IFSP Tutorial (Module 2)

Implementing the IFSP: Family/Child Supports & Services (Session 3)

Outcome: Understand how to provide family/child supports and services to promote a child’s participation in family and community life

Objectives:

  • Contrast the role of early intervention providers in supporting family members to ensure their child’s participation in family and community settings with providing direct service for a child
  • Illustrate with 2 examples how culture and past experience affect family/child supports and services
  • Describe at least 3 concerns families and other caregivers may voice during the implementation of family/child supports and services
  • Describe how the principles of adult learning influence provider-family collaboration
  • Explain how to support families in achieving their child’s IFSP outcomes
  • Illustrate with two examples how to ensure ongoing assessment of a child’s progress is part of early intervention supports/services
  • Explain how to modify early intervention supports and services to reflect child and family progress
  • Describe the importance of collaborating with formal (e.g., physicians and private therapists) and informal (e.g., child care providers, librarians, instructors at the YMCA pool) resources and support networks in implementing a child/family’s IFSP
  • Identify at least 3 issues to consider when using interpreters to communicate with families
  • Describe the key role of service coordination in implementing family supports and services
  • Specify at least 3 issues influencing the effectiveness of providing early intervention supports and services in child care and pre-school settings
  • Illustrate with 2 examples how to document family/child supports and services in user-friendly formats

Implementing Family/Child Supports and Services has four key activities for readers: reading essential content, engaging in application activities to integrate the presented information, reviewing recommended reading and completing a self assessment. The following chart gives an overview of the session’s activities with suggested time allotments.

Summary of Activities
Activities / Time allotment
Read Essential Content about implementing family/child supports and services / 2 hours
Application 3.1 Tracking how IFSPs are implemented with families / 1-2 hours
Application 3.2: Addressing concerns families may about implementing an IFSP / 1 hour
Application 3.3: Reflections on Adult Learning / 1 hour
Application 3.4 Individualizing strategies for adult learners / 1 hour
Application 3.5: Early intervention supports and services for Yvonne and Blake / 1 hour
Application 3.6: Early intervention supports and services for Nolan and his family / 1 hour
Application 3.7: Early intervention supports and services for Jenni and her family / 1hour
Application 3.8 Early intervention supports and services for Evan and his family / 1 hour

Recommended Reading

/ 2 hours
Complete Self-Assessment / .5 hour

Guiding question for Implementing Family/Child Supports and Services:

  1. How will early intervention providers use their expertise to support family members and other adults in promoting a child’s participation in family-desired settings and routines within natural environments?
  1. How will family members and early intervention providers collaborate to achieve desired child and family outcomes?

Why this topic was selected

Implementing Family/Child Supports and Services focuses onhow tosupport family members in helping their children participate in desired family and community life. A critical outcome for early intervention is to assist families in finding ways to develop and generalize the skills and behaviors of their children to ensure their participation in naturally occurring activities and settings. By observing and honoring each family’s unique culture and child rearing routines, early intervention providers can help children use an emerging skill and/or modify routines and tasks to take part in family life.

Working in natural environments enables early intervention providers to transform “their hands-on time with a child and move to a different position alongside the parent as a coach rather than as lead player” (Hanft & Pilkington, 2000, p.2). Early intervention providers can share their expertise and collaborate with family members to:

  • facilitate a child’s participation in meaningful family and community activities,;
  • follow a child’s interests and build on the strengths he or she is most likely to demonstrate when interacting with familiar people in familiar routines and environments;
  • ensure mastery of a child’s emerging skills through practice in multiple activity settings/situations;
  • rather than bringing items that providers are most comfortable in using; and

In doing this, many early intervention providers ask whether they are providing “real intervention” and wonder if they have diluted their profession to meet the demands of policy makers who really do not understand what they do. Review the evidence offered in Why provide family/child supports and services in natural environments? (Link to this subhead at the beginning of Module 2, session 2) and consider this essential point:

A child’s daily actions and interactions provide opportunities for learning and participation in situations which matter for the child and family. Supporting caregivers in facilitating a child’s optimal functioning within ordinary routines will greatly increase the likelihood that family members can prompt their children to practice and master essential skills within a meaningful context. (Hanft & Pilkington, 2004).

