https://learn.extension.org/events/2651

This material is based upon work supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture, and the Office of Family Readiness Policy, U.S. Department of Defense under Award Numbers 2014-48770-22587 and 2015-48770-24368.

VLE2: Opening Doors with Families Using the Routines-Based Interview

Connecting military family service providers to research and to each other

through innovative online programming

www.extension.org/militaryfamilies

MFLN Intro

Sign up for webinar email notifications at www.extension.org/62831 2

Robin McWilliam, PhD •  Experienced researcher, administrator,

early interventionist, teacher, parent, and writer

•  Developed the Routines-Based Model •  Research centers on infants and young

children with and without disabilities with a focus on child engagement, service delivery models, and collaboration with families

•  Provides consultation, training, and

technical assistance related to providing early intervention in natural environments and the Engagement Classroom Model

Today’s Presenter

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ìBuilding Family Strengths and Resilience With the RBI Robin McWilliam, University of Alabama

FamiliesFirstbyProvinceofBri4shColumbiaCCBY-NC-ND2.0

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Exploring the RBI

Installing the RBI

Implementing the RBI

Perfecting the RBI

ExploringtheRBI

Top signs you need the RBI

What is the RBI?

What does it do?

Why is it important

OnebyLazyLibrarian,CCBY-NC2.06

ì  Uncertainty of family priorities for their child and family

ì  Limited family participation in IFSP/IEP development

ì  Ambiguous outcomes/goals

ì  Too few outcomes; too many goals

ì  Vague understanding of children’s natural learning opportunities

ì  Concerns about caregiver implementation of intervention strategies

TopSignsYouNeedtheRBI

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ì  Semi structured interview 1.  Ecomap 2.  Main concerns 3.  Daily routines (define) 4.  Time, worry, and change questions 5.  Recap 6.  Outcome selection

ì  Participation-based child outcomes + family outcomes

WhatIstheRBI?

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ì  Establish positive relationship with the family

ì  Rich and thick description of functioning

ì  List of functional, family-centered outcomes

WhatDoesItDo?

9 BeingHealthyisBeau4fulbyArmyMedicineCCBY2.0

ì  IFSP outcomes; IEP goals

ì  Information for ì  Family Concerns and Priorities ì  Child’s Present Abilities ì  Family Strengths and Resources

Product

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TIMETOCHATWhatdoyouthinkyouneedtoimproveuponinthedevelopmentofIFSPs?HowmuchhaveyoubeenaQendingtofamilyneedsthroughtheIFSP?

ì  What are your main concerns?

ì  How does your day begin?

ì  What does your child do?

ì  How much help does he need?

ì  What about talking and getting along with others?

ì  What is everyone else doing?

ì  How happy are you with this time of day?

ì  What happens next?

SomeRBIQuestions

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Canyouverifythatwith…

ResearchDataManagementbyJannekeStaaks,CCBY-NC2.012

Research

McWilliam,R.A.,Casey,A.M.,&SimsJ.(2009).Therou4nes-basedinterview:AmethodforassessingneedsanddevelopingIFSPs.Infants&YoungChildren,22,224-233.Boavida,T.,Aguiar,C.,McWilliam,R.A.,Pimentel,J.S.(2010).Qualityofindividualizededuca4onprogramgoalsofpreschoolerswithdisabili4es.InfantsandYoungChildren,23,233-243.DOI:10.1097/IYC.0b013e3181e45925Ridgley,R.,Snyder,P.A.,McWilliam,R.A.,&Davis,J.E.(2011).Developmentandini4alvalida4onofaprofessionaldevelopmentinterven4ontoenhancethequalityofindividualizedfamilyserviceplans.Infancts&YoungChildren,24,309-328.Ridgley,R.,Snyder,P.A.,&McWilliam,R.A.(2014).Exploringtypeandamountofparenttalkduringindividualizedfamilyserviceplanmee4ngs.Infants&YoungChildren,27,345-358.DOI:10.1097/IYC0000000000000021Boavida,T.,Akers,K.,McWilliam,R.A.,&Jung,L.A.(inpress).RaschanalysisoftheRou4nes-BasedInterviewImplementa4onChecklist.Infants&YoungChildren. 13

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Thisimageiscopyrightprotected.Thecopyrightownerreservesallrights.

