https://learn.extension.org/events/2651
This material is based upon work supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture, and the Office of Family Readiness Policy, U.S. Department of Defense under Award Numbers 2014-48770-22587 and 2015-48770-24368.
VLE2: Opening Doors with Families Using the Routines-Based Interview
Connecting military family service providers to research and to each other
through innovative online programming
www.extension.org/militaryfamilies
MFLN Intro
Sign up for webinar email notifications at www.extension.org/62831 2
Robin McWilliam, PhD • Experienced researcher, administrator,
early interventionist, teacher, parent, and writer
• Developed the Routines-Based Model • Research centers on infants and young
children with and without disabilities with a focus on child engagement, service delivery models, and collaboration with families
• Provides consultation, training, and
technical assistance related to providing early intervention in natural environments and the Engagement Classroom Model
Today’s Presenter
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ìBuilding Family Strengths and Resilience With the RBI Robin McWilliam, University of Alabama
FamiliesFirstbyProvinceofBri4shColumbiaCCBY-NC-ND2.0
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Exploring the RBI
Installing the RBI
Implementing the RBI
Perfecting the RBI
ExploringtheRBI
Top signs you need the RBI
What is the RBI?
What does it do?
Why is it important
OnebyLazyLibrarian,CCBY-NC2.06
ì Uncertainty of family priorities for their child and family
ì Limited family participation in IFSP/IEP development
ì Ambiguous outcomes/goals
ì Too few outcomes; too many goals
ì Vague understanding of children’s natural learning opportunities
ì Concerns about caregiver implementation of intervention strategies
TopSignsYouNeedtheRBI
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ì Semi structured interview 1. Ecomap 2. Main concerns 3. Daily routines (define) 4. Time, worry, and change questions 5. Recap 6. Outcome selection
ì Participation-based child outcomes + family outcomes
WhatIstheRBI?
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ì Establish positive relationship with the family
ì Rich and thick description of functioning
ì List of functional, family-centered outcomes
WhatDoesItDo?
9 BeingHealthyisBeau4fulbyArmyMedicineCCBY2.0
ì IFSP outcomes; IEP goals
ì Information for ì Family Concerns and Priorities ì Child’s Present Abilities ì Family Strengths and Resources
Product
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TIMETOCHATWhatdoyouthinkyouneedtoimproveuponinthedevelopmentofIFSPs?HowmuchhaveyoubeenaQendingtofamilyneedsthroughtheIFSP?
ì What are your main concerns?
ì How does your day begin?
ì What does your child do?
ì How much help does he need?
ì What about talking and getting along with others?
ì What is everyone else doing?
ì How happy are you with this time of day?
ì What happens next?
SomeRBIQuestions
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Canyouverifythatwith…
ResearchDataManagementbyJannekeStaaks,CCBY-NC2.012
Research
McWilliam,R.A.,Casey,A.M.,&SimsJ.(2009).Therou4nes-basedinterview:AmethodforassessingneedsanddevelopingIFSPs.Infants&YoungChildren,22,224-233.Boavida,T.,Aguiar,C.,McWilliam,R.A.,Pimentel,J.S.(2010).Qualityofindividualizededuca4onprogramgoalsofpreschoolerswithdisabili4es.InfantsandYoungChildren,23,233-243.DOI:10.1097/IYC.0b013e3181e45925Ridgley,R.,Snyder,P.A.,McWilliam,R.A.,&Davis,J.E.(2011).Developmentandini4alvalida4onofaprofessionaldevelopmentinterven4ontoenhancethequalityofindividualizedfamilyserviceplans.Infancts&YoungChildren,24,309-328.Ridgley,R.,Snyder,P.A.,&McWilliam,R.A.(2014).Exploringtypeandamountofparenttalkduringindividualizedfamilyserviceplanmee4ngs.Infants&YoungChildren,27,345-358.DOI:10.1097/IYC0000000000000021Boavida,T.,Akers,K.,McWilliam,R.A.,&Jung,L.A.(inpress).RaschanalysisoftheRou4nes-BasedInterviewImplementa4onChecklist.Infants&YoungChildren. 13
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How the RBI Supports Family Resilience
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ì Family undergoing stressful situation feels supported
ì Family experiencing big change has opportunity to plan new routines
ì Helps families identify specific routines they want to change
ì With routines-based home visits afterwards, helps family feel confident and competent
RBIandMilitary-FamilyResilience
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ì Somehow, we have overlooked assessment of needs!
