I’m so excited to spread the word about our latest video featuring service providers, administrators, and families talking about early intervention! Specifically, the video answers the following 3 questions: What is early intervention? What does it look like? and Why does it work?

In addition to short interviews, the video includes photos and video clips of intervention visits to show families and service providers working together in natural environments. We produced the video at the request of local Part C system managers who asked for resources to help their staff explain early intervention to families, referral sources, and others in the community. English captions are available, and in the near future, we plan to add Spanish captions as well to make the video more widely accessible. The video is available on YouTube and on our VA Early Intervention Professional Development Center website.

Take a look:

How You Can Use this Video in Your Program

To help you think about how you might use this video, even if you aren’t in Virginia, here are a few ideas:

Embed the video on your program’s website – The video provides a wealth of general information that could be useful to new families looking into EI services.

Include the url in public awareness materials and information provided to families at the intake – If your program has brochures or parent information handouts, add the video title, url, and description (which you can find on the VEIPD Videos page).

Require that all new service providers and service coordinators watch it – Add the video to your new staff orientation checklist.

Share the link with referral sources – Invite pediatrician or social services offices who offer TVs in their waiting areas to show the video periodically throughout the day. Ask them to include the url in the information they give to families when a referral is being considered or is made to EI.

Share the link with your local public access TV station – Some local public access stations might be able to play the video when requested by community agencies. This could be a wonderful local public awareness/child find activity.

Guidance will be coming out soon with additional ideas for how to use this video to spread the word about early intervention in your community so stay tuned. We’d love to get YOUR ideas too!

What are some ways you envision using a video resource like this?? Share your ideas in the comments below!

For more free videos about early intervention, be sure to visit our Videos page!

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Where are your practices on the traditional vs. participation-based continuum?

Wherever you are on the continuum, take some time to examine the similarities and differences between the two interventions, reflect on your own practices, and plan for how to evolve your work to a more evidence-based approach. This brief provides a summary of research by Campbell & Sawyer (2007), who examined videotaped intervention visits to determine differences between traditional and participation-based intervention. One significant finding: parents and children are more engaged in general, and with each other, when intervention focused on the child’s participation in daily routines, rather than targeting missing skills. When parents and children are engaged, intervention is more likely to be meaningful, useful, and successful. Read on to learn more about how you can use participation-based intervention practices in your work with families.

Source: Campbell, P. H., & Sawyer, L. B. (2007). Supporting learning opportunities in natural settings through participation-based services  (PDF, New Window). Journal of Early Intervention, 29(4), 287-305.

Research: What Do We Know?

The authors of this study examined 50 videotapes of “typical” visits from early interventionists from a variety of disciplines. Videos were analyzed using the Natural Environments Rating Scale (NERS) and the Home Visiting Observation Form (HVOF) to determine differences between traditional and participation-based intervention. Traditional intervention included learning activities planned by the interventionist that targeted specific skills, with the interventionist working directly with the child. In contrast, participation-based intervention focused on helping the child participate in naturally occurring learning opportunities and teaching caregivers how to interact with their children using intervention strategies to support participation. Strategies were incorporated into family routines and activities because they provided the context for the child’s participation. A primary differences between the two types of intervention were what roles the interventionist and the caregiver played in the service. The authors provide a detailed table in the article comparing the two types of intervention (p. 290).

Based on the review of the videotaped visits, the authors concluded that more visits showed traditional practices (70%!) than participation-based practices, which is consistent with other EI literature. Despite what we know from the literature – that traditional practices are not most effective – they persist. When participation-based practices were used, children were more frequently rated as “very engaged” and the child or parent was more likely to be the leader of the activity. The interventionist acted more frequently as a facilitator with the parent-child-interventionist triad rather than providing more direct, child-focused intervention. Interventionists providing participation-based intervention engaged in more observation, used more modeling and verbal support, and focused more on the parent-child interaction. There was more caregiver involvement in general and more interaction with the child, with less time spent in a more passive role. In both types of intervention, materials in the home were used and play provided the context of triadic interactions between the parent, child, and provider. There was, however, a statistically significant difference between what occurred during traditional and participation-based intervention.

Practice: How Can You Use What You Know?

What practices can you start using to provide more participation-based intervention? Here are a few to get you started:

Videotape a few of visits – Use a similar method as was used in this study. Videotape a few visits (with parent permission) then compare your work with the table on pg 290 in the article. Reflect on whether your practices are more traditional or participation-based and why. This could be done individually, with a supervisor or mentor, or as a group staff development activity.

Step back and let them lead – Let go of your plan for the visit and let the parent and child lead. Try this with new families, or explain to a family you have a relationship with that you’d like to try something different. Keep the IFSP outcomes in mind and look for opportunities for learning and participation in whatever routine you find yourself in.

