breanna, eat a wider variety of foods. Right now, all she will eat is macaroni and cheese and Pringles chips. Camilla suggests that Jason start offering an unfamiliar food along with Branna’s favorites at each meal to expose her to different foods and maybe offer a cheesy dipping sauce since she likes mac and cheese. She also says that she will bring a great handout with some ideas to her next visit. Then, they return to working on Camilla’s ability to use a spoon to feed herself.

Clearly, Camilla did not do any problem-solving here. She spouted a few general suggestions and promised a handout without any idea of what Jason has already tried, why this was important to him, or how he envisioned success. Problem-solving with Jason would require much more effort and attention to what is unique about Jason’s and Breanna’s situation. It requires flexibility to allow the activity of an intervention visit to veer away from what was planned, to go where the family needs it to go. It also requires that Camilla step out of her standard answers and dig deeper into what the parent needs. These are not always easy for service providers (or service coordinators, who often find themselves in similar situations when asked for resources or to help out in a crisis).

Tips for Collaborative Problem-Solving

Collaborative problem-solving is a reciprocal process that focuses on a real situation for a child and family. Whenever possible, it works best when it happens in the moment, rather than by discussing a hypothetical situation. For instance, the service provider observes a challenging situation with the parent and child, then the parent and provider problem-solve together about how to improve it. Here are a few strategies for problem-solving with families:

Ask for the parent’s perspective first – Ask the parent “What did you think about that?” or “How did that feel to you?” Another good idea would be to ask the parent what he has already tried. This reinforces the importance of the parent’s perspective on solving the problem and gives you valuable information.

Find out the parent’s goal – A great next question would be “If this situation was better, what would that look like to you?” Again, find out what the parent’s goal is for improving the situation because it may be different from yours. Then, ask “What could be done differently here to get closer to that goal?” Let the parent think a bit before offering suggestions.

Offer suggestions if needed – Many of us skip straight to this step because we have so many child development strategies floating around in our heads. Collaborative problem-solving involves helping the parent solve his own problem, with your support. If you just give general suggestions, I guarantee that most of them will bounce right off the parent because they won’t be obvious to him how he can use them. Taking the first three steps first will help you link the right solution to the actual goal. Just be careful to avoid the “have you tried…?” trap.

Be specific, especially when the parent lacks the experience to offer a solution – Parents are great problem-solvers, but when they ask for your help, they often really need it. This doesn’t mean you have to spout answers, though. Offer information, maybe a choice of possible strategies, then let the parent decide what to try.

Let the parent decide – Let him choose how to solve the problem, then let him try out his choice with your support nearby. Coach him through using the strategy if needed, then reflect on the success of the strategy together.

Loop back to the original goal – This is an easy step to forget. Once the parent has a plan, wrap back around to the original challenge by asking if the parent feels that this plan will address his goal for the situation. If not, work through it some more. If yes, write it down with the parent so he has a record of the steps to solve the problem. This will help him remember what to do between visits when you aren’t there.

Follow-up on your next visit – Always.

Instead of telling Jason what to do, Camille may have been more helpful had she taken the time to explore Jason’s question more fully. Then, she would have learned that he had already tried offering other foods but Breanna seems to choke on anything chunky like meats. He’s also noticed that she gags really easily and seems to have a hard time moving food around in her mouth. The solutions to this problem are unlikely to be found by simply offering more foods or dipping sauce or reading a handout.

When a challenge surfaces, seize the opportunity to collaboratively problem-solve with the parent. It’s in this problem-solving that we can make such a big difference in the quality of life for a child and family.

If you were Camille, what would you do next?

What challenges do you face with trying to help families problem-solve?

What’s your biggest problem-solving success story?

Share your ideas and experiences in the comments below!

Reference

Woods, J. J., & Lindeman, D. P. (2008). Gathering and giving information with families. Infants & Young Children, 21(4), 272-284. (PDF, New Window)

The post The Value of Collaborative Problem-Solving appeared first on Early Intervention Strategies for Success.

Imagine you are the parent who’s child is newly referred to early intervention (EI). Someone calls you and asks to come by your home. “Why,” you wonder, “do they want to come here?” Then, when the service coordinator arrives for the intake, she asks you personal questions about your child’s medical history and your family finances. “Why do you need to know about my income?” you ask. The assessment is held and they say your child can’t stand on one foot or dump pegs from a bottle. You think, “So what? He’s never had a reason to before.” You’re exhausted but the group plows on and asks you about your goals for your child and what services you’re interested in. “I’m not sure, what do you think?” you ask, while wondering why they are asking you when they are supposed to be the experts. So many questions…it’s all overwhelming and puzzling. And then the therapist comes out for the first visit, and asks you more questions about your daily routines. Maybe if you understood why all these questions were important, you would know how to answer them…

Sure, this might be an exaggeration and some families might not feel this way at all. However, really try to put yourself in this parent’s shoes. If he or she has no previous experience with EI, all of these questions could seem like an intrusion. It’s easy for us (as early interventionists) to plow through these first visits because we know why we need the information and this is our world. Imagine for a moment what it must be like for a new parent, probably in a vulnerable position, to walk into this world and get asked so many questions.

