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ITINERANT CONSULTATION IN ITINERANT CONSULTATION IN ECSE:ECSE:

A Paradigm ShiftA Paradigm ShiftM. Diane Klein, CCC-SLP, Ph.D.

California State University Los AngelesSeptember 5, 2007

Columbus, OH

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Project SupportProject Support

A brief overview. . .

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Collaborators

• Anne Marie Richardson-Gibbs, M.A– El Monte, CA School District

• Sharon Kilpatrick, M.A– San Bernardino County Office of Special Ed

• Kathleen Harris, Ph.D– Professor, Arizona State University

• M.Diane Klein, CCC-SLP, Ph.D – Professor, California State University Los

Angeles, Division of Special Ed & Counseling

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Description of Project Support IProject Support I

• Early Childhood Inclusion Support Training Project

• OSEP funded in 1996OSEP funded in 1996• Motivation: Motivation:

– Concern that children were being included without Concern that children were being included without support.support.

– What kinds of supports should be available?What kinds of supports should be available?– Implications for preservice trainingImplications for preservice training– Paradigm shift for ECSE rolesParadigm shift for ECSE roles

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Context and Population

• Based on needs and experiences within large, urban, multicultural communities (Los Angeles, and San Bernardino Counties)

• Concerned with community-based settings in which Part C and Part B-eligible children were receiving some educational services without adequate support.

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Project Support Project Support Assumptions

• Child needs support– Range from intensive to monitoring only– Change over time

• Supports need to be coordinated– Especially in cases of severe/complex needs

• ECSE well-suited to new role of “inclusion support specialist”

• “Can’t we all just get along” approach is inadequate. Additional training in consultation, collaboration and conflict resolution is essential

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Issues in ECSE Inclusion

• Bricker (2000) TECSE– Parents’ dilemma: inclusion or support– Need for adequate supports– Need for trained staff:

• Re: disabilities• Collaboration skills• Positive attitudes not enough

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Issues (Cont’d)

• Guralnick (2000), JEI– Need for placement guidelines (e.g. child

characteristics matched to setting)– Evaluation of feasibility– Personnel preparation

• ECE re: disabilities• ECSE re: consultation/collaboration

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Issues (cont’d)

• Hanson (2001) Exceptional Children– (Elementary school follow-up of parent

perspectives)• Administrative infrastructure• Specialized supports• Personnel preparation

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Dinnebeil et al.(2006)(TECSE, 26(3)

• Investigated perceptions of ECE teachers, parents, ECSE itinerants, and supervisors re: roles and responsibilities of ECSE itinerants– Findings:“Lack of understanding of the nature of

the intervention itself or the roles of the persons who are delivering the interventions”(p.165)

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Williamson, et al. (2006)(Exceptional Children. 72(3)

• Examined national inclusion trends for K-12 students with MR during decade from 1990-2000.

• Results:– Overall, increase in at least partial day placement in

Gen Ed (in early part of decade) from27% to 44%. But plateau in last 3 years

– High variability from state to state• Recommendations:

– Research on outcomes and effectiveness of placement and support policies

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Project Support I Project Support I Activities

• Developed, tested and evaluated a training model for ECSE inclusion support specialists (consultation approach)

• Trained 60 ECSE professionals using a three-phase inservice training model

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Materials Produced

• Inclusion Specialist Practitioner’s Guide

• Three Videos/DVD: Itinerant consultation, Co-teaching, & Conflict Resolution

• Inservice Training Guide

• Preservice Supplement

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Inclusion Support Inservice Training: Collaborative Consultation

• Phase IPhase I: Intensive inserviceThree day training

• Phase IIPhase II: Mentoring On-site observation of consultation support

• Phase IIIPhase III: Demonstration of competencies Case study and coaching

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Evaluation Activities

• Pre- Post- Competency Self-Assessment

• Case Study

• Follow-up phone interviews

• Long-term follow-up mail surveys

• Parent focus group

• ECE Teacher focus group

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Follow-up survey of ECSE participants in Project Support Inservice Training

• Usefulness of different support activities/ strategies– Most useful

• Modeling for teachers• Coaching

– Least useful• Providing suggestions (written or verbal)

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• Assessment of own collaborative consultation ability:– In pre-test this was rated as one of highest areas of

competency. In follow-up, it was one of lowest.

Take-home message:

Collaborative consultation can be very effective, but requires training and skill.

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• Parent focus group findings:– Used ECSE consultant as a “bridge” to ECE

teacher and classroom– “luxury” of some shared responsibility in

overseeing inclusion

• ECE teacher focus group findings:– Some fear of being critiqued – Appreciated consultant’s role of supporting

them, and respecting/encouraging their expertise

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Project Support II Project Support II Activities

• Refunded as Project of National Significance:– Further developed materials (including video

tapes)– Trained 30 staff at co-teaching sites– Dissemination & technical assistance– Developed and fieldtested Preservice

Supplement (Course syllabus, fieldwork assignments, reading list, PPts, etc.)

