Providing Related Services in LRE
Preschool Environments
Laurie A. Dinnebeil and
William McInerney
University of Toledo
Judith Herb College of Education
April 16, 2010 - SST Region 11
DEC Position Statement on
Inclusion
“Early childhood inclusion embodies the
values, policies, and practices that
support the right of every infant and
young child and his or her family,
regardless of ability to participate in a
broad range of activities and contexts of
full members of families, communities,
and society.” (DEC, 2009)
Why Inclusion?
Inclusive experiences give children with
disabilities and their families:
 a sense of belonging,
 support positive social relationships and
friendships, and
 promote development and learning so
children can reach their full potential.
Inclusive Settings?
Where are ECSE Services Provided to Ohio's
Preschoolers?
>80%
40-79%
<40%
Separate class
Separate School
Residential
Home
Features of High Quality Inclusion
 Access
 Participation
 Supports
Access
Young children with
disabilities have
access to a full
range of activities
and learning
opportunities in
diverse early care
and education
programs and other
natural environments
Participation
Adults find ways to help young children with
disabilities participate and engage fully in a
variety of activities. They promote children’s
meaningful ‘belonging’ in intentional ways.
Supports
Adults who promote
early childhood
inclusion have the
supports they need
to help young
children with
disabilities. These
supports include
ongoing training and
professional
development.
Massed vs. Distributed Instruction

If episodic and massed intervention (usually 60-90
minutes per week in traditional itinerant service
delivery) is as efficient as distributed or spaced
instruction (or practice), then there is no need to adopt
a consultation model as the primary mode of
intervention
• However….. if distributed or spaced instruction or
practice is a more efficient model of learning, then
adoption of a consultation approach to itinerant service
delivery is warranted
Research Support:
Distributed Instruction and Practice
Adults
 Ebbinghaus, 1885/1964
 Donovan & Radosevich, 1999, meta-analysis
 Cepeda, Pashler, Vul, Wixted & Rohrer, 2006, metaanalysis
Children - ages 3 months to 8 years old
 Childers & Tomasello, 2002 (word learning)
 Rea & Modigliani, 1985 (spelling, math)
 Rovee-Collier, 1995 (visual recognition)
 Seabrook, Brown, & Solity, 2005 (phonics)
Massed vs. Distributed Instruction
Massed Instruction
• Child instructed with
same materials,
multiple times in
single session,
without a break
• EXAMPLE:
practicing v+c
combinations for 20
minutes
Distributed Instruction
• Child practices with
same or different
materials, multiple times,
with breaks between
instruction/ practice
• EXAMPLE: Practice
v+c combinations in
daily routines or
activities
Research with Children
Rea and Modigliani,1985
 3rd graders (8.5 years) taught spelling words
and math facts


Students ranked as Level 1 (top half of class) or Level
2 (bottom half of class)
Results:


Better on spelling and math tests when had spaced
instruction rather than massed instructions
Spaced instruction was better for both Level 1 and 2
students (ability level didn’t matter)
Seabrook, Brown & Solity, 2005

Experiment
Task: 34 children (mean age 5 years.6 mos.)
taught phonics over two weeks
 Schedule:




Clustered = one, 6-minute session per day within a
regular classroom setting.
Distributed = three, 2-minute sessions per day within a
regular classroom setting
Results: Children in distributed condition had test
scores 6 times greater than children in clustered
condition
Childers & Tomasello, 2002
How many times (and how many days) does
a 2-yr old need to hear a word to learn it?

In 2 experiments, 2 yr olds were taught
‘silly’ nouns and verbs (words they had
never seen) over the course of a month in
sessions lasting 5 - 10 min
Childers & Tomasello, 2002
Results:
• Best learning occurred when teaching was distributed
• The more days that children heard the words, the
better able they were to learn the words


•
Best = 4 days, 3 days
Worst = 1 day, 2 days
Children learned words better if they heard the
words 1x/day for 4 days rather than 8x/day for I
day
Major Findings

Spacing (distributing) instruction
benefited children and adults whether
the tasks were physical or cognitive.