Now consider – what can you do to make this easier for the parent?

ALWAYS Explain Why

Adults naturally need to understand why something is happening, why it’s important, why it matters. Not knowing can be a barrier to developing the relationship with the family so start off on the right track with building understanding. Remember that most parents have never been a part of a system like EI and you are there as a guide. Take a few extra moments before you ask questions or share information to explain why it is important and how the information is relevant to each step in the EI process. For example, rather than starting the conversation with “What are your goals for your child?” (which can really put some parents on the spot), start with an explanation such as “One of the things we do when we are writing the Individualized Family Service Plan, or IFSP, is talk about what you would like to see your child learn to do. We call these goals because they will help us understand what you’d like to get out of early intervention. The goals also help us figure out how to help you and which service provider might be best to come work with you. When you think about  your child’s development, what would you like to see him be able to do in the next few months?” Sure, it takes longer but it helps the parent understand why the question and answers are important. It also encourages her active participation and decision making , which is key for a successful EI partnership.

Have a Conversation – not an Interview

Parents in EI should never feel like they are being interviewed. Everything we need to know can be gathered from a rich, engaging conversation. No matter how much paperwork you have to complete or how many questions are on your intake form, take the time to have a conversation and I bet you’ll learn all about the family’s priorities, concerns, resources, outcomes, and interests. Use open-ended questions, and follow them with feedback that lets the family know you’re listening. Dig deeper and listen for key information…then maybe you won’t have to ask so many questions.

Read the Situation and Adapt

Some parents will be ready to go – sharing information and freely asking and answering questions. For others, they might need to go a little slower and absorb what is happening at their own pace. Be mindful of where the parent is in the moment. You might have to make more than one visit to complete the intake. You might have to schedule the IFSP meeting at a different time because the parent has had enough with the assessment. Yes, we have our timelines, but our family-centered practices are important too. If the parent needs more time, or opts out of sharing something, that’s okay. Be sure to let the parent know that too and then document their decision. Afterall, we do this job to support them. It’s their IFSP and their EI experience. Let’s make it a great one.

What strategies would you add to this list?

How do you avoid overwhelming parents with too much information and too many questions at the intake, assessment, IFSP meeting, or the first service visit?

Share you great ideas in the comments below!

The post Explaining WHY We Ask So Many Questions appeared first on Early Intervention Strategies for Success.

In your busy day, there’s often very little time to stop and really think about what you’re doing. Instead, you just “do” what needs to be done. In Virginia, and in many states, early interventionists (EIs) are working very hard to adopt coaching practices as a means of interacting with families. When you do stop to think about it, you may think, yes, I use coaching all the time. Or, you may think that you’re trying very hard to coach but find that some coaching strategies are easier to use than others. Research is emerging that is seeking to find out which coaching practices early interventionists are actually using. There are some interesting trends that may give you pause as you consider your own work with children and families.

Source: Salisbury, C., Cambray-Engstrom, E., & Woods, J. (2012). Providers’ reported and actual use of coaching strategies in natural environments. Topics in Early Childhood Special Education, 32(2), 88-98.

Research: What Do We Know?

Salisbury, Cambray-Engstrom, and Woods (2012) conducted a small study of six early interventionists in one state. These interventionists had been receiving professional development in the Family Guided Routines-based Intervention (FGRBI) approach for over two years.  The FGRBI approach describes a group of coaching strategies that include: conversation/information sharing, observation, problem-solving and planning, demonstration, joint interaction, caregiver practice with feedback, guided practice with feedback, and direct teaching. These strategies are used by EIs during visits with families to promote development during targeted routines and activities. To determine how much these providers were using the FGRBI coaching strategies, the authors coded 90 videos of intervention visits that occurred over a 4-month time frame. They also analyzed contact notes for each visit to determine whether there was a match between the coaching strategies described in the notes and those that were actually used.

Interestingly, the authors found that the coaching strategies used most were conversation and information sharing and engaging in joint interactions with the family. The strategy used least often across providers was problem-solving with the family, which was used in less than 1% of the intervals coded from the videos (researchers looked for these strategies to occur during each 30-second interval of time). About 20% of intervention visit time was spent with the provider interacting with the parent and child using strategies such as direct teaching, demonstration, caregiver/guided practice with feedback, and observation. Overall, providers used a range of coaching strategies but tended to under report the specific strategies they used when describing the visit in a contact note.

