Recent Articles, Engaging Families, Intervention Visits, Practical Strategies

Shaking Up the *Typical* Intervention Visit

Olivia’s IFSP outcome reads: “Olivia will use 20 different words to talk about her favorite people, objects, and foods when interacting with her family and child care provider each day forshutterstock_112399364 two weeks.” A developmental services provider alternates weekly visits between the child care center and Olivia’s home to help the important people in Olivia’s life address the outcome. The strange thing is, despite the setting, Olivia’s visits basically follow the same format: the provider greets Olivia and the caregiver, settles down on the floor, and engages the caregiver in discussion. She plays with Olivia some and coaches the caregiver to use strategies to facilitate Olivia’s communication during play. The visit ends with a discussion of what the caregiver plans to do during the week with Olivia and the next visit is scheduled.

Sound familiar?

The Most Common Intervention Visit Format

This is probably the most common intervention visit format, regardless of discipline or service. The setting might change but the intervention context is usually play, the location is usually on the floor, and there are usually 3 primary participants: provider, child and caregiver. In EI, we say that we individualize intervention to the child and family needs, but I wonder why, then, do most visits look pretty much the same?

Take a few moments to reflect on what intervention looks like when you facilitate a visit. Ask yourself:

  • What was similar about the visits I’ve facilitated in the past week? What was different?
  • What was unique to each child? Each parent/caregiver? (Try to pinpoint what was truly individualized during the visit.)
  • What did we DO on each visit? What were the intervention activities?
  • Where was the visit conducted?

Time to Shake Things Up!

If your answers to these questions are pretty similar across visits, then read on! You, as the service provider, are the team member who sets the pace and guides the “work” of the visit. It’s very likely that your visits follow the same format across families because you are the common denominator, not because that’s how intervention should be done. Let’s pick apart the characteristics of a typical visit and think about how to shake it up!

Context: Play-based Routines – Results of a recent study by Campbell and Coletti (2013) indicated that providers used strategies that encouraged families to practice intervention significantly more in play contexts than non-play contexts. Rather than joining non-play routines, providers tend to talk about them instead. We probably aren’t as comfortable joining other routines, and we tend to believe that discussion is enough. Adults just don’t learn this way – and you are there to help the parent learn too. When an opportunity arises to address the child’s development in a non-play routine, seize it. Ask if you can observe the routine, join it, and work within it. Schedule the next visit to coincide with the natural routine. You’ll be so much more helpful to the parent by helping them practice how to use a strategy in the actual routine instead of just talking about it. Talking about a strategy will never be as effective as practicing it – in context, in real-time, together.

Location: On the Floor – We know that most play happens under two circumstances with very young children with disabilities: during independent play (child playing by himself) or play during caregiving routines (Childress, 2011). Wait…I didn’t mention parent-child play on the floor. Hmm…something to think about. Yes, teaching families how to play with their children has merit and children truly do learn so much during play. Just try to think about play more broadly – from toy play to being playful across the day in different places and during different routines and activities. Most early learning doesn’t just happen on the floor. Infants and toddlers learn during bathtime, eating meals and snacks, getting dressed, taking stroller rides, hanging out with family, during playdates at the park, tagging along on errands and shopping trips, riding in the car with siblings and exploring the environment on their own.

Participants: Parent, Child, & Provider – If the parent is more of a passive observer, engage him/her in planning for what to do differently. Revisit successful and problematic daily routines that were listed on the IFSP (on the VA IFSP, this would be in Section II). Ask for updates and identify an activity or routine to target, either for the current visit or next time. If you’ve primarily been the child’s interaction partner, try to boost parent-child interaction instead.

Shaking Things Up for Olivia

Olivia’s IFSP indicates that her best times of day are when her mother wakes her up and they interact during dressing, during music and art times at the child care center which she really enjoys, and in the evenings when she plays with her child-sized kitchen while her dad makes dinner. Her biggest challenges revolve around her frustration when a caregiver doesn’t understand her. She has begun to throw toys and scream at the child care center when her needs aren’t met immediately. Rather than plopping on the floor and pulling out the puzzles, what could Olivia’s service provider do differently on her next visit?

Share your ideas by leaving a comment below!

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Campbell, P. H., & Coletti, C. E. (2013). Early intervention provider use of child caregiver-teaching strategiesInfants & Young Children, 26(3), 235-248.

Childress, D. C. (2011). Play behaviors of parents and their young children with disabilitiesTopics in Early Childhood Special Education, 31(2), 112-120.

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