Spacing instruction within the day (e.g.,
three 2-min sessions/day) or across days
(e.g., 1x/day for 4 days) helped children
learn.
Distributed
Practice
Research
Results
Better
Learning
with
Distributed
Practice
Distributed Instruction-Examples
Consider a 4-year old child with mildmoderate cognitive delays (functioning @
24-36 mos.) and who has an IEP
objective of ‘following a 2-step direction’.
•
How would an Itinerant professional
address this learning objective, in her
weekly visits with child using a MASSED
instruction approach ?
Distributed Practice - Examples
Consider this same 4 year old child with mildmoderate cognitive delays (functioning @ 2436 mos.) who has an IEP objective of ‘following
a 2-step direction’.
• How would an Itinerant professional
address this learning objective, during
her weekly CONSULTATION visits and
planning for DISTRIBUTED instruction
and practice?
Developing (and Detoxing………)
Learning Goals & Objectives
Top 10 ... Least Heard Phrases
By Colleen F. Tomko

10. I hate to brag, but my kid can grasp and maintain grasp during activities.
9. I love my husband because he can comb his hair.
8. Its really nice the way you cross your mid-line plane.
7. My mother is a wonderful person, she can count change.
6. You're a great friend, you can really isolate your index finger.
5. If I couldn't vacuum, why life wouldn't be worth much.
4. My sister is really cool, she can take pennies out of theraputty.
3. Every time I hear this song, it reminds of when I first reciprocal stepped up
stairs.
2. Man, if only "I" could tolerate a vestibular board like she does.
1. From the moment I first saw his pincer grasp, I knew we were going to have a
good meeting.
SMART Objectives (Jung, 2007)
Specific
 Measurable
 Attainable
 Routines-based
 Tied to a functional priority

Other Ways to Address Functionality
Goal Functionality Scale (McWilliam,
2005)
 Congruence Assessment (Wolery,
Brashers, & Nietzel, 2002)
 MEPI (McInerney & Dinnebeil, in press)

Objectives – Quality Indicators
 Functionality
 Generality
 Integration
 Hierarchical
Relationship
 Measurability
and Monitoring
Noonan & McCormick, 2006
I. Functionality
 Will
the skill improve the child’s
ability to participate, independently
or with assistance, in all or most
natural environments?
 Will
the skill increase appropriate
interactions with peers and
materials in the natural
environments?
Notari-Syverson & Shuster, 1995
Use of Functional Verbs in IEP Planning
•
•
Use actions that can be observed
Examples of Functional Verbs:
point to, name, write, say, share, sing, put
away
Examples of NON-functional Verbs:
– improve, understand, increase, exhibit,
identify
… will improve his communication skills
… will identify her name …
–
Mcwilliam & Casey, 2008
Functional Verbs
Kai will identify colors …
Functional Verbs
To change a nonfunctional to a functional
verb ask what the behavior should look like.
Nonfunctional: … will become involved in
circle time …
What does ‘being involved in circle time’ look
like?
Functional: … during circle time, Aaron will
choose a song from the choice board and
sing song with peers …
McWilliam & Casey, 2008
Functionality
True test of functionality is to ask WHY the
child is working on the given goal/objective.
If skill is functional, the answer will be
immediately apparent.
Helps to add a rationale statement
… skill is necessary so that …
… skill is necessary in order to …
… if child could not perform this skill, adult or
peer would need to do so
Where in the World is the
“Functional” objective?
1.
5 year old Robin will string 5, 1” beads on a
string, by herself.
2.
4 year old Traci will verbally respond to
another child who asks her a question.
3.
5 year old Justin will follow 2-step
directions provided by a familiar adult.
4.
3 year-old Rannon will stack 6,1.5 “ blocks,
by himself.
Material taken from Project Open House,
Drs Dinnebeil and McInerney
Is That Your Final Answer?
If you think that objectives “2” and “3” are
functional, you’re right!
–
Responding to another person who asks a
question is an important skill that will help Traci
interact with her peers and be part of the group.
•
–
Traci will verbally respond to another child who asks her
a question …..RATIONALE…..so that she can interact
with her peers and be part of the group.
Following multi-step directions is an important
skill for Justin to learn because he’s going to
need to do that when he goes to kindergarten.
•
Justin will follow 2-step directions provided by a familiar
adult …..RATIONALE….. in order to be prepared for
kindergarten.
Material taken from Project Open House,
Drs Dinnebeil and McInerney
What About Stringing Beads
and Stacking Blocks?
 Can
Robin be successful in
preschool or kindergarten if she
can’t string beads? Will Rannon get
along OK if he can’t stack blocks?
 In
isolation, string beads or stacking
blocks, are not critical skills or
behaviors.
Material taken from Project Open House,
Drs Dinnebeil and McInerney
What are the skills “behind” stringing
beads or stacking blocks?
Stringing beads or stacking blocks
depends on the ability to use your hands
to accomplish a task requiring good finemotor control. These are important skills
that allow children to be successful in
other settings and are linked to more
mature skills (e.g. dressing, printing, use
of utensils).
•
How could we rewrite objectives for Robin
or Rannon so that they are functional?
Material taken from Project Open House,
Drs Dinnebeil and McInerney
Other activities that require similar skills?
 Instead
of “stringing beads”…
…Robin will use both hands to
complete a task …
Such as? …………………………
 Instead
of “stacking blocks……
Rannon will …………?
Material taken from Project Open
House,
Drs Dinnebeil and McInerney
II. Generality
Can the skill be ‘generalized’ or demonstrated
across a variety of people, activities,
materials, and settings/environments?
• Examples:
– …will manipulate puppets, block, spoons,
and zippers using both hands …
– … during circle time, snack, and outside
play …
– … with the teacher, peer, or Mom …
Notari-Syverson & Shuster, 1995
III. Integration of Skills
Do the child’s peers demonstrate this skill within
a variety of daily activities and routines?
• Are there naturally occurring antecedents and
logical consequences for the skill in the child’s
daily activities and routines?
• Can the skill be taught and practiced in a variety
of activities and settings?
•
Examples:
–
–
… will request help bathroom…accessing materials
… will clean up…. after building center… snack …
Notari-Syverson & Shuster, 1995
IV. Hierarchical Relationship
 Is
mastering the learning objective necessary
in achieving the learning goal?
Example:
 Goal: Jackie will participate in morning circle
routine.
 Objective necessary to reach that goal:

In morning circle, Jackie will say “I’m here” when
her name is called in attendance roll, on 3
consecutive days.
Notari-Syverson & Shuster, 1995
V. Measurability and Monitoring
 Can
the skill be seen and/or heard so
that it can be counted?
 Can an example of the skill be recorded?
Purpose of monitoring is to let the team,
including the family, know when the
objective has been accomplished.
Notari-Syverson & Shuster, 1995
EMBEDDED INTERVENTION
Weaving Teaching and
Intervention into Routine
Activities
Recipe for Embedding Instruction for
Children with Special Needs
Opportunities for children to learn and
practice functional skills or
behaviors occur across the
curriculum and across
developmentally appropriate
routines and activities
Material taken from Project Open House,
Drs Dinnebeil and McInerney
A Routines-Based Approach
What’s the best way to address
children’s learning goals and
objectives?
Most experts in early childhood and
early childhood special education will
agree that a “routines-based
approach” works best (Bricker, PrettiFrontzcak, & McComas, 1998; Sandall &
Schwartz, 2002).
Material taken from Project Open House,
Drs Dinnebeil and McInerney
Examples of Routines
Family / Home




Wake up
Eat meals
Church on Sunday
Laundry on Mon. &
Weds
At School




Snack
Outside Play
Circle Time
Centers
Embedded Instruction
- Focuses on a child’s daily routines or
activities like snack, playtime, circle time,
dramatic play as a context for learning and
OPPORTUNITY for EMBEDDING
- Teachers give children opportunities to
practice targeted IEP or IFSP goals or
activities during these daily routines or
activities instead of creating special
instructional time.
Material taken from Project Open House,
Drs Dinnebeil and McInerney
Daily Routines and Activities Provide Opportunities
for Learning for Young Children
Play time!
Blocks, dramatic
play, outside
play,
manipulatives,
art materials
Reading!
Reading alone
or being read to
individually or in
groups
Singing songs!
Participating in
group songs or
fingerplays
Eating!
Breakfast,
snack, lunch or
dinner
Resting!
Napping,
sleeping,
spending quiet
time alone
Taking care of
oneself!
Bathroom,
washing, getting
dressed
Transitioning!
Coming to
school and
going home,
changing
activities during
the day
Others?? Are
there other
routines or daily
activities that
occupy the time
of children you
know?
Material taken from Project Open House,
Drs Dinnebeil and McInerney
Why does a “Routines-Based”
approach help young children learn?
Children learn best when they’re interested
and motivated.
2. Children learn best when opportunities to
learn and practice skills occur throughout
the day, instead of just during one period of
time.
3. It’s difficult for busy early childhood
teachers to take time out of the classroom
schedule to provide special instruction to
meet children’s learning needs.
1.
Material taken from Project Open House,
Drs Dinnebeil and McInerney
How do I use a “Routines-Based”
Approach?

