So far in this series, you’ve learned about the importance of two interventions associated with positive outcomes for children and families. In Part 1, we explored strategies that emphasize caregivers’ awareness and interpretation of their own actions. In Part 2, you learned how to help caregivers identify and use everyday learning opportunities to enhance child development. Now, let’s focus on the third intervention: supporting caregivers’ responsiveness to their children (Dunst & Trivette, 2009; Mahoney, 2009; Swanson, Raab, & Dunst, 2011). For some caregivers, responsiveness comes naturally, especially when there is naturally a good fit between how the child interacts and communicates and how the caregiver parents. When it doesn’t come naturally or the caregiver struggles with responsiveness, it can have a significant impact on the parent-child relationship and the child’s development. Let’s think more about what this looks like and what you can do to support responsive interactions.

Supporting Caregivers’ Responsiveness to their Children

Responsiveness – how a parent or caregiver responds to and meets the needs of a child – has been found to have significant connections to communication and social-emotional development during early childhood (Mahoney, 2009). Responsiveness is one of those concepts that we know when we see it. We know it when we see a mother who reads her child’s cues, even the subtle ones, like when he shifts his gaze to make a choice about which book he wants her to read. We see it when a father hears his baby cry and immediately picks her up, bounces her and pats her back while soothing her with his voice. We see it when a childcare provider uses a warm expression and voice to calm a toddler then invite him into a turn-taking game of blowing bubbles. All of these interactions teach young children that they are important, that adults care, and that their attempts to communicate and engage with others and the environment have meaning.   

Responsiveness is also something that jumps right out at us when it’s not there. Think of the grandmother who ignores her grandson’s vocalizations because he “doesn’t make sense” and who swats him when he acts out from frustration. Think about the mother who misreads her daughter’s arching back and gaze aversion as a personal offense, which negatively impacts their attachment to each other. Or, consider the father whose depression makes it hard for him to respond to his child’s needs consistently or at all. There are many factors that can interfere with a caregiver’s ability to be responsive, and truthfully, we are not always able to mitigate them. We can, however, keep our eyes on responsiveness and encourage it, celebrate it, teach it, and praise it whenever we have the opportunity.

What Does This LOOK Like in Practice?

Here are a few strategies you can use to support responsive interactions between caregivers and children:

Label it when you see it – When you notice a parent being responsive, talk about it. Describe what you saw the parent do and how the child responded. Ask the parent questions to help her identify responsiveness and the impact, such as “What did you do that made Elena smile?” or “What did Elena do after you smiled at her?” Point out the delight the child showed when her parent interacted with her and praise the parent’s efforts.

Model and facilitate contingent interactions – In the context of interacting with the parent and the child together, model contingent interactions that are responsive to the child’s communication and social cues. Talk about what you are doing and why. Coach the parent to notice the child’s communication attempts, movements, or behaviors and help him/her interpret them with meaning. Point out what the child did before and after the interaction and talk about what the parent could do to respond, keep the interaction going, help the child be successful, etc. Just be careful to turn the interaction back over to the parent after modeling so he/she can practice engaging the child. You may be great at using a responsive strategy but that only matters if the parent can learn from you and use the strategy successfully with the child.

Use your voice and facial expressions – Affect is an important part of responsiveness (Mahoney, 2009). Using a warm voice and expressive facial expressions that convey that you are present, engaged, interested, and enjoying the child send an important message. Talk about the importance of affect and provide specific feedback to parents when they are using their affect in responsive ways. This is especially important when interacting with children who struggle with social-communication or who have sensory differences.

Encourage imitation and turn-taking – Use imitation and turn-taking as the vehicles for building responsiveness. When a caregiver struggles with responsiveness, help her understand the back-and-forth nature of interactions and communication. Use simple turn-taking games to entice the parent and child into interactions. Look for turn-taking games that they can enjoy and sustain (for a reasonable amount of time depending on the child’s age and developmental level). Start small, with the parent imitating the child’s actions or sounds, and shape these interactions into turn-taking. Help the parent look for ways he can take a turn whenever the child does something and vice versa. Encourage the parent to expect, wait for, and prompt the child to respond whenever there is an opportunity. Responsiveness is reciprocal but the parent sets the tone.

All three of the interventions you’ve learned about in this series have responsiveness at their core. When caregivers are more aware of how important their own actions and interactions are, understand the learning opportunities they can facilitate during daily interactions, and recognize how to engage and respond to their children to facilitate development, you increase the chances of intervention happening everyday. You also help build stronger parent-child relationships that last well beyond EI. Like I said before, that’s powerful stuff.

Now it’s your turn.

