Mission Part C early intervention

builds upon and

provides supports and

resources to assist family

members and

caregivers to enhance

children’s learning and

development through

everyday learning

opportunities.

Some material taken from and edited with

permission :

7 Key Principles

1. Infants and toddlers learn best through

everyday experiences and interactions

with familiar people in familiar contexts.

2. All families, with the necessary supports and

resources, can enhance their children’s

learning and development.

3. The primary role of a service provider in early

intervention is to work with and support family

members and caregivers in children’s lives.

4.The early intervention process, from initial contacts

through transition, must be dynamic and

individualized to reflect the child’s and family

members’ preferences, learning styles, and cultural

beliefs.

5. IFSP outcomes must be functional and based on

children’s and families’ needs and family-identified

priorities.

Workgroup on Principles and Practices in Natural Environments, OSEP TA

Community of Practice: Part C Settings. (2008, March). Agreed upon mission and

key principles for providing early intervention services in natural environments.

Retrieved from

http://ectacenter.org/~pdfs/topics/families/Finalmissionandprinciples3_11_08.pdf

6. The family’s priorities, needs

and interests are addressed most

appropriately by a primary

provider who represents and

receives team and community

support.

7. Interventions with young

children and family members

must be based on explicit

principles, validated

practices, best available

research, and relevant laws

and regulations.

6

Hanft, B. (April, 2010). Enhancing Services in Natural Environments [webinar]. Retrieved from

http://www.ectacenter.org/~pdfs/calls/2004/partcsettings/hanft.pdf

• Shares knowledge and resources with a child’s key caregivers through adult-to-adult relationships

• Family members are supported in their day-to-day responsibilities of caring for their child

OUR ROLE: SUPPORTING PARENTS AND CAREGIVERS

What does Birth to Three look like?

Natural Learning Environment

Practices

Coaching as a Style of

Interaction

Primary Service Provider

Approach to Teaming

Adapted from: Shelden, M. L., Rush D. D. (2013) The Early Intervention Teaming handbook: The Primary Service Provider Approach.

Baltimore, MD: Paul H. Brookes Co.

Increased Participation,

Confidence and

Competence:

• Parent

• Child

BIRTH TO THREE

NATURAL LEARNING ENVIRONMENTS

Natural Learning Environments

Are:

Natural Learning Environments

START with focus on the

ACTIVITY

Natural activities, routines, settings

Learning opportunities:

In ALL domains

Desired skills and behaviors

NATURAL LEARNING ENVIRONMENTS THREE AREAS OF FOCUS:

Activity Settings

and Family routines

Caregiver Responsiveness

Child Interests

Dunst, C. J., Bruder, M. B., Trivette, C. M., Raab, M., & McLean, M.

(2001). Natural learning opportunities for infants, toddlers, and

preschoolers. Young Exceptional Children, 4(3), 18-25. (Erratum in

Young Exceptional Children, 4(4), 25)

Shelden, M. L., & Rush, D. D. (2001). The ten myths about providing

early intervention services in natural environments. Infants & Young

Children, 14(1), 1-13.

• Natural learning

opportunities

• Every day routines and

activities of children and

families

• Within family and

community life

RESEARCH: HOW CHILDREN LEARN

McWilliam, R.A. (April, 2010). Enhancing Services in Natural

Environments [webinar]. Retrieved from

http://www.ectacenter.org/~pdfs/calls/2004/partcsettings/mcwilliam.p

df

“…amount of time

children spend

interacting

appropriately with

their environment.”

LEARNING REQUIRES ENGAGEMENT

Adolph, K. E., Vereijken, B., & Shrout, P. E. (2003). What Changes in

Infant Walking and Why. Child Development, 74(2), 475-97.

• The amount of a toddler’s

experience with walking is

the only predictor of

improved proficiency

• Toddlers practice walking for

more than 6 hours daily

• Average 500 – 1500 steps

per hour

• 9000 steps per day (length of

29 football fields!)

CHILDREN LEARN THROUGH INCREDIBLE AMOUNTS

OF PRACTICE!

Mastery of functional skills occurs through high-frequency, naturally occurring activities in a variety of settings that are consistent with family and community life.

MASTERY

Shelden,M.L., & Rush,D.D. (2001). The ten myths about providing early intervention services in natural environments..Infants & Young Children,14(1),1-13.

Dunst, C. J., Bruder, M. B., Trivette, C. M., Hamby, D., Raab, M., & McLean, M. (2001). Characteristics and consequences of everyday natural learning opportunities. Topics in Early Childhood Special Education, 21(2), 68-92.

Dunst, C. J., Bruder, M. B., Trivette, C. M., Raab, M., & McLean, M. (2001). Natural learning opportunities for infants, toddlers, and preschoolers. Young Exceptional Children, 4(3), 18-25. (Erratum in Young Exceptional Children, 4(4), 25)

Dunst, C. J., Hamby, D., Trivette, C. M., Raab, M., & Bruder, M. B. (2002). Young children's participation in everyday family and community activity. Psychological Reports, 91, 875-897.

NATURAL LEARNING ENVIRONMENTS BEST OPPORTUNITIES FOR SUCCESS

• Increase caregiver

competence

• Activities happen:

all day

everyday

during the family's

regular activities

• Activities lead to

Learning Opportunities

that lead to

Skill Development

• NOT

“therapy” working

directly with child with

little carry though in

everyday activities

• NOT

starting with

isolated skills and

embedding them in

routines

BIRTH TO THREE

COACHING AS A STYLE OF INTERACTION

COACHING AS A STYLE OF INTERACTION

Coaching Supports

Caregiver:

• Action/Practice

during everyday

activities

• Reflection/Analysis

Passive

Active

Based on Dale’s Learning Pyramid (1969). Information from the National Training Laboratories.

