Family focus: early intervention in Georgia, 2007 March

EARLY Family Focus
INTERVENTION

Early Intervention In Georgia
FOCUS TOPIC

INTERVENTION: WORKING

VOLUME 1, ISSUE 3

MARCH 2007

WITH YOU
SPECIAL POINTS OF INTEREST:
Helping a Family Help Their Child-- Intervention
Family Focus
Evidence-Based Early Intervention
Conceptual Framework
Getting Connected
Family Resources

INSIDE THIS ISSUE:

Getting

2

Connected:

Family

Opportunities for

Involvement in

Early

Provider's View 3

What's a Person 5 to Do?
Roles and
Expectations In
Early Intervention

Conceptual

6

Framework

Family Focus by Jackie Price, BCW Parent

Babies Can't Wait has been an amazing experience and very beneficial to our entire family. I do have to admit, however, it was not what I had expected. As a mother, I sensed a delay in Bronson's speech development and sought the support of Babies Can't Wait. Once he was accepted into the program, I believed that the actual speech sessions would remedy Bronson's speech obstacles. I was surprised to learn that the anticipated clinical approach was not the avenue we would be taking. Even though the plan of action was different than I had originally expected, there was still an organized strategy with desired benefits. I just did not realize how much my family would be part of the equation. The Babies Can't Wait speech sessions gave us excellent methods to help us help our son.
Our assigned speech therapist arrived and began explaining the coaching model approach. The coaching model involved getting to know the child in his environment. I was taught to listen to his word sounds and grunts with a fresh set of ears to help target the areas of concentration. This

also helped me to recognize advancements in his speech and relay new obstacles. We recognized his strengths and weaknesses and used that to seek our desired results. I was coached on how to use tools that were less threatening to Bronson. We used his love for cowboys, hats, and boots to create new patterns and sounds. His dad and sister also became involved in the activities and games. The pressure was lifted off the child to perform a certain task. He was not expected to behave in a textbook manner. We found ways of having therapy in everyday situations through play. Bronson was not defined as a child with speech delays, rather he was Bronson who played and had fun and we worked speech into his activities.
Bronson's response was incredible. In less than 6 months, he went from pointing and grunting to using 3- 4 word sentences and being comfortable and confident to be around others that were

non-family members. I remember a major concern of mine was, will he ever be able to form a sentence? Our therapist took the time getting to know Bronson in his environment and could discern the sentences were already there, we just needed the techniques to help him verbalize his thoughts and ideas. Bronson's new-found ability to verbally express his wants and needs has also exposed aspects of his remarkable personality. He is much less frustrated and much more willing to enter new situations. The Babies Can't Wait model may not have been what I had anticipated, but the results definitely surpassed my expectations. Our family has a great sense of admiration and ownership in the advancements that Bronson has made. We are thrilled with Bronson's development and are delighted to have been a part of the journey. The Babies Can't Wait support contributed greatly to our entire family's development.

"Our family has a great sense of admiration and ownership in the advancements that Bronson has made. We are thrilled with Bronson's development and are delighted to have been a part of the journey." Jackie Price, Parent

Helping a family help their child: Intervention
by James Ernest, Ph.D., BCW Technical Assistance (TA) Unit

Alphabet Soup: 6 Words to Know
Featured Family 7 Resources

As a family moves through the process of determining eligibility for Babies Can't Wait (BCW) and deciding on outcomes and needed supports for their family and child,

there is always one thing on a family's mind. What exactly are BCW staff going to do to my child and when? Most of the time when we think of "intervention" we

think of people doing things to us. This isn't what BCW is all about. BCW is moving to an evidencedbased approach of providing sup-
(Continued on page 3)

PAGE 2

Getting Connected by Project SCEIs

BCW Families:
GETTING
CONNECTED
How can I take a more active role in Babies Can't
Wait?
At the Family Level: Participate in evaluations & assessments Be prepared and share at IFSP meetings Be an active participant not just an observer during each early intervention visit Take advantage of naturally occurring learning opportunities for your child throughout the day
At the Program Level: Parent Newsletters Local Interagency Coordinating Council (LICC) State Interagency Coordinating Council (SICC) Parent Trainers
FAMILY FOCUS

Family Opportunities for Involvement in Early Intervention

Have you ever thought of getting more involved in Babies Can't Wait? Would you like to "give back" to the program? Would you like to have input in local and state planning and policy decisions that affect young children with disabilities? There are lots of opportunities for you!

