Friday, November 20, 2015

Guiding Principles for Early Intervention Services

We had our first Early Intervention session on Monday. Our speech language pathologist (SLP) came to the house and played with the boys. 


She said she would focus on Conor this week, and alternate next week when it will be Caden's turn. She wasn't excluding either of them in the session; she actually did a great job balancing both of them. But she made it a point to monitor Conor's speech development and write notes on just him this week. He warmed up to her quickly and enjoyed playing with her. As I mentioned in previous posts, they don't often get individualized attention, so I could tell her liked playing with her. When Caden started to join in, he got a little frustrated but he quickly got over it.

Let me back up a little bit.  So a few weeks ago, after the determination was made that both Conor and Caden qualified for the EI services, the next step is for the members involved (parents/family, SLP, pediatrician, child care provider) to develop a plan to implement the services. So the EI team leader and the SLP came over to my house last week and we carried out what is called the Individualized Family Service Plan (IFSP). This step is crucial, as it comes after the assessments and prior to the child/children receiving services. The goal of the IFSP is to determine intervention outcomes, approaches, methods, and settings. This plan was based on information from the boys' assessments regarding some of my concerns and priorities. During the IFSP, we set goals for both boys for 6 months out. I liked this step, because I feel it immediately set us up to be successful - and set us up to be on the same page. I say that because she asked me "when do you feel we would be successful in the EI program?" In other words, what do the boys need to be saying or doing in order to feel we reached a successful point. A few goals I suggested would be when Conor and Caden could speak about 5-10 words (up, milk, more, juice, eat, etc) and/or when they can sign some words to communicate their needs. Some signs I feel would be helpful would be me, more, up, and milk. I would love for both of those skill sets to develop, but would be happy and successful if just one means of communication developed in 6 months. I also mentioned that it would be helpful if/when the boys can start responding to simple commands like "where's your milk", "bring mommy a book", or "bring me your shoes". So basically, we set three attainable goals in the IFSP for both boys.
Here are some bullets on what the EI services offer:

1. Early Intervention services are family-centered and culturally and linguistically responsive.
2. Early Intervention services are developmentally supportive and promote children's participation in their natural environments.
3. Early Intervention services are comprehensive, coordinated, and team-based.
4. Early Intervention services are based on the highest quality evidence that is available 

What I like most about the program is that these services are provided [by SLPs] in the child's natural environment. This is important to me. The EI program emphasizes the minimal effort needed to sign your child up for services. For example, this means not having to take your child to a doctor's office or an appointment which can be difficult with schedules. Moreover, it is all conducted in a familiar setting so your child can carry out normal and typical behavior. Furthermore, with the SLP coming to our house, she can play with the toys the boys are already familiar with, and they can navigate throughout the room/house without feeling shy. The EI services also offer to go to the boys' daycare which will be super convenient when that starts, as well. I also like the emphasis of the program to be a direct or “hands-on” delivery to the child, that's inclusive with the child, parents, family, siblings, caregivers, and the SLP in a collaborative role. It isn't an arbitrary "instructive" type of a lesson or type of atmosphere. Rather, the SLP plays with Conor and Caden on the floor similarly to how Jim and myself play with them.


So, fast-forwarding a bit, we learned a few little strategies on Monday - during our first visit. The SLP was sort of narrating her thought process and tactics during the session to catch me up to speed. For example, she would kind of guide me through what she was doing and what she would expect to see from the boys (specifically Conor). By way of example, she held a toy car up high on the couch and she said "Ready, Set, _____" and waited for Conor make a noise or say "Go" (eventually Caden joined in too). The boys responded well and interacted happily in this type of play. She was pleased to see and hear their responses as they finished her sentence. She said that was a good sign. 

Another helpful hint she gave me was to make commands simple. I haven't been doing a good job at this, so I am glad she gave me some guidance. Before entering the EI program, I would say something like "Conor, put the blocks in the bin". However, she suggested I simply that by using one word - "IN". She emphasized the need to keep using one syllable words, with one vowel and one consonant. So I would hold the toy block and say "in" (while showing him) and repeat by saying "in", "in". And he eventually carried out the same action of putting the block in the bin. Similarly, we used big block like legos and said "ON" to put one lego on the other. We did it a few times, and now when I hold a lego and say "on", Conor puts a lego onto the one I am holding. :)

Lastly, I liked how she made little recommendations throughout the session. For instance, she suggested I hold an object close to my mouth and say the name of the object. That way, they can easily associate the item with the names of things throughout the house. I liked all the helpful hints she gave me - and I've been using them this week. I think the repetition is good, as well as the familiarity with the same toys she used. Now they can continue these strategies in their every day activities.

In other news, I just got this new candle. Bed Bath and Beyond was having a sale, as well as the paper store. They are BOGO right now. That's probably the best price you'll pay! My cousin Jen got me a pumpkin Yankee Candle a few months ago and it's almost gone. Time for a new one, this time for the winter season!


Hope you all have a great weekend!
Shaz