What is your favorite strategy for supporting caregiver responsiveness?

Share your ideas in the comments below!

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 3 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.

Okay, when you read that title, maybe you were curious, wondering if you were going to learn about three new discoveries that will make your job easier. Or, maybe you did a quick eyeroll, thinking “Here we go, the next big ‘thing’ that I need to do.” Either way, I’m glad you’re here. While I’m not sure that these three interventions will make your job easier, I do think they can make your work more effective. No, these interventions aren’t new or the next big “thing,” but they are based on the evidence we have about what early interventionists do that has a positive impact on child and family outcomes – meaning child development is enhanced, children learn and participate in everyday activities, families understand how to help their children, and quality of life is improved. One of the key aspects of these three interventions is YOU – how you interact with families and what you do to support parent-child interaction. You are a key, so read on and learn what you can do on your next visit to have that positive impact.

Here we go. Interventions that:

1. Emphasize caregivers’ awareness and interpretation of their own actions,
2. Help caregivers identify and use everyday learning opportunities to enhance child development, and
3. Support caregivers’ responsiveness to their children

have been found to be most effective in positively impacting child outcomes (Dunst & Trivette, 2009; Mahoney, 2009; Swanson, Raab, & Dunst, 2011). That’s big stuff. In this post, I’ll tackle what the first intervention looks like in practice. I’ll discuss the other two interventions in Parts 2 and 3.

Emphasize Caregivers’ Awareness and Interpretation of their own Actions

When you implement this intervention, you go deeper than just modeling or teaching caregivers intervention strategies. You approach intervention from the perspective of expanding how the caregiver thinks about her (or his) capabilities, her impact on her child’s development, and the positive effects of her everyday interactions with her child. Some caregivers come to EI already embracing their influence as the parent, but many are in the vulnerable position of being a new parent or a parent of a child with strengths and needs that are different from what they expected or previously experienced with other children. Early intervention can be a new window through which to see a child’s potentialities, and we can open that window with how we approach the support we provide.

I truly believe that it’s not enough to tell families that “you are the expert on your child.” Those can be empty words if we don’t back them up with support that builds on what caregivers already know and do. We need to convey, through practice and intentional interactions, that the parent is just the right person to help her child grow and learn, she is enough, and what she does really matters. She may not have entered the program knowing how to stretch her child, how to prompt her child to increase vocabulary, how to teach her child to sign, or how to regulate herself so that her child learns to manage his emotions – and that’s all okay. We are there to teach, guide, and help the caregiver become aware of, embrace, and learn to interpret the link between her actions and her child’s behaviors, interactions, and learning. That’s a deeper level of engaging families, a level at the core of who a parent is. Full disclosure – I don’t think this is easy (often it’s not), but I completely believe that if we walk in the door of every visit with the perspective that we are there to look for opportunities to build the caregiver’s awareness of her own actions and help her learn to interpret that impact, what we do and how we do it changes – for the better.

What Does This LOOK LIKE in Practice?

Here are some strategies I’ve learned from EI practitioners in recent conference sessions where we talked about this intervention:

Use open-ended questions to help the caregiver reflect and think about what she (or he) is doing and why. Ex: What did you notice…? What did you see Jack do when you…? Why do you think that happened? 
What did you do differently that time? What could you do differently next time to help Jack learn to…?

Look for moments to build awareness and interpretation. Keep your eyes and ears open for opportunities to point out those moments when the caregiver interacts with the child in ways that enhances development. Adult learners typically want to know if they are doing something “right” so reinforcing positive interactions helps caregivers know they are on the right track.

Provide specific feedback that points out what the caregiver did, what the child did, and the relationship between the two actions. Help the caregiver make the connection, then ask what she thinks about it. Ex: When you waited before helping Emma stand up, she reached up for the pack ‘n play bar to try to stand herself up. What did you think about that?

Use video recordings to build awareness and interpretation. Record the caregiver using a strategy with her child using her cell phone. Then, watch the video together and process it using reflection and feedback. Share what you notice and ask the caregiver about her observations and feelings. Problem-solve if the strategy or interaction can be tweaked to help the caregiver get closer to her goal for the child. You can also encourage the caregiver to record short videos between visits to watch together during the next visit. These videos can become joint plans and records of progress too, so their value (and the learning opportunity) expands beyond the reflection point that happens during your visit.

Now it’s your turn:

What strategies have you used to build caregivers’ awareness and ability to interpret their own actions? What did this look like on your last visit?

Share your ideas and examples in the comments below!

