Identifying Natural EnvironmentsNATURALLY

Juliann Woods, Ph.D.Florida State University

June 19PA Service Coordination Institute

TaCTICS

http://tactics.fsu.edu

Family-guided Routines

Match the child and family interests

Promote positive interactionsEmbed functional targets into

meaningful outcomesAre flexible and adaptableChange with the child and family

Guiding Principles Adults as diverse learners: Individualized

within formal and informal social networks Family guided: Family identified, child

preferred routines, activities and settings Team implemented: Joint problem solving

approach to decision making Experiential and action focused: Partners

and coaches for teaching and learning Dynamic engagement: Multi-modal

follow-up with continuum of supports for competence

Individualized Family Service Plan (IFSP)

Early Intervention promotes children's outcomes by enhancing the abilities of families.

The purpose of the Individualized Family Service Plan is to

describe how early intervention can assist families in helping their young child with special needs to develop and grow.

What Families Want in Assessment

adapted from Zero to Three Newsletter, Washington, DC

Opportunity to work together to learn about the child

A “real” picture that reflects the child in familiar and functional settings using multiple methods to share information

Participation in meaningful activities Information to support informed

decision making

8 Strategies to Support ALL Adult Learners

Comfortable Environment

Respect for Values and Priorities

Effective Communication

History and Experiences

Contributions and Participation

Collaboration and Problem Solving

Applicability to Life and Functionality

Competing Commitments

Dyad

Resources and Strengths

Concerns Family Priorities (include for child)

Family InformationThe following information was shared by the family with on . The family understands that they do not have to give any information on this page in order to receive services; however, information provided will help determine appropriate services and supports. This information reflects a summary of family considerations from conversations beginning with information collected from the family's first contact, the multidisciplinary evaluation and planning for the IFSP meeting.

Gathering and Giving Information In Routines-

based Assessment Conversations,

Interviews Questionnaires,

Checklists Problem-solving

Situations Environmental Scan,

Observations

Child and Family Preferences, Priorities

Developmental Skills, Concerns, Routines, Roles

Resources, Supports, Options, Strategies

Interests, Activities, Interactions

All About MeWho are the Important people in my life?

What activities do I like to do at home and in the community?

How do I play with children, adults, and toys?

What does my family want me to be able to do?

Adult Learning Styles

Active Experimenters Give it to me! Just do it; try, practice Parent completed

measures e.g. Ages & Stages Qs; DOCS

Conceptualizers Tell me about it! Think, analyze,

question Handouts, brochures;

e.g. Day in the Life, or Letter to … from Lorna

Observers Show me! Watch and reflect Videos of other parents

or role play assessments

Experiencers Share with me! Feel, listen, project Questionnaires or

structured interviews, e.g. Getting to Know Your Child or Community Map

Child

Family

Outcomes

Data

New and Old Activities and Events

Progress Problems Participation Planning

Talk! Listen! Watch!

Information Gathering

Talk! Listen! Watch!

Information Sharing

Development

Disability

Resources, Supports

Confidence

Competence

Connections

Conversation Startersfor Family and Caregiver

Routines Typical day Nights, weekends Regularly or frequently scheduled

appointments/events Sibling activities Family activities/events Preferences Expectations

Powerful Questions What’s working well for you now? What worry wakes you up at night? If you had an assistant for a day, what

would you be doing? What would your assistant be doing?

What has been an accomplishment for you and your child that makes you happy?

What community activities do you feel you are missing where you would like to participate?

What makes a day challenging?

Strengthening Skills inIdentifying Routines

Practice thinking out of the IFSP boxes Shop for ideas while completing the

tasks of your everyday life Survey the family for special interests or

activities Complete an environmental scan of

your own routines and materials Complete an environmental scan during

a home visit

Beyond the List of Routines and Activities

Parents, preferred playmates, caregivers, pets, places

Physical space, materials, resourcesExpectations, rules, ritualsLife style, roles, responsibilitiesLanguageFrequency of opportunities, events,

activities

Why Go “Beyond” the List?

Gives the family “more” voice in the process

Provides meaningful information for the family and team members

Increases ease of putting information into functional family words on the IFSP

Individualizes routine for the identified outcomes for the child and family

Supports actual implementation through adequate and accurate information

What? How? When?

Conversations… listening and learning, sharing and showing

Problem solving and picking a few comfortable care giving and play routines

Observe, discuss, record the dyad interaction

Review results in a checklist or parent report form and answer questions

Continue conversations… priorities, expectations, possibilities, examples to provide framework and first steps

Multidisciplinary Evaluation: The Big Picture

Adaptive/Self-Help

Medical Health (Immunizations, Allergies, Medications, ect.)

Date:

Types of Assessment:

Instrument:

Signature/Role:

Agency:

Date:

Types of Assessment:

Instrument:

Signature/Role:

Agency:

Making the Most of Every Opportunity

RoutinesGetting the mailPetting the catWaiting for snackGetting a drinkGoing down a slidePlaying ballTurning on music

OutcomesWashing handsUsing wordsWalking stairsPlaying with toysFollowing directionsSitting without

supportReach, grasp, release

Multidisciplinary Evaluation: Recommendations

Recommendations/ConsiderationsIn forming recommendations, consider the following: 1. Skills needed by the child and/or skills desired by caregivers, 2. Adaptations/Acquisitions, 3. Identifying and assessing community resources and family activities, 4. People connections or information desired, and 5. Appropriate natural environments/community resources and family activities.

Eligibility:

Plan of ActionFamily’s Priority: Communicate using words everybody understands.

Specific Outcome: JP will use 5 new words (supported with gestures where needed) to gain attention and answer questions.

STRATEGIES WHO WHERE At music, computer and play time, encourage JP to imitate sounds, noises, words, and motor actions.

Ms. MaryMom & Kelly will share songs& computer time

Home and Childcare

While playing outside JP will be asked to choose between bikes, ball, and favorite sand toys.

Dad, Ms. Mary, Friends, Derek, Anne

Home and Childcare

Plan of ActionFamily’s Priority: Communicate using words everybody understands.

Specific Outcome: JP will use 5 new words (supported with gestures where needed) to gain attention and answer questions.

STRATEGIES WHO WHERE During activities in the community such as Church, softball, or errands, JP will name family, friends, and common objects with models

Dad, Mom, Kelly, Jennifer, Josh, Derek, friends

Community

activities, car, church

During caretaking routines (bathtime, meals, dressing, potty) JP will label choices when asked

Mom Home

Strategies for Ongoing Communication among

Providers Engage the family as liaison Develop common formats and share

progress notes at center or family Use Email, voice mail, fastfax Schedule periodic co-treatment or

assessment updates Review video tapes or use videoconferencing Attend joint training, coaching, consulting Require communication in provider contracts