Parent Newsletter Many districts publish Babies Can't Wait newsletters for parents and service providers. Parents are invited to submit articles, share their story, or include their child in a Family Spotlight. Call your service coordinator or parent educator for more information. (All items are subject to editing and review.)
Local Interagency Coordinating Council (LICC) Each health district has an LICC which is a group of parents and service providers who share an interest in early intervention services. Parents are encouraged to attend meetings and serve on the council and various committees. Ask your Service Coordinator or Parent Educator for a schedule of meetings.
State Interagency Coordinating Council (SICC) The SICC advises and assists the Georgia Depart-

ment of Human Resources in making policies and implementing procedures for Georgia's Babies Can't Wait Program. Federal law requires that parents be represented on the council. All Council members are appointed by the Governor. The Council includes parents of children aged 12 or younger with disabilities. Speak with your Parent Educator for more information about meetings or how to submit public comments to the Council.
Parent Trainers Project SCEIs (Skilled Credentialed Early Interventionists) provides six workshops, offered at introductory and advanced levels, which cover a variety of topics of interest for parents and service providers in early intervention. Each workshop is taught by a professional-parent team. Parent participation is an important part of the workshop as the parent trainer

presents the parent/family focus on the topics being discussed. Parents help provide valuable information about family needs, how services were provided to them, and suggestions on how service providers can be more effective. While all parents in the BCW program can attend SCEIs workshops for free, parent trainers are paid for their participation. Speak with your Parent Educator for more information about being a Parent Trainer.

Sometimes Talking to Another Parent Helps by Project SCEIs

Babies Can't Wait Parent Educator Program The Babies Can't Wait (BCW) Program introduces families to a variety of early intervention professionals trained to work with children with special needs. The Parent Educator Program has been developed to provide a parent resource to Babies Can't Wait families. BCW recognizes that sometimes it's just easier to talk to another parent who is welltrained and knowledgeable about the BCW system.

Parent to Parent of Georgia
1-800-229-2038 www.parenttoparent
ofga.org
Parent Educator Program
Project SCEIs 1-404-651-0162 http://education. gsu.edu/sceis/ Parent_Education.htm

If you would like to talk to a Parent Educator, ask your service coordinator to give your name and telephone number to the parent educator for your district or contact the BCW Central Directory which is managed by Parent-to-Parent of Georgia at 1(800)229-2038 or in Atlanta at (770)451-5484.
For more information on the Parent Educator Program, visit the Project SCEIs website or contact the SCEIs office at 404-651-0162.

Provider's View by Jennifer Thomas, Speech Language Pathologist

Babies Can't Wait is a developmental program designed to help families and children become more successful in their daily activities. That's always been true, but with the new coaching approach, we can really make that happen. Families are members of a team that consists of a physical therapist, speech therapist, occupational therapist, early intervention specialist and service coordinators. One member of the team is selected as a primary provider who makes the ongoing home visits.
The initial visit begins by identifying what happens in the family's day, what the family (and child) likes and is good at, and how the child participates in all the activities of the day. Most importantly, we figure out what is important to the family. Instead of talking about what the child is not doing, we talk about

what he is doing and how he does it. Parents' understanding of how their family works, how their child learns, and what motivates their child is the most important resource that we have just begun to utilize. I continue to give information, share strategies that work with kids, and show families how to help their kids. But with the new approach, I share that information in different ways. Some parents learn through conversation, some families like to read information, and some families need to see it in action. Instead of telling families how to "work on" making skills better, we talk about what families are doing and lots of times, we even do those activities (i.e. mealtime, diapering, dressing). When we need help and more expertise from another provider such as a physical therapist, she visits with us.

Those skills we used to "work on" become activities that a child does naturally during his/her day. When families embrace an idea, they are able to figure out how to make it work at their house. Sometimes I tell families that I know "what to do" to help kids, but they know "how" to make it happen for their family. When the focus is on participation in daily activities, we're able to talk about the child as a kid who plays, communicates, moves, and interacts with family members...not as a child who cannot talk or walk.
I knew that one family had embraced the coaching approach when I walked into their home, and Mom showed me all of the new ways she was playing and interacting with her child that encouraged him to talk
(Continued on page 6)

PAGE 3
"Now, when families leave our program, they can continue to help their child learn, and they know how to find and use available resources." Jennifer Thomas, Speech Language Pathologist

Helping a family help their child: Intervention cont.

