Training, Connecting, Coaching:Guiding Early Intervention Professionals to Implement Evidence-Based Practices

This Session• Where is Juliann?• Approach to Early Intervention

Professional Development • Focus on Implementation Fidelity and

Sustainability

Tertiary Few Families

Secondary Some Families

Universal All Families

The Pyramid Model: Promoting Social and Emotional Competence and Addressing

Challenging Behavior

Implementing the Pyramid Model

• State implementation and scale-up– State, cross-sector leadership team– Work side-by-side with a master cadre– Install high fidelity demonstration sites– Scale-up and expansion

Challenges• Demonstration site versus Professional• Statewide reach• Ongoing PD and support• Coaching of professionals

Professional Development Goals

• Demonstrate the use of a social emotional lens to guide family coaching (home visiting) practices

• Enhance caregiver’s capacity to promote their child’s social emotional competence

• Identify and implement targeted supports at home for supporting caregivers in promoting social emotional development and competence and preventing challenging behaviors

• Conduct functional assessment and individualized behavior support plans with caregivers in the home

Professional Development Components

1.Targeted Practices2.Delivery Methods3.Data Systems 4.Outcomes

1. Targeted Practices

Universal • Building and

sustaining relationships

• Self-reflection • Culturally relevant

family support• High-quality

environments• Universal & periodic

screenings

Targeted • SE assessment• Writing participation-

based goals • Family coaching• Targeted, intentional

teaching • Positive parenting

practices

Intensive, Individualized • Positive behavior

support • Functional

assessments• Behavior support plan • Supporting

implementation in homes

Evidence-based Family Coaching Strategies

• Use adult learning strategies – Motivation, Hear, See, Do, Reflect

• Avoid directly intervening with the child• Use modeling

– Video or live – Engage parents in reflection of models

• Support parents in trying out new skills • Reflection of session skills practice• Build motivation and support clear between-visit

parent practice• Follow-up with parents • Performance-based feedback

(Jung, 2003; McWilliam, 2010; Powell & Dunlap, 2010; Rush & Shelden, 2011)

2. PD Delivery Components• Identification of “experts” and “experts

in training”– Master Cadre– Demonstration Professionals

• On-Site Training– Evidence-based content

• Distance Coaching • Peer Mentors • Social Networking

On-Site Training• Adult learning strategies

– Frequent activities – Demonstration videos – Case studies – Organized, meaningful handouts

• Evidence-based content

Distance Coaching • Monthly, web supported, phone calls• New content• Reviewed strategies • Discussed successes and challenges• Shared data

Peer Mentors• Master cadre members who have

similar responsibilities, but more sophisticated skill set

• Ongoing support to colleagues• Will be mentors of new cohorts in future

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3. Data Systems• Program Elements• Practitioner Implementation • Family and Child Outcomes

Practitioner Implementation• Family Coaching Checklists • Self-video reflections • Monthly conference calls

Family Coaching Checklist

YES: you are proficient with this practice

NO: you need support with this practice

Circle specific practices

N/O: no opportunity

N/A: not applicable

Notes: include anything about the visit you want to review

Family and Child Outcomes• Quarterly ASQ-SE• Direct Behavior Rating Scales • Individual level progress monitoring

ASQ:SE Procedures• After administering ASQ:SE and calculating score for each page, use the

summary sheet to tabulate score. This is the sheet you will be sending to USF. Use the labels to fill in your ID, child’s ID, child’s date of birth, date.

Your ID: WVDP5Child ID: WVDP501c1Child DOB: 4/20/2010Today’s Date: 8/2/2011

Insert scores for each page & total

We don’t need this info

So Which Questionnaire do I use?