In Part 2, I’ll dig into the second intervention to explore how to help caregivers identify and use every day learning opportunities…and what to do when this is hard. In the meantime, pay attention to how you build awareness on your next visit. Use this series to help you celebrate when it goes well and problem-solve when you need help. Let’s learn together!

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 1 appeared first on Early Intervention Strategies for Success.

We are at the end of our discussion on the levels of awareness of parent of young children with disabilities. We have explored the ostrich phase – a time when a parent has a lack of awareness about disabilities and may not recognize the characteristics of a disability displayed by his or her child. Additionally, we have examined the phase of special designation – the stage at which parents have, through some transformational experience, recognized that their child indeed has a disability, and will require some additional assistance from a service provider to maximize his or her personal potential. Last month, we reviewed the normalization phase when a parent minimizes differences between the child and his or her typically developing classmates and siblings.

Fourth Level of Awareness: Self-Actualization

Today, we are going to explore a parent’s fourth and final level of awareness – Self-Actualization. In this level of awareness, a parent fully recognizes that his or her child with disabilities need supports. Not only does a parent at this level recognize the need for support, but by this time in a parent’s journey, based on the experience of raising and loving the child, the parent has his or her own perspectives on how these needs should be met.

During the time of parenting their child with disabilities, the parent has developed an expertise on a subject – his or her child.

Parents of children with disabilities have been described as practical scientists, and co-therapists, who take an active role in educating and raising their children while becoming skilled at selecting appropriate interventions. Parents may not have the fancy words that you as an early intervention professional have based on your knowledge of the content. However, they are doing some of the same things that you are doing in your practice at home. The interventions just look a little differently.

A self-actualized parent is ready to exercise his or her role as your partner in moving the child’s growth and development forward. And at this point of development, the parent is incapable of being a silent parent. The self-actualized parent is vocal and active. At times, the strong opinion and confidence that develop during and after the self-actualization phase can be met with a bit of resistance from service providers. However, this new found parental authority, when discussing the needs of the child, should be met with a listening ear and an open heart. The parent is now fully capable of exercising and expressing expertise regarding who his or her child is and what the child needs.

The Magic is About to Happen!

As early interventionists, you are in a help-giving profession. Thus, you want to ensure that you are offering families help that is relevant to the family’s needs

How can you achieve that goal?

By listening to your partner – the parent.

The phase of self-actualization is a reflective space. The parent has had the opportunity to think about the child, think about his or her parenting, think about what he or she feels will be the best way forward for the child and family. The self-actualized parent is ready and fully expects to be your partner.

However, this partnership will require a respectful reciprocal relationship between you and the parent.

True Partnerships are Comprised of Two Equals

You can’t be in partnership if, as the service provider, you walk into the relationship and take the lead. That’s not a partnership. The parent is asked to follow your lead in that situation. However, if the relationship is approached with the understanding that you are the expert on the professional knowledge and the parent is the expert on the child and how the disability manifests itself in the child, you can begin to respect and acknowledge the parent as a true partner.

Also, it is critical to remember that, as early interventionists, the goal is to improve children’s outcome. Therefore, you want to empower and enable parents, because no matter how great of a service provider you are or how much you love a child, your time with that child will expire. Parents and caregivers are forever. So, take this time to strengthen your partner.

Therefore, instead of striving to have a parent say you were best service provider the child ever had, you want a parent to say, “While working Ms. Angela, I learned strategies that I use with Molly to this day.”

That self-actualized parent is primed to receive the knowledge you have to give. However, self-actualized parents require and expect that you recognize and accept the knowledge and input they have to offer, as well.

This Child is Their LIFE!

These parents have now fully owned their role as parents of a child with disabilities. They are no longer in a state of not knowing. They are no longer looking for someone to “fix” their child. They are no longer comparing their child to other children.

They just see their most precious child – uniquely different, but not less than.

Unfortunately, as professionals who works with young children and their families, you may not witness a parent move through all of these levels of awareness during your time with a family. However, you must trust the process, not rush the process. And remember a parent’s time of being a parent is 22 years +. And just like the children you serve, parents too take time to develop.

When you commit the time to truly partnering with a parent and assist in that parent’s development as a parent of a child with disabilities, your legacy lives on in that family forever. You become the gift that keeps on giving.

So, be the gift that keeps on giving! We’re counting on YOU!

Have you had the opportunity to partner with a parent who you believed reach the self-actualization phase of awareness?

How did that experience compare to partnering with parent in the ostrich, special designation, or normalization phases?