Graphic by John Mazza.

COACHING IS NOT COUCHING!

MYTH

• It’s all talking

• Hands off!

• It only works with some

families

• Practitioner can not

share expertise

TRUTH

• The emphasis is action & practice during visit

• Coaching is as hands-on as

it needs to be

• It is family-centered practice. Works for all.

• Practitioner first finds out what the parent knows and their ideas before sharing information

Rush D. D., Shelden, M. L. (2011) The Early Childhood Coaching Handbook. Baltimore, MD: Paul H. Brookes Co

KEY COMPONENTS OF COACHING

Joint Planning 1. Collaboratively determine specific

activities & strategies that parent will focus on during & between visits

2. Parent determines the specific activity that will be focus of next visit

Observation

of the parent and child by the interventionist during the visit

Action

By the parent with the child:

During the visit

Between visits

Reflective questions

Determine what the parent already knows & is doing

Foster analysis of information & alternative ideas by parent

Feedback Affirmative & informative by

interventionist:

- research-based knowledge

- hands-on modeling

Followed by practice by the parent

BECOMING SKILLED IN COACHING INTERACTIONS

IT’S HARD WORK!!!

BIRTH TO THREE

PRIMARY SERVICE PROVIDER A P P R O A C H T O T E A M I N G

PRIMARY SERVICE PROVIDER APPROACH TO TEAMING

Every child, every family has a full team

One interventionist functions as the primary support for the family

Strengthens parents confidence and competence in promoting child learning and development

Supports parents competence in obtaining desired supports and resources

Shelden, M. L., Rush D. D. (2013) The Early Intervention Teaming handbook: The Primary Service Provider Approach.

Baltimore, MD: Paul H. Brookes Co.

PRIMARY SERVICE PROVIDER TEAMS

Established team consisting of all disciplines that meets regularly (weekly is recommended)

Uses coaching as an interaction style with parents, caregivers and other team members

Provides all services and supports within the natural learning opportunities/activities of the family

Primary provider receives coaching from other team members at team meetings and on joint visits

PICKING THE PSP

• Decision made by whole team including the parent

• Based on ( in order of importance): Family

Child

Environment

Practitioner

• Determining amount of joint visits is based on: Complexity of family situation and child

Knowledge of the PSP and other providers,

Skill in coaching in the natural environment

History of teaming and trust built between team members

RESEARCH PRIMARY SERVICE PROVIDER

National report on helpfulness of early intervention:

• 96% of the time parents with

one provider rated him or

her as helpful • 77 % of the time parents with

two providers rated them as

helpful

• 69 % of the time parents with three or more providers

rated them as helpful

Bruder M.B. & Dunst, C.J. (2004)

www.uconnucedd.org/pdfs/projects/rtc/rtc_outcome_interview_data_report_10_15_04.pdf

Accessed May 15, 2015

MORE RESEARCH ON PSP

190 infants and families receiving 1 year of Early

Intervention services reported:

• less parental stress with one providers vs. multiple

providers

• the developmental outcomes for these infants

was also better when served by a single provider

vs. multiple providers(1)

Review of Literature

Families with multiple providers:

• increased parental stress and confusion

• multiple providers resulted in a significant

number of families having unmet needs,

especially for children with severe disabilities(2)

(1) Shonkoff, J.P., Hauser-Cram, P., Krauss, M.W., & Upshur, C.C. (1992) Development of Infants With Disabilities and Their Families: Implications for Theory and Service Delivery. Monographs of the Society for Research and Child Development, 57(6), 1-163

(2) Sloper, P., & Turner, S. (1992). Service Needs of Families of Children With Severe Physical Disability. Child: Care, Health and

Development, 18(5), 259-282

PILOT STUDY RUSH & SHELDEN

• Experimental group of children and families:

Primary Service Provider teaming, NLE’s &

coaching interaction style

• Control group - multiple independent

providers

• PSP/coaching families:

received less service hours

met IFSP outcomes more often

• Children in both groups showed developmental progress

• No differences in the amount of progress noted between the

groups.

Shelden, M.L., Rush D.D. (2013) A Pilot Study of the Use of Geographically Based Early Intervention Teams Using a Primary Service Provider Approach to Teaming in The Early Intervention Teaming handbook: The Primary Service Provider Approach. Baltimore, MD: Paul H. Brookes Co. (p. 40)

EVERY FAMILY, EVERY CHILD, HAS A TEAM

For More Information

• CT. Birth to Three Website

http://www.birth23.org/aboutb23/lookslike/

• Mission/Key Principles

http://www.ectacenter.org/~pdfs/topics/families/Finalmission

andprinciples3_11_08.pdf

• 7 Key Principles: Looks like, Doesn’t Look Like

http://www.nectac.org/~pdfs/topics/families/Principles_LooksLik

e_DoesntLookLike3_11_08.pdf

• Shelden, M. L., Rush D. D. (2011) The Early Intervention Teaming

handbook: The Primary Service Provider Approach. Baltimore,

MD: Paul H. Brookes Co.

• Rush D. D., Shelden, M. L. (2011) The Early Childhood

Coaching Handbook. Baltimore, MD: Paul H. Brookes Co