The Ohio Division for Early Childhood strives to
include at least one parent or teacher feature in our quarterly newsletters. In
the last newsletter, we had two features submitted! We decided to include the
parent feature in our newsletter and share the teacher feature on our Facebook
and Blog. Please enjoy this feature
about this Ohio practitioner who seized a rare opportunity to support families
in Okinawa, a small island in Japan.
From Ohio to Okinawa: An adventurous change in life and practice.
Written by Jess Howiler, ECSE-USNH for the Ohio Division for Early Childhood
If someone would have told me that I would be living and
providing early intervention to children and families on the subtropical island
of Okinawa, Japan, I would have laughed and said “I would have to be crazy to
move my husband, 6 month old daughter, 2 pugs, and our lives across the
world!”. Well, guess what. February of this year, my family and I packed our
lives up in boxes and moved to Okinawa, Japan. What a ride these past 7 months
have been for both my life and my career.
As I’m sure many of you know, Ohio is one of the many states trying to figure out this whole concept of best practices and how to provide the most cost-effective yet research-based early intervention services to children and their families in natural environments. What is meant by "natural environments"? Multidisciplinary team model versus Primary Service Provider (PSP) model? Providers thinking, “I’m a speech therapist, not a physical therapist” or “I’m the expert on what this child needs, I have the degree to prove it”. The world of Early Intervention is not as cut-and-dry as one might think. Lucky for us, a lot of the hard work and research into what truly is best practice has already been done. All we have left to do as providers is to be open to change and then committing to that change.
Here in Okinawa, I have had the opportunity to put to practice all of the research and theories that had been engrained in my Early Intervention studies while at Kent State University (shout out to the wonderful EI program team at KSU!). Don’t get me wrong, this has been a change that started just over a year ago and this change did not happen quickly. In fact, our team is still hashing out what works and what doesn’t for our program. We have really tried to look to the research and create a program that follows the ideals and best practice guidelines for an effective PSP model.
In my opinion, one of the biggest and most critical aspects of this change was the implementation of the Routines-Based Interview (McWilliam, 2010). Yes, when done correctly, the RBI can be very tedious, time consuming, and at times feel like an invasion of our families personal lives. However, when done correctly, the provider and family are able to have a rich, informal conversation about what is and isn’t working for them within the context of the family's daily activities and routines. From that conversation, the team (the family IS part of that team!) is able to create an Individualized Family Services Plan (IFSP) that is prioritized based on the family’s needs and therefore meaningful to that family. The outcomes on the IFSP are functional, making it easier for families to understand the outcomes and take ownership in working toward progress and change.
The other major change was working towards having a Primary Provider working with the family, rather than having 3 or more providers coming in and out of the home working on skills in a disconnected manner. Currently, we select a “best fit” provider that will work with the family on all of the IFSP outcomes. Each provider is on a team of providers that are experts in other disciplines (e.g. general development, speech, motor) who meet weekly to discuss cases and provide role gap support to each other as needed. When appropriate, we utilize joint visits as a way to provide extra support to the provider and family. A joint visit involves a PSP and another provider that specializes in a different discipline working together to coach the family on an intervention or strategy. The second provider’s role is to coach the PSP and the family.
Like I said, our program is a work in progress, but the changes we have made as a whole have been monumental both in practice and in how we have been able to create positive change in the lives of the families and children that we work with. Moving in this direction is not easy and takes a lot of effort system-wide, program-wide, and personally. It’s hard to make a change in how you practice when you have been practicing a certain way for so long.
What we need to remember is why we do what we do. It is our responsibility to provide the best service possible in an attempt to educate, advocate for, and empower families so that they may take the lead in making a positive change for their family.
Here are some examples of concerns that come from an RBI and then how that becomes a functional outcome:
Child Outcome:
* Family Concern: Daniel is becoming very frustrated when we eat and will not always eat what we give him so I end up making multiple meals.
* Child Outcome: Daniel will participate in meal times by making choices so that he can communicate what he wants to eat and meal times become more enjoyable for the family.
o Criteria: We know he does this when he makes a choice of 3 food items for 3 out of 4 meal times (breakfast, lunch, snacks, dinner) a day for 1 week.
