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Module Two: Lesson Three

Key Elements of the Primary Service Provider Model

Below is part 2 of the video segment, in which Dr. McWilliam discusses the key elements of an integrated service delivery model.

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Text version

Well, that' the wrong way of thinking. What we really should be thinking is "What is a child's, what kind of engagement problem does a child have, let's say, during hanging out time at home?" Well one of the problems is the child can't hold the small toys properly. So, in testing, we might have discovered the kid had a fine motor problem. That's almost irrelevant to me. What I'm really interested in, is the fact that at playtime he can't play with his toys, so the goal, the family might choose the goal "I want the child to able to play with his toys at playtime."

So then, now, the question is, "Well, who can support a family in interventions for that?". Well, the OT could probably provide good information from some further assessment, and from intervention suggestions, but the OT is not the only person in the world who knows anything about how to play with small toys.

People from other backgrounds might also contribute, because the child needs to communicate about that, or there might be a communication element. PT's, for example, might have some interesting things to say about what positioning the child is in, to be able to play with the small toys. In other words, playing with small toys, an engagement goal, does not belong to a discipline, and yet all disciplines can contribute to it. So, that's another reason for organizing your interventions by engagement, independence, and social relationships, rather than the traditional testing domains.

Another key element of the primary service provider model is weekly visits by the primary service provider. I think, especially when I talk about home visits, if I, if you can get that far, the amount of work we're trying to do in early intervention in natural environments is so much in supporting families, that it would be hard to do that, without weekly visits by a primary service provider.

Third, joint visits with other team members, is critical as a method of collaboration, when you use the primary service provider model. Going together. You don't want the other team members making too many separate visits because, then, the primary person doesn't really know what's been said to the family, and so on. So the joint visit is the best model, but be careful that you don't end up having every visit being a joint visit. That kind of destroys the whole concept of a primary service provider model.


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