Find good times to help children learn
about and practice new skills or
behaviors. Good times are times when
children usually use certain skills. For
example,




Manipulating items during a board game
Naming objects when playing in the
housekeeping area
Requesting things during a meal
Carrying items across room while walking
Material taken from Project Open House,
Drs Dinnebeil and McInerney
Using a Routines-Based approach:

Requires knowing what children are
interested in, what gets their attention, or
what motivates them



Favorite activities…going down the slide,
being read to, playing with blocks
Favorite foods…apple juice, graham
crackers, pizza
Favorite people…Ms. Susan, friend Tommy,
next door neighbor Mr. Gray.
Material taken from Project Open House,
Drs Dinnebeil and McInerney
Finding Time to Help Children
Practice
Once therapists and teachers have
identified opportunities where
children naturally use skills, they
can devise learning opportunities
that can be embedded within the
routine or activity.
. . . Some examples?
Material taken from Project Open House,
Drs Dinnebeil and McInerney
Let’s help Justin practice
following directions…..
Justin is 5 and has trouble following 2step directions (like “Put away the
truck and come sit down.”)
It’s important that Justin learns how to
follow directions because he’s going
to kindergarten next year (teaching to
requirements of the Next
Environment)
Material taken from Project Open House,
Drs Dinnebeil and McInerney
Angela’s Plan
Angela is Justin’s teacher and knows
that Justin really likes to look at books
after lunch.
He decides to use clean-up after lunch
(and before books) as a time to help
Justin practice following directions.
Material taken from Project Open House,
Drs Dinnebeil and McInerney
More About Angela’s Plan…

Once Justin is through with lunch,
Angela gives him a chance to
practice following directions by
saying…


“Justin, when you’re done with lunch,
throw your cup away and push in your
chair.”
She helps Justin follow the direction if
Justin needs help.
Material taken from Project Open House,
Drs Dinnebeil and McInerney
Planning for Ashley
Ashley is 4 and has a language delay and
problems in communication that often cause
her to have difficulty interacting with other
children. Her IEP includes the following
objectives:
 Engage in conversations with other
children
 Use words to describe common objects
 Take turns playing with toys and
materials
Material taken from Project Open House,
Drs Dinnebeil and McInerney
What about Ashley?
Ashley needs help naming common
objects…how could her teacher use
one or more of the “creating interest”
strategies to create an interesting
learning opportunity for Ashley?
Material taken from Project Open House,
Drs Dinnebeil and McInerney
How would you help Ashley?

Using the Curriculum Planning
MATRIX, identify WHEN and
HOW her teacher can help with
her IEP objectives during the
activities or routines marked with
an “X”.
Material taken from Project Open House,
Drs Dinnebeil and McInerney
Ashley’s Activity Matrix
IEP Objectives
Free Play
Engage in
conversations
with other
children
x
Use words to
describe
common
objects
x
Take turns
playing with
toys and
materials
x
Snack
Outside
Bathroom
x
x
x
Material taken from Project Open House,
Drs Dinnebeil and McInerney
x
Circle
How about these strategies?

Add novel materials to the room that are objects
that Ashley is familiar with—for example, new
dolls, a new kind of toy animal, ball, etc.
 Sabotage a situation by leaving out an essential
item (that’s a common object) that Ashley needs to
complete a task.
 “Violate expectations” by giving Ashley and
some others an inappropriate substitute for an item
(e.g., blocks for snack).
 Let Ashley choose between two types of a
common object (e.g., red cups or blue cups for
snack).
Material taken from Project Open House,
Drs Dinnebeil and McInerney
How about kids like Robert?
Robert will walk, unassisted, for 10 feet



Set up furnishings in the classroom so that it’s easy to
mark 10 feet—from the snack table to the bookcase.
During daily classroom activities, Robert’s teacher can
easily keep track of how far he walked (e.g., halfway
from the snack table to the book case—about 5 feet).
Remember that Robert’s teacher has to make sure
that he has opportunities to walk unassisted and a
good reason to go from one place to another.
Material taken from Project Open House,
Drs Dinnebeil and McInerney
What about kids like Todd?