Check out El’s archived webinar: Mama Bear: Using Parent Narratives and Experience to Improve Engagement Practices

Be sure to read the other posts in this series:

Emerging Parenthood: Trust the Process – Don’t Rush the Process

Levels of Awareness: The Ostrich Phase

Special Designation: The Parent’s Aha Moment

Normalization – The Hope Phase

El is an educator, entrepreneur, author, and PhD candidate specializing in Early Childhood Education/Early Childhood Special Education at George Mason University. Prior to leaving the traditional classroom, El served as an Elementary and Early Childhood Educator in the United States, Japan, and South Korea. She is the founder of KinderJam, an Early Childhood Education care, enrichment, and training agency. Above all, El is the proud mother of an 11-year-old son on the autism spectrum, affectionately known as SuperDuperKid (SDK). El can be reached at elbrown@kinderjam.com.

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Ever had one of those experiences where you realize that, while you think you did your best, you completely forgot what you were supposed to do? Ever had that experience on an intervention visit?

I had that experience recently…I was on a first visit with a family and was planning to set the stage for how we would work together. I was going to talk about what good early intervention looks like and how we would work together doing things the family naturally does or would like to do. I was going to stay firmly planted in my role as a consultant and coach for the parent. But, before I knew it, I was instead firmly planted on the floor by an adorable, funny toddler who was pulling out all of her tricks to get me to interact with her. After a few minutes (okay, more than a few), I realized that I was in the lead, the parent was watching, and I had gone off track. I relocated back to the couch and re-engaged the parent, and yet, before I knew it, I was up playing another game with the child. I just kept getting pulled in. In fact, I felt pulled in two directions and both of them were worthy. After the visit, I got in my car and realized that I felt like I had completely forgotten what I intended to do on the visit, which was focus on the parent-child interactions.

Was What I Did Wrong?

So that’s the question that came up for me…was what I did wrong? By spending time engaging the child, did I break the code of evidence-based early intervention, which focuses on supporting parents and children during their interactions in the context of their routines and activities? Honestly, I don’t think so, but what I did probably wasn’t the best way to help the parent know how to use intervention strategies with her child when I wasn’t there. Yes, she watched…yes, she talked about how she could use the strategies during the day…and yes, we developed a joint plan. What I could have done much better was remember to offer her the opportunity to practice using the strategy with her child. That was what I forgot.

So the more I reflected, the more I realized that I’m not sure that we were ready for the practice piece. It was a first visit and we were still getting to know each other. Even if I had remembered and offered practice opportunities, I’m not sure that she would have been comfortable yet. In typing that, I realized that it sounds like an excuse…well, she wasn’t ready so we didn’t do it. No – that is my assumption and it could be incorrect. I did not offer her the chance to try to strategy so how did I really know whether or not she was ready? Just thinking through that reminds me of what I’ve heard so many parent advocates say: “Don’t make decisions about what we need or what we want to do. Give us the information, provide the opportunities, and let us decide.” That was where I goofed.

Developing the Partnership that Facilitates the Practice

I do think that the close partnership between an early interventionist and a parent takes time to develop. Offering the parent the opportunity to take the lead, be observed, receive feedback, and decide which strategies he/she wants to use are activities that don’t need to wait until we have a certain level of rapport built. However, I think understanding that as the relationship builds, BOTH of us will feel more comfortable in our roles and those easy back-and-forth interactions of reflection, practice, and feedback should happen more fluidly. It has to start somewhere, though, and if I don’t remember my role in facilitating it, it may not happen. I set the tone of the visit, and I want that tone to be that I am there to support the family, not to just play with and teach the child.

Reflection is hard, but we don’t have to be hard on ourselves. I’ll go into the next visit with a greater awareness of what I need to do and how I hope to help the family. Yes, I’ll still likely get pulled right in by an amazing toddler, but next time, I will remember to pause and invite the parent along for the fun. Or better yet, maybe I can join their fun instead!

Have you ever felt like this? What did you do?

How do you balance engaging the parent and the child? What do you do to keep yourself on track?

The post Oops…Guess What I Forgot? appeared first on Early Intervention Strategies for Success.

In last week’s post, which was Part 1 in this series, I began trying to translate the DEC Recommended Practices for Interaction into practices we can use with caregivers. Rather than focusing on how we can implement these practices with children, we need to really think about how to help parents, child care providers, siblings, and other interaction partners in a child’s life learn how to engage children to promote development. So much of the development of social-emotional, communication, and cognitive skills occur within the context of these important relationships. We are typically pretty fantastic at interacting with young children, but we do our best work when we share what we know about how to engage them with caregivers so that they can use those practices everyday, between visits.

Helping Caregivers Use the DEC Interaction Practices (continued)

In the previous post, I provided descriptions and examples of how we can help caregivers implement intervention practices that focus on promoting children’s social and communication skills. Now, let’s wrap up this series by thinking about interaction practices that promote cognitive development and the use of problem-solving skills.