Essential Content: What early intervention providers and families need to know about implementing family/child supports and services

Implementing Family/Child Supports and Services, the third session in Module 2, is part of a tutorial about the IFSP process developed by the Maryland State Department of Education for early intervention providers, and interested readers. Other sessions available: (link to outcomes/objectives for each session below)

Module / Session
Module 1:
Evaluation and Assessment / 1: Legal Requirements
2: Planning with Families for Evaluation & Assessment
3: Comprehensive Evaluation and Assessment
Module 2:
Developing and Implementing an IFSP / 1: Legal Requirements
2: Developing an IFSP with Families
3. Implementing family/child supports & services (this session)

The following topics are covered in Implementing Family/Child Supports and Services:

  1. Natural environments and early learning
  2. Informal and formal early intervention supports and services

c.Concerns that families may have during IFSP implementation

  1. Role of early intervention providers in providing family support
  2. Being an expert vs. sharing expertise with families
  3. Collaborating with adult learners
  4. Service Coordinator’s responsibilities during implementation of an IFSP
  5. Assessing ongoing progress
  6. Models of team interaction
  7. Understanding cultural competence
  8. Becoming culturally competent early intervention providers
  9. Issues to consider when working with interpreters
  10. Considerations for providing early intervention supports/ervices in group settings

a. Natural environments and early learning

Each child and family have many natural environments - not just one - where they spend time with family, friends, and neighbors in specific activity settings. Early intervention providers can help families explore how spontaneous and routine interactions and actions within familiar places become the focal point for a child’s “learning and doing.” Such growth is most likely to occur when the setting for early intervention supports and services is in a family’s natural environment (Schmidt & Lee, 1999; McLean & Woods Cripe, 1997). The term “natural environment” describes a child and family’s context covering:

  • Physical location (e.g., family home, community park, grandma’s house);
  • Activity settings within a location (e.g., eating a picnic in the backyard, wading in a pool at a friend’s house, taking a bath , feeding the animals a petting zoo); and
  • Natural learning opportunities within a child’s activity settings (fitting lids on plastic containers, naming body parts during a bath, filling a dish with little pellets).

Infants and toddlers spend most of their time in three broad categories of natural environments: family, community and early childhood programs (Dunst et al, 2001). Each presents numerous activity settings and natural learning opportunities for promoting a child’s current skills and developing new ones.

Examples of activity settings (italics) and natural learning opportunities (italics) in natural environments common to young children and their families:

Family / Community / Early Childhood
Family routines:
Preparing a meal
Holding a spoon to stir / Family excursions:
Riding on a bus
Looking for red cars / Preschool/child care:
Circle games
Recognizing name
Parenting routines:
Brushing teeth
Standing on stool / Recreation:
Wading in a pool
Sitting independently / Family child care:
Playing in sandbox
Filling containers
Child routines:
Playing with family pet
Following movement / Children’s attractions:
Petting animals at zoo
Holding hand open / YMCA:
Infant swim class
Relaxing in water
Family rituals:
Birthday party
Blowing candles out / Place of worship
Singing songs/hymns
Remembering words / Mother’s morning out
Eating snack
Sucking on a straw
Interacting with family
Phoning grandma
Saying hi / Family outings
Eating at a restaurant
Drinking from cup / Library preliteracy group Listening to story
Paying attention
Play activities
Clapping games with sister
Using two hand together / Play centers
Sitting in baby swing
Enjoying movement / Informal play groups
Splashing in sprinkler
Interacting w/peers
Entertainment
Banging drum
Repeating rhythm / Art/music/entertainment
Attending puppet show
Sitting with peers / Community recreation
Finding Easter eggs
Finding specific object
Gardening
Planting seeds in pots
Poking with finger / Outdoor
Picnicking at a park
Crawling on grass / School drop-in center
Fingerpainting
Moving arm and hand

The mandate of natural environments is not only to identify where early intervention takes place but more importantly, to consider what happens for children and families families in specific locations. How early intervention providers offer family/child supports and services, not just where, is key to whether early intervention is truly family-centered or merely replicates a clinical model within a child’s home or child care setting. Daily routines and activity settings “are important contexts for integrating various family/child supports and services. For families and other caregivers, this approach allows infants and toddlers to participate more successfully in daily living activities and reduces the need for families to add ‘treatment’ sessions to already busy schedules” (Rainforth & Roberts, 1996, p. 252).

