Written by Elaine Aldridge, Provider Contract Coordinator, Mecklenburg County CDSA
So the Service Coordinator (SC) is going to come to one of your intervention sessions…what’s a provider to do? Not to worry, service coordinators aren’t coming to the “monitoring visit” to check up on you or to witness the “perfect” treatment session. The SC is there for ongoing assessment of child and family needs and to monitor the implementation of the Individualized Family Service Plan (IFSP)…… what is the progress with IFSP outcomes, are current services and supports meeting the needs of family, etc. In addition, the SC is there to support you as you support the family. We are all part of the IFSP team seeking to encourage children and families within the context of their day-to-day routines. Two of the most important of the Seven Key Principles: Looks Like / Doesn’t Look Like address that infants and children learn best in everyday experiences and interactions within the context of familiar environments. We believe that all families can enhance their children’s learning and development. Our job is to help families build on their strengths and to support families according to their identified priorities.
So what do providers need to know to have the most successful visits with families? I asked several service coordinators to give their input and can summarize their varied responses in one sentence:
It’s all about engaging and supporting the family!!!!
Here are the top ten ideas to consider:
1. Notify the service coordinator of your initial visit start date.
Because we operate under the federal regulations for Part C of the Individuals with Disabilities Education Act (IDEA), we have to provide services in a “timely” manner once they are added to the IFSP. This means that, here in North Carolina, we have 30 days to make the referral and have your first visit completed with the family. In addition, SCs want to join you on your first visit so that they can introduce you to the family and help “frame up” what families can expect with early intervention services. The SC will explain to parents that we are there to work with the family, not just the child who was referred. They will also explain why it is important to use materials that are found in the home and how to embed interventions within the context of daily activities.
2. Know and respect family priorities.
Family priorities may not be always the same as ours. Meeting the family where they are will help you to build a trusting relationship upon which you can build new strategies to support both the family and the child. For example, while we know that using a pacifier can inhibit speech development, the family may not be able or willing to start that process because their priorities are in a different place. Another family may want some help around changing their child’s sleeping patterns, but cosleeping may be impacting that routine – if the family feels that cosleeping is what is working for them, how else can we support this need?
3. Read the IFSP and ask questions to learn about the family dynamic and background.
Getting to know a family takes time, and relationships develop as trust builds. It is important to understand the family’s values in terms of parenting, decision making, and even food choices and leisure activities. The Individualized Family Service Plan, or IFSP, is the document that covers everything from who’s involved on the team, to medical history, to developmental information, to family priorities in outcomes. When you get the IFSP, it’s important to review the whole thing, not just evaluation/assessment results or outcome statements. After reviewing this information, your follow-up questions can help show families that you care enough to understand what is important to them.
4. You are part of the IFSP Team!
The IFSP team consists of parents and family members, service coordinators, interventionists, and evaluators. It can also include anyone the parents have deemed significant in the child’s life. Your participation in IFSP reviews is critical because only the IFSP team as a whole can make decisions about the early intervention support and services. Please remember to contact the Service Coordinator if you have any concerns about the IFSP outcomes and or service delivery plan. Together, the IFSP team can support the child and family.
5. Empathize with parents and help them to feel more competent.
This tip comes from a service coordinator who also had a child with special needs. Even when a parent seems to be in control of what’s going on, they can benefit from the support to know that they are doing a good job in caring for their child. Parents do not anticipate that their child and family will require additional professional support and may not be used to asking for or accepting help. Interventionists need to be sensitive to the parent’s pace and readiness.
6. Talk to the parent first instead of just going to work directly with the child.
It’s ok to sit on the sofa and talk with the parent first. A great way to start each visit is with joint planning so you can reflect on what has happened since your last visit. Ask the family open-ended questions about how the week went and what they did to help accomplish successes. You are there to support both the child and family within the context of their everyday routines. Sure, you can put your hands on the child during the course of treatment when you need to determine the best way to help the child develop and so you can suggest strategies to the family that address their concerns and outcomes.
7. Ask families to tell and show you what they already do.
This will help build confidence and also assist you in partnering with families to suggest new approaches to address priorities. You can build upon child and family strengths and later problem-solve new strategies together. Just remember that your goal is to interact with parents during visits so they feel comfortable and confident during the course of the week to try out intervention activities when you are not there.
8. Observe family routines during your visits.
You will learn a lot by just watching how families engage with each other. How does the child communicate when he wants something? How does the parent respond? Does the brother try to talk for the child or grab his toys? What does the parent do? You can help incorporate some of your observations into a plan with the family.
9. Engage the parents or caregivers during visits.
Consider parents and all family members and caregivers to be active participants in the IFSP process. Explain why you are doing something as you model intervention strategies, and ask the parents to share their observations about how the child responded. Invite the parents and caregivers to try what you modeled, and encourage them to provide feedback about what seems to be working and what is a challenge. End each visit with a plan until your next visit. Keep in mind that parents can most easily follow suggestions that will fit into their daily lives.
10. Involve siblings, cousins, or neighbors who are part of the child and family’s life.
Yes, additional little ones may seem as a distraction at first, but the child will have the most opportunities for practice within the context of their everyday routines when we really look at the child’s routines as a whole. After all, aren’t siblings, relatives, and neighbors part of the child’s natural environment? Children also learn a lot from other children!
So, after you consider all of these best practice tips, the bottom line is that yes, you are there to help the children develop, but when all is said and done, interventionists can best do this by partnering with the families. After all…….It’s all about engaging and supporting the family!
Have you had questions about how this should look or needed some more information about how your sessions should look? Here in Mecklenburg County, we have wonderful providers who can help mentor you to give you support as you are getting started with us. Check out our Mentoring information and Contact Us to get in touch with folks who can give you a hand.
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