The authors noted that the practices the providers used most often were those that placed the flow of information from themselves to the parent, rather than placing the parent in more of a leadership role. This group of providers used coaching strategies more frequently than what has been reported in other studies, perhaps because this group had received extensive training. Even so, the use of the strategies was still limited, which the authors interpreted to mean that shifting to use caregiver coaching can be challenging, even for well-trained EIs.

Practice: How Can You Use What You Know?

Because the study sample was so small, we really can’t generalize these results to the larger EI population. However, a provider or a program can reflect on these results to see if there are similarities with their own experience. Here are a few ways you can use what you’ve learned:

Consider how much problem-solving you actually do with families – This is the most interesting finding to me and has been confirmed in a few other articles too. Families have also said that the most valuable thing that happens on EI visits is problem-solving with the provider. Yet, it appears that we don’t do it very often. On your next 3 visits, pay attention to how you respond when the parent mentions a problem. Do you immediately offer suggestions, or do you take the time to help the parent problem-solve a solution that works for her?

Consider sharing leadership during a visit – Who leads most of the activities of the visit? Who leads the interactions with the child – you or the parent? If you find that the answer to both of these questions is YOU most of the time, then use this insight as an opportunity to look for ways to share leadership. As often as possible, step back and let the parent lead, with you in a supportive role.

Be intentional in facilitating the parent’s practice (with the child), problem-solving, reflection, and feedback – Sharing leadership means that you are supporting the parent as she practices using  strategies with the child, reflects on the experience, gives and receives feedback, and problem-solves to plan for how to use the strategy between visits. Look for opportunities at EACH visit to use these specific coaching strategies because they directly support the parent’s learning.

Be sure you capture all that you do in the contact note – You’ve heard it before: if it’s not written down, it didn’t happen. You have limited time to get your notes done, but use that time to accurately capture the variety of coaching strategies you use. Be specific and use the language of coaching to describe your interactions with families.

Which coaching strategies do you think you use most frequently? Which do you need to target to use more often? 

What do you think contributes to how much problem-solving occurs during visits?

Share your insights and experiences in the comments below!

Want to know more about the FGRBI approach? Check out the FGRBI website for information, tools, and videos!

The post EI Research to Practice Brief #5: Which Coaching Strategies Do We Really Use? appeared first on Early Intervention Strategies for Success.

In Virginia, we’ve spent the past few years working hard to learn about and adopt coaching practices. Six regions in our state have completed two levels of coaching training for master coaches and coaching teams. In total, 84 Master Coaches and 278 coaching team members participated in training and follow-up technical assistance with the coaching gurus, Dr. Dathan Rush and Dr. M’Lisa Shelden. We’ve seen impressive regional efforts blossom, led by master coaches and team members who are dedicated to using coaching when interacting with families. Now, we are in a phase of trying to figure out how to sustain this effort, to continue the learning and growth that began, for us, back in 2012.

You Asked For It…

Over the past few years, we’ve repeatedly heard from master coaches and supervisors that they just weren’t sure how to support their colleagues and staff to continuing their coaching work. Folks were concerned that service providers were sliding back into their old ways – playing with the child for the whole visit, giving the parent homework, etc. They asked for more support, PowerPoints or something that they could use in their local programs or regions to keep coaching fresh and continue the learning process. From those discussions, we decided to put together a guide to help these local leaders do just that.

We convened a small workgroup of master coaches who met monthly to brainstorm professional development activities that could be easily implemented as a book study to extend the learning from The Early Childhood Coaching Handbook (Rush & Shelden, 2011). This work culminated in our newest resource, Virginia’s Coaching Facilitation Guide (PDF, New Window). The guide is now posted on the Coaching in Early Intervention topic page on the Virginia Early Intervention Professional Development Center site. Soon, a PowerPoint will also be posted that can be used to provide an orientation to coaching practices for new service providers.

And Here It Is…Virginia’s Coaching Facilitation Guide

The Coaching Facilitation Guide is intended to be used by master coaches and program leaders to facilitate discussion at regular meetings about the use of coaching during EI visits. These could be staff meetings, regional provider meetings, or even at a local community of practice. If your program doesn’t have one of these meetings currently scheduled, you could use the guide to get a regular coaching group meeting off the ground. Or, you could plan to do one activity at a meeting that is already on the books. How you use the guide is up to you!