How the RBI Supports Family Resilience

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ì  Family undergoing stressful situation feels supported

ì  Family experiencing big change has opportunity to plan new routines

ì  Helps families identify specific routines they want to change

ì  With routines-based home visits afterwards, helps family feel confident and competent

RBIandMilitary-FamilyResilience

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ì  Somehow, we have overlooked assessment of needs!

ì  Functional outcomes/goals (target behaviors) ì  Address participation (engagement) needs ì  Address independence needs ì  Address social relationships needs

ì  Family priorities reflected in the IFSP/IEP

Need for Routines-Based Assessment

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ì  Outcomes/goals meaningful to the child’s caregivers

ì  To capitalize on learning opportunities, without embedding nonfunctional outcomes/outcomes

ì  To build on and promote family capacity and resilience, promoting strong families

Need for Routines-Based Assessment

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TIMETOCHATWhatistherichestrou4neoftheday?What4meofdayisthemostcommondifficultrou4ne?Whatclassroomrou4nesoeenleadtolowengagement?

•  Functioning •  Routines •  Family needs

Needs Assessment

•  Participation-based outcomes

•  Context; generalization

•  Family outcomes

Intervention Plan •  Meaningful child skills

•  Intervention in everyday routines

•  Family empowerment, enrichment

Support to Families

LinkBetweenRBIandServiceDelivery

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InstallingtheRBI

What’s involved with the RBI?

Who does what?

How does it work?

TwobyAdamBlust,CCBY-ND2.0

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ì  Go through each “routine” (i.e. time of day or activity)

ì  Get a sense of family’s and child’s functioning

ì  Write down significant information

ì  Star the concerns

ì  Recap concerns with the family, showing them the starred items

ì  Ask what the family would like to concentrate on

ì  Write down these outcomes

ì  Ask them for the priority order

TheRoutines-BasedInterview

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VariousProfessionalsWhoMightBeInvolved

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Intake SC

Others

Evaluators

Providers

Ongoing SC

LogisticsQuestions

Intake Evaluation IFSPMee4ng

ì  Who should be there? Why?

ì  When should the RBI be done?

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ImplementingtheRBI

What does it look like?

Where does it fit in?

How do we ensure it’s being done with fidelity?

Resources, tools, & training

Addressing misconceptions

ThreebyGrantHutchinson,CCBY-NC-ND2.024

Structure

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HomeRou(nesWakingup

Changingdiaper/bathroomGoingtokitchen

BreakfastParentgegngdressed

GoingoutInshopsLunch

GoingtoparkOtherfamilymembers

cominghomeDinnerprepara4on

DinnerBathTV

Bed4me

“Classroom”Rou(nesArrivalCircle

FreeplaySnack

SmalltoysCentersOutsideMusicStoryLunchNap

CentersDeparture

WithinEachRou(ne1.  Whatdoeseveryoneelse

do?2.  Whatdoesthischilddo?

a)  Engagementb)  Independencec)  Socialrela4onships

3.  Howsa4sfactoryisthisrou4ne?

4.  Howwellisthisrou4neworkingforthechild?(“goodnessoffit”)

ì  How does the child participate in this routine?

ì  How does the child spend most of his or her time?

ì  How sophisticated is the child’s engagement? ì  Not engaged? ì  Passive attention? ì  Repetitive behavior? ì  Differentiated behavior? ì  Solving problems? ì  Following the conventions of the routine?

Engagement

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ì  What does the child do by him- or herself? What does he or she need help with?

ì  Can the child be left to participate in this routine without assistance?

ì  How does the child indicate a need for help?

ì  How does the child respond when help is given?

Independence

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ì  How does the child communicate during this routine?

ì  How does he or she respond to communication from others?

ì  How does he or she express him- or herself?

ì  How sophisticated is the child’s communication?

ì  What communicative mode does the child use?

ì  How easy is it for the child to be understood?

SocialRelationships

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ì  How does the child get along with others during this routine?

ì  How cooperative is he or she?

ì  How much does he or she initiate interactions?

ì  How interested is he or she in others?

ì  How does he or she respond to correction from adults?

ì  What kind of correction do adults provide?

SocialRelationships(cont.)

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ì  Everything hinges on follow-up questions ì  Getting details of child functioning ì  Getting details of family functioning ì  Credibility demonstrated by salience of questions ì  Goal: Rich picture of routine

Follow-UpQuestions

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TIMETOCHATWhatmakesaninterviewsimple?Whatmakesonemorechallenging?