Finding interesting activities and
other children’s favorites during the
day isn’t a problem for most
children. However, for children like
Todd, finding interesting
opportunities to practice skills can
be challenging.
Material taken from Project Open House,
Drs Dinnebeil and McInerney
Do you know kids like Todd?
Todd is 3 and is in Maria’s preschool classroom
because he has a language delay. He doesn’t
seem to be interested in anything. He spends
most of his day wandering around the room,
rarely playing with toys or engaging in
activities. How can Maria help Todd practice
skills during daily routines if Todd’s not
interested?
Material taken from Project Open House,
Drs Dinnebeil and McInerney
Setting Up Opportunities to Interest
Children
Here are some ways that Todd’s
teacher can get Todd interested in the
activities around him…
 Provide interesting or novel materials
in the classroom. Consider cycling
toys or materials that children are
tired of and adding novel toys /
materials that can spark Todd’s
interest.
Material taken from Project Open House,
Drs Dinnebeil and McInerney
Setting Up Opportunities to Interest
Children

Place a desired toy or object within
Todd’s view but out of his reach. Todd
might become motivated to ask for
help so he can get the toy or the
object.

Provide “just a little” bit of a preferred
material or activity so Todd has a
chance to ask for more. For example,
Todd’s teacher might just give the
children one cracker so they’ll have a
chance to ask for more.
Material taken from Project Open House,
Drs Dinnebeil and McInerney
More tricks to interest children …
 Todd’s
teacher might provide Todd
and others a chance to make
choices between activities or
materials. For example, providing
different drinks during snack (milk or
juice) requires him to make a choice,
use different motor skills, and tell the
teacher what he wants.
Material taken from Project Open House,
Drs Dinnebeil and McInerney
And…..More tricks to interest children…
“Sabotage” an activity by “forgetting” to
provide all of the materials that Todd wants
or needs. For example, “forgetful” teachers
can give children paintbrushes and paper,
but no paint! Children love to remind the
teacher what they’ve forgotten!
Material taken from Project Open House,
Drs Dinnebeil and McInerney
Yet, more tricks to interest children..

Set up an absurd or silly situation that
violates a child’s expectations. For example,
Todd’s teacher might decide to serve the
children blocks and plastic animals for snack
and wait to see their reactions!
CAUTION: When using these “tricks of the
trade” remember not to single a child out.
Todd would feel badly if he was the only
child who always had to ask for “more”.
Material taken from Project Open House,
Drs Dinnebeil and McInerney
What is Effective PD?
Effective professional development (PD)
occurs through individualized assistance
and training.
 Coaching and Consultation provides this
individualized assistance that is critical to
supporting early childhood inclusion.
 In Ohio, a consultative itinerant model is
recommended by the ODE as a “best
practice”.

Itinerant Service Delivery:
Direct or Consultative (Indirect)?

Consultative
Assist educators and
primary caregivers to
provide specialized
instruction and plan
ways to address IEP
goals within the course
of the child’s typical day
and routine activities.

Direct
Tutor the child focused on
IEP goals within the
context of ongoing
activities or outside of
the child’s typical day.
IEP-based instruction is
limited to the Itinerant
Teacher’s visit.
Consultation: Preferred Method of
Itinerant Service Delivery
Project DIRECT focuses on consultation because we believe it
is the BEST way to support successful early childhood
inclusion. While there may be LIMITED times when a direct
approach is preferred, in the overwhelming majority of
cases, a consultative approach is most effective at helping
children achieve positive outcomes. (ODE Policy
Statement)
Definition of Consultation
Through a series of meetings and
conversations, the consultant [itinerant
professional] helps the consultee [ECE teacher
or primary caregiver] through:
• Systematic problem solving
• Appropriate use of social influence
• Professional support.
In turn, the consultee helps the ‘client(s)’
[child/children] with full support and assistance
from the consultant.
Definition continued…
The purpose of consultation is to address
the immediate concern or goal as well as
to prevent similar problems from
occurring in the future (Buysse & Wesley,
2005).
Definition of Consultation
Consultation is a process based upon an
equal relationship characterized by mutual
trust and open communication, joint
approaches to problem identification, the
pooling of personal resources to identify
and select strategies that will have some
probability of solving the problem that has
been identified, and shared responsibility in
the implementation and evaluation of the
program or strategy that has been initiated.
Brown, Wyne, Blackburn and Powell (1979)
Types of Consultation
Expert Consultation
Within an expert model, the ECSE professional helps the partner
learn new information, make a decision, or solve a problem.
Consultants who assume an expert role seek to determine what
their partner needs to know to advance development of child. This
is a particular challenge for RS professionals.
Collaborative Consultation
A more common approach to providing consultation services is a
collaborative approach. Collaborative consultation implies that both
the consultant and the partner bring to the relationship valuable
knowledge, experiences and skills.
Roles of Consultant