Spend more time actively observing – This was an important difference between the two approaches. Rather than “doing,” spend more time watching. Use what you learn from watching to provide guidance and support to help the parent adapt the routine so that the child can learn from it.

Focus on caregiver-child interactions – That’s where learning happens. Shift your focus from what you think YOU need to what the PARENT can learn to do.

Let go of assessment skills – What we learn at the assessment is important, but don’t let it be the guide for your intervention. Look at the bigger picture. How do children learn to use a pincer grasp in everyday life? Yes, the child isn’t standing in the middle of the floor for 5 seconds, so how can she learn this kind of balance while helping her dad rake leaves? Keep your eye on the prize – learning while participating in real life.

Where are you on the continuum? If your practices are more traditional, what’s your next step for becoming more participation-based? If you already focus on participation, what advice to you have for others?

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Do you know what the hairy eyeball is?? I do because I’ve been told that I give it without even knowing it. It’s that look that gives away what I’m thinking. It might be a glance or a raised eye brow, or my eyes might open a little more widely. Whatever it looks like, I have to be vigilant about it because so much can be read into it. We all know that our nonverbal communication speaks much more loudly than our words, so being aware of what we are saying with our faces and bodies during assessments and intervention visits is really important. Let me give you an example.

The Hairy Eyeball in Action

I was the primary provider for a child with multiple disabilities. It was time for his annual IFSP review and I had requested that an OT join the meeting because of concerns related to feeding and fine motor skills. While we were playing and talking with the child’s mother, the child did one of the “things” that I was concerned about which was an atypical hand posture. Without realizing it, I looked at the OT and gave her the hairy eyeball, as if saying “did you see that?” I had no idea that I did this until after the visit was over and a colleague told me. She had tagged along on the visit to observe and very frankly said to me, “You really need to watch the expressions on your face.” She was right. In that quick look to the OT, I was sharing what could have been construed by the parent as a secret message about something being “wrong” with her child. Of course, that wasn’t my intention at all. I just wanted to be sure that the OT saw what I saw so we could address it. What I should have done is called attention to the child’s hand verbally and explained my concern to the whole team. I had actually talked to the child’s mother before so she knew my concern, but using a look to signal the OT was not the best way to handle the situation. The worst part was that I didn’t even realize I was doing it. You better believe that I was much more careful of my body language once I became aware of what I was doing!

Monitoring Your Own Hairy Eyeball

In the last post, I talked about the challenge of working in a family’s home where there is a bug infestation. As mentioned in a comment on that post, we see lots of difficult things. Being aware of how we respond, including what messages we convey with our body and our words, is so important to how we handle the situation. Avoiding the hairy eyeball and being open and honest with families and colleagues is the best course of action. Here are a few ideas about how to do that:

Reflect on your own body language – It’s really hard to become more aware of your own body language without feedback and reflection. Ask someone to observe you during a visit or assessment, or better yet, digitally record yourself then watch and reflect on what you do and say. There is nothing as powerful as watching yourself.

Think about how you view the members of the IFSP team – Do you consider parents to be equal team members? Do you view them as equally worthy of the  information that you would provide to your professional colleagues? If you have a concern, share it with everyone on the team, including the family, and do so in a way that ensures that everyone understands.

Avoid passing secret messages – If it is important for someone to know during a visit or IFSP meeting, then it needs to be shared with everyone. If it only needs to be discussed with a particular team member, wait to do that until after the meeting. Avoid side bar conversations, funny looks, or passing notes. I’ve seen all of these things done in meetings with families and we can do better by making a commitment to not behave this way.

Imagine if you were the family and the educator was giving the OT the hairy eyeball about something your child just did. How would that make you feel? I learned my lesson and worked hard to monitor my behavior and body language from then on. Since more than half of our nonverbal communication comes from body language, and communicating with families is a key skill of EI service providers, it’s something important to think about. Just be careful of what you look like when you think about it. 🙂

How do you monitor your body language during interactions with families and colleagues? How do you handle it when team members are behaving like this?

The post Beware the Hairy Eyeball… appeared first on Early Intervention Strategies for Success.

You call to schedule the first intervention visit and the child’s father answers the phone. He says, “Hold on, let me get my wife…”

During the assessment, the father comes home for lunch, opens his front door, sees three strangers sitting in his living room floor, takes a quick glance at his girlfriend, then quietly closes the door and goes back to work.

Several months into early intervention, you finally meet the baby’s father. He is eager to learn but doesn’t want to “interrupt” the session so he stands in the hallway and watches. You invite him to join the fun but he says he’s okay watching for a while.

This toddler’s father comes home from work early to make sure he’s at each visit. He always has questions, is eager to show you what the child has learned, and likes to try new things. He struggles with understanding the medical jargon surrounding his child’s diagnosis so uses you as a resource regularly. He sees you as a partner with his family.

