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TRANSCRIPT
Session 2
Get RBEI
•Brookes Publishing•Amazon•Google.books.com
Outline
•Review homework•Finish what an RBHV is•RBI That Service Coordinators Did•Functional vs. Nonfunctional Outcomes/Goals•Adjusting if IFSP Isn’t Functional
• Functional skills vs. toy bags
Anonymous Entry Poll
•RBM CoSeE• I have completed it• I have not completed it
Emerging Understandings About RBHVs
1. About building caregivers’ capacity
2. Extending “intervention” to the whole day and whole week and, in Alabama, whole month
3. Professionals need to work together
4. Children’s functioning is not logically divided by domains or disciplines
Functioning
• A different way of looking at children
• Meaningful participation• Engagement• Independence• Social relationships• You will hear A LOT
about EISR!
What Does It Take to Build Caregivers’ Capacity?
RBHVs With Fidelity
•Strong relationship with one weekly professional
•Weekly collaborative (family) consultation
Where Are We Now
•Multiple professionals•Monthly or twice monthly
•Child-centered visits
Alabama: CSP
Special Instructor
Whole Child and Family
SLP
Whole Child and Family
Alabama: CSP
OT
Whole Child and Family
PT
Whole Child and Family
Alabama: Multiple Providers
Whole Child & Family?
SI
SC
SLP
PTWhole Child & Family?
SI (CSP)
SC
SLP
PT
Alabama, One Day: PSP
PSP (SLP)
SIPT OT
• Still more than enough work to go around, if different disciplines can function as PSPs (20 slots a week)
• RBHVs address all child and family outcomes and other needs
• Therefore, you are being trained to be CSPs
Whole Child & Family
Hot to Get From Here to There
•Train everyone to be a PSP/CSP• Role acceptance
•Have service coordinators identify the CSP for each family• Role release
Homework
• See last slide of "Unused in Session 2"
Midpoint Poll
What % of the time during a home visit should be spent working with the child?
•75-100%•50-74%•25-49%•0-24%
Routines-Based Interview (RBI)
How come I’m getting these weird goals?
• RBI that service coordinators did (we hope)
• Semi-structured interview
• Going through the family’s day
• Digging deep into EISR
• Keeping an ear out for family needs
• Time, worry, and change questions
• Recap• Goal decisions• Priority order
Functional v. Nonfunctional Child Goals
•Skills necessary for meaningful participation
•Feasible for caregiver•Chosen by caregiver
7-Point Test of Functionality
1. Is the skill needed for successful participation in a normal routine?
2. If not needed, will it help?3. Can it be taught in a manner that respects the child’s
interests and abilities?4. Can it be taught in a manner that respects the family’s day-
to-day life?5. Can it be taught by the child’s natural caregivers?6. Do the caregivers care about this skill?7. Is the skill developmentally appropriate?
Types of Nonfunctional Goals
Makes /k/ sound Why is this skill neededRolls ball back and forth Why should the child learn this 1
particular skill?Holds head up for 7 seconds What would motivate him to do this?Use flash cards When? Why? Massed trials—really?Stretching with PT during PT session Is the PT going to adopt the child?Track a light 180 degrees Why?Point to letters said by adult Why now?
2Parent chooses child outcomes
4Specialized assessment, if needed: Why does
child function like this?
6Home visitor supports caregivers in
implementing strategies
1Child functioning by caregiver report
3Home visitor develops strategies with caregivers
5 Specialist provides strategies
“Role Assistance”
2 Perspectives
From provider: What if goals aren’t functional?
From service coordinator: What if provider ignores families’ priorities?
Where are RBHVs with PSP/CSP being implemented?• Maine (statewide)• Illinois• Tennessee• Missouri• Portland, OR (2,500
families a year; 200 professionals)
• Tuscaloosa, AL!• Who knows where else?!
• Internationally,• New Zealand• Victoria and Western
Australia, Australia• Singapore• Taiwan• Portugal• Spain• Paraguay• Alberta and Ontario,
Canada
Breakout
•Come up with 3 outcomes related to different areas of functioning• They can’t all be language
•Analyze each with the 7-Point Test of Functionality
•Choose a reporter•Report back after 15 minutes
Routines-Based Conversation With Family to Get Functional Needs
RBC StagesStage Virtual ImplicationsMain concerns No changeEISR in routines Move box with parent to under your camera. Look at
camera. If typing notes, move notes to under camera.
Notes Type or hand-write. If typed, try to limit notes to concerns (starred) or use bold, italics, or all caps to indicate concerns. If you hand-write notes, use stars.
Time, worry, & change questions
No change
Recap Preferably, share screen or send notes.Goal decision making Professional writes goals down. Family sees goals they
decided upon, through shared screen or attachment, to order the priority.
Assessing Needs
• Engagement• Independence• Social Relationships
Midpoint Poll
1. Average number of outcomes2. Functionality of child outcomes
Video and Discussion
• Routines-Based Intervention (VA Early Intervention Professional Development Center)
Exit Poll: Developmental Appropriateness
• If the outcome is something the child is nowhere close to being able to do but might reach in 6 months, right now we should (CHOOSE ONE)
• Hold off working on this outcome• Explain to the caregiver (and service coordinator) this outcome is
inappropriate• Work with the caregiver on the first step towards this outcome
Homework, Questions, Wrap Up
• Review the RBHV checklist (www. eieio.ua.edu/materials)
• Check yourself on it after 3 visits• Read “How to use the NSF”• Come with a home visit to discuss