ì  Write down, in short notes, important information

ì  Especially note concerns (mostly parents’ but can be yours) ì  Put stars (Ö) next to them

ì  These are not the parent’s chosen outcomes yet

ì  This will be a list of 10-20 or more concerns!

ì  At the end of the interview, use these to remind the parent

NotingConcerns

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ì  Interviewer reads aloud notes about concerns

ì  The family selects 10-12 outcomes (goals); 6 is absolute minimum

ì  The family put outcomes into priority order

OutcomeSelection

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1.  Taking food by mouth (meals)

2.  Meaningful communication single words (play, evening fam time)

3.  Play independently not needing my attention – letting me leave the room without crying

4.  Diaper time going easier – less fussing

5.  Walking (play time, outings, outside)

JasonandSarah’sOutcomes

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6.  Going on outings that are doable with our 5-year-old and Alyssa

7.  Jason time to study for his promotion exam

8.  Sarah time for herself (1x/week)

9.  Organize days

10.  Finding a good school at our next duty station

JasonandSarah’sOutcomes

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ì  Lasts 2 hours; absolute minimum 1 hour

ì  Produces 10-12 outcomes; absolute minimum 6 outcomes

ASuccessfulInterview

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TIMETOCHATHoweasyisittoaddoutcomes,ifservicesdon’tchange?Doyoualwayshaveatleastonefamilygoal?

ì  Child-level ì  Home context ì  Classroom context

ì  Child-related family goal ì  E.g., know about the child’s disability

ì  Family-level ì  E.g., mother find employment

KindsofGoals

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ì  Appropriately natural and informal

ì  Put the parent at ease

ì  Look the talking parent in the eye

ì  Avoid the use of jargon

ì  Affirm what the parent is saying

ì  Express admiration for what parent does

ì  Acknowledge or ask about feelings

ì  Place papers being written on flat

ì  Use “self-disclosure” or “therapeutic use of self”

ì  Handle crying appropriately

ì  Respect cultural conversational norms

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CriticalInterviewBehaviors

ì  Handle emotional topics sensitively

ì  Don’t engage in judgmental talk about the other parent

ì  Jump to later routines, if necessary

ì  Ask detailed questions at the beginning

ì  Keep structure of 6 questions per routine: 1.  What’s everyone doing? 2.  What’s this child doing? 3.  What’s this child’s

engagement like? 4.  What’s this child’s

independence like? 5.  What are this child’s social

relationships like? 6.  How satisfactory is this

time of day?

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MoreInterviewBehaviors

ì  Knowledge of child development ì  To be able to ask sensible follow-up questions

ì  Knowledge of family functioning ì  To be able to ask sensible follow-up questions

ì  Interview skills ì  To be able to keep an easy conversation going

InterviewSkills

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Intake Establishedcondition?

Testing for developmental

delay

Delayed?Eligible?

RBIOutcomes

Decide on resources, including services

Complete IFSP

No

YesYes

Refer out

No

Services start

Wheredoesitfitin?

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Ecomap

ì  Increasingly, communities/programs are scoring instruments from information provided during the RBI ì  What % of children tested for delay are ineligible?

ì  If > 10%, ì  Do evaluations first or ì  Screen children at intake

Adaptation

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ì  Family decides who they want from the family ì  Child does not have to be there ì  Minimize interruptions

ì  Ideal to have 2 professionals ì  One is manageable

Who’sThere?

42 Militaryparentspar4cipateinChildFindbyUSArmyCCBYNC-ND2.0

ì  Teacher Present ì  Parent interview on

home routines, through arrival at school

ì  Teacher interview about school routines

ì  Resume home routines ì  Recap both home and

school concerns ì  Parent picks goals for

home and school

ì  Teacher Absent ì  Parent permission to

interview teacher ì  Teacher interview about

school routines ì  Another time, parent

interview about home routines, through arrival at school

ì  Interviewer reports on school routines

ì  Resume home routines ì  Recap both home and

school concerns ì  Parent picks goals for

home and school

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TeacherInterview

Take-HomeMessage

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ì  RBI best done between eligibility determination and IFSP completion

ì  …with primary service provider involved

But there are workarounds for everything!

