3-12-19 ASHA ppt-TM · – Financial compensation from ASHA for this presentation – Salary...
Transcript of 3-12-19 ASHA ppt-TM · – Financial compensation from ASHA for this presentation – Salary...
Core Competencies for Early Interventionists:A Foundation for Building Leaders Within InterprofessionalEducation
ASHA Online ConferenceBirth to Three: Working Together to Serve Children and Their Families
Core Competenciesfor Early
Interventionists
A Foundationfor Building
Leaders WithinInterprofessional
Education
Toby Long, PhD, PT, FAPTA
Director, Certificate in EarlyIntervention
Disclosures
• Financial:– Financial compensation from ASHA for this presentation
– Salary support from The Early Childhood Personnel Centerfrom 2017-2018
• Nonfinancial:– Early Childhood Personnel Center – professional
presentation participation at professional conferencesfrom 2013-2018, including APTA, ASHA, AOTA, and DEC
– Peer reviewed publications in Infants and Young Children
Core Competencies for Early Interventionists:A Foundation for Building Leaders Within InterprofessionalEducation
ASHA Online ConferenceBirth to Three: Working Together to Serve Children and Their Families
PresenterToby Long, PhD, PT, FAPTA is Professor, Department of Pediatrics, Georgetown University,Director of Professional Development at the Center for Child and Human Development, andthe Director of the Georgetown University Certificate in Early Intervention Program. Sheteaches within the GU Minors in Education, Inquiry and Justice and Disability Studies. She is amember of the Leadership Team for the Early Childhood Personnel Center at the University ofConnecticut. Dr. Long received her physical therapy degree from Boston University, a master’sdegree in early childhood special education from George Washington University and a doctoraldegree in human development from University of Maryland. Dr. Long collaborates withcolleagues on serving infants and toddlers with disabilities and delays using contemporary,evidenced based practices throughout Eastern Europe, Central Asia, the Gulf region, and Asia.She is on the editorial boards of the Journal of Early Intervention, Physical and OccupationalTherapy in Pediatrics, and Infants and Young Children. She is the author of over 60 peer-reviewed publications including The Handbook of Pediatric Physical Therapy, Third Edition. Dr.Long is the recipient of a variety of prestigious awards including, the Lucy Blair Service Awardfrom the American Physical Therapy Association, the Jeanne Fisher Distinguished MentorshipAward from the American Academy of Pediatric Physical Therapists, and the Bud DehavenAward from the American Academy of Pediatric Physical Therapists. She is a CatherineWorthingham Fellow of the American Physical Therapy Association and a Fulbright Fellow.
Description• Part C, Individual with Disabilities Education Act
– Requires states to design and implement 16 key components
– Comprehensive System of Personnel Development (CSPD)
• Insures infants and toddlers with disabilities and their families areserved by professionals with appropriate skills and knowledge
• Used to recruit and retain highly qualified providers and provideongoing professional development to enhance skills andknowledge of providers
• Services support inter- or transdisciplinary approach– States are implementing a transdisciplinary, primary service provider
(PSP) model of service
• Requires providers to coordinate and collaborate on serviceoutcomes, strategies, methods, and approaches
• Requires professionals serving young children with disabilities andtheir families to be competent in common and unique knowledgeand skills
Core Competencies for Early Interventionists:A Foundation for Building Leaders Within InterprofessionalEducation
ASHA Online ConferenceBirth to Three: Working Together to Serve Children and Their Families
Objectives
Describe the essential elements of contemporary early childhoodintervention practice
Identify the interprofessional early childhood interventioncompetencies for providers who serve young children with disabilitiesand their families
Identify the activities of the Early Childhood Personnel Center topromote interprofessional personnel competencies for earlychildhood intervention providers
Discuss the implementation and use of these competencies inacademia and practice
Early Childhood Intervention (ECI)
Pu
rpo
se
• Build capacity andcompetence of familiesto:
• Enhance development
• Minimize potential fordelay
• Reduce educationalcosts
Des
crip
tio
n • System of services &supports that is
• Coordinated amonghealth, therapeutic,education, and socialservices systems to
• Promote child’s growthand development and
• Support families duringthe critical early years
Core Competencies for Early Interventionists:A Foundation for Building Leaders Within InterprofessionalEducation
ASHA Online ConferenceBirth to Three: Working Together to Serve Children and Their Families
ECI
ECI services should help children:
• Participate in activities that they would like to or are expected toparticipate in
• Interact with peers, family members, and others
ECI is an integrated program of services and supportsthat are embedded into naturally occurring activitiesand routines
Family-centered and culturally and linguistically competent
Developmentally supportive, strengths-based, and promotechildren’s participation in their natural environments
Comprehensive, coordinated, and team-based