Family Outcome:
* Family Concern: Daniel does not have any children his age that live in our building. We are worried that he does not play with other children enough.
* Family Outcome: The Smith family will have a regular play group or play date established for Daniel so that he may play with other children his age.
o Criteria: When the Smith family has taken Daniel to at least 1 play opportunity for 3 consecutive weeks.
From Ohio to Okinawa: An adventurous change in life and practice.
Written by Jess Howiler, ECSE-USNH for the Ohio Division for Early Childhood
As I’m sure many of you know, Ohio is one of the many states trying to figure out this whole concept of best practices and how to provide the most cost-effective yet research-based early intervention services to children and their families in natural environments. What is meant by "natural environments"? Multidisciplinary team model versus Primary Service Provider (PSP) model? Providers thinking, “I’m a speech therapist, not a physical therapist” or “I’m the expert on what this child needs, I have the degree to prove it”. The world of Early Intervention is not as cut-and-dry as one might think. Lucky for us, a lot of the hard work and research into what truly is best practice has already been done. All we have left to do as providers is to be open to change and then committing to that change.
Here in Okinawa, I have had the opportunity to put to practice all of the research and theories that had been engrained in my Early Intervention studies while at Kent State University (shout out to the wonderful EI program team at KSU!). Don’t get me wrong, this has been a change that started just over a year ago and this change did not happen quickly. In fact, our team is still hashing out what works and what doesn’t for our program. We have really tried to look to the research and create a program that follows the ideals and best practice guidelines for an effective PSP model.
In my opinion, one of the biggest and most critical aspects of this change was the implementation of the Routines-Based Interview (McWilliam, 2010). Yes, when done correctly, the RBI can be very tedious, time consuming, and at times feel like an invasion of our families personal lives. However, when done correctly, the provider and family are able to have a rich, informal conversation about what is and isn’t working for them within the context of the family's daily activities and routines. From that conversation, the team (the family IS part of that team!) is able to create an Individualized Family Services Plan (IFSP) that is prioritized based on the family’s needs and therefore meaningful to that family. The outcomes on the IFSP are functional, making it easier for families to understand the outcomes and take ownership in working toward progress and change.
The other major change was working towards having a Primary Provider working with the family, rather than having 3 or more providers coming in and out of the home working on skills in a disconnected manner. Currently, we select a “best fit” provider that will work with the family on all of the IFSP outcomes. Each provider is on a team of providers that are experts in other disciplines (e.g. general development, speech, motor) who meet weekly to discuss cases and provide role gap support to each other as needed. When appropriate, we utilize joint visits as a way to provide extra support to the provider and family. A joint visit involves a PSP and another provider that specializes in a different discipline working together to coach the family on an intervention or strategy. The second provider’s role is to coach the PSP and the family.
Like I said, our program is a work in progress, but the changes we have made as a whole have been monumental both in practice and in how we have been able to create positive change in the lives of the families and children that we work with. Moving in this direction is not easy and takes a lot of effort system-wide, program-wide, and personally. It’s hard to make a change in how you practice when you have been practicing a certain way for so long.
What we need to remember is why we do what we do. It is our responsibility to provide the best service possible in an attempt to educate, advocate for, and empower families so that they may take the lead in making a positive change for their family.
Here are some examples of concerns that come from an RBI and then how that becomes a functional outcome:
Child Outcome:
* Family Concern: Daniel is becoming very frustrated when we eat and will not always eat what we give him so I end up making multiple meals.
* Child Outcome: Daniel will participate in meal times by making choices so that he can communicate what he wants to eat and meal times become more enjoyable for the family.
o Criteria: We know he does this when he makes a choice of 3 food items for 3 out of 4 meal times (breakfast, lunch, snacks, dinner) a day for 1 week.
Family Outcome:
* Family Concern: Daniel does not have any children his age that live in our building. We are worried that he does not play with other children enough.
* Family Outcome: The Smith family will have a regular play group or play date established for Daniel so that he may play with other children his age.
o Criteria: When the Smith family has taken Daniel to at least 1 play opportunity for 3 consecutive weeks.
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