New York State Department of Health Division of Family Health Bureau of Early Intervention

1. New York State Department of Health Division of Family Health Bureau of Early Intervention Advanced Service Coordination Working With Families Presented by: Just Kids Early Childhood Learning Center Revised January, 2014 Updated: April, 2014

2. Unit 1 Welcome and Course Overview

3. Today’s Agenda

4. Purpose of This Training • Provide information about the role and responsibilities of service coordinators • Develop skills that promote effective communication and partnerships with families and service providers • Learn about family differences, stress and coping strategies • Learn how to use family-centered strategies that support the family’s meaningful involvement in EI

5. A Case Scenario – AlexeiPretraining Assessment Alexei was found to be eligible for services. The team at the Initial IFSP meeting agreed that he would receive special instruction and physical therapy in the home two times a week for each service. You, as the Ongoing Service Coordinator, cannot locate providers who speak the family’s dominant language. Mom speaks no English. The family has financial difficulties and the father, who does speak some English, would like to be involved in the early intervention sessions. However, he cannot miss work. The family has applied for Medicaid.

6. Unit 2 Recognizing Family Differences

7. “The Power of Family” OPEN SOCIETY FOUNDATIONS - Working in every part of the world to improve lives and foster change – Video: “Early Childhood Intervention: The Power of Family”

8. What is a FAMILY ? The dictionary defines “FAMILY” as: “The basic unit in society traditionally consisting of two parents rearing their children.” Newer definitions of FAMILY have emerged in our society, as the number of different types of families has increased.

9. Familiesare theFoundationof ourSociety. How Do You Describe or Define “FAMILY?” 9

10. Cultural Differences In addition to the different members that can make up a family, there are other factors that make families different: Heritage – where you come from Culture – your way of life, who you are Language Beliefs Traditions Social habits Thoughts and behavior Culture shapes the way of life shared by members of a population.

11. Cultural Context Not all cultures share the same concept of disability. Children and others with disabilities may be: Included in their communities and in leadership roles Protected from the outside world by their families Exploited, neglected, isolated Valued or limited in community roles or employment Institutionalized with restricted rights as citizens Educated in segregated or mainstream settings Excluded from full involvement by a lack of resources, including adaptive equipment or services, accessible transportation, and other barriers

12. Cultural Differences and the EIP A family’s culture and view of disability influences their expectations for developmental stages such as weaning, talking, and walking willingness to seek or accept help extent of involvement how they communicate with their service providers choices for service delivery options medical interventions they choose or do not choose

13. Cultural Competence Cultural Competence: an awareness of one’s own cultural identity and views about difference, and the ability to learn and build on the varying cultural and community norms of others Cultural competence allows providers to deliver services that are respectful of and responsive to the beliefs, practices, and cultural and linguistic needs of all families 13

14. Recognize Family Differences Racial Colorblindness: treating everyone as equally as possible without regard to a person’s race, culture, or ethnicity Ignoring or pretending not to notice differences negates a person’s social reality and the reality of their day-to-day lives A “color-blind practice” is an unrealistic approach to interacting with others and building relationships “All human beings are entirely the same, entirely different, and somewhat the same and somewhat different at the same time.”

15. Unit 3 Keys to Effective Communication

16. Communication Communication is the primary tool for expression between two or more people. It serves as a vehicle for: Relaying information Receiving information Expressing thoughts, ideas, opinions, facts, needs Having our needs met 16

17. Types of Communication 17

18. Good vs. Effective Communication Good Communication EffectiveCommunication 18

19. Effective Communication A way to better understand people and situations Builds trust and respect Fosters an environment for creative ideas and problem solving Reduces misunderstandings and conflict Strengthens personal and professional relationships 19

20. Four Components of Effective Communication 20

21. Effective Communication: Active Listening Focus fully on the speaker Understand the words or information being communicated and avoid misunderstandings Understand how the speaker feels about what they are saying Build a solid relationship or connection with the speaker Do not interrupt the speaker Do not be judgmental Show interest 21

22. Non-Verbal Communication The largest part of our daily communication with others is non-verbal. Spoken Words 7% Tone of Voice 38% Non-Verbal 55% 22

23. Effective Communication: Awareness of Non-Verbal Cues Use open body language Arms uncrossed Uses an open stance Leans slightly forward Maintains eye contact Be aware of how you look, listen, move, and react to another person Be aware that different cultures may use different non-verbal cues and gestures to communicate and be able to recognize these cues Be observant 23

24. Effective Communication: Managing Stressful Situations Recognize when you or someone else is becoming stressed and take a moment to calm down Willing to compromise Agree to disagree Appropriately use humor or an amusing story to lighten a tense situation 24

25. Effective Communication: Emotional Awareness Enables you to read “emotional cues” to better understand and empathize with other peoples’ problems/issues Helps you understands your own problems and issues Helps you stay motivated even when interacting with challenging people or situations Allows you to communicate effectively even when delivering negative messages Helps you builds strong, rewarding relationships 25