INT4. Practitioners promote the child’s cognitive development by observing, interpreting, and responding intentionally to the child’s exploration, play, and social activity by joining in and expanding on the child’s focus, actions, and intent.

Early interventionists can be partners in promoting cognitive and social play. Through the parent-child-practitioner triad, the interventionist and parent can practice play strategies that expand the child’s ability to focus, problem-solve, and persist.

Example: While observing play with a shape sorter, a physical therapist (PT) notices how the child throws the shapes rather than trying to insert them. The PT coaches the child’s older sister through using hand-over-hand guidance to help the child feel successful. The PT then helps the sister learn how to gradually reduce how much guidance she provides so that her sibling learns to complete the action of finding and inserting the shape with less help. They talk about how this same strategy could be used when the siblings take turns feeding their baby dolls.

INT5. Practitioners promote the child’s problem-solving behavior by observing, interpreting, and scaffolding in response to the child’s growing level of autonomy and self-regulation.

Example: An educator observes a child and mother at lunchtime to look for opportunities for the child to practice problem-solving and using his hands together. She and the mother brainstorm ways to challenge the child without upsetting him. They come up with the idea to offer him “seconds” on his Goldfish crackers by putting the crackers in a small plastic container. At first, they offer the child the container with the lid closed, and the child cannot open it. They scaffold the activity by opening the lid just enough that the child can more easily remove it next time. They use this activity to motivate the child and help him learn persistence and how to request help from his mother when needed.

These examples remind us that, in order to do our best work, we need to work within the context the caregiver-child relationship. Sure, we will still interact with the child, but we do it for the purpose of supporting the caregiver in learning new strategies he/she can use with the child during the week. Implementing these practices requires a sensitive balance of interacting with caregivers and children in ways that build their capacity to engage each other when we aren’t there. Take a moment to reflect on how you do this, who you primarily interact with during visits, and whether your practices match the examples in this post.

If you want to reflect further, check out the DEC Recommended Practices Products for Interaction. You’ll find checklists you can use for self-assessment and practice guides for you and for families (also available in Spanish). Here’s an example:

Adult-Child Interaction Checklist (PDF, New Window)

Access this checklist and share a comment about it below. Consider this:

How could you use this checklist and these practices to guide your interactions with families?

What is your favorite strategy for helping caregivers interact with their children to encourage problem-solving skills? Communication? Playful engagement?

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

The post DEC Recommended Practices – Interaction (Part 2) appeared first on Early Intervention Strategies for Success.

When we whittle early intervention down to its core, I think it’s all about interactions. Interactions between the child and caregiver, first and foremost…interactions between the child and the environment (toys, sofa cushions, spoons and cups, buttons on the TV remote, the family dog)…interactions between the EI practitioner and caregiver that facilitate positive interactions with the child in the natural environment. See where I’m going here? It’s all related to positive, reciprocal, contingent interactions.

Translating our Super Powers

The Division for Early Childhood (DEC) Recommended Practices provide our field with a list of five interaction practices that we can use to “promote specific child outcomes” (p 14) when working with families. As early interventionists, we often have super powers related at using these practices – we know how to use our voices and language to engage children, how to observe behavior and encourage reciprocal communication, and how to help children sustain interactions and respond to the environment. Our use of our super powers won’t ever be enough, though. We have to use what we know to help others interact with the child in ways that boost development and learning. When caregivers use recommended practices for interaction, the child has more opportunities to develop social skills, communication, cognition, and independence throughout the day. Those daily interactions are what really matter.

Helping Caregivers Use the DEC Interaction Practices

Let’s consider the first three practices, which focus on promoting social and communicative interactions.

INT1. Practitioners promote the child’s social-emotional development by observing, interpreting, and responding contingently to the range of the child’s emotional expressions.

Early interventionists are great resources for caregivers in helping them observe and interpret their child’s behavior. This is especially helpful with children who communicate in ways that are harder to understand, such as children who may have autism or those with multiple disabilities. The interventionist can help the caregiver notice the child’s attempts to engage and communicate. Then, they can figure out how the caregiver can respond in ways that help the child learn the benefits of engaging others.

Example: An educator sees a child’s tendency to stroke his mother’s hair as an attempt to engage the mother and feel close to her. The mother originally found the “hair pulling” slightly annoying, but when she sees the possibility that it represents affection from her child, she can respond to the child with a warm smile and voice, encouraging rather than discouraging the interaction.

INT2. Practitioners promote the child’s social development by encouraging the child to initiate or sustain positive interactions with other children and adults during routines and activities through modeling, teaching, feedback, or other types of guided support.