(Continued from page 1)

who interact with the child in natu-

ral environments. The term natural

ports. There are three components environments simply means the

to this: natural environments,

places that any infant or toddler

coaching style of interaction, and

typically are- in the family's home,

the use of a primary coach within a community settings, a family child-

team context.

care setting, or a child development

center. As BCW staff provide sup-

ports/services, they may interact

"PrearnvsaaldecirsdatcihtiEairroiecdbocevnd(eelnhcieDssdstease,iluernrytqianendhnucridsnceaaewttfnneht,ooheceT-urdaimBecmtrorrhscpiaeevsoitoslteraomhwiefitntctedieephaeofn.orlac,"nlPovtyhr&sirdamahrearuoCisppaccentNucratemdattbiecscaa-ebprtenitiey-sstuctai,lcr2sa00l 2E)Dnturvfaancimdshdrit"ietio,lli.dyvo.H2.neenaa0alxmonsn0m.pddp"0ebiencfrNyaoign,memaTnctitAhclrmsyuieivclrudsretaonrtiaelviutnteniLtydt,ineyacRoesaeaSpslrpae,penabbfotari,rtnrtma&itgntouiilBonfgyEridnstrnu)asiiwevdtialausiyeinrrartaoeldlhfisvf.n,op.i.naamr"angdr,fdeeakcdnmhctisfatiillitttdymcehherhidieeeannsilyn.mnvdtitcdRi'hssrhsehigapeoneaarokiptesltonndadeeapeehnsmiuuttrrsnanluod,attretrgtepmiticiehncncmfnonpeiutheiesegtpocelooss,t.tsahnrcahsfoauttTiwagacttanitipesaortnhthhoitegntgnveiraethfhenr,ihivrtemdteidenieieheenia-essri,r-

First, BCW staff will be working

natural environments leads to chil-

with the family and other caregivers dren being engaged in more func-

tional activities for longer periods of times. The resulting skills and abilities that are learned are more likely to be generalized to other settings, activities, times of day, etc. Children are more likely to develop to their potential when they are provided learning opportunities found in natural environments.
Coaching Style of Interaction The formal way of defining this approach is to say that the coaching style of interaction is a type of capacity-building, help-giving practice. Quite a mouthful! The informal way of describing this is to say that the BCW professional (sometimes called the primary coach) is there to provide help so that the people who are a consistent part of the child's life feel confident in their ability to help their child participate, learn and develop. The primary coach provides support to
(Continued on page 4)

FAMILY FOCUS

PAGE 4
Helping a family help their child: Intervention cont.

(Continued from page 3)