Observer/‘ Reflector’
•

Fact Finder
•

‘teaches’ partner specific special education strategies
Expert
•

offers alternatives and participates in decisions
Trainer/Educator
•

gathers child ‘data’ and intervention support
Problem Solving Partner
•

raises issues for partner reflection. ‘What if………’
recommends partner practice options or strategies
Advocate (child and partner)
•
‘lobbies’ for supports for child and partner
Adapted from Lippett & Lippett (1986)
Consultation & TRIADIC Intervention


“[A]n indirect, triadic service delivery
model”
Indirect and triadic—the focus of the
work is still on meeting the needs of
the child. However, the person who
directly addresses those needs is the
partner teacher or parent, not the
itinerant
Consultation & TRIADIC Intervention
In early childhood education, consultation
is defined as an INDIRECT intervention
model in which a consultant (Itinerant
professional) and a consultee (ECE
teacher or parent) work together (in a
triadic service delivery model) to address
an area of concern or common goal for
change.
The TRIADIC Model
The triadic service
delivery model is an
INDIRECT intervention
model in which the ECSE
teacher or RS
professional supports
children’s development by
working primarily with
another teacher or parent
rather than directly with
the child.
Child
Itinerant
Teacher/
Related
Srvs Prof
ECE
Teacher
or
Parent
Helping each other…
There are different ways that professionals
help other adults. Some include:


Shares written information,
Explicitly models intervention strategies,
observes consultee and provides
feedback to improve practice
Can you think of others?
What’s so special about a Triadic
approach?
Other adults spend more time with children
than the RS professional does.
Through a triadic approach, an ECSE
professional can help a parent or another
teacher do what she does best—better
help the child learn and reach his or her
IEP goals.
What’s so special about a Triadic
approach?
A triadic model helps improve the
FREQUENCY and QUALITY of IEP-based
instruction that occurs between the visits of
the ECSE professional.
A recent federal study indicated that very
little specialized services are provided to
preschoolers with disabilities by general
early childhood teachers (PEELS, 2008)
“More is Better”
A consultative itinerant model can increase the
ability of ECE teachers, RS professionals and
parents to provide specialized services to
young children with disabilities throughout the
day and across the week when the itinerant
professional is not present. This expands
opportunity for teaching, learning AND
practice of skills
Components of Effective Itinerant
Consultation Service Model
Monitoring of Child
Progress
Analysis of Learning
Environment
Feedback/Partner
Progress
Prioritizing Child
IEP Objectives
Transfer of
Knowledge, Skills,
Attitudes & Values
Administrative
Support
Interpersonal
Communication
Skills
Communication with
Families
Self-Advocacy &
Professional
Development
Key Factors in the Consultation Model

It is essential that both consultants and
consultees (or partner) agree on the
intended outcome of the consultation
process
 The overall goal of consultation is to
implement the child’s IEP through
enhancement of the skills of the consultee
(or partner)
Essential Elements of Consultation
“Through a series of meetings and
conversations, the consultant helps the
consultee (or partner) with systematic problem
solving, social influence, and professional
support”
•
Consultation is a planned process that
takes place over time and includes problemsolving, social influence and professional
support
Essential Elements cont’d…
“In turn, the consultee (or partner) helps
the child with support and assistance of the
consultant.”

It is the partner’s responsibility to work with
the child with appropriate support from the
Itinerant consultant
Consultation in Related Services
Jane Case-Smith, O.T.R., Ph.D.
The Ohio State University
Adapted from Presentation Fall 2007
Therapist roles in support of teachers

Provide information and materials




Create handouts for recommendations
Provide information about a disability or diagnosis
Provide information about evidence based practices.
Teach alternative methods for instruction



Introduce Picture Exchange Communication Systems
(PECS)
Help to write Social Stories
Assist in creating Intellitools programs
Tools to recommend for the classroom
.
Recommend modifications to classroom environment


Suggest a bean bag chair for a child with sensory
needs
Suggest a tent for quiet time of children with high
activity levels.
Recommend adapting activities or
materials


Obtain adapted spoon, cups, plates.
Obtain easel for vertical surface drawing
Provide support, encouragement

Assure teaching staff that they are implementing
appropriate interventions for difficult medical
issues.

Provide feedback about child response to
teacher-designed interventions.
Examples
•Create Intellikeys program
•Problem solve how child will use new
wheelchair on the playground.
Research on Consultation in RS
A study found that children with OT on
the IEP made the same progress when a
consultation model of services delivery
was compared to direct services.
 Teachers reported that they valued the
consultation model more than the direct
services model.

Research on Consultation in RS
The progress of 14 students who
received consultation services in OT/PT
was compared to 19 students who
received direct OT/PT therapy.
 Following 6 months of 1x a week
intervention, both groups improved in
motor and visual perceptual skills.
 The consultation group however made
greater gains in gross motor skills.