Here’s a quick peek at the Coaching Facilitation Guide’s contents:

• Introduction and Facilitation Tips
• Section 1 – What is Coaching in Early Intervention?
• Section 2 – Characteristics & Beliefs of EI Practitioners Who Use Coaching
• Section 3 – Interacting with Parents & Caregivers
• Section 4 – Implementing the Components of Coaching during EI Visits
• Section 5 – Coaching Families & Caregivers in Special Situations
• Conclusion

Each section has from 3-9 activities, each of which include specific instructions (including the purpose of the activity, materials needed, length of time, and steps to facilitate the activity), links, handouts, and answer keys. Guidance for what to do before, during, and at the end of each meeting during which you use the activities is also provided. Most of these activities have been piloted at regional coaching groups and edited based on user feedback.

The Coaching Facilitation Guide is free to use, and we would love to hear how you’re using it. We want to know about successes and challenges; any feedback is always welcome. We hope the Guide will help you and your staff avoid the backslide into old practices and extend the coaching work in your program and across the state!

Implementation Project – Get Involved!

We are just beginning an implementation project to support the use of the Coaching Facilitation Guide in Virginia. The project will include 6 months of online implementation support for local leaders who are using the guide in their localities. Local coaching leaders will be meet online 1x/month to discuss related topics for each section of the Guide, process their experiences with using it, and plan for how to use each section with their staff/colleagues. We are currently recruiting Virginia leaders by October 16th who are able to commit to the 6 month support. If you’re interested, please either comment below or email me at dcchildress@vcu.edu.

Questions? Ideas? Thoughts about how you can use the guide in your program?

Let me know in the comments below!

For more detailed information about Virginia’s Coaching Facilitation Guide (PDF, New Window) and the implementation project, check out the archived webinar, 3…2…1…Blast Off! – Launching Virginia’s Coaching Facilitation Guide.

The post VA’s Coaching Facilitation Guide – A New Tool for Local Coaching Leaders appeared first on Early Intervention Strategies for Success.

Have you ever taken a yoga or dance class? If you haven’t, let me tell you about my experiences. In either class, I’ve always found myself in a big room in front of wall-sized mirrors facing an instructor. While soft music played, the teacher would call out the names of poses I was supposed to imitate. I’d try my hardest to get my body to cooperate, and found myself struggling with new poses that I’d never done before. I’d do my best to copy the instructor or even the person next to me (while praying I kept my balance). As far as I could tell, I was doing pretty well. It was only when the teacher came over and gently helped me hold my arm in the right position or reminded me to straighten my back that I really knew where I was in space and whether I was doing the pose correctly. With feedback on my performance, I was able to improve on what I was doing. Without feedback, I might have never figured out how to really do a grand plié because watching someone else only went so far. I needed to try the pose out myself, experience it, adapt it to what my muscles could do, and receive feedback from someone who knew about it. That feedback was an integral part of my learning. (Could I do a grand plié now without falling over…well, that’s another story… 🙂 )

Adult Learning Principle #5 – Feedback is How We Grow

Just like with ballet or yoga, adults who are learning something new need feedback on their learning and performance. Feedback is like a barometer we use to help us know whether or not we have understood something accurately or whether we are performing a new skill as intended. Without feedback, we only have our own perspective, which isn’t always accurate. While we may not always like the feedback we receive, we typically crave knowing if we are on the right track.

Feedback can come in different forms. It can be physical, as when a OT uses hand-over-hand guidance to help a father position a child for safe feeding. It is most often verbal, as when the SLP points out that the way the child care provider modeled the sign for “cow” beside the picture of the cow will really help the toddler understand what the sign means. Feedback might only come from the interventionist or from the caregiver, but is often more beneficial when it is a reciprocal, reflective process between both adults.

How Can We Use This Principle?

Ask for permission to provide feedback – As you talk with families about how EI works, encourage them to share their feedback and let them know that you will do the same. When you need to provide feedback, ask for permission first until you have developed a relationship where you can move into feedback easily.

Invite the parent’s feedback first – Ask the parent what she thinks about what she just did with her child – how it felt, what worked, what didn’t work, what she’d like to do next time – before you provide feedback. Inviting her to share first is probably more powerful because it facilitates her own reflection, which we know is so important for adult learning.

Be specific – Always use specific descriptors when sharing feedback. Rather than saying “you did a great job!,” specifically describe what went well and how you know it went well. If the parent’s use of an intervention strategy had a positive effect on the child, first ask the parent what she noticed about the child’s reaction. Then, you can share your observations as feedback; you might say something like “when you supported him at his hips, he was able to bear weight on his flat feet for longer this time.”

Be honest, positive and constructive – Feedback won’t always be an affirmation, but it can still be positive and helpful. Adult learners typically appreciate your honesty, and I think parents are really good at knowing when we aren’t being honest or when we’re uncomfortable. Be mindful of the verbal and body language you use and remember to convey your feedback in a way that supports the parent’s learning. Instead of “You didn’t support his head correctly” you could say “Did you notice how his head feel back? Let’s try again but this time, see if you can pick up him with your hand under his neck to keep his head up.”

