Notes from Relationships Drop-In, 11/29/16
Sam: How flexible are you in adapting your TA?
Lisa Lawter (OK): Early on, she just went in and told them what she saw and what she thought they needed. Has now changed her approach—she’ll have them talk a lot about the kid and will ask them what they see as the biggest issue. That throws the ball into their court and will hopefully make them buy in more. They always say communication, but other things pop up too. Because she’s the only person in her state, she doesn’t get to spend as much time as she would like in the places she goes into, so her intensive TA looks a little weird. With schools that are close, she can go back and forth and can build a relationship. She remembers what they say so she can ask about it next time, and they build on those conversations to decide what to do. But that takes a lot of time—the time to build the relationship is pretty critical.
Sam: What’s your sense about how long it takes to build a relationship?
Lisa: With the places she goes to a lot (which are close), she’s known the people forever—she was a beginning teacher with them. She can pop into their classrooms anytime and they’re not threatened—she has that background with them. Usually it takes several visits before people are comfortable with her. Teachers in the rural communities are really desperate, because there are barely any services there for anyone. They seem like they’re more willing and listen more, because she may be the only one who understands the kid they’re working with. In the larger districts, they have more support/resources, and they look at her more critically—she has to prove herself more. Rural teachers will call the free resources she suggests overnight, but with larger districts, when she checks back six weeks later, they’ll say they meant to do it.
Sam: His experience in NY was similar. When someone’s willing to come to them in those rural areas, that displays commitment. In cities, you’re just another person telling them something along with all the professional development they’ve already had.
Lisa: A mom from the panhandle emailed her and said she knew Lisa couldn’t come out there. They’re used to people saying it’s too far away. It makes TA pretty tricky.
Sam: He wonders about people’s ability to engage in distance TA if they haven’t done the face-to-face relationship building first. You have to show you’re reliable in some way.
Lisa: Agrees. One of her families lives in a town where there’s nothing but a school, grocery store, tiny restaurant. A few houses and a dried up main street. The mom came to a statewide training she put on her first year. They’re ranchers and that’s their livelihood, so they’re not going anywhere—they need to make it work for the kid at the current school. She asked the mom if the family could videotape the daughter or ask the school to do it—it could just be five minutes—nothing formal. The family agreed but they haven’t sent her anything yet. Distance TA and videotaping is tricky. Trust piece is really important.
Sam: Videotaping may take a higher degree of trust, since it’s a more permanent format.
Lisa: Might be a generational thing, too.
Sam: How open are you about talking to recipients about things they’re not doing that you want them to do? Do you ask them whether they’re not comfortable with the process/the practice/your TA? He’s had those conversations, but it tends to be when things are really at a standstill and he’s tried everything else.
Lisa: Doesn’t want to continue beating her head against a wall if she doesn’t think they’ll ever implement the practices, but she doesn’t like to set a specific time limit. Sometimes there are other things happening in their lives (e.g., a child who’s off having eye surgeries), especially with the kids who are medically fragile.
Rose Moehring (SD): Just attended an IFSP and the mom didn’t answer the door—turned out the mom isn’t getting enough sleep because she’s having to work shifts at the meat packing plant, and she has providers coming in five days a week.
Sam: Interesting that families aren’t comfortable telling providers what’s going on. They don’t know if people will judge them.
Sherri Nelson (ND): We sometimes forget how you have to have basic foundations of safety, comfort, and trust before you can really go into homes and work with families. That isn’t an easy task for some staff members.
Sam: We live in an outcome-driven environment, and the time it takes to build trust with the family or team isn’t necessarily valued because you can’t document it. It’s minimized for teachers and TA providers in a way it probably shouldn’t be.
Sherri: Challenging with students on the reservations because the TA providers are white females. Some families just won’t let them in the door. A lot of times if you attend a meeting at the school first or are introduced to the family via a joint visit, that can be a key to starting to build a relationship and gaining trust. Going alone isn’t as effective.
Rose: The elders have more pull, so if you can go through an elder, that might help. The reservations are just another lifestyle and you have to be nonjudgmental. A lot of times transportation is a problem for the people there. If you can help them with something like that, you can get your foot in the door.
Sherri: Sometimes the family isn’t home after staff have driven several hours for a home visit. Then they try to find the family if they can to make use of the time and make sure the family gets the services they need. When you get to know the extended family, you can ask them where the family is. You just go search them out.
Sam: In their culture, that’s not considered invasive.
Sherri: She’s always had positive experiences/reactions when she tracks people down—they’ll say they just forgot but are happy to see her.
Rose: She’s been in situations where there’s been drinking and it can be a little awkward, but she’s never really felt threatened.
As the only person in her state, she worries about how much impact she has, since she can’t do as much intensive TA.
Sam: How many visits does it take to build a trusting relationship?
Rose: Strives for quarterly contact with one to two in-person visits per year—then you can stay on their radar. There’s also outreach from the schools for the deaf and blind, and people will think she should be like them—come and see them and bring something. With TA recipients who are more resistant, she might just give them one thing to ponder and come back later. They won’t bite off a lot if they think they’re doing fine.
Peggy: Do you try to have contact with all kids in a year?
Rose: No, some parents don’t sign consent forms. She sees about 15 (out of 30) kids. She could probably see all 30 but doesn’t for various reasons.
Sherri: ND has eight regions and uses staff from schools for the deaf and blind to visit students. Has 38 kids on the census and they all get visited at least once—some get visited once a week. There are 500-600 visits total per year. Because of the regions, staff only have to travel a maximum of two hours or so to see kids. The average person at the school for the deaf and school for the blind has had 20 plus years of experience. They mentor the new staff who come in. She knows practically every early interventionist across the state. Since people have been there so long, they all know each other, which makes relationship building easier.
Rose: In SD she feels like there is a better relationship with the school for the blind than the school for the deaf. Maybe because the latter also emphasizes communication, so there may be some stepping on toes. She thinks Sherri’s model is better.
Sam: Seven schools for the deaf in NY, and it was always difficult working with them, partly because of cultural issues around Deafness and vision loss. Schools for the blind were always more open and receptive to what they had to say.
Sam (to Rose): Would you try to use a regional model like ND in the future if that were possible?
Rose: For that to be successful, the grant would probably have to go back to the Department of Ed rather than being at a university. She can’t do the same trainings she used to—would love to be able to do a training once a year and bring in an awesome speaker.
Sam: If you know someone at a school who already has a trusting relationship with the team, you might be able to shortcut some of the relationship building.
Sherri: The modules have been a game changer for ND as far as building capacity across the state. She and Rose are very limited in what they can do because of dollars and time. She’s had as many as 150 module participants, even teachers who aren’t working directly with a deaf-blind student. It’s built capacity more than anything else she’s done in 10 years.
Rose: Has just started directing people to Families Matter stories as well.
Sam: Do you get people willing to take modules whom you’ve never met?
Rose: Yes. Thinks sometimes people find out about them by word of mouth. Great when parents can go through the modules as well.
Sam: You’re gaining credibility through a network of people telling each other about the modules.
Rose: Surprised they’re designed for interveners because teachers seem to get a lot out of them.
Sherri: Teachers are applying them to other students as well, especially those with autism.
Sam: How do you get feedback about your TA? Do you try to formally or informally gather it from recipients in a qualitative way?
Rose: Tends to ask about two areas—communication skill development and transition. Have they seen improvement in those areas? Used to use NCDB Outcomes and Indicators—doesn’t use them anymore, but they were useful tools at one point.
Sherri: Does parent interview—general satisfaction with TA. Staff have to record any TA they do. She uses OPIs and follows up with a survey at the end of the year for 8-10 locations where there’s been more intensive work. The survey has around five general questions—are they satisfied, etc. The school for the blind also does follow-up on all their TA, so she doesn’t want to duplicate that.
Lisa: Uses a couple qualitative-type interviews.
Rose: Her new strategy is to go to IEP meetings and get her recommendations included rather than waiting till later when the teams already have a plan. She’ll let us know how it goes.