Review a video clip from Just Being Kids illustrating how a mother, Yvonne, and her early intervention provider, Trudy, figured out how Yvonne could “multitask” i.e.,buy groceries and help her son, Blake, enjoy shopping while prompting his communication and pre-literacy skills. (link to Just Being kids in recommended reading this session)

Parent’s perspective about how early intervention could be helpful (link to Blake A)

How an occupational therapist views natural environments(link to Blake B)

Parent’s comments about early intervention in everyday routines(link to Blake C)

NOTE: Application activity 3.5 provides an opportunity for an early intervention team to consider how they could provide supports/services to Yvonne and Blake. (link to activity 3.5)

b. Informal and formal early intervention services

Throughout this tutorial, the phrase “family/child supports and services” or “early intervention supports and services “ is used to encourage readers to think of early intervention as more than formal services from therapists, educators, nurses, social workers etc. Early intervention provides supports and resources to families of young children includes formal and informal networks (Trivette, Dunst & Deal, 1997):

Formal supports/services includeearly intervention services in a local Infants and Toddlers Program funded by the IDEA, as well as from other departments, organizations or programs serving children and families such as parent education classes in a public school or social service agency, health and specialized medical services, or housing options for homeless families.

Informal resources include child care centers, toddler programs in libraries, community service clubs, recreation and sports programs, education programs in parks, nature centers and museums. These informal resources in natural environments prompt natural learning opportunities for infants and toddlers. (Link to section a in this session)

Effective IFSP planning identifies a range of formal and informal resources to assist families in achieving their functional outcomes for their children. Where family/child supports and services are provided depends on what needs to be done to help a child participate in key activity settings. This means that families and early intervention providers should agree on IFSP outcomes before talking about which supports/services a child will receive, where they will be provided and how frequently. Each family’s unique culture, including their daily activities and parenting routines, form the basis for helping a child use emerging skills to participate in desired activity settings.

Examples of informal support networks are illustrated in the following written and video vignettes. Consider how each vignette illustrates how child/family interests and routines/interactions in familiar or desired natural environments were used to prompt desired functional outcomes for children and families.

Using the library to encourage making choices

Sharon’s family wants her to “talk more” i.e., express her needs and wants instead of whining and crying. Sharon loves to sit on her grandmother’s lap and look at pictures but needs books with large print and pictures to accommodate her limited vision. Her early intervention provider joins Sharon, her mother and grandmother at their local library to look for appropriate books and talk about how to use them to prompt Sharon’s language and social interaction. The three adults talk about how to help Sharon use words to indicate which book she wants to look at, what she sees on each page, and how to ask for drink of water. The early intervention provider also talks with Sharon’s mother about how she can cue the librarian to accommodate Sharon’s low vision (e.g., sitting Sharon right next to the librarian, making her the page turner, avoiding glare from the overhead lights) so she can enjoy the toddler pre-literacy group.

Playing at home and at a playground to promote social and motor skills

Deep loves to play with his older brother, Rajiv. His early intervention provider, Sheila, schedules visits when Rajiv is home because he motivates Deep to use his arms and legs to move around and play. Sheila accompanies the brothers and their mother to the playground in their apartment complex as well as to the local McDonalds to explore strategies for prompting Deep to engage in active play activities with his brother that encourage using both hands together to climb on and over the play equipment, throw, catch and roll balls, and chase one another.

Talking walks in the neighborhood to increase verbalizations

Donelle’s mother would like him to start talking. His big interests are trucks and buses, and he gets really excited whenever he sees them. His early intervention provider accompanies the family on walks around the neighborhood so she can model sounds and gestures to help Donelle communicate his excitement when he sees trucks and buses, as well as practice using specific sound for familiar people, pets and places he sees during their walk..

Visiting the pumpkin patch with friends and family

TBA: Add text describing this visit to the pumpkin patch by families with early intervention providers from a Maryland Infants and Toddlers Program

Review a video clip of children visiting a pumpkin patch in Maryland with family and friends. This informal community resource provides family recreation and multiple learning opportunities for children to promote social interaction (e.g., sitting next to friends in a wagon), communication (e.g., listening to and/or singing a song), gross motor skills (e.g., sitting on a tractor seat), as well as fine motor skills and sensory input (e.g., holding food in open hand to feed goats).

(Insert video of pumpkin patch )

c. Concerns families may have during IFSP implementation

It is important to anticipate, and address as appropriate, concerns that family members may have while participating in an early intervention program. Early intervention providers can use four strategies to address a family’s concerns:

  1. Encourage family members to talk about any concerns;
  2. Listen, in order to understand and show respect for a family’s beliefs and traditions;
  3. Provide information, when available, to address concerns; and
  1. Offer to link families to parent-parent support networks, both in a Local Infants and Toddlers Program and through community support networks.

Keep in mind that some parents may not feel comfortable asking the following questions or talking about concerns that they are only beginning to think about, particularly with early intervention providers they have just met. Some examples of concerns that may arise for parents during implementation of their IFSP: