powerpoint presentation€¦ · 18-jan-17 2 objectives o learn about the meisr o why - foundational...

18-Jan-17

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Virginia Early Intervention

10 February

Naomi Younggren, PhD2

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Rate your understanding about the MEISR.

Rate your confidence with using the MEISR.

#1

Ogle, D.M. 1986. K-W-L: A teaching model that develops active reading of expository text. Reading Teacher 39: 564-570.

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#2

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Objectives

o Learn about the MEISR

o Why - Foundational Framework

o What - Purpose, Uses, Development, & Organization

o How - Scoring

o Who, When, Where, & How - Implementation

o Explore how the MEISR can assist with the COS process

o Discover how it can help in the IFSP process

o Practice using the MEISR

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Materials you should have for today

VA MEISR For Pilot

Copy of today’s slides (PPT)

Activity sheet to accompany slides

VA Decision Tree

MEISR excel

William MEISR Exercise Bundle

Privy Information about William

William’s MEISR

William’s MEISR by Outcome Area

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Picture Credit & Useful Resource

http://www.cdc.gov/ncbddd/watchmetraining/index.html

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Note

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Foun

datio

nal F

rame

work

http://www.cdc.gov/ncbddd/watchmetraining/module2.html

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Engagement

“The amount of time children spend

interacting with their environment

in a developmentally and contextually

appropriate manner.”

(McWilliam & Bailey, 1992, 1995)

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How does the foundational framework of the

MEISR align with your thinking about

early intervention?

#3

Purp

ose


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Purpose

Designed to help Families assess their young children’s

functioning in different routines.

Birth - three years of age.

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Uses


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Uses• Clarify goodness of fit between family routines and the child’s

abilities

• Guide family daily activities & routines discussions

• Help identify functional IFSP outcomes

• Assist teams with determining COS ratings

• Facilitate routines-based intervention

• Monitor child progress

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MisUses

• Exclusively used for eligibility determination

• Mechanically used to identify IFSP outcomes

based only on missed or next items

• Solely used to determine COS ratings

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The MEISR…

1. Is a standardized instrument.

2. Provides a profile of children’s functioning.

3. Can be completed by parents.

4. Is a curriculum for early intervention.

5. Generates COS ratings.

6. Can help parents define IFSP outcomes.

True or False

#4

Deve

lopme

nt


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Development

• 2007, 2010, 2012, and expected publication 2018

• Field tested with providers and families

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Age Guidelines

• Starting ages extrapolated from existing tests

and curricula

• Children vary considerably in their starting

ages for different skills

• Starting ages are considered good estimates

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Item Density by Age GroupItem Density by Age Group

zero - 5.9 6 -11.9 12 - 17.9 18 - 23.9 24 - 29.9 30 - 35.9 36

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Orga

nizat

ion


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Organization

• 13 common family routines

• Intentional mix of Engagement, Independence,

and Social Relationships (EISR)

• Cross referenced

• EISR

• 5 Developmental Domains

• 3 National Child Outcomes

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Functional Skills In Day to Day Routines

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3. Getting

Dressed

4. Toilet/Diapering

2. Meal Times

5. Going Out6. Play with Others

7. Play By Self

1. Wake Up

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8. Napping

9. Bath Time

10. Hanging Out, Books/TV

11. Grocery

Shopping 12. Outside13. Bedtime

What Functional Abilities do you see?

#5

Number of Items for Each Routine

25

48

29

21

35

40

36

16

31

39

19

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0 10 20 30 40 50 60

1. WAKING UP

2. MEAL TIMES

3. GETTING DRESSED

4. TOILETING/DIAPER

5. GOING OUT

6. PLAY TIME WITH OTHERS

7. PLAY TIME BY HIM- OR HERSELF

8. NAPPING

9. BATHING

10. HANGING OUT/WATCHING TV/BOOKS

11. GROCERY SHOPPING

12. OUTDOORS

13. BEDTIME

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Item Density by theThree National Child Outcomes

Item Density by O's

O1 O2 O3

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Item Density by theDevelopmental Domains

18%

18%

23%

19%

22%

Items by Developmental Domains

Adptive Cognitive Communication Motor Social

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Item Density by theDevelopmental Domains

0 10 20 30 40 50 60 70 80 90 100

Adptive

Cognitive

Communication

Motor

Social

Item Density by Developmental Domains

and Domain Clusters

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Scor

ing


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Scoring• Scale

• 1 not yet

• 2 sometimes

• 3 often

• 3 beyond this

• Percentage of mastered functional skills for age• By routine

• By 3 National outcomes

• By domain

• By E-I-SR• Overall

• Percentage of mastered functional skills for total skills• By routine

• By 3 National outcomes

• By domain• By E-I-SR

• Overall

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3 is considered mastered

MEISR Summary Scoring SheetBy Routine for Age & By Routine for Total Items

Scoring Summary

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Emmitt - 13 months old

10/19 = 53% mastered of age for wake up

Emmitt - 13 months old

Scoring Mastery by Routine for Age (Lucas 24 months)

In the “Getting Dressed” routine Lucas has mastered 13

of the 21 (62%) functional skills for his age (24 mo.). 35

= 1321=

Scoring Mastery by Routine for Age (Lucas 24 months)

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Scoring Mastery by Routine for Total Items (Lucas 24 mo.)

