Infant Toddler Development Training
Module 5, Lesson 5
The Family's Role in Developing Outcomes
With the focus in Early Steps on everyday routines, activities, and places (known as ERAP), the collaborative role of families on the team becomes even more crucial in developing outcomes. We need to know much more about what families do and what is important to them when services are provided in the ERAP model than we ever did when families came to us for services. The strategies to achieve the outcomes are designed to build upon the routines and activities of the family's everyday life. Therefore professionals must look at how interventions can be incorporated into daily activities. These activities include play (playing with pots and pans in the oven drawer, block play, following the figures on a mobile, etc.), daily routines (bath time, changing diapers, eating, reading stories, etc.), and planned activities (grocery shopping, going to the park, activities at child care, etc.) (Cripe & Venn, 1997; Rugg, 2000). Functional outcomes are achieved through the use of functional strategies which, in turn, lead to the development of functional skills.
Through the Looking Glass - Strength Based Perspectives
In the story of Alice in Wonderland, Alice went through a looking glass (mirror) and found herself in a very strange world on the other side. She struggled very hard to make sense of a place where all the rules that applied in her world did not apply in this strange place. The characters she encountered often made her feel uninformed and weren't very helpful.
When children and families in the early intervention system were regarded as "consumers of therapy services" with professionals assessing the child and recommending treatment, they often felt like Alice in a strange, new world. The role of the family and their perceived competence was very different than it is in the enhanced Early Steps system. If families are viewed as experts about their children and share equally in the decision-making process with professionals, they then set the priorities for outcomes and services. They begin to make sense of a world into which they have some input. They are viewed from a "strength-based" perspective rather than entities needing to be "fixed". Because children are to receive services in ERAP, it is important for professionals to actively engage families in service delivery and interventions and understand the contributions they make to the process of their child's development (Department of Health, 2005; Vacca & Feinberg, 2000).
Partnering to Develop Outcomes
In the old service delivery system, outcomes for children were often stated on the IFSP as therapies. In the enhanced Early Steps system, they are stated as basic functional outcomes. This promotes developmental skills that are important to the family and other primary caregivers. Because these outcomes will change as the child develops, it is important to keep in mind that team members will need to discuss child outcomes and progress on a regular and ongoing basis. It is especially important to talk with families about what they are seeing in the way of progress in the home setting.
Functional outcomes are a result of the information gathering process with families to determine their concerns, priorities and resources. Once these have been determined they should be prioritized. The family and primary service provider can then focus on a few at a time. A recommended practice is to develop less than five outcomes on an IFSP in order to concentrate on those most important to the team. The IFSP can be reviewed by the Service Coordinator or Primary Service Provider every three months and adjustments made and/or new outcomes added by the team (Shelden & Rush, 2004).
Read "Recommended Practice Number Three" on pages 13 -16 of the Resource Bank document, Our Journey with Families: Service Delivery in Natural Environments in Rural Areas
Consider how the child outcome information on page 14 reflects the natural settings within Kim's family.
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