Consider Two Examples

During Lacey’s visit, she coaches Michelle in how to help Tommy learn to roll over. She models how to hold a toy just out of Tommy’s reach while moving it around past his ear. She also shows Michelle how to place her hand on Tommy’s hip to guide him in rolling over. She suggests that Michelle watch what Tommy’s body does and how he shifts his weight during rolling. When it’s Michelle’s turn, Lacey notices that Michelle moves the toy very quickly and helps Tommy roll so much that he really doesn’t have to work at all.

Example #1: Lacey tells Michelle, “You really need to move the toy slower and let him help you with rolling. Let me show you again.” Lacey models again hoping Michelle will see how to do it this time. Michelle feels like Lacey thinks she isn’t listening or watching but she is.

Example #2: Before providing feedback, Lacey wants to see what Michelle thinks so she asks “How did you think that went?” Michelle responds that she thinks she did everything a little too fast because Tommy didn’t roll on his own at all. She wants to try again but isn’t sure how slow to go. Lacey said that she noticed the same thing. Michelle tries again and says that it’s too hard to move the toy and move Tommy’s hip at the same time. Lacey asks her which one she’s like to learn to do first. Since Michelle wants to learn to move Tommy’s hip, Lacey offers to move the toy. They work together, going slowly, until Michelle gets the hang of how to help Tommy move. Once she’s got it, she tries to move the toy too and gets excited when he rolls onto his belly for her.

When you use coaching, action/practice, reflection, and feedback are all often intertwined. When you share feedback, it’s often a means of sharing your expertise and facilitating reflection while wrapping it around the current practice activity. On your next visit, pay attention to how you share feedback and how the caregiver receives it. Also, reflect on how you receive the caregiver’s feedback – are you open to feedback about the strategies you suggest? Remember that feedback helps all of us grow so how you share it – and how you receive it – really matter!

As you can see in Example #2, Lacey welcomed Michelle’s feedback and made it safe for her to share her perspective. Lacey also responded to Michelle’s feedback by making it “okay” that she learn each step separately. Lacey didn’t have to share much direct feedback in this example because Michelle’s reflection did that for her.

Had Michelle not noticed that she was going too fast, what could Lacey do? How could she have shared feedback in a positive, constructive manner?

Don’t miss the rest of the posts in this series:

Adult Learning Principle #1: Making Intervention Immediately Relevant

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

Adult Learning Principle #3: Active Practice and Participation are Key!

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

The post Adult Learning Principle #5 – Feedback is How We Grow appeared first on Early Intervention Strategies for Success.

Lynn meets Devon and his mother, Janae, at the grocery store for their visit this week. When she arrives, she finds them trying to walk into the store. They are struggling because Devon is having a tantrum and Janae is trying to carry him while he kicks and screams. Lynn goes up to them and asks if she can help. Janae puts Devon down and says she doesn’t know what to do. She reminds Lynn that this is why they decided to meet at the store, so that Lynn could help with this problem. Lynn asks if she can try something, and Janae agrees. Lynn takes Devon’s hand and plays a game with him, pretending to be tigers, rabbits, and birds trying to get across the parking lot. Janae follows them and says “I wish you could come to the store with us every week because he won’t do that for me.”

Is the Problem Solved?

Lynn has had the awesome opportunity to observe a natural routine for Devon and his mother. Rather than just hearing about the struggles walking in to the grocery store, she has wisely scheduled to join the family during their weekly trip. Rather than sitting back at the family’s home and spouting out tons of “have you tried…?” ideas, she is able to problem-solve with Janae in the moment. Lynn is able to get Devon into the store without a tantrum, so…is the problem solved?

No, not by a long shot.

Lynn demonstrated a technique that involved playfully distracting Devon during an activity that he doesn’t like or typically cooperate in. She was successful at dodging the typical tantrum, but it really doesn’t matter because she won’t be there the next time the family goes to the store. She is probably assuming that Janae watched her and would pick up how to play the games she played with Devon. From Janae’s comment, though, you can get a sense that she watched, but she doesn’t think she can do it. If that’s what Janae feels, then Lynn’s modeling did not accomplish the real goal, which was to help Janae learn ways to get Devon into the store without a tantrum.

If we just rely on modeling or demonstration for families, we are not very likely to truly build the parent’s capacity to manage similar real-life situations in the future. In fact, it could have a detrimental effect because the parent could see someone else being successful when she herself cannot. Without a more intentional approach to supporting the Janae’s learning, Lynn could do more harm than good.

Three Ways to Use Modeling to Support Parent Learning

Let’s consider how Lynn could wrap the following three steps around her modeling to better support Janae’s learning. Here’s the same situation, but with Lynn more actively helping Janae participate in her son’s success:

Model with Intention – Before trying her strategies with Devon, Lynn asks Janae to watch for what she (Lynn) does to distract Devon and make the trip into the store fun for him. She also asks Janae to watch Devon’s reaction.