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In the “Getting Dressed” routine Lucas mastered 13

of all 29 (45%) functional skills. 37

Scoring Mastery by Routine for Age & by Routine for Total Items(Lucas 24 months)

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(Luc

as 2

4 mo

nths

)

#6

10 4 17 6

40

= 37

10 (27%) 4 (11%) 23 (62%)

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Often & Beyond combined to ease profile viewing #7

#7

2 4 5 9 56%9 64%14 3

Imple

ment

ation


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Implementation - Who

• Parent completed

• Team collaboration

• Family interview / The RBI

• Combination of above

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Implementation – When (Entry to Exit)

• Intake

• Assessment for Service Planning

• IFSP Development

• Service Delivery, including ongoing assessment

• IFSP Review

• Annual IFSP

• Exit

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Implementation - Wherever

https://www.pinterest.com/pin/164874036334811522/

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Implementation - How

• With Family Interview or The RBI

• As part of Functional Assessment

• Family Completed

• Combination

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Family Interview

How could the MEISR help me with interviewing

families about their “Daily Activities & Routines”?

#8

Family InterviewPrepare the MEISR for the child’s age &

what you already know, but only if you already know

With Family Interview (or RBI)Breakfast (Lucas 24 months)

Breakfast is in the kitchen. He eats with the rest of us . He and the girls usually have cereal. If it’s on the run the girls will give him a pop tart. He can’t get the wrapper off. If he needs help he doesn’t ask, he’ll just tries to bite through the wrapper. He doesn’t have much patience to wait, even for 5 minutes if he wants something. Rather he fusses ti l l someone helps.

Fortunately, most breakfasts that are not on the run and Lucas follows directions to sit at the table initially. But he does not stay at the table.

He sits in a regular chair at first, but squirms, up on knees and down on bum and up again. He comes and goes from the table, we often have to chase him back to the table

When eating he eats by himself and no longer needs to be fed. He chews his food well – no stuffing or drooling. He uses a spoon well and by himself, he spills some. He can take little bites. He’ll pick up (pinch) small bits and

eat them one at a time. At meals he can be picky. A favorite is chicken nuggets. He says “No” when I give him something he doesn’t l ike.

Veggies always get a No. He drinks from a sippy cup. But not a regular cup, he dumps that. When he’s done eating he pushes the bowl away or just leaves the table without returning. If he wants more he’ll reach or point for things, even climb on the table, I don’t l ike that He can say eat and drink, but doesn’t always say that but goes to get what he wants. More and finished are no

t yet part of his vocabulary. After breakfast if he played more than ate and the things are put away he sometimes asks for drink by saying

juice. He’ll say waf for waffles – he loves waffles. He knows cookie too and where they are kept on top of the fridge. He’ll point and ask for cookie. He knows wh

en I point to cookie that means it’s cookie time. If I ask him a couple of things l ike to go get something he doesn’t seem to understand, l ike bring me the milk

and your cup. But he does follow simple directions to throw things in the trash. He is very tuned into the girls , he even imitates what they do. They play a face game it’s funny. 51

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#9

Functional Assessment

How could I use the MEISR when observing children?

#10

Lucas (24 months)

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#11

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Observing Lucas (24 mo.)#11

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With Functional Assessment

Observations (Outdoors)

• Climbs up slide using feet and hands, gets almost to the top • Goes down slide backwards on feet holding on, then turns around and

goes down on bum• Does again on the parallel slide, getting closer, but not to the top• Slides down backwards on belly, turns around stands on end of slide• Jumps off slide from standing position with both feet• Walks up slide steps one foot on a step and using hand rail. On hands and

knees at first landing then walks up remaining steps. • Sits down at top of slide and slides down• Runs across playground across grass and sidewalk• Follows after ball, picks it up, tosses it up and forward with both hands• Throws ball upward underhanded at small basket hoop• Runs after ball when it rolls away, goes toward road

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#11

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Some items were not observed

#11

Parent Completed

How might I invite/encourage families to complete the MEISR.

#12

Parent Completed

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Family Interview, Functional Assessment, Parent Completed

How could weuse the MEISR in a combination

of different ways?