Teaming in the Coaching

person that will see the family con-

Approach

sistently on an on-going basis. The

families/caregivers by asking ques-

When a family receives supports/

PC may visit everyday for a period

tions about what they do with their services through BCW, they have

of time, a couple of times a week, or

child during the day, observing,

access to the professional wisdom once a month. This decision is made

hands-on modeling, and sharing

of a team of individuals with various by the team and this includes the

information. BCW's goal is to de-

professional backgrounds and

family. It might be that after visiting

velop the family/caregiver's compe-

with a family, the PC or family mem-

tence so that their interactions are

ber thinks that they need to seek

cmfopsac(gcwteok(rTvIpinamsceuernhiarntoaprhdnuooecraerspdrioapiselutcdn.epenrmatdpe)psrwhkanotegsdoglocooaiapleeiaouvlptnnsatvrarevtfwenhrehtfraehsetsoedwts-tddeleerienreohsme,vrpgteersihatheenetpftsavnesoeroehparcme,tlnrtnsletdyeesloloDh-t:e-n,dc)filaun"niAtetilasensThnttlacracoeedobtnslerfisriedvohlwetiBeeetcfehaiidnClhtler2eTapihstlidsshi0yWylfirteuedposrfo0pdnEnraaci.'paanmto4fnctsoiPdimrresbtf(mate)ititiTgumateiniocrimechsoyihdlhbdlcniaehiiitrpebittaereeatnliemoeeaveeylyliogs,ttirarfideintIicdiisromapntoniico.ninsaninnesorpunadee.ndctesr-clirir-ienisaph(so-yms-slurie)fnnpeoedaepCancs-locut-fhrtlrsjoiheotfieleeedsifanrapoItloFceclrnymStaii-mPhrv(cdSn/iooaetIhiEtyranvecMhyPceglsdopehleieooasrnrnitnnonuurpattttgedie&teCcepindcnrdaftopgRovloimu,esfceoeumaotcnsewrhchletutst,eiihist,osoiahnitndnnnsopegedrOavelifnsese-sdapl)noascnefspeoeToDl(reienusnSfwadaiserhtaasmbaeowptetgCaroeilee2hdaconsrnmc0koeokietnnt0nuieiualgayv0lranss,&neeFsc,ettfl/ade,ihdwaprRrmDernlreuieeteoddoenoesafqeilscihndkrpgnepufn,gbrecs=ir,iiyoensnnhopem2tgivnolilxpha.d%tiofidreycsieteitoonyecsiatnfghsendg=)ItialodsdemotisataiecsufilshvoaoweemitbnhdnieahsonaaeeektkeplghuiencynpieetToeptcgnteiagxheanunahfhtraporae-nlegeoarddboelmrsatuaodawfoianmPrmysttnpuaeasstoChasegnaetlniulereoeenwdtkdd.ssesikluotcadt.tltrorhnhyoneIoa-teftirtlsfdemrsotgiciobimgaeTtfmslhinsafhpTnIitotgengsmfeheCTubohoeeotercelocielHheettuoinlIthaaiftDiwhrEteha-PlplaEvhtdsatEuLnaeeahntAreAcnroocpielt:tW eoyodiyodssonef

and confidence

Just 20 everyday activities would equal 40,000

of their infants

needed to help the

learning opportunities by age one.

and toddlers

child learn." (See

2Ualrcmcwattihienphhe0cseaassdpiaeilnenuUnndrakylwlgocet.nhhSesaamtadaea.oscrCsivoncnhoceio.poranratnw1rneraghcaese4lciheyhctwgh7hteihi1vincsaf(ewgaekaprm)iopsl)luesi-lndinifgspwuerpxcahpappcirolerO-eeorrnttgpt,iershraaeoesnmvtidnaidfaPcfcecohCmrtrasisilechmdaahmasndianbrdtegrehav.iyresec(SlotspohCeeerrplldioremcmeincoaseat&ncterntRyihdtrcu,ascbshfMcoa,atimoansoocepfrihrlddyetosethsofo)lneththee

experience (e.g. educators, service coor-

(Dunst, 2001)

with

disabilities

strategies that could help the family. It may be that the team de-

H.R.5 SEC. 631 (a)(4)

cides another team

member should co-visit

with the PC to help the family de-

velop strategies. The important part

about this evidence-based approach

to providing supports/services is

that the team members work to-

gether toward the goal of helping

Early Intervention staff was there. It

dinators,

parents and caregivers develop their

is like the old saying, "If you give a

physical

therapists, oc- own competence and confidence.

man a fish, you feed him for a day. If cupational

therapists,

Empowering families to help their

you teach a man to fish, you feed

speech-language pathologists). Along children is a life-long strategy that

him for a lifetime."

with the service coordinator, the

research indicates helps children the

primary coach (PC) is the other

most.

FAMILY FOCUS

PAGE 5

What's a Person to Do?
Roles and Expectations In Early Intervention

NUTS `N BOLTS
ROLES AND EXPECTATIONS IN
EARLY INTERVENTION
FOR PROVIDERS: SHARE INFORMATION, EXPERTISE, AND
SKILLS ACROSS TRADITIONAL DISCIPLINE BOUNDARIES
CONTINUOUS
LEARNING TO EXPAND THEIR
KNOWLEDGE, SKILLS,
AND ABILITIES
FOR FAMILIES: BE PRESENT AND
ACTIVELY PARTICIPATE IN ALL VISITS
SELECT THE DAILY
ACTIVITIES AND ROUTINES
INFORM BCW IF
SERVICES ARE NOT MEETING THE NEEDS OF YOUR CHILD AND
Adapted from Infant and Toddler Connection of Virginia: Philosophy and Considerations for Individualizing Early Intervention Services 2003
FAMILY FOCUS

