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

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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.

On May 1, 2021, Governor Northam proclaimed May as Early Intervention Awareness Month in Virginia. Many EI programs use this month to raise awareness and build relationships with referral sources, physician offices, other community programs, and of course, families. The video What is Early Intervention in Virginia? is often shared widely because it provides an overview explaining what EI is, what it looks like, and how it works. One of the things I love about this video is the opportunity to see and hear from families who have experienced EI. I think family stories are perhaps the most powerful “tools’ we have to build awareness of what EI has to offer. They can help us reach new families and invite them into partnerships with us. Family stories also remind us about why we do what we do. With that in mind, I’m going to share several videos you can use to spread the word about EI from the perspectives of families. If you have other videos you love too, please share the links by leaving a comment below. Here we go!

Reflections during the Final Visit (CO Dept of Education, runtime 5:46)

This video features a mother reflecting on her relationship with the physical therapist who visited her home to support her and her daughter. I think that perhaps, showing what happens at the end of EI, like you’ll hear and see in this video, can help open a doorway to the beginning of EI for another family.

Liam’s Story: A Mother’s Voice (VEIPD, runtime 5:15)

This video also features a mother telling the story of her family’s experience with EI. This story is a powerful reminder of the impact of this work on the daily lives and relationships of families. As an early interventionist, you never know what you might say or do that can have a lifelong impact. EI Awareness Month can be a nice reminder about that too.

Dream Big: A FIT Family Story (FIT FOCUS Video Library, runtime 5:27)

In this video, you’ll hear from a mother and father about how EI worked for them. They explain the emphasis on helping the family help the child. They also describe about how coaching helped them to use strategies in their home during the things they already do rather than adding extra things to do. They also share advice for families to “dream big for your child.” (Due to permission settings, you’ll need to click the “Watch on Vimeo” button below. This video is definitely worth the extra click.)

Parents and Early Intervention (EITP Illinois, runtime 7:59)

I featured this video in another recent post because it’s new. I think it’s worth mentioning again as another resource to share a family’s story. Even though this isn’t a family in VA, I think this family’s message is universal.

That’s just a few of the fantastic family story videos that are floating around the web. If you’d like to see more videos of families in EI, check out the Early Intervention Video Library and look for Families’ Experiences in EI in the menu. You might also find the Early Intervention – General page helpful for sharing info about EI with others.

So what are you doing to celebrate EI Awareness Month? What is your favorite EI family story video?

Share your thoughts, ideas, and video links in the comments below!

The post EI Awareness Month in VA – The Power of Family Stories 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.

You’ve worked really hard this year. You’ve stretched to fit into a mold of providing early intervention (EI) that was unlike any you’d ever experienced before. You struggled, you persisted, and you succeeded. You did it because you love what you do. You also did it because you love the families.

This new video, Parents and Early Intervention, from the Early Intervention Training Program at the University of Illinois is like a gift to all EI practitioners for the hard work you’ve done this year. It reminds us about the power of high quality intervention and how important our partnership with families can be. I know you know this, but it sure is nice to hear it from a family. Now, take 7:59 minutes to meet the Warren family and hear their story. I guarantee it’ll make your day.

See, doesn’t that do your heart good?

So yes, this may have been one of the most challenging years we’ve faced as a field, but when other businesses and services closed, EI did not. You continued to support families, reaching them virtually, checking on them by phone, and working together in ways that were new, different, creative, and inspiring. Now, as you reflect on this past year, ask yourself:

When you think of families you have supported, what do you hope they say about their EI experience?

Type your reflections in the comments below.

*Thank you to EITP and the Warren Family for sharing their story!*

For more videos featuring families’ experiences, visit the Families’ Experiences in EI page on the EI Video Library.

The post A Gift for You – New “Parents and Early Intervention” Video from EITP Illinois appeared first on Early Intervention Strategies for Success.