Individualized, flexible, and responsive to the changing needs ofyoung children and families
Based on the highest-quality evidence available
The Essential Elements
Core Competencies for Early Interventionists:A Foundation for Building Leaders Within InterprofessionalEducation
ASHA Online ConferenceBirth to Three: Working Together to Serve Children and Their Families
A Brief History of ProfessionalDevelopment in ECI
1986-1991
• Carolina Institute forResearch on InfantPersonnel Preparation
• Developing a CSPD
• Specifying standards
• Focus on team, FCCinterdisciplinary
• Competencies: Core,cross-discipline
• Training to increasequantity of providers
1991-2000
•Winton, McCullum,Catlett
•Identified criticaltraining needs
•Quality trainingimpacts outcome
•Identifyinginstructional trainingmodels
•Modeling,coaching, reflection
2000-2009
• Center to InformPersonnel PreparationPolicy and Practice inEarly Intervention andPreschool Education
• Lack of systematic,sustainable PD
• Training inconsistentwith research oneffectiveness oftraining
• Lack of support toimplement bestpractices
2009-Now
• Early ChildhoodPersonnel Center
• Evidence ofeffectiveness
• Theories of change
• Implementing effectivemethodology
• Reflection
• Coaching
• Support
• Mentoring
Early Childhood PersonnelCenter (ECPC)
Core Competencies for Early Interventionists:A Foundation for Building Leaders Within InterprofessionalEducation
ASHA Online ConferenceBirth to Three: Working Together to Serve Children and Their Families
ECPC
Funded by the U.S. Dept. of Education, Office of Special EducationPrograms
• University of Connecticut, A.J. Pappanikou Center for Excellence in DevelopmentalDisabilities at UConn Health
National, multi-functional resource
• Support states to implement and evaluate integrated, comprehensive ECI systemsof care including CSPD
Address ECI workforce challenges
• Discrepancies with state adherence to national standards
• Shortages of personnel
• A lack of training: pre- and in-service
• Inequities in preparation and compensation across providers
Outputs of the ECPC
Knowledge Development
• National Database of State Personnel Standards
• National Database of CSPD Components: Reported by State Part C and 619 Coordinators
• Research Syntheses on Personnel Issues
• National Initiative on Cross-Disciplinary Personnel Standards
Technical Assistance
• General: Across audiences, regions, and states – to provide information and resources onpersonnel development
• Targeted: State-specific CSPD components – to align national personnel standards and statepersonnel standards and/or to align pre-service preparation with in-service preparation
• Intensive: State-specific – to develop CSPD framework within 8 states
Leadership and Coordination
• Leadership Institute with Part C and 619 Coordinators
• Collaborative with other OSEP Early Childhood TA Centers (DaSY, ECTA, IRIS, IDC)
• Collaborative with DoE and HHS TA Centers (RRCs, Workforce Development)
• Collaborative with professional organizations (APTA, AOTA, ASHA, DEC, NAEYC, Zero-Three)
Core Competencies for Early Interventionists:A Foundation for Building Leaders Within InterprofessionalEducation
ASHA Online ConferenceBirth to Three: Working Together to Serve Children and Their Families
CSPD: Theory of Action
States havehigh quality
CSPD
More ECleaders and
providershave therequisite
knowledgeand skills
Improvedeffectivenessof EI, ECSE,EC services
and supports
Improvedoutcomes forchildren and
families
If we want improved outcomes for infants & childrenwith disabilities and their families THEN…
Integrated Comprehensive System
PersonnelStandards
Recruitmentand
Retention
Pre-ServiceTraining
In-ServiceTraining
Leadership,
Sustainability
Leadership,Coordination,
&Sustainability
Evaluation
Core Competencies for Early Interventionists:A Foundation for Building Leaders Within InterprofessionalEducation
ASHA Online ConferenceBirth to Three: Working Together to Serve Children and Their Families
Cross-Disciplinary PersonnelCompetencies/Standards
Family-Centered Care
Instruction &InterventionInformed by
Evidence
Collaboration &Coordination
Professionalism
15
Research Affirms the Importance ofProfessional Competencies/Standards
Core Competencies for Early Interventionists:A Foundation for Building Leaders Within InterprofessionalEducation
ASHA Online ConferenceBirth to Three: Working Together to Serve Children and Their Families
Cross-DisciplinaryCompetencies
Alignment
The Process
National meetings of organizations: Share information andpriorities
Joint presentations at discipline-specific conferences
Completed crosswalks of personnel standards acrossCEC/DEC, NAEYC, AOTA, APTA, ASHA
Work group validated a refined item-by-item analysis ofDEC/NAEYC personnel standards
Articles published by discipline organizations (IYC)
Core Competencies for Early Interventionists:A Foundation for Building Leaders Within InterprofessionalEducation
ASHA Online ConferenceBirth to Three: Working Together to Serve Children and Their Families
Family-CenteredPractice
Intervention &Instruction
Informed byEvidence
Coordination &Collaboration
Professionalism
ECPC Cross-Disciplinary PersonnelCompetencies: AOTA, APTA, ASHA,
CEC, DEC, NAEYC, & ZTT
Process of Cross-Discipline CompetencyAreas and Sub-Areas
Organizations provided 1-10 documents
• Knowledge and skill statements, position statements,technical reports, systematic reviews, etc.