Part 3: Intervention
Knowing what to expect may help your family feel more comfortable as you journey through the Babies Can't Wait (BCW) program and allow you to take a more active role in the early intervention process.
As during the previous steps through your Babies Can't Wait journey, your confidence (trust) and competence (knowledge) in the early intervention process is continuing to increase. You are becoming more familiar with what you can expect as a family and what you can expect from the other members of your early intervention team such as your service coordinator and providers.
If the child was found to be eligible for BCW after the evaluations and assessments were completed, the team (which includes the family) developed the Individualized Family Service Plan (IFSP) to plan and guide the actual intervention process.
The laws are pretty clear that one of the requirements of early intervention is that it helps families increase or enhance their ability to meet the special needs of their infants and toddlers with disabilities or developmental delays. This means that the purpose of BCW is to help build the capacity of families and other caregivers (such as grandparents, childcare providers, foster parents, etc.) to meet the special needs of the child. In the past, the focus was often to work only with the child. Research and experience now show that children can make more lasting and meaningful gains if the family and caregivers are taught how to support the child in meeting those needs.

This may look and feel a bit different than you had imagined. Think of it this way. You are the expert on your child. You are the agent of change for your child. You know him/her far better than anyone else could, and you spend more time with your child than anyone else. The Babies Can't
Role of Service Providers
(1)Consulting with Parents, other service providers, and representatives of appropriate community agencies to ensure the effective provision of services in that area; (2)Training parents and others regarding the provision of those services; and (3)Participating in the multidisciplinary team's assessment of a child and the child's family, and in the development of integrated goals and outcomes for the individualized family service plan.
(IDEA Sec. 303.12 Early Intervention Services `97)
Wait team members are experts in child development and family support. Their role, according to federal law, the Individuals with Disabilities Education Act (IDEA), is to consult with parents and other service providers to ensure effective provision of supports/ services and to train parents and others regarding providing those supports/services. It's a way to build the capacity of families to meet the special needs of their infants and toddlers with disabilities.
The bottom line is that the BCW team is there to work with you as the family and caregivers. That is why it is so important that you be present and actively participate in all visits. Your participation is the key ingredient that will help insure success for your child. The BCW team, guided by the

program's conceptual framework (see page 6), will focus on providing you with the supports and knowledge you need to help guide your child through life's everyday activities. You will not be expected to become a therapist but you can expect to learn new strategies that you can use to support your child as he/she participates in everyday routines and activities. (i.e. snack time, bath time, park time, etc.).
Another important purpose of early intervention is to help support and enhance the development of children. Research shows that one of the best ways to do this is to provide supports and resources to the family in the child's natural environment, doing what he/ she needs to do (like eating, diapering, etc.) and wants to do (dreams, wishes, hopes). Things that are really important to the child and family.
Your coach will have conversations with you regarding what activities your family participates in or would like to participate in during the week. You'll begin to see all of the opportunities for your child to practice so that he/she can achieve the priorities that you identified as a family during the development of the IFSP.
Using their combined expert knowledge, the coach and team members will support you as you build your capacity to support your child. This in turn will allow your child to use his/ her existing abilities to develop new skills and improve participation and functioning. The team can only be with a child and family until they turn three. But if they've helped families learn to meet the needs of their child, there can be a lifelong impact.

VOLUME 1, ISSUE 3

PAGE 6

Conceptual Framework

New
Promotion Models

Traditional
Treatment Models

Focus on promoting compe- Focus on remediation of a

Research indicates that some ways family supports. The conceptual of providing supports and resources framework provides the founda-

tence and positive functioning disorder, problem, or disease, or its consequence

to children and families are more effective than others. In order to consistently provide Babies Can't Wait families the supports and resources in the best possible man-

tional structure needed to support the teaming between parents and providers (coaches) that is needed to help children succeed.