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Project Support II Project Support II Evaluation

• Co-teaching self-assessment

• Co-teaching cohort focus group

• Dissemination training feedback

• Faculty initial phone survey re: IHE inclusion support curriculum

• ECSE Faculty field test feedback re: Project Support materials

• ECSE Faculty focus group

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Preservice Fieldtest

• Pre-test phone interviews re:curriculum & fieldwork related to inclusion support competencies (ECSE faculty at 5 California IHE’s)

• Distribution of materials (Practitioner Guide, Preservice Supplement and Videos)

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Pretest Results

– Mostly infused Mostly Level II (advanced)– Mostly focused on collaboration/teaming, but

little focus on problem solving and perspective taking

– No specific focus on various inclusion support models: itinerant consultation, co-teaching, etc.

– No clear guidelines for fieldwork activities

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Preservice Fieldtest Follow-up

• Acknowledged that previous curriculum content related to inclusion support models and skills was limited to collaboration and teaming.

• Most useful materials included videos and handouts for ECE teachers re: specific disabilities.

• Continued to feel that content on inclusion support could be infused.

• Acknowledged that competencies related specifically to inclusion support need to be better developed.

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Inclusion Support Competencies:

Preservice Curriculum

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Inclusion Support Competencies

• 1. Understand and enhance learning of young children with disabilities

• 2. Demonstrate adaptations of environment and curriculum

• 3. Access resources for low incidence and multiple disabilities

• 4. Support families• 5. Insure monitoring of IEP • 6. Supervise paraprofessionals

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(Competencies cont’d)

6. Demonstrate collaborative consultation techniques; co-teaching strategies

7. Establish collaborative partnerships between ECE & ECSE

8. Engage in effective problem solving and conflict resolution processes

9. Demonstrate communication, teaming and coordination skills

10. Use Embedded Learning Opportunities (ELO), “Within routines” .

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Models of Inclusion Support

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Evidence of Effectiveness of Collaborative Consultation

• Data based research mostly in area of Psychological Consultation (Applied Behavioral Analysis)

• Some ECSE studies of practitioner comfort/perceptions of Itinerant models of service delivery (e.g. Wesley & Buysse, Dinnebeil, McInerney & Hale)

• Operationalization of Itinerant Consultation in ECSE not well defined

• Few empirical studies of effects on preschool outcomes; no comparison with other inclusion support models (e.g. co-teaching)

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Need to define what “it” (i.e. consultation) is!!

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Legal decisions re: Inclusion in natural environments/ LRE

• Etscheidt (2006).TECSE, 26(3)

– Court seems to find in favor of classrooms offering both specialized services and interactions with typical peers

– In 7 autism cases requesting specialized DTT settings, only 2 were supported.

– Court gives significant weight to IEP team, ruling against administrative override

– Court insists on continuum of options, supporting solutions within the community (including private preschools) and customized solutions

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Levels/Expectations of Inclusion

• Access (ADA issues)?

• Social participation?

• IEP goal achievement in LRE?

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• What do people expect child to learn in inclusive setting?

• Who will meet those expectations?

• Defining the role of the inclusion specialist.

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Models of Inclusion Support

• “Dump and hope”

• Inservice training– e.g., for early childhood staff

• Use of one-to-one aide

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Models of Support (cont’d)

• Use of related service providers (therapists, disability specialists)

– Multidisciplinary model

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McWilliam, R. (1995; 2003) “Integration of therapy and consultative special education”

Individual or Group Pull-outIndividual or Group Pull-outVV

Individual (one-on-one) in ClassroomIndividual (one-on-one) in ClassroomVV

In-class Small Group ActivityIn-class Small Group ActivityVV

Individualized w/in Routines (ELO)Individualized w/in Routines (ELO)VV

ConsultationConsultation

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Models of Support (cont’d)

• Co-teaching (ECSE & ECE teacher)

• Itinerant – Direct Service (in class or pull-out)

–*Consultation: • Expert / Collaborative

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Itinerant Consultation Approach

Inclusion support provider visits site on a regular basis (e.g. weekly)

Service is predominantly “indirect”/”triadic”

Requires collaborative partnership with ECE teacher & team

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• Consultation Definitions– An indirect method of solving problems in

which the consultant and the consultee work together in some way to define the problems and bring about a solution or resolution.

– (Pryzwansky & Schulte (1987)

– Consultation is “triadic” in that the consultant works with the consultee (e.g. early childhood teacher) who works with the client (child).

– (Tharp, 1975)

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Video

Early Childhood Inclusion Support: Itinerant Consultation

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Itinerant Consultation Activities and Strategies

• Building collaborative relationships– Communicating with team members

• Coordinating services;referrals; resources

• Problem solving (systematic process)

• Involving parents

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• Supervision of one-to-one paraprofessionals. Issues:– Training and background of paras– Teacher expectations– Need to clarify role– 1:1 assistant as “most restrictive

environment!”– Supervision responsibility

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Specific In-Class Strategies

• Observation

• Assessment; data collection

• Direct intervention

• Demonstrating interventions for staff

• Coaching staff

• Coaching peers

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Consultation Strategies (cont’d)

• Adaptations:– materials– environment– Curriculum

• Helping staff design “Embedded Learning Opportunities”

• Assisting in the classroom

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Consultation = Collaboration?

• Definition of Collaboration - Direct interaction between coequal parties voluntarily engaged in shared decision making…toward a common goal (Friend & Cook, 2003)

• Requires:– Effective communication; mutual respect– Problem solving approach

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Consultation Challenges in Early Childhood Inclusion

• Lack of parity

• Consultant not on own “turf”

• Different goals; philosophies

• Personality clashes

• Lack of time to communicate & plan

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Example #1: ECSE Itinerant Consultation Program:

El Monte, CA School District

• Itinerant ECSE program– Up to 25 children @ 5 - 9 Head Start sites

• Special Day Classes used primarily for safety issues (e.g. most severe behavioral challenges; complex health needs)

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• Administrative partnership with Head Start• Uses ECSE consultation model and

paraprofessionals:– One very experienced ECSE credentialed itinerant

teacher– Two full-time special ed paraprofessionals (district)– One-to-one assistants, as needed (minimal)– Additional Head Start assistants

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Inclusion Coordinator determines individual needs of each student, in

consultation with team

• Type of support (Per IEP: Specialized/therapeutic, one-to-one, etc.)

• Intensity of support (frequency, # hours)

– Assigns, schedules, customizes paraprofessionals:

• One-to-one full-time• One-to-one specific times/activities• Classroom assistance, part-time• Classroom assistance, full-time• No paraprofessional

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– Balance intensity needs, e.g. six children: • One child with severe disability, w/ full-time one-to-

one;• Two children with part-time classroom assistance• Three children who receive consultation support

only.

– Paraprofessional may be assigned to more than one site; assigned only as needed to maximize efficiency and support

– LOTS OF ORGANIZATIONAL CHARTS!

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• Every classroom w/ special needs students receives Consultation support—frequency for each child determined by:1. # hrs. specified in IEP (1hr per quarter to 4 hrs/mo)

2. And child characteristics, paraprofessional skills, teacher, staff, classroom population, etc.

• Consultant supervises ECSE paraprofessionals• Consultant uses range of strategies working with

children and adults

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• Time allocated for– Debriefing and reflective supervision of consultants

provided by Inclusion Coordinator– Consultant supervision of paraprofessionals– Consultant communication/ problem solving with staff

and therapists

• This administrative/organizational model reflects “individualized educational plan and least restrictive environment” at its best.

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Example #2: Single site, HybridLAUSD/Head Start

• Head Start Site: 3 a.m. 3 p.m classes

• Full time ECSE teacher

• Full time ECSE paraprofessional

• Eight special needs students

• Children with most severe needs in two a.m. classes; ECSE teacher and Assistant each serve as co-teacher with HS teacher

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• Children with less severe needs placed in p.m. classes with “itinerant” assistant under supervision of ECSE teacher

• Frees ECSE teacher to engage in coordination, collaboration, paperwork, parent communication, etc. in a.m.

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Example #3: Small emerging program, wider geographic area

• ECSE teacher works half-time as Part C EI teacher; half-time as transition/inclusion support itinerant consultant.

• One full time assistant assigned as needed and supervised by ECSE consultant

• As child leaves Part C program,Transition IEP determines possibilities for inclusive setting, SDC or dual enrollment.

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• Uses variety of community-based preschools (e.g. church affiliated, Montessori, Head Start)

• Small number of students on inclusion caseload (4-5)

• Careful planning up front with ECE teachers• Frequent consultant visits initially, development

of specific support plan, then implemented by paraprofessional, under close supervision of consultant.

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Reflections on Success & Failure from AMRG

• Barriers to Success– Really poor ECE program– Itinerant time-management skills:

• Travel, logistics, car-as-office, etc.

– Isolation– Administrative inflexibility– Consultant inflexibility (an oxymoron!)– Inability to supervise paraprofessionals– Personality clashes

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• Key to Success– Ability to multi-task re: needs of

• Children• classroom (teacher, staff, typical children)• paraprofessionals

– Collaboration/consultation skills– Confident about they’re own ECSE

knowldege; able to say “I don’t know” when they don’t

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• Ability to find info/resources when they don’t know.

• Ability to impart information clearly

• Ability / willingness to listen and help

• Belief in ECE program staff potential

• Opportunity for debriefing and reflective supervision for consultant

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A Note on Conflict Resolution

• Different perspectives bring conflict. The goal is not to avoid conflict but to resolve it effectively.”

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Take Home Messages

• Importance of thinking outside the box; customizing organizational and service supports. Creativity & Leadership.

• Administrators and supervisors have an absolutely critical role to play:– Demanding key elements of collaborative

consultation: i.e. triadic, embedded, collaborative, respectful, coordinated support.

– Insuring time for problem solving and debriefing.

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• Importance of documenting and sharing creative models and solutions with broader ECSE professional community, and forming “communities of practice”.

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Consultation can work. . .Consultation can work. . .But it is work! But it is work! (And And

sometimes really fun!)sometimes really fun!)