Early interventionists can help caregivers seek out opportunities for the child to interact by observing typical routines, especially those that the caregiver and child enjoy together. By asking the caregiver open-ended questions (“What makes your child laugh? What do you like to do together? When do you do to spend time together? What would you like to do together?), the interventionist can identify activities to target for intervention.

Example: An occupational therapist (OT) observes the morning dressing routine, during which a mother plays peek-a-boo and tickle games with her infant. The OT coaches the mother to use an expectant look and extra wait time to facilitate her child’s engagement and teach her child how to take turns, make sounds, and perhaps pull the blanket from the mother’s face to keep the game going.

INT3. Practitioners promote the child’s communication development by observing, interpreting, responding contingently, and providing natural consequences for the child’s verbal and non-verbal communication and by using language to label and expand on the child’s requests, needs, preferences, or interests.

Rather than being the communication partner for the child for most of the visit, the interventionist can coach the caregiver in how to respond contingently, use words that are just above the child’s language level, and expand on what the child says. This works well during play and other routines.

Example: A speech-language pathologist coaches a father in how to expand a child’s gestural request for his cup to be filled with water. The child hands his cup to his father and walks away. Through modeling and practicing simple prompts, the father can learn to label the child’s request (“More water?”), hold the cup up near his own mouth to draw the child’s attention to the word being said, and wait before meeting the need so that the child has a chance to imitate the model. The father and child can then practice this interaction whenever this request is made, which is likely to be often – more often than if the therapist used this strategy 2-3 times on a single visit.

These are just a few examples of how we can implement the Interaction Recommended Practices through the caregiver-child interaction.  Our knowledge of how to facilitate interactions can translate into the strategies we share and practice with families. Using those parent-interventionist interactions to facilitate parent-child interactions in natural environments – that’s what it’s all about!

Next week, we’ll continue this discussion by looking at the next two practices, which focus on facilitating cognitive skills. In the meantime:

Why is it important that early interventionists translate these practices for use with families?

How have you use these practices on visits? With child care providers?

Share your thoughts and examples of implementing these practices by leaving a comment below!

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

The post DEC Recommended Practices – Interaction (Part 1) appeared first on Early Intervention Strategies for Success.

Today, we completed our two-part Talks on Tuesdays webinar series entitled “Beyond Cultural Competence: How to Effectively Work with ALL Families.” This webinar series introduced what may be a new concept to early intervention practitioners. This concept, cultural humility, helps us think more deeply about culture and involves a sense of understanding that we do not and cannot know all that there is to know about any culture. While we may think we are culturally competent, the reality is that we can never truly be fully competent about any culture. There are too many other, unique influences in any one person’s life to assume that he or she will behave or think a certain way because of cultural identity. Our presenter, Barbara Grant, MA, shared a key idea today that summed this up: Treat everyone as if they have their own unique culture. 

If you did not participate in the webinar series, I invite you to watch the archived recordings. You can find both of them on the Talks on Tuesdays 2017 Recordings page (the archive for today’s webinar will be posted soon).  To help you continue this journey, here are some additional resources where you (and your staff) can learn more about cultural humility.

VIDEO: Cultural Humility

For a complete overview of this concept from Dr. Melanie Tervalon and Dr. Jann Murray-Garcia, watch this 30-minute documentary. As you watch, consider the following questions:

1. How does the concept of cultural humility apply to my work with families?
2. What cultural influences are present in my community?
3. What is one thing I will do differently now that I am aware of cultural humility?

SELF-REFLECTION: Promoting Cultural & Linguistic Competency: Self-Assessment Checklist for Personnel Providing Services and Supports In Early Intervention and Early Childhood Settings (PDF, New Window)

A key component of practicing cultural humility is self-reflection. You will hear the doctors in the video discuss its importance. Take time to complete this reflection checklist (PDF, New Window) to examine your own ideas about promoting cultural and linguistic competence.

Once you complete the self-assessment, consider discussing the following questions during a staff meeting or supervision session:

1. What did you identify as strengths for yourself? If you reflect more broadly on your work culture, what does your agency do well?
2. Where could you improve? How would these changes affect your work with families? With your colleagues?

BLOG: True Confessions: Checking My Biases with Family-Centered Practices

Another aspect of practicing cultural humility is raising awareness of your own cultural biases. We all have them, but are not always aware of them. Taking the time to consider what biases might be affecting your relationships with families is the first step. Read this blog post and discuss it with a colleague or at a staff meeting. If want to dig in a little deeper, complete this checklist: Cultural Competence Checklist: Personal Reflection (PDF, New Window). Be sure to answer honestly, not how you think you “should” answer. Be open to learning about yourself as you process your responses with a colleague or your supervisor.