Several years ago, I found that my EI caseload included a couple of families with stay-at-home dads. This was a first for me, and I found myself struggling to connect with family caregivers, which hadn’t happened to me since I was new to the field.  Both men were quite nice, but I stumbled when I tried to make conversation to build rapport.  What did I have in common with these men? With moms, I could build rapport around so many shared experiences being moms and women.   One dad was a former football player and the other was a fitness expert.  My idea of working out was to walk from the couch to the bookshelf. 

So, I did what I always do when I’m unsure- I read and researched.  I searched and searched for good information on working with dads.  I found almost nothing except for a few articles on how men and women communicate differently.  I had to muddle through mostly on my own, but we all made it through together.  These experiences helped shaped my later academic research. 

3 Key Strategies for Building Relationships with Dads

Here are some of the key strategies I used to build successful relationships with dads.

Talk side to side rather than face to face.

I can’t remember the source anymore, but the one tip I did garner from searching for books and articles was that men are socialized to talk with each other and others while they are engaged in a task or standing side by side, while woman are socialized to look at each other while talking. This strategy was immediately helpful! When the fitness expert dad offered to make me a fancy coffee, I took that opportunity of having his back to me to ask some deeper questions about what his hopes for his daughter were and what he wanted from EI.  It worked! This became part of our weekly routine.  He would make me a fancy coffee and I would use this time while he wasn’t looking at me to chat and build rapport.  With the other dad, I started positioning my body angled from him instead of looking directly at him.  This also worked immediately.  He opened up a little more when we weren’t looking directly at each other and I realized we could connect over our similar senses of humor.  He hasn’t been a client in years, but our relationship became strong enough that he sends updates on his son’s progress several times a year. 

Explicitly invite dads into therapeutic activities.

I learned to do this based on anecdotes from my own work in EI and the dads in my research verified it’s really important.  Many dads aren’t sure about what EI is supposed to be, especially if they aren’t the primary caregivers of their children. They hang back and watch or wait for their wife or partner to give them a summary of what happened.  Extend a direct invitation by saying, “Hey, we’re going to work on motor skills.  Come on over and help me make an obstacle course with the couch cushions” or “One of our outcomes that your kiddo can communicate her wants and needs.  Let’s take her in the kitchen and work on some strategies to get her communicating for snack time.” This signals that the dad is an important part of what’s happening and that you want him to participate. 

Be really clear about what you are doing and why.  Provide this information in writing, too.

Both the dads I worked with and the dads in my research wanted clear explanations of why their EI providers were giving them and their children specific tasks.  They wanted to know exactly how doing an obstacle course was related to motor development or how giving a choice of two items at snack time helped with communication development. For many of EI providers this information is so much a part of what we do, that we don’t think to explain the connection.  The dads in my research didn’t always feel comfortable asking providers these questions or they asked the questions but didn’t remember the answers after the provider left.  Make sure to provide written explanations that address the what and the why.  Remember, a quick text (if allowed by your program) counts as being in writing (just make sure you send it to mom AND dad).

Have you tried any of these strategies? Have one we haven’t thought of? Or maybe want some advice about a tricky situation with a dad?

Leave a comment and let us know!

For more information about working with dads, you can check out the Dads Matter! Webinar Series (external website) on the VA Early Intervention Professional Development Center (external website) site. Scroll down on the page to find both archived webinars.  

Megan has over a decade of experience working with fathers as an early intervention developmental specialist. Currently, she is an assistant professor at Salem State University, where she teaches future early interventionists and researches dads’ experiences working with early intervention programs. Megan lives in Salem, MA, with her husband, daughter, and two exceptionally naughty cats.

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Technology is great when it works, right? It’s such an embedded part of most of our lives when we are not in the throws of a global pandemic that many of us hardly think about it. Now, though, when early interventionists are chin deep in trying to navigate tele-intervention, figuring out how to connect through technology is essential.