Model with Narrative – While playing the pretending game with Devon, Lynn narrates what she is doing for Janae. She says she’s trying to make the walk more enjoyable as a way to help Devon learn that the trip into the store can be fun.

Model with Reflection – After they get about half way to the store, Lynn asks Janae what she observed so far. They talk about Devon’s different reaction and why he didn’t tantrum. They reflect on the specific activities Lynn used and which of those Janae wants to try.

After modeling, it’s ALWAYS good to remember to hand the reins over the parent. Giving the parent the opportunity to try what she has just observed and make that strategy her own is really when the learning happens!

Here’s what happened next for Lynn and Janae:

After establishing a few specific strategies that might work for Janae, Lynn steps back and Janae takes Devon’s hand. He starts to squirm and fuss but Janae says “Let’s jump like a kangaroo into the store!” and takes Devon’s hands to help him jump. When they reach the entrance, they stop and reflect about how that went. Devon made it into the store with his mom without incident. Success!

Consider, though, who is responsible for Devon’s success? At this point, both Lynn and Janae are, but Janae feels more capable because she has experienced her own ability to use the strategy. She is more likely to own this new strategy now. When the strategy becomes hers, and she’s able to use it when Lynn isn’t there for support – that’s when they’ll know that intervention worked!

How have you used modeling to support caregiver learning? 

For those of you who are using coaching interactions with families, what could Lynn have done differently before and after her modeling to make this activity even more successful?

Share your insights about how we can improve this interaction in the comments below!

The post Watch Me! – Using Modeling as a Caregiver Teaching Tool appeared first on Early Intervention Strategies for Success.

Think about it. How did you learn to drive? Sure, you read the driving manual, went to a driver’s ed class, and you probably talked about driving a lot. Before getting behind the wheel, you’d observed people driving for years. Was reading, talking about the new skill, and observing someone doing it enough to prepare you for using what you learned? No way! You really learned to drive by getting behind the wheel and practicing it…with the real-time support of the (possibly terrified) adult in the passenger seat!

Keep this in mind: Adults learn and remember best when what they are learning is practiced in real-time and in the context in which the new knowledge or skill will be used.

You learned to drive by driving. Parents in early intervention (EI) are much more likely to learn and remember how to interact with their children in developmentally enhancing ways by doing it – by trying out strategies and problem-solving in real-time, during the activities that they do everyday. The adult who taught you to drive would’ve been minimally helpful sitting on the sidelines continuing to talk about what you should be doing. Same goes for an EI service provider. We’re going to be much more successful achieving the mission of early intervention, which is to enhance the family’s capacity to meet their child’s needs, when we get in there, ride beside the parent, and work together with the child.

How Can We Use This Principle?

Join In – Rather than just talking about family activities, ask if you can join them. Explain this principle and get the family’s permission to practice strategies in real-time. If the parent mentions an activity that doesn’t usually happen during the visit, plan to come when it happens next time.

Step Back – Be careful that your “joining in” doesn’t look like “taking over.” Step back, observe things usually work, then coach the parent to think about how to embed an intervention strategy in the activity. You will build the parent’s capacity much more successfully if she has a chance to think about what she’s doing first.

Model if you must – If the parent really needs to see you use the strategy first, that’s fine. Be sure to ask for permission to model and tell the parent what you are doing and what to watch for. Then step back and let her practice. Remember that a key to her learning is HER practicing, not just her watching you practice.

Make room for mistakes – Just like when I ran over a painter’s bucket and broke the fan under my dad’s station wagon when I was learning to drive (yes, that actually happened), give the parent permission to goof up. Making mistakes while practicing is normal and necessary. This also helps prepare the parent for having to adjust how she uses the strategy when you aren’t there. Believe me, I never ran over another bucket again.

Consider Two Examples:

Example #1: Jayne, Liam’s mother, describes how hard it is for her to get him dressed. Liam screams, twists and turns, and has even begun to run away when she mentions getting dressed. Some days, they both end up exhausted and in tears, and other days, they just don’t go anywhere because Jayne doesn’t want to fight the battle. Tristan, the occupational therapist, asks Jayne if she’s tried having Liam wear tagless clothing. When Jayne replies that all of Liam’s clothing is tagless, Tristan asks if she’s tried letting Liam dress himself. Jayne says that he’d probably just stay in his training pants all day. Tristan continues to make suggestions, but Jayne has either already tried them or doesn’t think they’ll work. When Tristan leaves, Jayne feels frustrated that she didn’t receive the help she’d hoped for.