Every Father is Different

I’ve met each of these fathers…maybe you have too. Just like any caregiver, every father is different. Unfortunately, though, I think fathers in early intervention are often put into a category, one that has them designated on the side lines of intervention. Most intervention visits are conducted with mothers, or even other female caregivers. Mothers are most likely to be our main contact for the family. This is certainly not true for all families, but being aware of our thoughts about fathers’ roles in early intervention is important because it affects how services and supports are delivered.

Fathers’ Roles in Early Intervention

Father’s roles in EI can vary just as much as they generally do across families and within cultures. Some dads are more hands-on than others; some dads see themselves in more of a supportive role with the mother being the primary caregiver. In many families, this varies from day-to-day. The father’s role can be affected by many things, such as his parenting beliefs, his cultural values, his understanding of the child’s delay or disability, his concerns for the child’s future, or his thoughts on how to support his family. All of these issues and more affect how fathers choose to participate in early intervention and are important considerations for service providers as they collaborate with fathers. We have to be careful not to judge these considerations and understand that our role is to meet families, including fathers, where they are. Fathers are part of that essential parent-professional partnership that makes early intervention work, so don’t forget them!

Don’t Forget Fathers!

If we are truly using family-centered practices, then being sure that we remember to include fathers in intervention activities is so important. Here are a few ideas to help you do that:

Consider fathers’ schedules – When scheduling the intake, assessment, IFSP meetings, and intervention visits, ask about who would like to be present. Try to accommodate the family’s schedule, including the father. If he is typically unable to join the visit because he works during the day, consider offering a session in the evening, videotaping a visit, or doing a visit using Skype or some other teleconferencing. This might work well with parents who are separated by many miles, such as when a military parent is deployed or parents don’t live together but both wish to be involved.

Ask for the father’s insights – Rather than primarily shooting questions to the child’s mother, which often happens, turn your body towards the father to ask if he has anything he’d like to share. Often, he may have a different perspective that can help the rest of the team better understand the family’s priorities or the child’s abilities.

Build intervention around father-child interests – Even if the father isn’t able to join visits, ask about what they do together and try to provide some ideas so that he has some strategies to try. For instance, if he loves wrestling with his toddler, you might talk with the mother about ways they can integrate communication into that game and help her be prepared to coach her husband in doing that. Sometimes those “daddy” games really get children excited and motivated and offer fantastic learning opportunities that shouldn’t be missed!

What other strategies do you use to include fathers in early intervention? If you are a father of a child who has received EI, what ideas do you have for how providers can support dads?

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Here in VA, we are so excited to release our new video series entitled Early Intervention: A Routines-Based Approach! These videos were professionally produced, are less than 7 min each, and are available for FREE on our professional development website or on our YouTube site. I’m going to give you a quick description of each video below. I encourage you to watch them, use them, and of course give us feedback! After the embedded videos, you’ll also find 3 ideas for how you can use them for staff development. Enjoy!

Early Intervention: A Routines-Based Approach – Part 1: Traditional vs. Routines

This 5 min video is the first in the series and features an experienced early interventionist sharing her personal journey from a traditional, clinical approach to one focusing on family routines and activities as the context for effective early intervention.

Early Intervention: A Routines-Based Approach – Part 2: What Intervention Can – and Should – Look Like

This video is about 7 minutes long and features three early interventionists discussing and demonstrating what intervention looks like when it is provided by collaborating with families during their natural routines and activities. Examples of parent-provider collaboration during a trip to a restaurant and visits in families’ homes are shown.

Early Intervention: A Routines-Based Approach – Part 3: Changing the Mindset

This video is under 5 minutes and focuses on insights from the three early interventionists about how they evolved their practices toward a more effective, routines-based intervention approach.

Three Ideas for Using these Videos

If you are a program supervisor or trainer, here are a few ideas about how you might use these videos for staff development:

Idea #1: Group Staff Development – Plan a staff development activity across 3 staff meetings. Watch one video each meeting and reflect together on where individual and program-wide practices are on a continuum of traditional to routines-based intervention.

Idea #2: Training Activity – Have participants bring contact notes or descriptions of recent intervention visits. Collect the contact notes and shuffle them. Watch the first two videos and break the participants into small groups. Each group gets three randomly-chosen contact notes to review and discuss. They can compare and contrast the visit activities with the practices shown and discussed in the videos. You might also ask them what suggestions would they have for that interventionist for the next visit to try to use more routines-based practices. No one has to “fess” up and own the contact note but everyone can learn from them. Wrap-up the activity with the third video.

