EI and Preschool Conference 2009 Pinto, Vick, Wanous A Good Start Makes A Difference for Families...

EI and Preschool Conference 2009 PEI and Preschool Conference 2009 Pinto, Vick, Wanousinto, Vick, Wanous

A Good Start Makes AA Good Start Makes ADifference for Families and Difference for Families and

Service Coordinators!Service Coordinators!

Voluntary Family Assessments Voluntary Family Assessments and IFSP Outcomesand IFSP Outcomes


WelcomeWelcome

We are Teri Pinto, Mary Beth Vick and Amy We are Teri Pinto, Mary Beth Vick and Amy Wanous…Wanous…

Who are you? Who are you?


Service Coordinators were askedService Coordinators were asked

What is the most fundamental thing you What is the most fundamental thing you should know to do your job?should know to do your job?

What is the one thing you wished you had What is the one thing you wished you had known when you first started that no one told known when you first started that no one told you?you?

What is the hardest aspect of your job?What is the hardest aspect of your job? What is the easiest aspect of your job? What is the easiest aspect of your job?


Who responded?Who responded?

25 service coordinators responded to the 25 service coordinators responded to the questionnairequestionnaire

Work experience ranged from 3 weeks to 18 Work experience ranged from 3 weeks to 18 yearsyears


What they saidWhat they said

What is the most fundamental thing you should What is the most fundamental thing you should know to do your job?know to do your job? Time management skillsTime management skills

PrioritizingPrioritizing OrganizingOrganizing

Good documentation skillsGood documentation skills Computer skillsComputer skills

Knowledge of medical concerns and reportsKnowledge of medical concerns and reports Working with other professionalsWorking with other professionals


All great things to know All great things to know

But what about….But what about….

Interpersonal skillsInterpersonal skills

Being a good listenerBeing a good listener



What is the one thing you wished you had What is the one thing you wished you had known when you first started that no one told known when you first started that no one told you?you? How much paperwork there would beHow much paperwork there would be How intense PAR can beHow intense PAR can be You can’t MAKE families follow-throughYou can’t MAKE families follow-through How hard it is to get services in some areas How hard it is to get services in some areas


All great things to knowAll great things to know

But what about…But what about… Understanding child development and family Understanding child development and family

dynamicsdynamics What “routines-based intervention” meansWhat “routines-based intervention” means The plan is driven by the family’s needsThe plan is driven by the family’s needs



What is the hardest aspect of your job?What is the hardest aspect of your job? PaperworkPaperwork GIFTSGIFTS Scheduling therapistsScheduling therapists TimelinesTimelines



What is the easiest aspect of your job?What is the easiest aspect of your job? Direct intervention with the familiesDirect intervention with the families Advocating for familiesAdvocating for families Home visitsHome visits Working with parents who “get it”Working with parents who “get it” When families buy into the philosophy that they When families buy into the philosophy that they

are their child’s teacher and they implement our are their child’s teacher and they implement our suggestionssuggestions


What do these things tell us?What do these things tell us?

You LOVE working with families - You LOVE working with families -

that’s what got you here in the first placethat’s what got you here in the first place

Paperwork, timelines, and GIFTS are all Paperwork, timelines, and GIFTS are all necessary evils, so you do them….so you can necessary evils, so you do them….so you can spend more time with familiesspend more time with families


So…what if we offered youSo…what if we offered you

A way to spend more time on the things you A way to spend more time on the things you LOVE about your job and find the EASIEST LOVE about your job and find the EASIEST

Working directly with familiesWorking directly with families Home visitsHome visits Helping parents “get it”Helping parents “get it” Getting families to “buy into” our philosophy Getting families to “buy into” our philosophy


ANDAND

Less time on the things you DISLIKE and find Less time on the things you DISLIKE and find the HARDEST to dothe HARDEST to do

PaperworkPaperwork GIFTSGIFTS TImelinesTImelines


What if…. What if….

… … we went in a new direction?we went in a new direction?

… … we really addressed the issues of life for each we really addressed the issues of life for each family and their child?family and their child?

… … we looked at the quality of the voluntary we looked at the quality of the voluntary family assessments and maximized what we family assessments and maximized what we got out of them?got out of them?


Here is what we see nowHere is what we see now

““Georgie was born 3 months premature. He Georgie was born 3 months premature. He lives with his foster parents, twin sister and 6 lives with his foster parents, twin sister and 6 other siblings. He remained in the hospital 3 other siblings. He remained in the hospital 3 months after birth. He shows significant months after birth. He shows significant delays in fine motor, cognitive, and language delays in fine motor, cognitive, and language areas. He also shows slight delays in gross areas. He also shows slight delays in gross motor and social emotional areas. He is motor and social emotional areas. He is unable to stoop down to pick up toys…” unable to stoop down to pick up toys…”


More of the sameMore of the same

““Ms. Burris stated that Aaron wasn’t born Ms. Burris stated that Aaron wasn’t born premature. He has a younger brother which premature. He has a younger brother which they both attend the same day care. Ms. Burris they both attend the same day care. Ms. Burris stated that Aaron isn’t talking as he should…” stated that Aaron isn’t talking as he should…”


One more for good measureOne more for good measure

““Paul is a 32 month old little boy who is Paul is a 32 month old little boy who is currently in the custody of DHR. He was currently in the custody of DHR. He was picked up and taken into care due to lack of picked up and taken into care due to lack of parent supervision. He has little parent supervision. He has little communication skills, unable to say his name. communication skills, unable to say his name. He was referred by the pediatrician. The DHR He was referred by the pediatrician. The DHR social worker would like EI to assist her in social worker would like EI to assist her in making sure that Paul gets all the services he making sure that Paul gets all the services he needs.” needs.”


What do you think?What do you think? Yes, you have been writing these for years!Yes, you have been writing these for years!

Just don’t know another way?Just don’t know another way? It is easy and the information is already there? It is easy and the information is already there?

Yes, we have been accepting them as Voluntary Yes, we have been accepting them as Voluntary Family Assessments and giving you credit during the Family Assessments and giving you credit during the PAR review.PAR review.

No, that will NOT continue! No, that will NOT continue! We are revising the PAR so that it better assesses the We are revising the PAR so that it better assesses the

QUALITY of your work, not just the quantity.QUALITY of your work, not just the quantity.


So, what do you do?So, what do you do? Learn some interviewing skillsLearn some interviewing skills

Ask some open ended questionsAsk some open ended questions Learn to stop, look and listenLearn to stop, look and listen

Adopt a new way of conducting a voluntary Adopt a new way of conducting a voluntary family assessment and writing outcomesfamily assessment and writing outcomes You can teach an old dog new tricksYou can teach an old dog new tricks Let the FRAMES work for youLet the FRAMES work for you Rate your outcomes for functionalityRate your outcomes for functionality


Reasons for the VFAReasons for the VFA

Getting to know the familyGetting to know the family Develop a bond with the familyDevelop a bond with the family Provides a short cut to much informationProvides a short cut to much information

Assessing family needsAssessing family needs If you could change anything, what would it be?If you could change anything, what would it be? When you lie awake at night, what worries you?When you lie awake at night, what worries you?

Setting prioritiesSetting priorities


What is FRAMES?What is FRAMES?

The Frames Tool Process is invaluable tool for getting The Frames Tool Process is invaluable tool for getting to know the child /family and is an excellent tool for to know the child /family and is an excellent tool for conducting the Voluntary Family Assessment. conducting the Voluntary Family Assessment.

The Frames Tool provides a rich profile and history The Frames Tool provides a rich profile and history that helps provider become familiar with the child / that helps provider become familiar with the child / family and is the foundation from which the IFSP family and is the foundation from which the IFSP may be developed. may be developed.


The FRAMES ProcessThe FRAMES Process

The 12 basic topic areas for open ended The 12 basic topic areas for open ended questions…questions… HistoryHistory Eco MapEco Map Functional CommunicationFunctional Communication Child’s WorldChild’s World Child and Family RoutinesChild and Family Routines


The FRAMES ProcessThe FRAMES Process

HealthHealth ChoicesChoices Appropriate Behaviors and Behaviors of ConcernAppropriate Behaviors and Behaviors of Concern Fears and ConcernsFears and Concerns Child/Teacher/Family StressorsChild/Teacher/Family Stressors Stress Related StrategiesStress Related Strategies Future Plans/Changes in Next 12 monthsFuture Plans/Changes in Next 12 months


History


Eco Map


Com

plex speech C

omplex speech

(sentences)(sentences)