Two ECPC staff members grouped individual items into eachof four multidisciplinary competency areas through thematicanalysis
• Categorizing process was iterative
• Two staff reviewed, re-reviewed the groupings and re-grouped items based on discussion
• ECPC director reviewed groupings and subcomponentnames for each of the four competency areas
Core Competencies for Early Interventionists:A Foundation for Building Leaders Within InterprofessionalEducation
ASHA Online ConferenceBirth to Three: Working Together to Serve Children and Their Families
Methodology
Categorization of Standards by Cross-Disciplinary Competency Areas
OrganizationNumber
of Items
Competency Areas
Family-
Centered
Practice
Instruction/
Intervention
Collaboration &
Coordination Professionalism
Total 752 149 406 98 99
Percent 20% 54% 13% 13%
AOTA 40 1 20 6 13
APTA 40 8 17 11 4
ASHA 263 42 163 36 22
CEC 35 4 21 4 6
DEC 80 12 50 10 8
NAEYC 24 4 12 0 8
ZTT 270 78 123 31 38
Family-Centered Practice
• Parent Partnership, Advocacy & Help-Giving
• Parent Education in Child Development & Interventions
• Family Involvement in Assessment
• Cultural, Linguistic and Socioeconomic Competency
• Family Systems Theory
• Laws & Policies
• Supporting Home Language Development
• Stress, Trauma, & Safety
• Parent/Caregiver Social Emotional/Attachment Communicating WithFamilies
• Nutrition
Culturally competent practice in naturalsettings that involves and actively engages
the family in decision-making and theprovision of services
Core Competencies for Early Interventionists:A Foundation for Building Leaders Within InterprofessionalEducation
ASHA Online ConferenceBirth to Three: Working Together to Serve Children and Their Families
Example
Family-Centered Practice: Family Involvement in Assessment
Organization Personnel Standard
APTA Evaluate family strengths, resources, concerns, and priorities: a) conductfamily interview; b) select and administer supplemental family surveys
ASHA Skills (ability): To interview families in family-friendly, culturallycompetent manner to obtain background history
CEC Beginning special education professionals in collaboration withcolleagues and families use multiple types of assessment information inmaking decisions about individuals with exceptionalities
DEC Integrate family priorities and concerns in the assessment process
NAEYC Knowing about assessment partnerships with families and withprofessional colleagues
ZTT Assesses family strengths and risk factors and connects the family toappropriate resources to both enhance the family’s ability to build ontheir strengths and protect children and family members from risks
Intervention/Instructionas Informed by Evidence
Use of scientifically based evidence to inform all screening,assessment, intervention/instruction and evaluationdelivered to child and family; refers to the process of
collecting data about a child to design and implement a plan(e.g., IEP, IFSP) of instruction/intervention that is evidence-
based and focused on remediating a child’s and family’sneeds
• Intervention• Assessment• Knowledge of Typical Child
Health & Safety• Development & Behavior• Progress Monitoring• Evidence-Based Practice• Health & Safety
• Communicating & InterpretingAssessment Results
• IEP/IFSP• Knowledge of Risk Factors &
Atypical Child Development• Accommodations &
Adaptations• Service Delivery Models
Core Competencies for Early Interventionists:A Foundation for Building Leaders Within InterprofessionalEducation
ASHA Online ConferenceBirth to Three: Working Together to Serve Children and Their Families
ExampleIntervention/Instruction: Assessment
Organization Personnel Standard
AOTA An occupational therapist is responsible for all aspects of the screening, evaluation,and re-evaluation process
APTA Use valid, reliable, and nondiscriminatory examination instruments and proceduresfor: a) identification and eligibility, b) diagnostic evaluation, c) individual programplanning, d) documentation of child progress, family outcomes, and program impact
ASHA Knowledge of methods of evaluation & assessment appropriate for the 0-3population (including interview, parent report, observational, and criterion-referenced tools)
CEC Beginning special education professionals use multiple methods of assessment anddata sources in making educational decisions
DEC Alignment of assessment with curriculum; content standards; and local, state, andfederal regulations
NAEYC Understanding the goals, benefits, and uses of assessment
ZTT When available, uses evidence-based screening, observation, and assessment toolsand strategies to inform planning and provision of appropriate services for the uniqueneeds of each individual child, including children with special needs and duallanguage learners
Coordination & Collaboration
• General Teaming
• Resource & Referrals