Age in months:

3 months to

8 months

9 months to

14 months

15 months to

20 months

21 monthsto

26 months

27 months to

32 months

33 monthsto

41 months

42 months to

53 months

54 months to

65 months

Age in years and months:  

9 months to

1 year, 2 months

1 year, 3 months

to1 year, 8 months

1 year, 9 months

to2 year, 2 months

2 years, 3 months

to2 years, 8

months

2 years, 9 months

to3 years, 5

months

3 years, 6 months

to4 years, 5

months

4 years, 6 months

to5 years, 5

months

                 Questionnaire  

  

  

  

 

6 months X12 months   X18 months   X24 months   X30 months   X36 months   X48 months   X60 months   X

After calculating the child’s age, use the table below to choose the questionnaire

4. Overall Outcomes 1. Implementation2. Family Outcomes 3. Child Outcomes4. Reflections

Full Implementation of Pyramid Model Components - WV

Tier 1

Initial 1-year

Use of social emotional screening tool on quarterly basis (e.g., ASQ-SE, BITSEA)

0% 100%

Checklist or screening tool to identify caregiver and environment risks (ESQ, IPCI)

0% 25%

Journal or visitation log that includes section for observations of caregiving, emotional responsivity, child social emotional development

0% 50%

Process for scoring screening tools and determining next steps for support/intervention.

50% 75%

Resource list for referrals to additional supports to assist caregiver with risk factors, family or personal challenges, home environment, etc.

50% 100%

Parent information resources to support responsive caregiving, appropriate child guidance approaches, safe environments, etc.

25% 75%

Reflective supervision to discuss observations, review data, determine next steps

0% 25%

Tier 2 Curriculum-based assessment that includes a social emotional domain for the identification of targeted interventions (e.g. SEAM)

75% 75%

Family-centered goal identification process to select targeted skills and routines (What)

50% 75%

Activity/skill matrix for family guided routine intervention (When); Procedures for caregiver implementation within routines (How)

0% 75%

Coaching process for caregiver implementation of interventions

25% 100%

Checklist for observing caregiver implementation fidelity 0% 75%

Data collection tool and form to monitor child/caregiver progress

0% 75%

Behavior incident recording form for families to capture information on emerging concerns

0% 50%

Home visitor protocol for inquiring about behavior challenges/emergent concerns and offering support

0% 75%

Tier 3 Functional assessment observation forms/procedures and interview

0% 100%

Process for gaining team input and/or outside referrals 0% 75%Information gathered is synthesized into hypotheses; Hypotheses validated/reviewed by other team members

0% 50%

Data collection system is established (by home visitor or family/caregiver)

0% 100%

Hypotheses review and support plan development in partnership with the family

0% 50%

Written plan is provided to the family/caregiver using family-friendly language; Needed supports are provided to the family

0% 100%

Coaching process for caregiver implementation of interventions 25% 100%Checklist for observing caregiver implementation fidelity 0% 100%Data are reviewed to monitor child/caregiver progress 0% 100%

Family Outcomes

JANUARY FEBRUARY MARCH0

10

20

30

40

50

60

70

80

90

100

Caregiver Implemented InterventionWVDP201

Month

Perc

ent o

f Tim

e

Child Outcomes

JANUARY FEBRUARY MARCH0

10

20

30

40

50

60

70

80

90

100Child Engagement

WVDP201

Month

Perc

ent o

f Tim

e

JANUARY FEBRUARY MARCH0

10

20

30

40

50

60

70

80

90

100

Child Disruptive BehaviorWVDP201

Month

Perc

enta

ge o

f Tim

e

Reflections“I have learned to step back, examine my own practices, and most importantly, shift the focus of my work to mirror the goals and needs of the family”

Reflections...I completed my first visit today [after the IFSP meeting] and at the end of the visit, Mom told me how much better she felt in this last week since this process started. She said we validated her concerns, but didn't overreact to her family despite our concerns. She said she felt so much better about strategies and had already started using some strategies since the IFSP and was already seeing some progress….The family is carrying over and following through on our strategies already and already feel empowered by what they see. I am excited to see what the future holds for this little one.

Discussion

• Approaches you are using to ensure that EBPs are implemented with fidelity.

• Approaches for measuring fidelity. – Preservice– Inservice

• Innovations for Ongoing Supports and Professional Development