Multiple w

ord phrasesM

ultiple word phrases

One w

ord utterancesO

ne word utterances

Echolalia

Echolalia

Other vocalizing

Other vocalizing

Com

plex signingC

omplex signing

Single signsSingle signs

PointingPointing

Leading

Leading

Shakes Head

Shakes Head

Grab/reach

Grab/reach

Gives objects

Gives objects

Increased movem

entIncreased m

ovement

Moves close to you

Moves close to you

Moves aw

ay or leavesM

oves away or leaves

Fixed gaze Facial Fixed gaze Facial expressionexpression

Aggression-

Aggression- hits

hits

Cries / tantrum

sC

ries / tantrums

Self-Injury- Self-Injury- bum

ps headbum

ps head

Other- throw

sO

ther- throws

Request attentionRequest attention

Request helpRequest help

Request preferred Request preferred food/objects or food/objects or activitiesactivities

Request breakRequest break

Show you something Show you something or some placeor some place

Indicate physical pain Indicate physical pain (headache, illness)(headache, illness)

Indicate confusion or Indicate confusion or unhappinessunhappiness

Protest or reject a Protest or reject a situation or activitysituation or activity

Functional Communication V= Consistent * =Sometimes

Communicative Function

Mode


Home

Work

School

Community


Weekday Weekend

Child and Family Routines

Saturday Sunday


Health

+ -

Medication name: Prescribed by: Reason: Possible side effects:

None


ChoicesFamily/TeacherChild


Appropriate Behaviors & Behaviors of ConcernAppropriate Behaviors & Behaviors of Concern


NameName I am concerned about…I am concerned about… Low to HighLow to High

1 2 3 4 51 2 3 4 5

Fears and Concerns-List name in first column, concerns in middle column, then rank level of concern in third column.


Child/ Teacher/ Family Stressors

List name in first column, stressors in middle column, then rank level of stress in third column.

NameName I feel stressed when…I feel stressed when… Low to HighLow to High

1 2 3 4 5 1 2 3 4 5


Stress Related Strategies

What Works What Does Not Work


HomeWork

School Community

Future Plans/Changes in Next 12 months?


Now what?Now what?

Now that we have the FRAME work, how do we Now that we have the FRAME work, how do we develop better functional outcomes and develop better functional outcomes and

ultimately provide better services?ultimately provide better services?


Developing Functional Outcomes Developing Functional Outcomes

What outcomes can YOU come up What outcomes can YOU come up with for the IFSP? with for the IFSP?

(your turn to work)(your turn to work)


Family Defined OutcomesFamily Defined Outcomes

Family Defined Goals To Enhance Child’s Family Defined Goals To Enhance Child’s Development, Page F of the IFSP formatDevelopment, Page F of the IFSP format

(handout) (handout)


But are they functional?But are they functional?

Scale of Early Intervention Goal FunctionalityScale of Early Intervention Goal Functionality Developed by Robin McWilliamsDeveloped by Robin McWilliams Goals focusing on Goals focusing on

Engagement and participation needsEngagement and participation needs Independence needsIndependence needs Social relationship needsSocial relationship needs


EXCELLENT!EXCELLENT!

Now how hard was that?Now how hard was that?


Willing to give it a try?Willing to give it a try?

We pledge to…We pledge to… Provide more training on VFA at Journey IProvide more training on VFA at Journey I Give you the tools to useGive you the tools to use

FRAMESFRAMES Goal functionality scaleGoal functionality scale

If you will… If you will… Work on improving your listening skillsWork on improving your listening skills

Incorporate FRAMES and McWilliams ScaleIncorporate FRAMES and McWilliams Scale

Call us with any questions, we are here to help!Call us with any questions, we are here to help!


How to contact usHow to contact us Teri PintoTeri Pinto

DMH – Office of Children’s ServicesDMH – Office of Children’s Services 205-941-9904205-941-9904 [email protected]@mh.alabama.gov

Mary Beth VickMary Beth Vick Community Service Programs of West AlabamaCommunity Service Programs of West Alabama

205-752-0476 x 115205-752-0476 x 115 [email protected]@cspwal.com

Amy WanousAmy Wanous ADRS – Division of Early InterventionADRS – Division of Early Intervention

334-293-7211334-293-7211 [email protected]@rehab.alabama.gov

EI and Preschool Conference 2009 Pinto, Vick, Wanous A Good Start Makes A Difference for Families...

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