Capacity-Building Models Provide opportunities for people to use existing abilities and develop new skills

Expertise Models Depend on professional expertise to solve problems for people

ner, Georgia has adopted five ideas or concepts. These concepts are supported by the research on effective early intervention. They also represent the intent of the federal law known as the Individuals with

Strength-Based Models Acknowledge the assets of people and help them use these assets to improve functioning

Deficit-Based Models Focus on correcting a person's weaknesses or problems

Disabilities Education Act (IDEA).

Resource-Based Models Service-Based Models

These evidence-based ideas form the backbone or conceptual framework that guides early intervention in Georgia.

Describe practices in terms of Describe practices primarily a wide variety of formal and in terms of professional serinformal supports within a vices community
Professionally-Centered

Families have long been recognized as a very important part of the early intervention process. You are the EXPERT on your child, and Babies Can't Wait provides staff with expertise in child development and

Family-Centered Models View professionals as agents of families and responsive to family desires and priorities
Adapted from Conceptual Framework for Evidence-Based Practices in

Models View professionals as experts who determine the needs of a person from their own as opposed to the other person's perspectives

Early Intervention

Dunst (2000)

Alphabet Soup

Coaching Approach/ Primary Service Provider: A family-centered system for providing supports to children who are enrolled in Babies Can't Wait and their caregivers. A single person is selected from the support team to be the primary coach. This team member will use coaching as the key intervention strategy to build the capacity of parents and other care providers to use everyday learning opportunities to promote the child's develop-

ment. The coach has regular contact with and full access to the entire team and can plan co-visits if needed.
Intervention: The activities, supports, resources, and services necessary to enhance the development of the child and the capacity of the family to meet the special needs of the child.
Natural Learning Opportunities: Opportunities that oc-

cur within the

context of an activity

setting which promotes the child's growth and development.

For example, all of the different learning opportunities that might

occur at home, the park, grocery store, the restaurant, or

Words To Know

at Grandma's.

Provider's View cont.

(Continued from page 3)

mom who had embraced the idea of

more and talk more clearly. Then, she shared that she tried some of the things I mentioned, but they just "didn't happen naturally during their

participation, trusted her judgment for what would work for her family, and appreciated her child and all that he does.

day, so they didn't work." That's a In the end our goal is still the same,

for kids to be successful in what kids do. With this approach, families learn how to identify what their child needs to do to participate, how their child learns, and what motivates their child. Now, when families leave our program, they can continue to help their child learn, and they know how to find and use available resources . And that's what early intervention is all about.

"Those skills we used to `work on' become activities that a child does naturally during his/her day. "

FAMILY FOCUS

Local Program Contact Info
Address:
Phone: Fax: E-mail:

Mailing Address Line 1 Mailing Address Line 2 Mailing Address Line 3 Mailing Address Line 4 Mailing Address Line 5
Visit Babies Can't Wait on the Web: http://health.state.ga.us/programs/bcw
For other Georgia public health programs visit
http://health.state.ga.us/programs/

Featured Family Resources

Families enrolled in Georgia's Babies Can't Wait program frequently indicate a need to locate additional resources for their children and family members. Each issue of the Family Focus will feature a few of the numerous resources currently available to support families on their early intervention journey. If you would like to share additional resources, please forward your recommendations to listen@valdosta.edu.
Babies Can't Wait: Georgia's statewide interagency service delivery system for infants and toddlers with developmental delays or disabilities and their families. Phone 1-888-651-8224 or visit their website. http:// health.state.ga.us/programs/bcw
Circle of Inclusion: Available in

five languages, this site provides and demonstrates inclusive educational programs for children birth through age eight. Recommended for families considering childcare or preschool for their child. Be sure to visit the Links page for information on various child and family-related topics. http:// www.circleofinclusion.org
Coaching in Early Childhood: Developed for both early intervention professionals and families, this site provides an in-depth look at information and resources related to the use of evidence based practices. It includes re-

search, references, FAQs (Frequently Asked Questions), and learning modules that will provide a deeper understanding of "evidence-based natural learning environment practices " and how they are supported through coaching. http:// www.coachinginearlychildhood.org
Tools for Life: Increasing Access to Assistive Technology: Provides information and resources for Georgia residents who need assistive technology. Site includes several different areas ranging from an equipment loan library, recycled computers, assistance understanding learning disabilities, and finding funding for assistive technology. http://www.gatfl.org

FAMILY FOCUS

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DPH07/014HW March 6, 2007