{"id":113,"date":"2012-08-01T19:46:53","date_gmt":"2012-08-01T23:46:53","guid":{"rendered":"http:\/\/veipd.org\/earlyintervention\/?p=113"},"modified":"2020-06-25T03:15:09","modified_gmt":"2020-06-25T03:15:09","slug":"embedding-strategies-into-family-routines-one-pts-perspective","status":"publish","type":"post","link":"https:\/\/www.veipd.org\/earlyintervention\/2012\/08\/01\/embedding-strategies-into-family-routines-one-pts-perspective\/","title":{"rendered":"Embedding Strategies into Family Routines: One PT\u2019s Perspective"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright wp-image-115 size-full\" style=\"border: 1px solid black; margin-left: 10px;\" src=\"https:\/\/www.veipd.org\/earlyintervention\/wp-content\/uploads\/2012\/08\/kim.jpg\" alt=\"Kim with Walker\" width=\"300\" height=\"343\" \/>I agree with Mahoney, Robinson and Perales (2004), \u201c\u2026.the time has come to stop talking about parent involvement and to commit to learning how such involvement can be accomplished across a range of family constellations, circumstances, and values.\u201d\u00a0 When I first start working with a family I explain that there shouldn\u2019t be a \u201ctherapy\u201d hour, rather the family should have lots of ideas on how to \u201cwork\u201d with their child by incorporating strategies into activities they are already doing throughout their day.\u00a0 The following are a few tips that will assist the early interventionist in learning how to embed strategies into a family\u2019s natural routines.<\/p>\n<h2><strong>Start with a routine-based interview.<\/strong><\/h2>\n<p>The early interventionist could use a formalized, extensive routine-based interview like McWilliam\u2019s RBI (2004).\u00a0 I tend to do a less formal interview: I ask the family to tell me about a typical day (starting from when the child wakes up until they go to bed for the night).\u00a0 If the family hasn\u2019t mentioned it during their accounting of a typical day, I ask about specific activities they do: shopping, walks, visits to friends, parks, library, day care, etc.<\/p>\n<h2><strong>Incorporate family goals into strategies<\/strong><\/h2>\n<p>This is important for a couple of reasons.\u00a0 First, because the family\u2019s goals help shape the child\u2019s IFSP outcomes.\u00a0 Second, when our approach is compatible with family routines and priorities, the result is collaboration among all team members (Blythe, 2012).\u00a0 Lynne Blythe, local system manager of the Infant and Toddler Connection of Rappahannock-Rapidan suggests an equation:\u00a0Family identified routines + prioritized outcomes = Collaboration + Cooperation\u00a0\u201cTake away any factor and the equation becomes unbalanced\u201d (Blythe, 2012). Sometimes this requires the early interventionist to explain how the strategy is a precursor to an outcome skill.<\/p>\n<h2><strong>Set up the environment<\/strong><\/h2>\n<p>While changes to the actual family activity should be avoided, sometimes it is necessary to modify the environment where the activities take place.\u00a0 For example, let\u2019s say a family\u2019s outcome is for their child to use words and start walking like their cousin\u2019s same aged child.\u00a0 This child\u2019s toys are always on the floor for easy access during playtime.\u00a0 Moving the toys up on top of the coffee table encourages the child to either use his words to request a toy or to pull up to stand to reach the toy, or both!<\/p>\n<h2><strong>F<\/strong><strong>ollow the family\u2019s and the child\u2019s lead<\/strong><\/h2>\n<p>I recently had a child with a diagnosis of Spina Bifida who was resistant to walking with her reverse walker.\u00a0 I suggested making the walker a fun activity by adding a basket to carry a favorite toy.\u00a0 The Mom put the child\u2019s favorite bear in the sling seat and encouraged the child to push the walker from behind like a stroller.\u00a0 Was it the correct way to use the walker?\u00a0 Technically speaking, no, but for our purposes, heck yeah it was!\u00a0 As a pediatric physical therapist I\u2019m trained to break developmental activities up into sequences.\u00a0 First a child crawls, then cruises then walks.\u00a0 First a child must be comfortable on an even surface with an assistive device before you introduce uneven surfaces.\u00a0 As an early interventionist I have learned to keep that training in mind, but follow the family\u2019s lead.\u00a0 This same child refused to walk more than a few feet with her walker inside.\u00a0 Admittedly, I was running out of ideas.\u00a0 That weekend I received a video from the Mom of her daughter walking &#8211; outside, in gravel!<\/p>\n<h2><strong>Be creative!<\/strong><\/h2>\n<p>This is the fun part!\u00a0 For instance, going for a walk provides numerous opportunities to incorporate multiple developmental strategies: squatting to pick up rocks or flowers, marching, going up on toes to reach for leaves, labeling objects and colors, experiencing different textures on hands and feet, etc. Can you use a favorite toy in a new way?\u00a0 Can the siblings be models for the strategy during the naturally occurring activity?\u00a0 As an early interventionist you\u2019ll have to think on your feet and outside the proverbial box!<\/p>\n<p>\u201cInterventions fail to be implemented and sustained when they do not fit the daily routine of the family\u2026when the intervention cannot be incorporated into the daily routine, or when the intervention is not compatible with the goals, values, beliefs of the parents\u201d (Bernheimer &amp; Keogh, 1995, p.424).\u00a0 I am just one pediatric physical therapist.\u00a0 As early interventionists we learn the most from each other.\u00a0 <strong>What are some specific examples of how you have incorporated interventions into the daily routines of your early intervention families?<\/strong><\/p>\n<p><strong>References available upon request.<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>I agree with Mahoney, Robinson and Perales (2004), \u201c\u2026.the time has come to stop talking about parent involvement and to commit to learning how such involvement can be accomplished across a range of family constellations, circumstances, and values.\u201d\u00a0 When I first start working with a family I explain that there shouldn\u2019t be a \u201ctherapy\u201d hour, [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_s2mail":"yes","footnotes":""},"categories":[139,10,12,14],"tags":[37,43,46,50,54,55,58,59,62,67,68,77,79,86,87,96,100,112,125],"class_list":["post-113","post","type-post","status-publish","format-standard","hentry","category-all","category-engaging-collaborating-with-families","category-intervention-visits","category-practical-strategies-for-intervention","tag-collaboration","tag-daily-routines","tag-development","tag-early-intervention","tag-embedding","tag-engagement","tag-families","tag-family-centered-practices","tag-home-visits","tag-implementation","tag-infants","tag-motor-development","tag-natural-environment","tag-parent-professional-partnership","tag-parents","tag-research-to-practice","tag-routines-based","tag-strategies","tag-toddlers","clearfix"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - 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