Example #2: At the next visit, Tristan notices that Liam is just wearing his training pants so she asks Jayne how dressing went that morning. Jayne said it was a battle as usual and Liam won. Tristan asks if she can see what happens when Jayne tries to dress Liam. She tells Jayne that she hopes that they can work together to come up with some strategies that might make dressing a little easier. Jayne agrees but is nervous about what will happen. She asks Liam if he’s ready to get dressed and he runs away. She snatches him up and takes him, already struggling, to his bedroom. Jayne places Liam on his toddler bed and turns to get his clothes. He wiggles off the bed and runs away again. Tristan coaches Jayne to consider why Liam might be running away and what they could do differently to make this a more pleasant experience for him. By working together, they come up with ideas such as having the clothes ready on the bed before getting Liam and letting Liam stand on the floor to get dressed rather than having to lie down. Tristan also coaches Jayne in how make dressing playful. Tristan knows that Liam loves stories, so she suggests that Jayne try telling Liam a story while she dresses him. Tristan models how to let Liam chose his own clothing and help with putting it on. Jayne tries it too, letting Liam chose which pants to wear then telling him a funny story about how his feet are going on an adventure. Dressing takes longer than Jayne wants, but she’s able to get Liam dressed with no tears. Afterwards, Tristan and Jayne reflect on what happened, and Jayne identifies three strategies she will try during the week. When Tristan leaves, Jayne is still nervous about dressing Liam without help, but plans to try the strategies tonight when dressing Liam for bed.

It can be so easy for service providers to get in to the “Have you tried…?” habit, avoiding the real-time aspect of this adult learning principle. Using this principle really challenges us to release that habit and, instead, actively problem-solve with the parent in the moment. It’s a very different approach, and one that parents report to be so much more effective.

Seize the moment on your next visit to “get behind the wheel” with the parent and see what happens!

Which example resonates more with you?

Think about your last three visits and your own practices. Did you help the parent practice strategies in real time, in real contexts? If not, why not?

Do you have a great example of successfully joining a real-time activity to help the parent and child learn? Share it below!

For more info on adult learning principles, check out these other two posts:

Adult Learning Principle #1: Making Intervention Immediately Relevant

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

Adult Learning Principle #3: Active Practice and Participation are Key!

Adult Learning Principle #5: Feedback is How We Grow

The post Adult Learning Principle #4: Practicing Intervention Strategies in Real-Time appeared first on Early Intervention Strategies for Success.

Why do we always sit on the floor?

You know, when you think about it, it’s a really good question. Adults plopping on the floor in strangers’ homes is not normal. However, sitting on the floor to play with young children is pretty normal for folks who specialize in early childhood. Being on the floor allows us to be at the child’s eye level, giving us easy access to the child and the child equal access to us. Here’s the kicker, though – if we are providing family-centered intervention, shouldn’t we be sitting where the family sits when we aren’t there?

Think about it – when you’re not in the home, do you ever wonder how often families really “get down on the floor” with their children. Maybe the real question is this: Do families really need to sit on the floor to positively impact their children’s development? What do you believe?

What I Believe

I believe that floor play is only one of the many ways that families interact. In reality, there are some families who love to play together with toys, crawling around on the floor playing hide-and-seek or chasing balls. There are other families who think that toys are for the children to play with, that adults don’t do that. In the middle somewhere are families who play with their children on their laps or when the child brings a toy to them while they’re sitting on the couch. What ALL of these families do, though, is take care of their children – change diapers, feed them, dress and bathe them, calm them when they cry, and take them places. These caregiving routines are important and probably happen much more frequently than toy play on the floor.

That doesn’t mean that floor play isn’t important – it definitely is because it offers lots of fun, stimulating learning opportunities for the child. It can also offer a great way for the parent and child to interact and enjoy each other – if it’s something the parent does or is interested in doing. The key here is that floor play is only one of the MANY activities that families do with their infants and toddlers. If we really want to be effective as early interventionists, then it makes sense that we think about toy play on the floor as just one of our many options to explore with families – not necessarily the “thing” we do at every visit.

If Not Playing on the Floor, then What Else Do We Do?

I’m not advocating that you abandon toy play or never plop on the floor again because that’s not realistic or even necessary. I encourage you to broaden your perspective on what you can do during visits. A recent study found that we are great at toy play, but when it comes to intervention in other routines, we tend to just talk about them rather than joining them. We talk about what’s going wrong with getting the baby into in his car seat, rather than walking out to the car to observe and problem-solve in the moment. We talk about how the child loves to play with his siblings in the afternoon but we never change our schedule to join that special time.

We know that adults learn best when they have the opportunity to practice, problem-solve, and plan in real time. When you can coach a parent through a problematic routine or during a special family activity, that’s when the magic happens and families become more able to use intervention strategies with less stress. When we get off the floor, join caregiving routines, and help parents find ways to be playful and supportive during real activities, we’ve provided meaningful intervention that they’re more likely to feel confident using when we aren’t there.