• Effective Communication
• Transitions
• Teaming With Families
• Role as a Consultant
• Problem Solving
• Leader of a Team
• Medical Home
• Positive & Respectful Relationships
Refers to working across professionals fromother disciplines and community organizationsin every facet of intervention/instruction with
a child and family
Core Competencies for Early Interventionists:A Foundation for Building Leaders Within InterprofessionalEducation
ASHA Online ConferenceBirth to Three: Working Together to Serve Children and Their Families
Example
Coordination & Collaboration: General Teaming
Organization Personnel Standard
AOTA An occupational therapy practitioner is an integral member of the interdisciplinarycollaborative health care team; he/she consults with team and family members toensure the client-centeredness of evaluation and intervention practices
APTA Supervise personnel and professional students: a) monitor the implementation oftherapy recommendations by other team members, b) establish a student clinicalaffiliation, c) formally and informally teach/train therapy staff
ASHA Skills in implementing strategies to function as an effective member of aninterdisciplinary programming team
CEC Beginning special education professionals use collaboration to promote the well-being of individuals with exceptionalities across a wide range of settings andcollaborators
DEC Collaborate with caregivers, professionals, and agencies to support children’sdevelopment and learning
ZTT Collaborates with other service providers and provides information, guidance, andsupport to assist families who are caring for a child with special needs
Professionalism
• Advocacy/Public Awareness
• Laws, Policies, & Practice Standards
• Professional Development & Self-Reflection
• Knowledge of the Field
• Ethics
• Administrative Leadership
• Supervision
• Communication
• Wellness
Requires all providers to have knowledge and skills in the laws,policies, and practices that govern their professional discipline;
requires demonstration of professional ethics and advocacy witheach child and family; professionals in early childhood
intervention will also take responsibility to improve theirknowledge and skills through professional development and self-
reflection
Core Competencies for Early Interventionists:A Foundation for Building Leaders Within InterprofessionalEducation
ASHA Online ConferenceBirth to Three: Working Together to Serve Children and Their Families
Example
Organization Personnel Standard
AOTA An occupational therapy practitioner is an effective advocate for the client'sintervention and/or accommodation needs
APTA Promote public awareness of early intervention services: a) disseminate informationabout the availability, criteria for eligibility, and methods of referral; b) collect anduse data from multiple sources for child-find systems
ASHA Skills in disseminating information related to early intervention services through avariety of print, media, technology, and professional organization networks
CEC Beginning special education professionals advance the profession by engaging inactivities such as advocacy and mentoring.
DEC Advocacy for professional status and working conditions for those who serve infantsand young children and their families
NAEYC Engaging in informed advocacy for children and the profession
ZTT Understands and takes a leadership role in advocating for families and youngchildren with special needs at the programmatic, local, state, and federal levels
Professionalism : Advocacy/Public Awareness
Applying the ECPC Cross-Disciplinary Competencies
Professional DevelopmentTeam Decision-Making
30
Core Competencies for Early Interventionists:A Foundation for Building Leaders Within InterprofessionalEducation
ASHA Online ConferenceBirth to Three: Working Together to Serve Children and Their Families
Graduate Education Of Related Service Providers atGeorgetown and George Washington Universities in Early
Intervention (GEORGE)
10 interdisciplinary students: ECE, SLP, PT, OT
Course Work
• Providing services to young children with disabilities
• Gathering information to determine eligibility and program plan
• Evidence-based practice
• Leadership
Capstone
• Cross-disciplinary, yearlong project
Practicum
• Team-based
• Apply key practices: Family interview, eco-map, RBI, standardized testing, plandevelopment, PSP, coaching, teaming…
GEORGE graduates will, in partnership withfamilies in the context of their communities:
Identify developmental, behavioral, and emotional problems and disordersearly
Assess developmental, functional, and behavioral status
Work collaboratively with families to design responsive functionaloutcomes and program plans
Provide contemporary, evidence-based services and support
Develop and manage effective systems of supports and services