ì Functional outcomes/goals (target behaviors) ì Address participation (engagement) needs ì Address independence needs ì Address social relationships needs
ì Family priorities reflected in the IFSP/IEP
Need for Routines-Based Assessment
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ì Outcomes/goals meaningful to the child’s caregivers
ì To capitalize on learning opportunities, without embedding nonfunctional outcomes/outcomes
ì To build on and promote family capacity and resilience, promoting strong families
Need for Routines-Based Assessment
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TIMETOCHATWhatistherichestrou4neoftheday?What4meofdayisthemostcommondifficultrou4ne?Whatclassroomrou4nesoeenleadtolowengagement?
• Functioning • Routines • Family needs
Needs Assessment
• Participation-based outcomes
• Context; generalization
• Family outcomes
Intervention Plan • Meaningful child skills
• Intervention in everyday routines
• Family empowerment, enrichment
Support to Families
LinkBetweenRBIandServiceDelivery
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InstallingtheRBI
What’s involved with the RBI?
Who does what?
How does it work?
TwobyAdamBlust,CCBY-ND2.0
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ì Go through each “routine” (i.e. time of day or activity)
ì Get a sense of family’s and child’s functioning
ì Write down significant information
ì Star the concerns
ì Recap concerns with the family, showing them the starred items
ì Ask what the family would like to concentrate on
ì Write down these outcomes
ì Ask them for the priority order
TheRoutines-BasedInterview
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VariousProfessionalsWhoMightBeInvolved
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Intake SC
Others
Evaluators
Providers
Ongoing SC
LogisticsQuestions
Intake Evaluation IFSPMee4ng
ì Who should be there? Why?
ì When should the RBI be done?
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ImplementingtheRBI
What does it look like?
Where does it fit in?
How do we ensure it’s being done with fidelity?
Resources, tools, & training
Addressing misconceptions
ThreebyGrantHutchinson,CCBY-NC-ND2.024
Structure
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HomeRou(nesWakingup
Changingdiaper/bathroomGoingtokitchen
BreakfastParentgegngdressed
GoingoutInshopsLunch
GoingtoparkOtherfamilymembers
cominghomeDinnerprepara4on
DinnerBathTV
Bed4me
“Classroom”Rou(nesArrivalCircle
FreeplaySnack
SmalltoysCentersOutsideMusicStoryLunchNap
CentersDeparture
WithinEachRou(ne1. Whatdoeseveryoneelse
do?2. Whatdoesthischilddo?
a) Engagementb) Independencec) Socialrela4onships
3. Howsa4sfactoryisthisrou4ne?
4. Howwellisthisrou4neworkingforthechild?(“goodnessoffit”)
ì How does the child participate in this routine?
ì How does the child spend most of his or her time?
ì How sophisticated is the child’s engagement? ì Not engaged? ì Passive attention? ì Repetitive behavior? ì Differentiated behavior? ì Solving problems? ì Following the conventions of the routine?
Engagement
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ì What does the child do by him- or herself? What does he or she need help with?
ì Can the child be left to participate in this routine without assistance?
ì How does the child indicate a need for help?
ì How does the child respond when help is given?
Independence
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ì How does the child communicate during this routine?
ì How does he or she respond to communication from others?
ì How does he or she express him- or herself?
ì How sophisticated is the child’s communication?
ì What communicative mode does the child use?
ì How easy is it for the child to be understood?
SocialRelationships
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ì How does the child get along with others during this routine?
ì How cooperative is he or she?
ì How much does he or she initiate interactions?
ì How interested is he or she in others?
ì How does he or she respond to correction from adults?
ì What kind of correction do adults provide?
SocialRelationships(cont.)