I encourage you to keep this conversation going, either internally or with your colleagues. Practicing cultural humility is an ongoing learning process, one that can be enhanced when we commit to learning and reflecting together.

What is one thing you do to practice cultural humility?

How do you ensure that you are open to learning about families from backgrounds that are different from your own?

For more information and resources related to cultural competence, visit the Cultural Competence topic page on the VA Early Intervention Professional Development Center site.

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Jenni has two options on every intervention visit:

Option 1: She can work directly with the child while the child’s caregiver observes nearby, or

Option 2: She can provide instruction to both the caregiver and the child by facilitating their interactions with each other during naturally occurring, developmentally enhancing activities.

The first option is probably easier, because in grad school, Jenni was mostly trained to teach infants and toddlers so she really knows how to help them learn. The second option, though, is more in line with the mission of early intervention and the field’s key principles (PDF, New Window). Unfortunately, Jenni just isn’t sure how to implement Option 2 so when she really reflects on her practices, she finds herself slipping back in to Option 1.

What Can Jenni Do?

The first thing that Jenni is doing well is reflecting on her practices. She is aware of her struggle and how it often leads her to slip back into practices that are not aligned with our mission. That’s an important step, but it’s not enough to help her change her practices. For that, she has to dig deeper, think about how to change, and then do it, every day, on every visit, with every family.

One place Jenni can go to help her dig deeper is the DEC Recommended Practices, Instruction strand. This strand focuses on practices that “are intentional and systematic strategies to inform what to teach, when to teach, how to evaluate the effects of teaching, and how to support and evaluate the quality of instructional practices implemented by others” (DEC Recommended Practices, 2014, p. 12) (PDF, New Window). Thirteen practices are listed that describe what Jenni should do. While this is very helpful for interventionists to read what they should do, we have to keep in mind that we are not the only one providing instruction. A key responsibility of early interventionists is to provide support to the caregiver as he/she engages the child using instructional (or intervention) strategies that promote development. We share the role of “providing instruction to a child” with the caregiver. With that in mind, let’s look at the some of the Instructional practices through the lens of early intervention.

DEC Recommended Practices: Instruction

INS1. Practitioners, with the family, identify each child’s strengths, preferences, and interests to engage the child in active learning.

INS2. Practitioners, with the family, identify skills to target for instruction that help a child become adaptive, competent, socially connected, and engaged and that promote learning in natural and inclusive environments.

Jenni’s role here is clear – she will work with the family to learn about what the child likes to do, doesn’t like to do, what he does well, what’s challenging, and what the family would like to do. This information will help them work together to identify the outcomes the family wants for the child and the skills and abilities the child needs to learn to reach the outcome. All of this information will provide the context for intervention.

INS4. Practitioners plan for and provide the level of support, accommodations, and adaptations needed for the child to access, participate, and learn within and across activities and routines.

INS5. Practitioners embed instruction within and across routines, activities, and environments to provide contextually relevant learning opportunities.

Here, Jenni’s role gets a little murky. If she follows Option 1, she would be directly providing the support and accommodations to the child. If she follows Option 2, she will be providing this support using methods that support the child’s caregivers in helping the child “access, participate, and learn…” Sure, she might still work directly with the child to try out new intervention strategies, model them for the caregivers, etc. Her end goal, though, would be to help the caregiver know how to use those strategies with the child so that instruction is embedded “within and across routines, activities, and environments,” both during the visit and most importantly, between visits when Jenni is not in the home.

INS6. Practitioners use systematic instructional strategies with fidelity to teach skills and to promote child engagement and learning.

INS7. Practitioners use explicit feedback and consequences to increase child engagement, play, and skills.

Here again, we have to check our options against the mission of early intervention. Jenni has the skills to promote child engagement, learning, and play, but she will see greater results if she shares her expertise with the caregiver so that the caregiver learns how to promote the child’s learning whenever opportunities arise. For instance, Jenni could read books to a toddler and model common words in the story for the child to repeat. Or, she could coach the caregiver in how to do this during book reading and other playful routines so that when the caregiver and child find themselves walking to the mailbox, in the cereal aisle at the grocery store, or playing in the bath tub, the caregiver knows how to encourage communication anytime. Helping the caregiver learn how to use instructional strategies and feedback requires that Jenni use what she knows in different ways. This is often where the struggle between Option 1 and 2 lies…in how to translate what we know how to do into strategies we can teach others to use.