I’ve been picking the brains of amazing EI practitioners and local system managers to find out what they are doing to make the technology work, not only for themselves but also for the families they support. I’ve organized some of the great ideas I’ve heard into the list below.

A big THANK YOU to the practitioners and leaders from Fairfax, Norfolk, Prince William, Danville-Pittsylvania, Southside, Roanoke Valley, Rockbridge Area, Central VA, Cumberland Mountain, Middle Peninsula-Northern Neck and others who shared their experiences with me!

7 Technology Tips

Here are 7 tips for managing technology when preparing for or providing tele-intervention:

1. Prepare yourself first – Before you contact the parent, make sure you have an understanding of what tele-intervention is. Watch the TelePractice in Early Intervention webinar for a fantastic overview and tons of strategies. Watch a video such as A Home Visit with Zander, Providing Early Intervention Services through Distance Technology, or Tele-Intervention – Coaching during Family Chore-Laundry to see how coaching works during tele-intervention. Educate yourself about the technology so you can answer parents’ questions as best you can. Larry Edelman has prepared a great resource document about technology: Planning for the Use of Video Conferencing for Early Intervention Home Visits during the COVID-19 Pandemic (PDF, New Window)– check it out!

2. Touch base the “usual way” – Reach out to the parent using your typical means of communication – phone, email, or text, depending on what’s permitted in your program or preferred by the family. Check in about the family’s welfare first, then ease the conversation into virtual options for connecting.

3. Explore and explain options – Without making any assumptions about family preferences or capability, explore the available options for video visits or phone contacts for service delivery. Explain how each option could work and paint a picture of what it might look like. If the parent is interested (or even unsure), share a link to the video, A Home Visit with Zander, so he/she can watch a visit and hear from a parent about how tele-intervention can work. Be sure to invite the parent to ask questions, share any worries, and think through the possibilities with you.

4. Share your vulnerability – It’s okay to let the parent know that this is new for you too. Assure the parent that you will figure it out together and that, if the parent chooses the high tech option (aka video confererencing) and something goes wonky, you always have a low tech option as Plan B (aka phonecall).

5. Schedule a tech check – Before the actual video visit, schedule a 15 minute tech check. This may be a non-billable activity, but it’s worth it. Send the parent the video conferencing link with detailed instructions about how to connect. Get online together, check video, audio, lighting, etc. and talk about where the device will be positioned so you can see the family the best. Plan together for what the parent wants to do during the actual visit and how the technology can be used so you can observe and collaborate. If you or the parent has tech problems, remember the #1 rule of thumb with troubleshooting: when in doubt, back out and try again. Log out of the video conference and try to log back in. If that doesn’t work, log out and restart the computer. If that still doesn’t work, try another browser. Persistence will pay off, I promise.

6. Problem-solve Wifi issues – Here’s where practitioners are getting creative. I’ve heard of folks parking in the family’s driveway for the video visit so the family can access the practitioner’s hotspot, then holding the visit using technology with the practitioner parked outside. What an idea! Some schools are offering hotspots for older children – can the family use that connection for the visit? If there are limitations on data or bandwidth, schedule the visit at a time when issues should (hopefully) be at a minimum, like in the afternoon after older children are finished with online learning.

7. Let the parent decide – If a parent is unsure about either option, encourage him/her to try a phone or video visit then evaluate how it went. If the parent declines, that’s okay. Parents can put their services on hold at any time; just be sure that they fully understand their options, privacy, and the support you can provide. Be sure to document your discussion and check back in with the family often in case they change their minds.

Once everything is in place and your fingers are firmly crossed, schedule that first visit and go for it. Take a deep breath before you connect with the parent and enter the video call with confidence. Expect some hiccups, be flexible, practice your patience, and exercise your sense of humor. This will get easier and both you and the family will adjust, together.

You’ve got this.

What strategies are you using to prepare families for tele-intervention?

What creative ideas are you using to help families manage technology needs?