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ì Everything hinges on follow-up questions ì Getting details of child functioning ì Getting details of family functioning ì Credibility demonstrated by salience of questions ì Goal: Rich picture of routine
Follow-UpQuestions
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TIMETOCHATWhatmakesaninterviewsimple?Whatmakesonemorechallenging?
ì Write down, in short notes, important information
ì Especially note concerns (mostly parents’ but can be yours) ì Put stars (Ö) next to them
ì These are not the parent’s chosen outcomes yet
ì This will be a list of 10-20 or more concerns!
ì At the end of the interview, use these to remind the parent
NotingConcerns
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ì Interviewer reads aloud notes about concerns
ì The family selects 10-12 outcomes (goals); 6 is absolute minimum
ì The family put outcomes into priority order
OutcomeSelection
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1. Taking food by mouth (meals)
2. Meaningful communication single words (play, evening fam time)
3. Play independently not needing my attention – letting me leave the room without crying
4. Diaper time going easier – less fussing
5. Walking (play time, outings, outside)
JasonandSarah’sOutcomes
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6. Going on outings that are doable with our 5-year-old and Alyssa
7. Jason time to study for his promotion exam
8. Sarah time for herself (1x/week)
9. Organize days
10. Finding a good school at our next duty station
JasonandSarah’sOutcomes
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ì Lasts 2 hours; absolute minimum 1 hour
ì Produces 10-12 outcomes; absolute minimum 6 outcomes
ASuccessfulInterview
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TIMETOCHATHoweasyisittoaddoutcomes,ifservicesdon’tchange?Doyoualwayshaveatleastonefamilygoal?
ì Child-level ì Home context ì Classroom context
ì Child-related family goal ì E.g., know about the child’s disability
ì Family-level ì E.g., mother find employment
KindsofGoals
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ì Appropriately natural and informal
ì Put the parent at ease
ì Look the talking parent in the eye
ì Avoid the use of jargon
ì Affirm what the parent is saying
ì Express admiration for what parent does
ì Acknowledge or ask about feelings
ì Place papers being written on flat
ì Use “self-disclosure” or “therapeutic use of self”
ì Handle crying appropriately
ì Respect cultural conversational norms
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CriticalInterviewBehaviors
ì Handle emotional topics sensitively
ì Don’t engage in judgmental talk about the other parent
ì Jump to later routines, if necessary
ì Ask detailed questions at the beginning
ì Keep structure of 6 questions per routine: 1. What’s everyone doing? 2. What’s this child doing? 3. What’s this child’s
engagement like? 4. What’s this child’s
independence like? 5. What are this child’s social
relationships like? 6. How satisfactory is this
time of day?
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MoreInterviewBehaviors
ì Knowledge of child development ì To be able to ask sensible follow-up questions
ì Knowledge of family functioning ì To be able to ask sensible follow-up questions
ì Interview skills ì To be able to keep an easy conversation going
InterviewSkills
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Intake Establishedcondition?
Testing for developmental
delay
Delayed?Eligible?
RBIOutcomes
Decide on resources, including services
Complete IFSP
No
YesYes
Refer out
No
Services start
Wheredoesitfitin?
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Ecomap
ì Increasingly, communities/programs are scoring instruments from information provided during the RBI ì What % of children tested for delay are ineligible?
ì If > 10%, ì Do evaluations first or ì Screen children at intake
Adaptation
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ì Family decides who they want from the family ì Child does not have to be there ì Minimize interruptions
ì Ideal to have 2 professionals ì One is manageable
Who’sThere?
42 Militaryparentspar4cipateinChildFindbyUSArmyCCBYNC-ND2.0
ì Teacher Present ì Parent interview on
home routines, through arrival at school
ì Teacher interview about school routines
ì Resume home routines ì Recap both home and
school concerns ì Parent picks goals for
home and school
ì Teacher Absent ì Parent permission to
interview teacher ì Teacher interview about
school routines ì Another time, parent
interview about home routines, through arrival at school
ì Interviewer reports on school routines
ì Resume home routines ì Recap both home and
school concerns ì Parent picks goals for
home and school
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TeacherInterview
Take-HomeMessage
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ì RBI best done between eligibility determination and IFSP completion
ì …with primary service provider involved
But there are workarounds for everything!