#13

Using

the

exce

l spr

eads

heet

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MEISR - Excel spreadsheet

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Summary Score Sheet in Excel

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COS

Proc

ess

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https://www.cdc.gov/ncbddd/watchmetraining/module4.html#objective-3

Enter “custom sort” to organize by outcome and age

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Enter sort by 2 levels: Outcome and Starting Age

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Open the excel spreadsheet & practice

1. Sort items by outcome2. Then sort by age

#14

MEISR sorted by outcome & age

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Functional Skills

AE

IF

Missing AE and IF functioning

7172

Considering all the information gathered…

• Are the skills and behaviors demonstrated what one would expect for a child this age? AE

• Are they like those of a younger child? Are they the skills and behaviors that come just before

the age-expected skills and behaviors? IF

• Are they like those of a MUCH younger child? Are they farther away from age expected skills

and behaviors? (much earlier or atypical skills and behaviors) F

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Using the Decision Tree is Key!

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Use theMEISRto assist with Decision Tree discussions

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Sophie (9 month) COS mini exerciseFrom the information below what do you know about Sophie’s skills in Outcome 2?

#15

IFSP

Dev

elopm

ent

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IFSP Outcome Identification

• What would you like Teddy to be

able to do?

• What are activities would you like

Teddy and your family to be able

to do?

• In 6 months to a year what would

you like your child to do?

• What do you want to work on?

• Based on our assessment the

next important steps for Teddy

would be…

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MEISR can help teamsidentify functional and specific

IFSP outcomes

IFSP Outcome Identification

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Earlier, you identified _____ and

_____ as your priorities. As we

have talked through your

routines and discussed the

assessment, we noted that ____,

_____ and _____ also seem to be

challenging. In light of that,

what is most important to

you to work on first?

• Alex will participate in toileting by

lowering his pants before sitting

on the potty +measurement criteria

• Baldwin will play appropriately

(not throw) with toys in the sandbo

x outside in the backyard +

+ measurement criteria

• Carmen will eat a variety of foods (beyond chicken nuggets and pasta)

at lunch and dinner + measurement

criteria

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• Alex will increase

independence with

toileting.

• Baldwin will stop

throwing toys in the

sandbox.

• Carmen will tolerate

eating different foods.

Functional, Contextual,

Positive, Active, and

Discipline and Jargon Free

Vague, Negative, Passive,

Discipline Particular

Reminder! IFSP Outcomes must include 1) functional skill, 2) the routine/activity, and 3) measurement of achievement

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Sophie (9 month) mini IFSP exercise

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Serv

ice D

elive

ry

8182

Welcoming early interventionists to work on the functional priorities

I set for my child and family

Remembering the names and faces of different providers and trying to decipher what they are doing and sharing

Prac

tice

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Materials• Video clip “Meeting William” – we’ll watch this together (video)

William MEISR Exercise Bundle (paper)

VA Decision Tree (paper)

Actions (Small Groups Assigned 1 of the 3 Outcomes to Focus On)

1. Conduct functional assessment – get to know William.

2. Use all information (including excel sort) to DRAFT what you know about

William’s functioning for your assigned outcome. Use IFSP Section II: Team Assessment to write your draft.

3. Use information including the MEISR to work through the COS process

with the Decision Tree for your assigned outcome (Child’s Development in

Relation to Other Children the Same Age).

4. Use the MEISR and other information available to help identify two

possible IFSP outcomes.

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Observing William (30 mo.)#17

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In your groups for the outcome you are assigned…

1. Conduct functional assessment – get to know William.

2. Use all information (including excel sort) to DRAFT what you know

about William’s functioning for your assigned outcome. Use IFSP

Section II: Team Assessment to write your draft.

3. Use information including the MEISR to work through the COS process

with the Decision Tree for your assigned outcome (Child’s Development in

Relation to Other Children the Same Age).

4. Use the MEISR and other information available to help identify two

possible IFSP outcomes

#17

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#17

Tell us how it went. What did you learn?

What do you wonder about?

Using

the

MEI

SR

in yo

ur P

roce

ss

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ExitAnnual6 mo.

ReviewIFSP

(COS)Assessment

Intake

How might it be used in your process?

#18

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FAQ

Jot down the questions that come to mind.

We’ll review these in our follow up webinars too.

#19

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For the MEISR Pilot… My next

step is to………

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• Monthly March - July

#1 on

# 2-6 - To be Scheduled

• Please send in questions and the things you wonder about ahead of time

• Topics will evolve as we proceed

Follow UpWebinars

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[email protected]

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powerpoint presentation€¦ · 18-jan-17 2 objectives o learn about the meisr o why - foundational...

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