INS10. Practitioners implement the frequency, intensity, and duration of instruction needed to address the child’s phase and pace of learning or the level of support needed by the family to achieve the child’s outcomes or goals.

INS13. Practitioners use coaching or consultation strategies with primary caregivers or other adults to facilitate positive adult-child interactions and instruction intentionally designed to promote child learning and development.

These strategies provide Jenni with guidance on how to overcome her struggle. She needs to work closely with her team to determine how much support is needed by the family to help the child achieve the IFSP outcomes. She doesn’t have to decide that by herself (and in fact, shouldn’t). Once the frequency, intensity, and duration of services is determined, she can begin providing services using coaching and consultation strategies that build the capacity of the caregivers to promote the child’s learning and development. Jenni’s next step, after reading these practices, could be to learn more about coaching and consultation. She’ll want to learn, watch videos, observe others who are skilled at coaching and consulting with families, complete self-assessments, and continually reflect on her practices.

Providing good early intervention is an ongoing process. Jenni will never be there, at the place where she is an expert and is finished learning. Instead, she can hope to reach a place where she only finds one option – to share her expertise in ways that promote caregiver-child engagement, learning, play, and positive interactions. How she does this will be different for each child and family, but her underlying practices will be the same.

What have you done to help you evolve your instructional practices from Option 1 to Option 2?

What strategies have you found most helpful when sharing your expertise with caregivers?

Share your thoughts, ideas, and best strategies in the comments below!

To help you reflect on the Instructional Practices, check out these resources on the Recommended Practices Products: Instruction page:

• Systematic Instructional Practices Checklist (PDF, New Window)
• Child Learning Comes Naturally (PDF, New Window)
• Encouraging Child Learning in Everyday Activities (PDF, New Window)

If you are like Jenni and want to grow your practices, check out this new module on the ECTA Center site:

Family Capacity-Building Module

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

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How much do I value families’ everyday routines in being able to positively influence children’s development? So very much. Yet… how often do I find myself on a home visit either: 1) only talking with a family about their routines, or 2) engaging with the family in only the routine of play? Too often!

Values versus Actions

What we know about early interventionists is that they tend to have values that align with current recommended practices about the importance of providing services that focus on families’ everyday routines. However, we also know that even with those values, our services tend to focus heavily on having discussions with families, or when we do participate in routines with them and their children, that routine tends to be play-based.

As the saying goes: ‘It’s easier to talk the talk, than walk the walk.’

Neither of these things, discussions or a focus on play, are problematic. Yet we know that our services have much greater potential to be useful to families and supportive of their children when they focus on the typical, everyday parts of their lives.

Therefore, if we want to be most supportive of families and their children, our actions during home visits need to align with our beliefs about the importance of all types of family routines!

Get Back to Walking the Walk

Many of us may be stuck in the ‘talk the talk’ portion of this – we know and value families’ routines. We may talk and brainstorm with families about many routines each time we see them. But how often are these routines themselves the focus of our visits?

Now may be the time to say to ourselves: “It’s time to get back to walking the walk!” That may mean doing some active observation of a particular family routine and providing strength-based feedback, or it may mean being part of the routine with the family (such as going on a walk to the park together). If we want to get back to ‘walking the walk’ of routines based services, one way to do this is to take a moment to evaluate your visits with families. Pause. Reflect. Be generous with yourself and notice your strengths. Be willing to notice the routines you struggle to be part of with families. Take the time to think about the barriers that either you or the family may face.

You are likely very knowledgeable about recommended practices in early intervention. Therefore, one of the most powerful ways to shape who you are as a continually developing professional is to simply reflect on what you do. Self-reflection can be a great step in the right direction for us as professionals by using it to first identify where we are now, and then set goals about where we’d like to be heading.

A Resource for Self-Reflection

This resource, Self-Reflection Worksheet on Home Visiting, can help you to do some self-reflection. Open up the link and take a moment to yourself, or discuss the questions with a trusted colleague. What do you notice when you reflect on the services you provide? For example:

• How do you spend time with families and their children during your visits?
• What routines could you incorporate into your visits with families in order to move past discussion?
• What are the barriers that you or the families you work with are facing that may make this challenging?
• What are your greatest strengths based on these questions, and what are the areas you hope to improve upon?

Share something you learn from this self-reflection by leaving a comment below!

Kalli is an Assistant Professor of Early Childhood Education & Child Services at Montana State University where her research focuses on early intervention services. Kalli also works part time as a Family Support Specialist through Family Outreach, a nonprofit agency in Bozeman, Montana. As a Family Support Specialist Kalli provides early intervention through home visiting services for infants and toddlers with delays or disabilities and their families.

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