Let’s hear your best ideas! Share them in the chat and let’s continue to support one another. J

For more information, videos, webinars, and online training related to tele-intervention, visit these sites:

COVID-19 and EI Tele-Intervention Updates – VA EI Professional Development Center

Coronavirus Disease (COVID-19) – ECTA Center

The post 7 Technology Tips for Tele-Intervention appeared first on Early Intervention Strategies for Success.

Let’s get right to the point. You are not trying to engage an infant or toddler on video for 45-60 minutes during your virtual visit. Re-read that last sentence and let it sink in. Take a deep breath in and breathe out any expectation you may have had about playing with the baby you see on video. When we step back and let our anxiety about tele-intervention settle, it’s easier to realize that there is very little chance of a 2-year old interacting with you on video for more than a moment or two – and that’s okay. You can still do early intervention without that interaction when you focus on engaging the parent (or other caregiver) who will then engage the child. If you think about coaching and the Mission of EI, that’s where your focus should be anyway. You’ve probably already been doing this and if not, you can do it now.  

Okay, you might be asking yourself: If I’m not interacting with the child, what do I do instead?

Let’s answer that question.

What Do You Do?

Now, more than ever, early interventionists are using their coaching skills to engage parents during virtual visits conducted using video conferencing technologies. Interventionists have been thrust into the world of tele-intervention (you might know it as telepractice or telehealth) with often little preparation or experience. The whole world has shifted and it feels like EI practice has shifted along with it (and they have).

Here’s what hasn’t changed, though: You are still a coach to the parent/caregiver. Your primary mission is to support caregivers so they learn ways to interact with their children during everyday routines and activities to encourage development. Whether you are sitting in their home or yours, you are still a coach. You did not coach the child before tele-intervention; you coached the parent. You probably did spend time playing with and engaging the child, practicing stretches, prompting for sounds, and challenging the child’s problem-solving or social skills. You probably modeled the use of strategies in these activities for the parent. Now, you have to figure out how to let go of your need to directly interact with the child and embrace the golden opportunity you have to support the parent’s learning.

Here are 10 strategies for focusing on parent/caregiver learning during tele-intervention. You can do this!

10 Strategies for Engaging Parents during Tele-Intervention

Before the Visit:

1. Prepare with the parent – Touch base by phone before the virtual visit to discuss technology needs and answer questions. Plan for how to connect, what device the parent will use, and how it will be positioned so the parent can see you and you can observe the parent-child interaction. Plan for how the parent will access the link you will send to the virtual meeting platform. Consider different types of devices and how access might look different (a quick google search for instructions can be helpful if needed).

2. Prepare yourself – Before the virtual visit, collect your thoughts. Remember that you don’t need toys because you are not trying to engage the child. You may need a prop, such as a doll or teddy bear to model movements for the parent, but you can put your bubbles away.

3. Preparing for what to do – Chat with the parent about ideas for what to do during the visit. Be prepared to follow the parent’s lead and let her know she can take you with her in whatever she and her child do during the visit. You can also plan for activities, like if you are going to work together on the child’s feeding or encourage play skills with siblings who are also home. Just like any visit, though, preparing can go right out the window if another opportunity arises or the family needs the visit to go in a different direction. Prepare when you can, but go with the flow when you need to.

During the Visit:

4. Take time to check in – Just like any other visit, touch base on how the family is doing and check in on child progress. This check in time may take longer now and that’s okay. Remember that everyone is adjusting to the new normal so approach this relationship-building time with ease.

5. Use your voice to join in (instead of your body) – Join the activity you planned or search for opportunities based on what you see. Observe that feeding session, watch the siblings play, and use your coaching skills to share your observations, ask reflective questions, and provide verbal guidance on how to use intervention strategies. You have to use your voice to join in so be gentle with your suggestions and always ask the caregiver what she thinks, how it feels, etc.