TIMETOCHATWhatiftheteacherwantscertaingoalsontheIFSP?

ì  Ecomap-With-RBI Checklist

ì  85% correct

EnsuringFidelity

BabyEmo4onsbyAlexMotrenkoCCBY-NC-ND2.045

ì  Articles and chapters ì  Protocol ì  RBI Outline ì  EISR prompts ì  115 certified trainers ì  RBI Certification Institute ì  Bootcamps ì  Coming soon: Online RBI Fidelity Coach (Younggren)

Resources,Tools,&Training

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Perfecting the RBI

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ì  Not for every family ì  Intrusive

ì  Worry and change questions ì  New baby (assumption that there aren’t many routines or things

the baby does) ì  Articulation only concern ì  Takes too long ì  Can get the information in other ways ì  Why do we need so many outcomes/goals? ì  What if parents miss child needs?

AddressingMisconceptions

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ì  What if a professional has detected a delay or other problem? ì  Why is this a FUNCTIONAL concern? ì  Fit the intervention into existing outcome ì  Obligation to give families information ì  But make sure it is evidence based

Interventionists’Concerns

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TIMETOCHAT Whataretherepercussionsifwedon’taddressacertainneedprofessionalshaveiden4fied?

ì

“What if a parent wants something like more time to herself, and we don’t have the resources to meet that need? Am I expected to go babysit her kids?”

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ì  Parents with mental-health needs

ì  Parents with intellectual disabilities

ì  Parents who don’t want to be in early intervention

ì  Talkative parents

ì  Monosyllabic parents

ì  Divergent thinkers

ì  Overbearing grandparents

ì  Children looked after by nanny or “foreign worker”

ì  Non-English-speaking parents

ì  Distractions

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HowtoFaceSpecialChallenges

ì  robin@mcwilliamconsulting.com

ì  www.ramgroup.info

ì  www.naturalenvironments.blogspot.com

ì  @robinmcwilliam1

ì  Facebook

Contact

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What is one significant thing you learned today?

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Military Families Learning Network

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MFLN Intro

We invite MFLN Service Provider Partners to our private LinkedIn Group!

https://www.linkedin.com/groups/8409844

DoD Branch Services

Reserve Guard

Cooperative Extension

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Family Development Upcoming Event

VLE3:RebuildingA?achmentsWithMilitaryChildrenU(lizingPlayTherapy

•  Date:September15,2016•  Time:11a.m.–12:30p.m.Eastern•  Loca4on:h"ps://learn.extension.org/events/2652

Formoreinforma4ononMFLNFDEarlyInterven4ongoto:h"ps://blogs.extension.org/militaryfamilies/family-development/ 56

Evaluation and CE Credit

•  For this webinar, we are offering Early Intervention, NASW, and Georgia Marriage and Family Therapy CE credits.

•  Webinar participants who want to receive a certificate of continuing education (or just

want proof of participation in the training) will need to take an evaluation and post-test at the end of the webinar.

•  You must submit your certificate of completion and any other materials required to your state/agency in order to receive credit.

•  CE certificates of completion will be automatically emailed to participants upon

completion of the evaluation & post-test.

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•  For this webinar, we are offering Early Intervention, NASW, and Georgia Marriage and Family Therapy CE credits.

•  Early Intervention CE credits are available to participants in Illinois, Georgia, Kansas, Kentucky, Ohio (EISC & EI CE credit), North Carolina, Tennessee, Texas, and Virginia.

•  Webinar participants who want to receive a certificate of continuing education (or just want proof of participation in the training) need to take this evaluation and post-test:

https://vte.co1.qualtrics.com/SE/?SID=SV_2f5yXWhkaOUhN65

•  You must submit your certificate of completion and any other materials required to your state/

agency in order to receive credit.

•  CE certificates of completion will be automatically emailed to participants upon completion of the evaluation & post-test.

Questions/concerns regarding EI CE credit certificates? Contact MFLNFDEarlyIntervention@gmail.com Questions/concerns regarding NASW CE credit certificates? Contact MFLNFamilyDevelopment@gmail.com

CE Credit Information

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www.extension.org/62581

This material is based upon work supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture, and the Office of Family Readiness Policy, U.S. Department of Defense under Award Numbers 2014-48770-22587 and 2015-48770-24368. 59