Idea #3: Individual Staff Supervision – Use these videos with individuals in your program who are struggling with adopting these practices. Rather than doing this as a group activity, watch the first video together with the individual and reflect together on the person’s current practices. Ask him to watch the 2nd video by himself and reflect on it in writing. You could create a compare and contrast handout for him to use during the week to reflect on his visits and what practices he uses. You could also tie this to a discussion and compare/contract activity using the 7 Key Principles: Looks Like/Doesn’t Look Like (PDF, New Window) document from the ECTA Center. Review the reflection together and watch the third video. Come up with a plan for “changing the mindset” with suggested readings, maybe have him join visits with others who are using routines-based practices, etc. Follow-up on the plan in supervision and provide lots of support along the way.

What other ideas do you have for using these videos for staff development??

Special heartfelt thanks to the early interventionists and families who shared their experiences with us!!

The post Three New EI Videos! – Your “Must Watch” for the Day appeared first on Early Intervention Strategies for Success.

Last week I wrote about strategies for using videotaping during and between EI visits.  Here are three fabulous resources to help you think more about the potential use of video to positively impact our work with families:

Results Matter Video Library

Larry Edelman from the University of Coloradco produced these videos and has been a leader in developing short videos for use in EI/EC professional development. If you completed VA’s credentialling modules, you watched some of these videos. Take a look at the clips on using video for self-reflection, celebrating progress, and sharing with families.

Early Intervention Home Visits

This video was developed by Connecticut’s early intervention system. It provides parents with a fantastic overview of what to expect on a home visit and what recommended practices (like coaching and consultation, using a primary provider model, parent-professional collaboration, and routines-based intervention) should look like. Even though the video refers to a specific state’s system, I think it would be a great resource for new families, practicum students, and funders who need to learn about what early intervention should look like.

Liam’s Story, A Mother’s Voice

This video was developed as part of our work in VA and shows interventionists working with Liam and his family. The video focuses on the positive impact of early intervention in Liam’s family’s life, and also shows some nice examples of early intervention that moved beyond the living room floor.

I’ve searched youtube and google for examples of early intervention videos and, not surprisingly, the resources are scarce. I hope these videos get you thinking about how powerful video can be with helping you think about your work with families. Whether used as a personal reflection tool, as part of a professional development activity, or directly with families to support their learning, videos can help you bridge two gaps: the gap between visits and the gap between recommended and actual practice.

The post Videos of Early Intervention in Action – Examples & Resources appeared first on Early Intervention Strategies for Success.

One of the interesting ideas that’s percolating around in my brain following the DEC conference is about using videotaping during and between early intervention visits. Here are a few ways I’ve either heard about or read about for using videotaping in early intervention to help families bridge the gap between visits and everyday life:

Using a parent’s cell phone camera to record the parent or provider using the strategy during the visit.

This is a great idea because so many phones now have video capability and it seems like everyone has one. A parent can then show the video to another caregiver after the visit or can refer back to the video him/herself between visits as a reminder of what to do. I can’t take credit for this fantastic idea. Check out this video clip on our site to hear from the PT who shared this idea with us. Thanks Belkis!

Loaning the family a flip camera to record a daily routine that occurs between visits.

Maybe dinnertime is a disaster or the child has trouble with being put into his carseat in the mornings to go to daycare. Of course, the best idea is to observe these routines first-hand to offer support, but when the provider can’t be there, videotaping may offer another way to support the family. The video can then be watched during the next visit and the provider and parent can problem-solve together. OR, maybe there’s a routine that goes really well that can be taped. When the video is watched, the provider and parent can talk together to develop strategies that can fit into the routine to support the child’s development.

Asking the family to videotape themselves using an intervention strategy between visits.

Seeing what life is like when the service provider isn’t there can really help the provider offer better, more meaningful support than just making random suggestions that may or may not fit with what actually happens between visits. The video can provide a jump off point for the next visit and a great way to review the strategies that were discussed during the last visit.

Videotaping the parent and child interacting during a routine then analyzing it together.

There’s nothing like watching yourself on camera. This would need to be done sensitively, of course. After the routine is recorded, the parent and provider could watch together, with the provider helping the parent reflect on what he/she did. Watching the video together can offer a fantastic opportunity for the parent to come up with strategies to improve the situation with only minor guidance and coaching from the provider.

Videotaping throughout intervention to track progress.

This can be a great visual way to see how much a child has changed over the time, physically and developmentally. It can also be a way to see quality of changes, such as a child’s developing ability to interact, communicate more clearly, become more independently mobile, etc. A nice bonus of this type of taping is that a compilation of the videos makes a great graduation gift when the child leaves the early intervention system!

It probably goes without saying, but be sure to protect the family’s confidentiality by always getting parent consent before turning on your camera and by destroying the videos when you’re done.  I’d love to hear from you if you have used one of these strateiges with families or if you try out one of these ideas. Do you have other creative ways you use videos? Share your ideas in the comments or shoot me an email and I’ll do the sharing for you: dcchildress@vcu.edu

The post Peeking into Real Life: Videotaping Routines between EI Visits appeared first on Early Intervention Strategies for Success.