6. Be descriptive and specific – When you provide guidance, share observations, or give feedback, be specific and describe what you see and what you suggest. Following verbal directions might be harder to process for the parent who is used to watching you, so take it slow and check in frequently.

7. Be flexible – If the visit is a little shorten than usual, that’s okay. Be sure to document why. If what you planned with the parent falls flat, try something else. If you end up discussing development more than observing it, especially on your first visit, that’s okay. Use the “show me…” prompt to move from discussion to observation and support; it’s a great tool on an in-person visit and it’s your best tool now.

8. Keep your focus on the parent, who facilitates learning for the child – This is key. This is also best practice in EI whether you are face-to-face or on video. What you can help the parent practice during the visit with the child is more likely to continue between visits. Use your coaching skills to keep the focus on parent learning, which extends learning to the child.

9. Write down the joint plan – Plan with the parent as you always do, but create a written version of the joint plan at the end or after the visit. Email or text the plan to the parent as a reminder and follow-up on that plan at the start of your next visit.

During and Between Visits:

This last strategy might be the most valuable right now:

10. Cultivate patience for the parent and yourself – Providing intervention this way might feel wobbly nowand that’s okay. Both you and the parent are in the midst of significant change, and not just for the EI visit. Being patient with the family will help them feel comfortable with this new way of interacting with you. Being patient with yourself means giving yourself permission to feel nervous and stumble, laugh about it, learn, pat yourself on the back, and try again next week.

Consider this: Your relationship to early intervention and with the parent has changed because of the pandemic and tele-intervention, but maybe that change is for the better. This way of supporting parents (and children) might make you a better coach. Give it time, approach intervention with openness, and take a deep breath. We will all be okay.

What strategies are you using before or using your tele-intervention visits to engage parents?

What’s working well? What’s challenging you?

Share your tips and experiences in the chat below and let’s support each other. 🙂

For information, videos, webinars, and online training related to tele-intervention, visit these sites:

COVID-19 and EI Tele-Intervention Updates – VA EI Professional Development Center

Coronavirus Disease (COVID-19) – ECTA Center

For technology tips and links to video reflections about tele-intervention, check out these posts:

7 Technology Tips for Tele-Intervention

Introducing Teleflections©: We’re All In This Together

The post 10 Strategies for Engaging Parents (not Children?) during Tele-Intervention appeared first on Early Intervention Strategies for Success.

In Part 1 of this series, you learned about the first intervention, which focuses on the caregiver’s awareness and interpretation of his or her own actions. This first intervention emphasizes (to us and the caregiver) the power the caregiver has to positively impact the child’s development through interaction and action. In Part 2, we’re going to dive a little deeper and think about the context of those actions and interactions – where and when learning occurs.

Helping Caregivers Identify & Use Everyday Learning Opportunities

Our second intervention emphasizes the importance of helping caregivers identify and use everyday learning opportunities to enhance child development (Dunst & Trivette, 2009; Mahoney, 2009; Swanson, Raab, & Dunst, 2011). This intervention reminds us that the context for most of the learning a child will do is within his or her interactions with the people and the environment that are most familiar and most constant. We can collaborate with caregivers by respecting what is already happening in the natural environment and helping them notice and take advantage of interactions and opportunities that help the child learn or practice using a skill. When learning is situated in a naturally occurring, familiar context, there are more opportunities for the child and caregiver to practice what they are learning together every day beyond the EI visit. The cognitive load is also decreased since the context is familiar, hopefully making it easier to use a new intervention strategy (for the caregiver) and learn a new skill (for the child). Practice during infant and toddler development is essential so the more opportunities we can help the caregiver provide, the better!

What Does This LOOK LIKE in Practice?

