Identifying Natural Environments NATURALLY

1. Identifying Natural EnvironmentsNATURALLY Juliann Woods, Ph.D. Florida State University June 19 PA Service Coordination Institute

2. TaCTICS http://tactics.fsu.edu

3. Family-guided Routines • Match the child and family interests • Promote positive interactions • Embed functional targets into meaningful outcomes • Are flexible and adaptable • Change with the child and family

4. Guiding Principles • Adults as diverse learners: Individualized within formal and informal social networks • Family guided: Family identified, child preferred routines, activities and settings • Team implemented: Joint problem solving approach to decision making • Experiential and action focused: Partners and coaches for teaching and learning • Dynamic engagement: Multi-modal follow-up with continuum of supports for competence

6. What Families Want in Assessmentadapted from Zero to Three Newsletter, Washington, DC • Opportunity to work together to learn about the child • A “real” picture that reflects the child in familiar and functional settings using multiple methods to share information • Participation in meaningful activities • Information to support informed decision making

7. Comfortable Environment Respect for Values and Priorities Effective Communication History and Experiences Contributions and Participation Collaboration and Problem Solving Applicability to Life and Functionality Competing Commitments 8 Strategies to Support ALL Adult Learners

8. Child Coordinator Dyad Careprovider

9. Family Information Resources and Strengths Concerns Family Priorities (include for child) The following information was shared by the family with on . The family understands that they do not have to give any information on this page in order to receive services; however, information provided will help determine appropriate services and supports. This information reflects a summary of family considerations from conversations beginning with information collected from the family's first contact, the multidisciplinary evaluation and planning for the IFSP meeting.

10. Conversations, Interviews Questionnaires, Checklists Problem-solving Situations Environmental Scan, Observations Child and Family Preferences, Priorities Developmental Skills, Concerns, Routines, Roles Resources, Supports, Options, Strategies Interests, Activities, Interactions Gathering and Giving Information In Routines-based Assessment

11. All About Me Who are the Important people in my life? What activities do I like to do at home and in the community? How do I play with children, adults, and toys? What does my family want me to be able to do?

12. Active Experimenters Give it to me! Just do it; try, practice Parent completed measures e.g. Ages & Stages Qs; DOCS Conceptualizers Tell me about it! Think, analyze, question Handouts, brochures; e.g. Day in the Life, or Letter to … from Lorna Observers Show me! Watch and reflect Videos of other parents or role play assessments Experiencers Share with me! Feel, listen, project Questionnaires or structured interviews, e.g. Getting to Know Your Child or Community Map Adult Learning Styles

13. Child Family Outcomes Data New and Old Activities and Events Progress Problems Participation Planning Talk! Listen! Watch!Information Gathering

14. Development Disability Resources, Supports Confidence Competence Connections Talk! Listen! Watch!Information Sharing

15. Conversation Startersfor Family and Caregiver Routines • Typical day • Nights, weekends • Regularly or frequently scheduled appointments/events • Sibling activities • Family activities/events • Preferences • Expectations

16. Powerful Questions • What’s working well for you now? • What worry wakes you up at night? • If you had an assistant for a day, what would you be doing? What would your assistant be doing? • What has been an accomplishment for you and your child that makes you happy? • What community activities do you feel you are missing where you would like to participate? • What makes a day challenging?

17. Strengthening Skills inIdentifying Routines • Practice thinking out of the IFSP boxes • Shop for ideas while completing the tasks of your everyday life • Survey the family for special interests or activities • Complete an environmental scan of your own routines and materials • Complete an environmental scan during a home visit

18. Beyond the List of Routines and Activities • Parents, preferred playmates, caregivers, pets, places • Physical space, materials, resources • Expectations, rules, rituals • Life style, roles, responsibilities • Language • Frequency of opportunities, events, activities

19. Why Go “Beyond” the List? • Gives the family “more” voice in the process • Provides meaningful information for the family and team members • Increases ease of putting information into functional family words on the IFSP • Individualizes routine for the identified outcomes for the child and family • Supports actual implementation through adequate and accurate information

20. What? How? When? • Conversations… listening and learning, sharing and showing • Problem solving and picking a few comfortable care giving and play routines • Observe, discuss, record the dyad interaction • Review results in a checklist or parent report form and answer questions • Continue conversations… priorities, expectations, possibilities, examples to provide framework and first steps

21. Multidisciplinary Evaluation: The Big Picture Adaptive/Self-Help Date: Types of Assessment: Instrument: Signature/Role: Agency: Medical Health (Immunizations, Allergies, Medications, ect.) Date: Types of Assessment: Instrument: Signature/Role: Agency:

22. Routines Getting the mail Petting the cat Waiting for snack Getting a drink Going down a slide Playing ball Turning on music Outcomes Washing hands Using words Walking stairs Playing with toys Following directions Sitting without support Reach, grasp, release Making the Most of Every Opportunity

23. Multidisciplinary Evaluation: Recommendations Recommendations/Considerations In forming recommendations, consider the following: 1. Skills needed by the child and/or skills desired by caregivers, 2. Adaptations/Acquisitions, 3. Identifying and assessing community resources and family activities, 4. People connections or information desired, and 5. Appropriate natural environments/community resources and family activities. Eligibility:

24. Plan of Action Family’s Priority: Communicate using words everybody understands. Specific Outcome: JP will use 5 new words (supported with gestures where needed) to gain attention and answer questions. STRATEGIESWHO WHERE

25. Plan of Action Family’s Priority: Communicate using words everybody understands. Specific Outcome: JP will use 5 new words (supported with gestures where needed) to gain attention and answer questions. STRATEGIESWHO WHERE

26. Strategies for Ongoing Communication among Providers • Engage the family as liaison • Develop common formats and share progress notes at center or family • Use Email, voice mail, fastfax • Schedule periodic co-treatment or assessment updates • Review video tapes or use videoconferencing • Attend joint training, coaching, consulting • Require communication in provider contracts