Here are a few tips for making all of this happen:

Seize the opportunity to stand beside the parent – When the parent mentions a different routine, don’t just talk about it. Ask if she will show it to you. Stand beside her and collaborate in that moment. Use your coaching skills and work together to come up strategies that really matter.

Focus on parent-child interactions instead of toy play – It’s a big shift for some of us. Wrapping your brain around supporting parent-child interactions, with you playing a background role, is very different from arriving at the home to teach the child. Toy play might still be a way to motivate the child, and it might still be fun for the parent too, but remember that it’s just one piece of the pie. Focus your energy on building playful and supportive interactions across a variety of routines, whenever possible.

Pause…before you sit – When you walk into the home, it might be your reflex to greet the family then sit down on the floor. It certainly was mine when I started a visit. Instead, pause before you kick off your shoes. Ask the parent what she would like to do today. Offer other ideas. Ask what she would be doing right now if you weren’t there – then ask if you can do that. Even if you end up on the floor, taking that moment to pause, think and behave differently will help you ease into a more broad way of thinking about your role during the intervention visit.

Broadening your perspective really begins with how you think about your purpose and what you do during visits. You set the tone for how each visit works. You don’t have to sit on the floor to provide good intervention. It’s not the main place where children learn and it’s not the only place where parents and children interact. It’s just one of many activities during which you could really make a difference.

Do you have a good example of intervention that DIDN’T occur while sitting on the floor?

What are your thoughts about why we rely on floor play?

Share your experiences and thoughts in the comments below!

The post Seize the Opportunity to Stand Beside the Parent appeared first on Early Intervention Strategies for Success.

*What’s Your Outcome for 2015?? Share it below and maybe you’ll win a free book!*

Some of you might be thinking…oh no, not another post about new year’s resolutions. If that’s you, then breathe easy because this isn’t about resolutions most of us won’t keep. Voicing a resolution really means very little if it doesn’t have a specific plan behind it. Kind of like IFSP outcomes – if we write them using really general language then they are harder to achieve. Think of the outcome 60% of kids in EI could have: Caleb will use words to communicate his wants and needs. It’s not very meaningful without more information that is specific to Caleb and his family. Without the individualized details in our own resolutions, we won’t know how to reach them or how to measure progress and we’re must less likely to be successful. Instead of thinking generally – like “I will exercise more” or “I will spend more time with my family” (sound familiar?) – let’s think specifically, pulling from those strategies we use to write good IFSP outcomes.

My Outcome for 2015

I have one big goal for the coming year: I want to graduate! I’m in a doctoral program and have just finished my classes (happy dance!). The coming year brings my comprehensive exams (written and oral) and my dissertation research and writing. If I let myself, it feels a little (okay, alot) overwhelming. In order to reach my outcome, I need to first define it. Here’s goes: I will complete my comps by March and dissertation by October so that I can graduate in December 2015. This includes completing the required paperwork by my deadlines, submitting my comps question, writing my exam paper and presenting it, identifying my dissertation committee, developing my prospectus (plan) for my dissertation, presenting and defending that, conducting my research, writing it up, then presenting and defending that. No big deal, right? Sheesh.

In order to reach my outcome, I’ll need to plan out my year, dedicate time each week to working on my outcome, and commit to myself that I will honor my plan. I need to get organized and do the work. I also need to think about how I will balance achieving this outcome with managing the rest of my life. It sounds like a huge undertaking, but when I break it into smaller steps, it’s much less scary and much more manageable. My plan is to chart it all out by actually making myself a checklist to keep track of my requirements (plus I get the joy of checking things off of the list!). This can be a great strategy for achieving any goal – breaking it down into specific achievable steps.

YOUR Outcomes for 2015

So what do you want to accomplish this year? What are the smaller steps you need to take to get there? Take 5 minutes today and write down an outcome for yourself for the coming year. Don’t just write an empty resolution like “I want to exercise more.” Instead, use the other 4 min and 45 sec to map out steps you need to take in your life to make this change. Write down what you need to do, who can help you, when you’ll do the activity/work, and where you will need to be. Imagine that you are writing an IFSP outcome for yourself.

Remember: how you spend your time this year, from the big picture outcome to the minutes of each day, are all up to you!

Share your outcome in the comments below so that your colleagues can draw inspiration from you! Let’s see if we can get 15 outcomes listed for 2015! I’ll randomly draw a name from the list on February 13th and send the winner a free copy of Family Centered Early Intervention: Supporting Infants and Toddlers in Natural Environments.

Happy New Year!

The post Let’s Get 15 Outcomes for 2015! appeared first on Early Intervention Strategies for Success.