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Intervention in Natural Environments: Setting the Stage for a Lifetime of Learning. Kat Stremel Pip Campbell Sheila Pearson. Challenges to Implementation. Theoretical Frameworks Preservice Training Service Provider Knowledge Service Provider Experience & Skills.
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Intervention in Natural Environments: Setting the Stage for a Lifetime of Learning Kat Stremel Pip Campbell Sheila Pearson
Challenges to Implementation • Theoretical Frameworks • Preservice Training • Service Provider Knowledge • Service Provider Experience & Skills
A Framework of Implementation • Source: Core intervention practices • Communication Link #1: Training, coaching, supporting interventionists and teachers • Communication Link #2: Collaborating, coaching, supporting families as major providers • Destination: Child/Youth and families within home, communities, daily routines and activities (Based on Fixsen et al. 2005)
Relationships with families Assessment in the environment Identification and use of locations, settings, activities/routines Outcomes-based Decisions Environmental arrangements and adaptations Child-individualized intervention strategies Evaluation Generalization Core Components of Natural Environment Practice
Asset & interest based Acceptable to families Authentic: Observed in natural environment Typical behavior across routines Reflect different perspectives, including families (Based on Neisworth and Bagnato – 2005) Accommodate the child’s motor and sensory development Sensitive to show progress Materials validated Critical Qualities of Child Assessment
Identification and Use of Locations, Settings, Activities, and Routines • Family routines • Parenting routines • Child routines • Play • Physical play • Entertainment • Family rituals and celebrations • Socialization activities (Dunst, Hamby, Trivette, Raab & Bruder, 2000)
Outcomes Based Decision-Making • Increasingaccess to locations, settings, activities • Increasing participation • Increasing family enjoyment • Building relationships or skills for development • Decreasing behavior that interferes with learning • Promoting acquisition, maintenance, and generalization of learning skills
Environmental Arrangements, Adaptations & Assistive Technology • Children with physical and sensory disabilities • Common “Wait to Fail” strategies in EC • Resources for families
Development of Child-Individualized Intervention Strategies • Families best know the interests and characteristics of their children • Service providers should know which intervention techniques (evidence-based practice) works best for which child, for what purpose, under what circumstance. • Natural environment practice is only as effective as the intervention techniques that are individually designed for children
Meet Cass at 2 years of age • OSEP-Funded Early Childhood Program • Parent Participation…”this makes sense so I don’t rush through the activities Cass enjoys to “work” on her therapy, but aren’t you asking me to be her Speech Therapist, OP, PT, Early Interventionist and still give her a bath?” • Initially identified 32 skills to target during undressing, bathing, hair drying routine.
Early Skills Areas to Target • Vision • Hearing • Physical • Communication • Cognitive • Health
Cass: Bathing Routine • Increase participation in continued movement • Increase head control • Increase reach to grasp • Increase grasping objects • Increase visual fixation • Increase response to voice • Increase anticipation through touch and object cues (adaptations)
Promote Learning of Targeted Skill: Undressing, Bathing, Hair Drying Routine
Cass at 19 years of age • Skill areas that remain critical
Teaching Strategies that remain relevant • Partial or full participation • Responsiveness to self-determination & self-initiations • Opportunities for choice making • Opportunities for higher forms/functions of communication • Consistent prompts, cues, waiting for responses • Reinforcement and feedback • Utilization routines and activities for learning
Components for Implementation • Selection of practitioners who are qualified to carry out child interventions • Provision of preservice or inservice training • Use of ongoing consultant/coaching within the environments where interventions will be practiced • Assessments of practitioner performance • Evaluation of the Early Intervention Program (Campbell) • Provision of administrative support and leadership (Fixsen et al. 2005)