Working Draft
Guiding Principles of the Howard County Infants and Toddlers Program
The participants of the Howard County Infants and Toddlers Program believe in family-centered practices
to address each child’s needs in natural environments. The following seven principals outlined by the OSEP
Workgroup on Principles and Practices in Natural Environments (February, 2008) guide our practice.
1
Infants and toddlers learn best through everyday experiences and interactions with familiar people in
familiar contexts.
2
All families, with the necessary supports and resources, can enhance their children’s learning and
development.
3
The primary role of the service provider in early intervention is to work with and support the family
members and caregivers in a child’s life.
4
The early intervention process, from initial contacts through transition, is dynamic and individualized
to reflect the child’s and family members’ preferences, learning styles and cultural beliefs.
5
IFSP outcomes are functional and based on children’s and families’ needs and priorities.
6
The family’s priorities, needs and interests are addressed most appropriately by a primary provider
who represents and receives team and community support.
7
Interventions with young children and family members are based on explicit principles, validated
practices, best available research and relevant laws and regulations.
Working Draft
Implementation
Team
Collaborative,
multidimensional
assessment to
determine
eligibility and
identify strengths
and needs
Linda Flanagan,
Instructional Facilitator,
Countywide Services
Jen Harwood, Project
Facilitator, Early
Intervention Services
Anne Hickey, Instructional
Facilitator,
Early Intervention Services
Jane Jung-Potter, Program
Head, Physical Therapy
Collaborative
consultation to
child care to
enhance the staff's
capacity to help the
child between visits
Emily Kinsler, Instructional
Facilitator, speech and
Language Pathology
Joan Ogaitis, Program
Head, Occupational
Therapy
Stephanie Wickstrom, Early
Intervention
Specialist/Cluster Lead
Vacancy
Vacancy
Support-based
home visiting to
build the capacity
of each familiy to
enhance learning
between visits
Family assessment
to help families set
priorities and
outcomes
HCITP Program
Model to
Support
Achievement of
Child and Family
Outcomes
Functional,
participation-based
child and family
outcomes
Vacancy
Integrated services
through a flexible,
primary service
provider model
Working Draft
Component
Policy
Evidence-base
Alignment with HCPSS Strategic Plan
Family assessment to
help families set
priorities and outcomes
Family assessment and multidimensional
assessment as defined in COMAR
13a.13.01.05, …ongoing multidisciplinary
assessment of the child and the familydirected assessment of the resources,
priorities and concerns of the family, as it
relates to the needs of the child in the
development of integrated outcomes for the
IFSP . IDEA CFR 303.321(a)(2), A statement of
the family’s concerns, priorities, and resources
related to enhancing the development of the
child as identified through assessment, with
the concurrence of the family.
As defined in COMAR 13A.13.01.08 and IDEA
CFR §303.344. A statement of the measurable
results or outcomes considered
developmentally appropriate and expected to
be achieved for the child and family.
As defined in COMAR 13A.13.01.08, Services
based on peer-reviewed research that are
necessary to meet the unique needs of the
child and the family to achieve the results or
outcomes.
As specified in IDEA CFR §303.12(b)(3)
Providers are responsible for consulting with
and training parents and others concerning
the provision of early intervention services
described in the IFSP of the infant or toddler
with a disability. Additionally, this consultation
and training will provide family members and
others with the tools to facilitate a child’s
development even when a teacher or therapist
is not present.
Guidance from Professional
Organizations (CEC/DEC, NAEYC, ECTA,
MSDE)
•
Agreed-Upon Mission and Key
Principles for Providing Early
Intervention Services in Natural
Environments
•
Seven Key Principles: Looks Like
Doesn’t Look Like
•
Agreed-Upon Key Practices in the
Early Intervention Journey
•
Occupational and Physical
Therapy Early Intervention and
School-Based Services in Maryland
http://ectacenter.org/ & HCPSS site
Selected Research
“Family involvement results in
significantly greater intervention effects
“(Shonkoff & Hauser-Cram, 1987;
Ketelaar, Vermeer, Helders, & Hart,
1998)
STUDENT ENGAGEMENT
Outcome 1.4: Students are engaged in the learning
process.
1.4.4 Provide authentic learning experiences to solve
real-world problems.
STUDENT WELL-BEING
Outcome 1.7: Schools support the social and
emotional safety and well-being of all students.
1.7.5 Ensure students have access to culturally
proficient professional staff members who support
them and
help them solve problems.
STAFF PERFORMANCE
Outcome 2.3: Staff members are held accountable for
and supported in meeting performance expectations.