Here are a few excellent strategies you can use to implement this intervention. These strategies were suggested by EI service providers in conference sessions on this topic:

Use the unique interests of the child and the caregiver as your guide. Ask caregivers what they enjoy doing with the child. Ask about the typical flow of the day. Ask about what makes the child laugh (or feel frustrated, excited, engaged, motivated, etc.). Find out what they would like to be able to do together and what that would look like if it worked well. Build on what you find out by observing those activities and routines, talking about the learning opportunities you see, and helping the caregiver learn to seize them.

Individualize IFSP outcomes and goals by including specific learning opportunities that already exist for the family. Ground the outcomes in the context of everyday activities. If the outcome describes how the child will learn to move about independently, place the measurement of the outcome in a typical activity. For example, let’s say that the child will move about her home independently by crawling or walking 10 feet from the kitchen to the family room after each meal. When she can do this consistently across time, we’ll know she’s met the outcome. Plus, the family can see the progress because they can practice the movement strategies in a frequently occurring context that’s natural for them. Including context in outcomes helps families identify with their important role in intervention from the beginning. Individualizing outcomes is a great place to start with building awareness (our first intervention) too.

Observe and join different activities and routines to help the caregiver look for the learning opportunities. There is nothing as effective as “seeing it.” Whenever you can, sit back and observe parent-child interactions and specific routines that are meaningful, problematic, or just typical for the family. Point out learning opportunities that you see. Reflect with caregivers to help them create their own ideas. Encourage them to try out the strategies that come from these conversations while you observe again, provide support, problem-solve, and share feedback.

After the caregiver practices using a strategy, talk about how to extend the use of the strategy in other routines to create more learning opportunities. You can facilitate this thinking process by asking, “When do you think you can use this strategy outside of the visit today? What other times of the day might work for using the strategy?” If needed, ask about other routines you know about and help the caregiver think about how the strategy could be embedded. Have the conversation and land on a joint plan. By doing this, you may be expanding the caregiver’s thinking, which again, overlaps with our first intervention. See, this is powerful stuff.

Now it’s your turn:

What’s your favorite way of helping caregivers identify and use natural learning opportunities? What did this look like on your last visit?

Share your ideas and examples in the comments below! And don’t miss Part 3, the final post in this series!

References:

Dunst, C. J., & Trivette, C. M. (2009). Using research evidence to inform and evaluate early childhood intervention practices. Topics in Early Childhood Special Education, 29(1), 40-52.

Mahoney, G. (2009). Relationship-focused intervention (RFI): Enhancing the role of parents in children’s developmental intervention. International Journal of Early Childhood Special Education, 1(1), 79-94.

Swanson, J., Raab, M., & Dunst, C. J. (2011). Strengthening family capacity to provide young children everyday natural learning opportunities. Journal of Early Childhood Research, 9(1), 66-80.

The post 3 Interventions Every Early Interventionist Needs to Know – Part 2 appeared first on Early Intervention Strategies for Success.

In evidence-based early intervention, our primary aim is to coach, rather than to “do therapy” ourselves. We teach families how to help their children. The most challenging part of coaching can be finding effective ways to invite parents to participate and join in the interactions with their child.

Location, Location, Location

As therapists, it is natural for us to think about our relationship with the child in service. After all, we are teaching the child. That’s what we are trained to do. Right? Not exactly. We’re teaching the parent, so that the parent can teach the child. That changes the relationship. Our relationship with the parent, and the parent’s relationship with the child suddenly become much more important when we look at them through this lens. As coaches, we know that the interactions that the parent has with the child are primary and we work to keep those interactions at the forefront. I’ve learned to place myself behind a child rather than in front of him during an activity, or to create a triangle between myself, the mom, and the child. This breaks up the traditional child-therapist pair and gives the parent a space to join in. Locations other than the living room floor that can make this easier include the couch, a high chair, a table, or wherever the parent and child typically spend time together.

Start with Routines

Keep in mind that unless parents have been involved with coaching before, they’re probably expecting traditional therapy. All parents want to be involved and want to help their children, but they may not know how to step in and participate, especially during playtime. Coaching phrases like, “Do you want to try this?” or “Can I model that for you?” can feel awkward to deliver if you aren’t used to them. And we all know, if you feel awkward, it will be awkward.