TIMETOCHATWhatiftheteacherwantscertaingoalsontheIFSP?
ì Ecomap-With-RBI Checklist
ì 85% correct
EnsuringFidelity
BabyEmo4onsbyAlexMotrenkoCCBY-NC-ND2.045
ì Articles and chapters ì Protocol ì RBI Outline ì EISR prompts ì 115 certified trainers ì RBI Certification Institute ì Bootcamps ì Coming soon: Online RBI Fidelity Coach (Younggren)
Resources,Tools,&Training
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Perfecting the RBI
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ì Not for every family ì Intrusive
ì Worry and change questions ì New baby (assumption that there aren’t many routines or things
the baby does) ì Articulation only concern ì Takes too long ì Can get the information in other ways ì Why do we need so many outcomes/goals? ì What if parents miss child needs?
AddressingMisconceptions
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ì What if a professional has detected a delay or other problem? ì Why is this a FUNCTIONAL concern? ì Fit the intervention into existing outcome ì Obligation to give families information ì But make sure it is evidence based
Interventionists’Concerns
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TIMETOCHAT Whataretherepercussionsifwedon’taddressacertainneedprofessionalshaveiden4fied?
ì
“What if a parent wants something like more time to herself, and we don’t have the resources to meet that need? Am I expected to go babysit her kids?”
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ì Parents with mental-health needs
ì Parents with intellectual disabilities
ì Parents who don’t want to be in early intervention
ì Talkative parents
ì Monosyllabic parents
ì Divergent thinkers
ì Overbearing grandparents
ì Children looked after by nanny or “foreign worker”
ì Non-English-speaking parents
ì Distractions
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HowtoFaceSpecialChallenges
ì www.ramgroup.info
ì www.naturalenvironments.blogspot.com
ì @robinmcwilliam1
ì Facebook
Contact
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What is one significant thing you learned today?
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Military Families Learning Network
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MFLN Intro
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https://www.linkedin.com/groups/8409844
DoD Branch Services
Reserve Guard
Cooperative Extension
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Family Development Upcoming Event
VLE3:RebuildingA?achmentsWithMilitaryChildrenU(lizingPlayTherapy
• Date:September15,2016• Time:11a.m.–12:30p.m.Eastern• Loca4on:h"ps://learn.extension.org/events/2652
Formoreinforma4ononMFLNFDEarlyInterven4ongoto:h"ps://blogs.extension.org/militaryfamilies/family-development/ 56
Evaluation and CE Credit
• For this webinar, we are offering Early Intervention, NASW, and Georgia Marriage and Family Therapy CE credits.
• Webinar participants who want to receive a certificate of continuing education (or just
want proof of participation in the training) will need to take an evaluation and post-test at the end of the webinar.
• You must submit your certificate of completion and any other materials required to your state/agency in order to receive credit.
• CE certificates of completion will be automatically emailed to participants upon
completion of the evaluation & post-test.
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• For this webinar, we are offering Early Intervention, NASW, and Georgia Marriage and Family Therapy CE credits.
• Early Intervention CE credits are available to participants in Illinois, Georgia, Kansas, Kentucky, Ohio (EISC & EI CE credit), North Carolina, Tennessee, Texas, and Virginia.
• Webinar participants who want to receive a certificate of continuing education (or just want proof of participation in the training) need to take this evaluation and post-test:
https://vte.co1.qualtrics.com/SE/?SID=SV_2f5yXWhkaOUhN65
• You must submit your certificate of completion and any other materials required to your state/
agency in order to receive credit.
• CE certificates of completion will be automatically emailed to participants upon completion of the evaluation & post-test.
Questions/concerns regarding EI CE credit certificates? Contact [email protected] Questions/concerns regarding NASW CE credit certificates? Contact [email protected]
CE Credit Information
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www.extension.org/62581
This material is based upon work supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture, and the Office of Family Readiness Policy, U.S. Department of Defense under Award Numbers 2014-48770-22587 and 2015-48770-24368. 59