THE INSITE MODEL
A Model of Home Intervention for
Infant, Toddler, and Preschool Aged
Multihandicapped Sensory Impaired
Children
SPE 552
LA 5
THE INSITE MODEL
Created by:
Julie Tilley
Sara Smith
James Hale
Home-based programs such as THE INSITE MODEL may
be used with children who are medically fragile. These
are children who:
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may not demonstrate an understanding of daily routines, gestures, or other
communication skills.
often show limited recognition of significant persons in the environment
demonstrate little purposeful movement
display little reaction to stimuli such as noise, movement, touch, etc.
rarely function above the six-month level during the early home program.
WHAT THE INSITE MODEL IS:
 A support model for families of multi-handicapped sensory impaired
infants, toddlers, and pre-school aged children
 Home-based services which may also include care-givers in a day care
setting
 An early intervention service obtained through referrals, public
awareness, and high-risk screening
 An intervention done after diagnosis and medical clearance are given
 A parent-based intervention which is guided/taught by a parent advisor
WHAT THE INSITE MODEL IS
NOT:
 A norm-referenced test
 Administered in a standardized test setting
 A numbers-based assessment comparing one child to another
Programs addressed by
THE INSITE MODEL:
Vision
Hearing
Cognition
Communication
Motor impairment
Developmental Resources
EACH OF THE SIX PROGRAM TOPICS
INCLUDES:
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parent goal
list of materials needed
instructions for the parent advisor
sample discussion for advisor and parent
sample activities
sample challenges
supplemental/reference materials
RESPONSIBILITIES OF THE
PARENT ADVISOR:
 Become familiar with the guidance material contained in the
“Information for Parent Advisors” section of the manual.
 Plan and deliver home visits.
 Provide emotional support to the family.
 Arrange for other support services as necessary.
THE VISION PROGRAM:
 Contains a comprehensive series of topics on the visual system, eye
disorders, eye specialists, and exams
 Promotes the development of various visual skills such as looking,
eye-hand/ eye-foot co-ordination, recognition, and discrimination
skills.
 Helps parents understand visual loss.
 Teaches parents skills to help their child make use of his or her
residual vision.
THE HEARING PROGRAM
CONTAINS:
 Hearing Aid Management
* includes the treatment of hearing disorders
* teaches the parents how to manage the hearing aids
* consists of nine associated topics
 Auditory Development
*develops attention to sounds and voices along with the child’s
awareness of his/her own vocalizations
* encourages recognition of sound sources and increased
vocalization
* presents auditory input in meaningful, interesting activities
COGNITION PROGRAM:
 Focuses on the sensorimotor stage of development—usually birth to
three years.
 Enables parents to promote early thinking skills in their child.
 Includes seven topics:
introduction
object exploration
gestural imitation
means-end
causality
object permanence
spatial relationships.
COMMUNICATION PROGRAM:
 Forms a crucial aspect of family programming
 Establishes a communication relationship that involves their child
 Addresses three main issues:
creating an environment that foster communication (bonding)
using informal communication (cues and gestures)
using formal communication (signals, signs, and words)
 Includes thirteen topics covering bonding, touch, face-to-face
contact, facial expression, intonation, turn-taking, cuing, playing
with the child, teaching the child to play with toys, varying
positions, varying locations, and exploring the indoors.
MOTOR IMPAIRMENT PROGRAM:
 Involves a team effort between parent, parent advisor, and any
therapists who may be working with the child
 Teaches parents to understand the child’s motor delays, demonstrates
correct handling and positioning of the child, obtain and use adaptive
equipment, recognize feeding problems and how to ease them, and
understand the importance of their roles in helping their child develop
 Contains thirteen topics 5 which deal with understanding delayed
posture and movement and 8 which involve dealing with delayed
posture and movement.
DEVELOPMENTAL RESOURCES:
GROSS MOTOR, FINE MOTOR,
SELF-HELP, AND SOCIALEMOTIONAL DEVELOPMENT
 Four sections which cover each of the four developmental areas
 Each section contains an introduction which includes a listing of the
type of skills in that developmental area, a discussion on the normal
developmental sequence for each, information on how impairments
affect the development of each skill, and suggestions/resources to
facilitate the planning of activities for a particular skill area
SAMPLE DESCRIPTION OF THE
CHILD SERVED BY THE INSITE
MODEL
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Patsy is a 12-month old girl who was born three months prematurely resulting
in a mild sensorineural hearing loss and visual impairment.
She appears to be intelligently intact with good motor skills.
Patsy has near-normal hearing when wearing her hearing aids but she has had
repeated middle ear infections.
She lives with her natural parents and is beginning to babble, sit alone, and
sees light, shadows, and movement of bright shiny visual targets.
SAMPLE TOPIC INCLUDED IN THE
VISION PROGRAM
 Parent Goal: Parent will learn about size and distance factors and how
to use these to enhance Patsy’s vision.
 Parent Advisor Instructions: Assign the parents a few activities to try
during the week that will help them observe how Patsy functions.
 Materials: examples of books; visual toys and materials Patsy is able
to respond to and manipulate.
 Sample Discussion: Decreased acuity means Patsy will have to
move closer to people or objects in order to see them more clearly. Or,
if she additionally has a field loss, it may reduce the amount of the
target that she sees at one time. Remember that Patsy’s eyes are
working very hard. Be aware that she may become fatigued and have
a shorter attention span for objects that are close.
Continued:
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Sample Toddler Activity: Encourage the parent to look at books with Patsy.
Choose books like PAT THE BUNNY that are less cluttered than other
children’s books.
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Sample Toddler Challenge: Help Patsy learn to recognize familiar people or
objects in large photographs. Then see if she can recognize them in smaller
photographs.