Rather than starting with an activity that we initiate, we can set the stage for authentic parent involvement by observing the family’s natural routines first. I sometimes ask parents what they would be doing if I wasn’t there. Is it snack time? Does little Joey need a diaper change? This leads naturally into a mutual discussion about ways to increase interaction and language in everyday activities. If it is snack time and Joey heads for the refrigerator or brings us his cup, we have a perfect opportunity to introduce a word or sign for “eat” or “drink”, model and practice offering choices to build language, or encourage eye contact as a first way of requesting. Snack time, diaper changes, and dressing are activities that parents generally do so they are more likely to take the lead and give us a chance to support and encourage, rather than waiting for us to lead an activity.

When You Have to Play

If parents seem more inclined to hang back, say that their child normally plays by himself while they do other things, or are otherwise hesitant, we may have to fall back on some more traditional therapy or play activities. This is when we are most likely to lose parent interaction if we don’t keep it at the forefront. If we are looking at a book, rolling a ball, working on a puzzle, blowing bubbles, or doing any other traditional therapy activity, it is very easy to let the focus drift back to us and the child. I have to work to consciously keep the parent-child interaction at the forefront, rather than my interaction with Joey. If we are looking at a book and working on pointing out pictures, I stand or sit behind him and put the parent in front of us or next to Joey on the couch to ask those, “Where’s the…?” questions and help him point out the pictures. This tends to feel much more natural and I find it less intimidating for everyone. It also increases the chance that the next time Joey brings a book to his mom, she will point out a few pictures rather than reading complicated text because we’ve practiced this together.

If I’m rolling a ball or car back and forth, once Joey is into the game I roll or throw the ball to his mom and have her join the game that way. If Joey is having trouble getting into the game, I sit behind him and help him throw the ball to his mom, rather than encouraging him to throw the ball to me. I find that most parents want to participate with us, we just have to invite them in. The responsibility for not pushing parents out is with us, even when we are working with more traditional play activities.

Stepping Back in Trust

Once we have used location, positioning, routines, and a bit of creativity to get parents engaged and interacting with the child, this is when the magic happens. Once we have the parents involved, our job is to get out of the way. When I am in a visit, I feel this as a continual sense of stepping back from the parent-child dyad, maybe most during those times when I really want to get involved. If they are engaged in a social game or activity, the last thing I want to do is get in the way. I may give a suggestion of something to try, but I often stop myself from even doing that much.

Wait It Out

Instead, I tend to smile and nod encouragingly and wait. The last thing we want to do after the parent gets involved is to pull her back out of the activity again and put the attention on us rather than on Joey and the interaction. Generally, it lasts a few minutes and then the child is off to something else. This is my time to open a discussion, starting with, “Wow, he loved that game and he was really engaged with you.” From there we might reflect together and move to brainstorming strategies. If parents struggle with coming up with a strategy I might share some expertise with ideas like, “Next time you play that game with him, wait a little bit longer for him to look at you.” Having parents reflect first gives them an opportunity to think about how an activity went before I add to their thoughts. This encourages them to seek out and capitalize on opportunities for interaction during the time when I’m not in the home.

While it can be challenging to encourage parents to join in on the interactions during visits, paying attention to our words and actions can help us to create space for parents to actively participate rather than watching us play.

What strategies have you found for encouraging parents to join in during intervention visits?

Share your strategies in the comments below!

Stacy Zogheib has been a Developmental Specialist in Arizona since 2006. She has a Bachelor’s degree in Elementary and Special Education from Wittenberg University, and a Master’s degree in Early Childhood Education from Northern Arizona University. Stacy has a passion for supporting and empowering families with young children who have delays or disabilities. You can reach her at: stacypro@yahoo.com

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