26. Unit 4 Understanding Family Behaviors

27. What is Stress? The dictionary defines STRESS as: a state of mental tension and worry caused by problems in your life, work, etc. something that causes strong feelings of worry or anxiety

28. Common Challenges or Stressors Many families experience challenging or stressful issues such as financial difficulties, family conflicts, health problems, drug or alcohol abuse, violence, etc. Families participating in the EIP often experience additional stress caused by: Learning about their child’s diagnosis or developmental issues Coordination of busy schedules Raising other children in the home Awareness of children, close in age, who are meeting or exceeding developmental milestones

29. Responses to Stress Individuals use a variety of positive strategies to cope with stress or when faced with challenging circumstances. These strategies vary greatly in intensity and effectiveness from family to family, and can range from maintaining a healthy diet to seeking professional help. Some families and individuals may engage in challenging behaviors and can appear to be negative or uncooperative.

30. What is Ambivalence? The dictionary defines AMBIVALENCE as: the state having both positive and negative thoughts or emotions at the same time uncertainty

31. Causes of Ambivalence In the EIP, ambivalent behavior may be displayed because the family is: Apprehensive that they will be judged because of cultural, racial, or value-based differences Reluctant to disclose personal information or experiences Skeptical based on previous experience Confused about the Early Intervention Program and how it can help their child and family

32. The service coordinator can help alleviate the family’s concerns and discomfort by: Encouraging questions and providing clear answers Giving the family the opportunity to express their feelings and talk about them Helping the family focus on the positive aspects of their participation in the EIP Dealing With Ambivalent Behaviors

33. What is Resistance? The dictionary defines RESISTANCE as: refusal to accept something new or different the ability to prevent something from having an effect

34. Causes of Resistance Families may display resistance to participating in the EIP because they: Do not fully understand or accept the extent of their child’s needs Feel overwhelmed and frightened Feel that their concerns and priorities have not been heard Feel that EI professionals make all the decisions

35. Dealing With Resistance The service coordinator can: Revisit the child’s needs and clarify outcomes “Go back to the beginning” – Reevaluate the family's Concerns, Priorities, and Resources Verify that the desired outcomes are achievable and are appropriate for the child and family Help families work through their anxiety Point out previous successes Ask if it would be helpful to speak to another parent

36. Helping Families Deal With Stress, Ambivalence and Resistance Service Coordinators should: Expect that there will be some level of stress, ambivalence and resistance in each family they serve Encourage discussions that will help identify the root causes Include the family in all decision-making about their child’s services Don’t overload the family with too much information or suggestions of helpful resources all at once

37. Helping Families Deal With Ongoing Stress and Other Serious Issues Have an honest discussion with family members about their interest in seeking therapeutic professional intervention for recurring, unresolved issues or concerns.

38. 15 Minutes Break Please Return on Time

39. Unit 5 Tools for Providing Successful Service Coordination

40. Families and EIP Service Coordinators Effective communication is vital component to developing a working and productive partnership between a family and their service coordinator Effective communication will help to ensure that the child’s and family’s participation in the EIP is successful Service Coordinators can use various strategies to communicate effectively with families

41. Take Time to Learn About Each Family Obtain and read all available existing records (with family’s written consent) Consult with other service providers (with the family’s written consent) Obtain as much information as possible about the family and its history during home visits, phone calls, IFSP meetings, and other conversations

42. Use Effective Speaking and Listening Skills

43. What are Family-Centered Principles? “Family-Centered Principles are a set of interconnected beliefs and attitudes that shape directions of program philosophy and behavior of personnel as they organize and deliver services to children and families.” ECTA Center – The Early Childhood Technical Assistance Center 43

44. Using Family-Centered Practices 44

45. Using Family-Centered Practices (cont’d.) 45

46. Using Family-Centered Practices (cont’d.) Service Coordinators can ask themselves: “Am I doing things this way because this is the way it has always been done? Could things be done differently? Am I listening to families and working creatively to provide options?” 46

47. Encourage Parent Participation Service Coordinators should inform parents: They have the right to be involved in all decision making for their child and in determining what early intervention services the child will receive They can participate at the individual level with their own child’s services They can also choose to participate at an organizational level to determine policies for EI programs

48. Create a Partnership with Families Keep the lines of communication open – make frequent phone calls to “check in” Schedule home visits with the family Answer questions and clarify roles Break down large tasks or processes into smaller, meaningful steps Use existing family supports

49. Create a Partnership with Families (cont’d.) Encourage the family’s participation and provide opportunities for them to have input and make their own decisions Encourage growth and child advocacy Be timely and consistent Keep your word

50. Assist Families in Accessing Community Resources No single agency, organization, program, or discipline can accommodate all of the diverse needs of infants and toddlers with disabilities or developmental delays and their families. 50