Research on Consultation in RS
Consultation by related service
personnel has similar child outcomes to
direct services.
 Teacher outcomes are more positive
with consultation versus direct service.



Teachers benefit from learning new
techniques, methods.
Teachers appreciate a collaborative
approach.
Research on Consultation in RS
Use of consultation supports the
development of interdisciplinary and
interdisciplinary approaches to problems.
 Consultation may support the sustained
effects of related services intervention.
 Consultation supports mastery and
generalization of skills.

Summary - Consultation in RS

Best practice consultation uses a problemsolving, collaborative approach





Relationships are established.
The teacher’s perspective is provided first, followed
by assessment of the child and environment.
The goal is to support the teacher to affect a child
outcome.
Uses collaborative problem solving process
Involves shared responsibility and shared data
collecting
Summary - Consultation in RS

Administrators can support collaborative
consultation by:





Allowing time for collaborative planning
Allowing flexible scheduling
Encouraging in-services for sharing of skills among
team members.
Fostering mutual respect and parity among all
school personnel
Allowing creative solutions in a child-first
environment.
Implications for Related Service Delivery

Current laws state that educational practice
needs to be research-based (NCLB; IDEIA, 2004)
 How should we schedule instruction for young
children?


Massed or Spaced ? Research supports Spaced
How should we schedule the Itinerant
professional’s time?

Direct instruction vs. Consultation / Coaching ?
Research suggests Consultation/Coaching
Therapist consultation requires
comprehensive evaluation

Therapist needs to observe child in multiple
settings, at different times of day.
 Interview with teacher is critical to obtain
her/his perspective of the problem.


Consultation is based first on the teacher’s
perception of the problem.
The child’s problem must be viewed within the
demands of the preschool environment and the
curriculum.
How does consultation work?

Interview with parent, other therapists and staff
may be helpful.
 Problem solving: Teacher and therapist
engage in problem solving (brainstorm first)
and identify 1-2 strategies to try first.
 Planning: Teacher and therapist identify who is
responsible for what action and who collects
data on the child’s response (shared
responsibility)
Develop GOALS &
OBJECTIVES with IEP Team
Decide how to MONITOR
child’s progress
(Matrix Planning Tool)
Decide WHICH
Goals/Objectives to include
in IEP
Decide on
FORM & SCHEDULE of
Intervention/Instruction
- Direct, Consultation,
Combination
Identify TEACHING
STRATEGIES to address
target skill
(Matrix Planning Tool)
Identify WHO will deliver
instructional services
- Direct Services by Related
Serv. Prof. &/or Consultation
Services
Identify TIMES &
OPPORTUNITIES for
Instruction
(Matrix Planning Tool)
The Process of Consultation

Buysse and Wesley (2005, p. 18) describe
an 8-Stage process in CONSULTATION:
Stage 1:
Stage 2:
Stage 3:
Gaining Entry
Building the Relationship
Gathering Information
Through Assessment
The Process of Consultation cont’d…
Stage 4:
Stage 5:
Stage 6:
Stage 7:
Stage 8:
Setting Goals
Selecting Strategies
Implementing the Plan
Evaluating the Plan
Holding a Summary Conference
Progression of Consultation Partnership
What about challenges?
A consultative approach to ECSE
service delivery isn’t easy (but many
things that are worthwhile aren’t easy!)
 What are some of the challenges in
adopting CONSULTATION practices in
Related Services that you can think of ?
 How might these challenges be
addressed ?

Addressing Barriers
Barriers
 Teachers and
therapists do not
know each other’s
roles

Teachers and
therapists do not feel
parity, lack trust.
Potential Solutions
 Make sure therapists are
invited to school events,
in-services
 Schedule regular social
activities.
 Create a collaborative
culture
 Work on equity issues,
pay, status, support
proximity.
Addressing Barriers
Barriers
 Teachers and therapists
do not have time to
collaborate and plan.


Holland (2007)
Sometimes therapists
and teachers do not value
collaboration.
Potential Solutions
 Allow for and build in
planning time on a
regular basis
 Use 3 and 1 model
(therapists see child for 3
weeks and then have a
week for meeting with
teacher).
 Encourage creative use
of time, therapists meet
with teacher while
assistant runs class.
Addressing Barriers
Barriers
Potential Solutions


Teacher waits until
behaviors are
unmanageable.