Support team members to serve children and families in an integrated andcomprehensive system of care
Core Competencies for Early Interventionists:A Foundation for Building Leaders Within InterprofessionalEducation
ASHA Online ConferenceBirth to Three: Working Together to Serve Children and Their Families
Aligning GEORGE with Cross-DisciplinaryCompetencies
Each GEORGE standards of practice aligned tocross-disciplinary competency area
FCCData-Based
Coll &Coor Prof
Evaluation & Assessment X X X
Family X
Context & Environment X X
Program Planning X X
Service Delivery & Transition X X
Team Collaboration X X X
Leadership X
Team Decision-Making
Family-Centered Care
Instruction &InterventionInformed by
Evidence
ProfessionalismCoordination &Collaboration
Core Competencies for Early Interventionists:A Foundation for Building Leaders Within InterprofessionalEducation
ASHA Online ConferenceBirth to Three: Working Together to Serve Children and Their Families
Family Stories
• Communicating to create a collaborative relationship
• Ensuring families have skills and knowledge
• Respecting background, concerns, priorities
• Advocating
Family-Centered Care
• Team-based service delivery
• Coordinating community-based services
• Effective communication
• Sharing information and knowledge
Collaboration &Coordination
• Evidence-informed decision-making
• Interprofessional practice
• Knowledge translation
Intervention/InstructionInformed by Evidence
• Ethics
• Legal, regulatory, policy knowledge
• Self-reflection, professional development
Professionalism
AidenFamily
• Aiden, a 15-month-old
• Gwen, Aiden’s mother, attends high school
• Ms. Berry, Aiden’s grandmother
Natural Environment
• Child care at high school
• Home where all three live
Concerns
• Language
• Behavior
Team
• Pediatrician, child care provider, mother, grandmother, special instructor, SLP, OT
• PSP: Special instructor
Services
• Special instruction in CC weekly
• Consult from OT, SLP to PSP
Core Competencies for Early Interventionists:A Foundation for Building Leaders Within InterprofessionalEducation
ASHA Online ConferenceBirth to Three: Working Together to Serve Children and Their Families
Making it Work
Challenges
• Teaming
• Professional identity
• Professional preparation
• Lack of awareness– Discipline competencies
– Practice models
Facilitators
• Readiness forinterprofessional learning
• Professional development
• Team meetings
• Professional associationdocuments/programming
CONCLUSION
• Early childhood providersserve infants and toddlerswith disabilities and theirfamilies under Part C of IDEA
• Evidence-based ECI requiresproviders trained in inter-professional practice
• Critical to team-basedservice provision is therecognition of cross-disciplinary competencies aswell as the unique disciplinecontribution to teaming.
• Highly qualified ECIproviders
– Family-CenteredPractices
– Intervention &Instruction Informedby Evidence
– Coordination andCollaboration
– Professionalism
Core Competencies for Early Interventionists: A Foundation for Building Leaders Within Interprofessional Education, by Toby Long
ASHA Online Conference Birth to Three: Working Together to Serve Children and Their Families
Resources
Catalino, T., Chiarello, L., Long, T., & Weaver, P. (2015). Promoting professional development
for physical therapists in early intervention. Infants and Young Children, 28,132-149.
Chiarello, L., & Effgen, S. K. (2006). Updated competencies for physical therapists working in
early intervention. Pediatric Physical Therapy, 8, 148-158
Early Childhood Personnel Center: https://ECPCTA.org
Muhlenhaupt, M., Pizur-Barnekow, K., Schefkind, S., Chandler, B., & Harvison, N. (2015).
Occupational therapy contributions in early intervention: Implications for personnel preparation
and interprofessional practice. Infants and Young Children, 28, 123-132.
Muhlenhaupt, M., Sam Lazaro, S., Fabrizi, S., Sandra Schefkind, S., & Owens, A. (2019).
Interprofessional core competencies to enhance occupational therapy services in early
childhood settings. OT Practice, 12-16.
Prelock, P., & Deppe, J. (2015). Speech-language pathology: Preparing early interventionists.
Infants and Young Children, 28, 150-164.
Rapport, M. J., Furze, J., Martin, K., et al. (2014). Essential competencies in entry-level pediatric
physical therapy education. Pediatric Physical Therapy, 26, 7-18.
Stayton, V. D. (2015). Preparation of early childhood special educators for inclusive and
interdisciplinary settings. Infants and Young Children, 28, 113-122.
ASHA Resources
ASHA Practice Portal, Early Identification: www.asha.org/Practice-Portal/Professional-Issues/Early-Intervention/
ASHA resources on interprofessional practice: www.asha.org/practice/interprofessional-education-practice/ ASHA Strategic Objective 2: www.asha.org/uploadedFiles/Strategic-Objective-Highlights.pdf