Consulting therapist
does not take
ownership of the
problem

Encourage use of
consultation at onset to
prevent difficult situations.
Suggest that both
therapist and teacher
monitor the effects of the
new strategy or
equipment.
Alternative solutions
should be offered.
Addressing Barriers
Barriers
 Therapists are only
needed when the
child fails to make
progress.
Potential Solutions
 Preventive services
are optimal.
 Therapy services are
most effective when
intervention is early.
Key Factors in Consultation
 It
is essential that RS professionals,
ECSE/ECE teachers, and their
supervisors agree on the intended
outcome of the consultation process
 The overall goal of consultation is to
implement the child’s IEP by enhancing
the skills of the ESCE or ECE partner
teacher or the child’s parent.
Outcomes of Consultation
 Improved
•
comfort level of other adults
Early childhood teachers may feel less
isolated and in greater control of
classroom and instruction after working
with RS consultant
Outcomes of Consultation

Increased skills or knowledge of parents and
other teachers
•
•
•
•
ECE teachers have a “bigger tool box” to use
when dealing with challenging situations.
The parent understands why children act the way
they do and changes the way she interacts with
the child
ECE teachers are able to provide IEP-based RS
intervention/instruction BETWEEN itinerant visits.
Parents can better engage in problem-solving to
address difficult issues
Outcomes continued
 Children’s
enhanced developmental
success:
•
•
•
Children are better able to participate in
routine activities throughout the day.
Children’s interactions with others (adults
and peers) are improved.
Children have the consistent support they
need to access the general or regular
education curriculum
Outcomes of Consultation
 Changes
•
•
in child’s environment
The child’s classroom is rearranged to
promote active exploration and interaction
Materials and expectations may be
modified in accord with children’s skills
Outcomes of Consultation
 Improvements
in service delivery
systems
•
The child’s Speech Pathology schedule is
modified so the child can be observed by
the SLP in an informal, play-based activity.
Outcomes of Consultation?

Other outcomes?
Surfin’ the Web

Head Start Center on Inclusion
http://depts.washington.edu/hscenter/
 Special Quest
http://www.specialquest.org/
 National Early Childhood Center on Transition
http://www.hdi.uky.edu/NECTC/Home.aspx
 CONNECT
http://community.fpg.unc.edu/connect
Surfin’ continued

OCALI & Autism Internet Modules
http://www.ocali.org/
 Autism Speaks
http://www.autismspeaks.org/
 Circle of Inclusion
http://www.circleofinclusion.org/
 TACTICS
http://tactics.fsu.edu/
Administrative and Professional Challenges
in Consultation Process
 Time
Demands (e.g. caseload, travel,
planning time)
•
•
•
Creating released time for ECSE/ECE
Partner (volunteer relief, university students,
subs)
Scheduling meetings w ECSE/ECE partner
Establishing consultation logs / information
exchange (e.g. listserv)
Factors that Affect
Consultation Process continued…
 Administrative
Support of LEA and ECE
Program Administrators
 This can be addressed, initially, through
formal ‘Letters of Introduction’
•
•
•
•
•
to Parent
to Home-based Provider
to ECSE/ECE Partner Teacher/Consultee
to CC Administrator
from Supervisor to CC Administrator
Factors that Affect Consultation
Process continued…

While the same kind of formal agreement may not
be appropriate with a parent, there should be
some kind of written information that is jointly
reviewed and discussed before Itinerant services
begin.
Components of a Formal Agreement
Formal Agreement should include:
Description of RSs including emphasis on
consultation model
 Name/contact information for immediate
supervisor of RS professional
 Name, credentials and experience of RS
professional

Components:
Formal Agreement continued…

Relationship between RS professional and
ECSE/ECE partner
 Addressing of child IEP requirements
 Anticipated frequency and duration of
scheduled visits
 Interactive professional development
‘contact’ (RS professional & ECSE/ECE
professional)
Components:
Formal Agreement continued…
 Need
for meetings with ECSE/ECE
partner teacher/consultee re: child
progress
 Plans for communication with parents re:
child progress
 Description of related responsibilities of
RS professional
Discussion

What are the benefits of communicating,
before Related Services begin, the role
and responsibilities of the RS professional
to….
•
•
Director of the ‘receiving’ preschool or child
care center?
Parent of the child receiving related services?
Discussion…continued
What are the benefits of communicating, before
itinerant services begin, the role and
responsibilities of the RS professional to:
•
ECSE/ECE partner teacher / consultee?
What are the limitations of failing to communicate
the role and responsibilities of the RS
professional?