2.3.2 Provide a professional learning program that
supports all employees in meeting performance
expectations.
FAMIIES AND COMMUNITY COLLABORATION AND
WELLBEING
Outcome 3.1: HCPSS collaborates with family and
community partners to engender a culture of
trust, transparency, and mutual respect.
3.1.5 Develop intentional strategies to involve parents
in decisions regarding their child’s HCPSS experience.
3.1.6 Develop intentional strategies to connect directly
with families who need additional supports
Outcome 3.4: HCPSS supports the well-being of
students and families.
ORGANIZATION PERFORMANCE
Outcome 4.6: Decisions are informed by relevant data
in all operational areas.
4.6.1 Regularly consider research-based
best practices.
4.6.2 Consistently include collaborative stakeholder
teams in planning processes to inform decisions.
4.6.4 Develop evaluation plans for all pilots and refine
programs based on evaluation results.
Collaborative,
multidimensional
assessment to
determine eligibility
and identify strengths
and needs
Functional,
participation-based
child and family
outcomes
Integrated services
through a flexible,
primary service
provider model
Support-based home
visiting to build the
capacity of each family
to enhance learning
between visits
Collaborative
consultation to child
care to enhance the
staff's capacity to help
the child between visits
“Programs focused on family strategy use
were more effective than other family
participation methods”(Shonkoff &
Hauser-Cram, 1987)
“Intervention effects dependent upon
supporting families in using effective
interaction strategies” (Mahoney, Boyce,
Fewell, Spiker, Wheeden, 1998)
See attachment, The Importance of
Family Strategy Use to Promote Child
Development
See attachment: Selected Bibliography
Working Draft
Component
Family assessment to help families
set priorities and outcomes
Collaborative, multidimensional
assessment to determine
eligibility and identify strengths
and needs
Procedure/Practice
All families will participate in a RoutinesBased Interview, including ecomap,
completed as part of evaluation and
assessment process. (or document denial
of consent)
All service providers will embed ongoing
assessment of concerns, priorities and
resources into practice.
All service providers will complete
collaborative evaluations and assessments
using DAYC-2 and other approved tools.
All service providers will ensure family
participation in COS entrance and exit
ratings.
Functional, participation-based
child and family outcomes
Each outcome is understandable,
observable, functional, and linked to a
family concern.
Integrated services through a
flexible, primary service provider
model
90% of eligible children and families will
receive a weekly home visit by a primary
service provider. Co-visits as needed to
support the primary service provider.
100% of service providers will implement
support-based home or community
visiting practices.
Support-based home visiting to
build the capacity of each family
to enhance learning between
visits
Collaborative consultation to child
care to enhance the staff's
capacity to help the child between
visits
Timeline/Fidelity Measure/Target
By September 1, 2014 100% of returning service providers will complete a RBI training with 90% accuracy as
measured by the implementation checklist. (new service providers will begin process with completion by
January, 2015 or subsequent years.)
Sept-June 2014 and beyond – annual rechecks completed with maintained accuracy for each provider.
By January,2016 Howard County will meet or exceed the state target for Child Outcome Summary Indicator 3.
% who entered below age
expectations and increased
their rate of growth by
time of exit
7/1/15-12/31/15
Social Emotional
Knowledge and Skills
Adaptive Behavior
81.1%
86.3%
87.5%
1/1/15-6/30/15 target
70.36%
74.1%
78.56%
7/1/14-12/31/14 target
59.61%
61.63%
69.62%
1/1/14-6/30/14 pending
pending
pending
pending
7/1/13-12/31/13 pending
pending
pending
pending
1/1/13-6/30/13 actual
48.86% (81.1%)
48.89% (86.3%)
60.68% (87.5%)
(state target)
By June 30, 2014, 100% teams will conduct peer review using the Recommended Practice: Functional
Outcomes Checklist. (Implementation team facilitation provided.)
By December 1, 2014, the implementation team will review 4 outcomes from at least 2 children/families from
each service provider. The FOC will indicate average rating of 3-4.
By January,2015 data will indicate that 70% of eligible children and families are receiving a weekly home visit
provided by a primary service provider.
By September,2015, data will indicate the 90% of eligible children and families are receiving a weekly home
visit provided by a primary service provider.
September 1, 2014-January 31, 2015 100% of service providers will have the Support-Based Home Visiting
Checklist completed and reviewed by the Implementation team.
February 1, 2015-September 1, 2015 100% of service providers will receive an average rating of 3-4 on the
Support-Based Home Visiting Checklist.
September 1, 2015 and beyond – Each service provider will maintain an average rating of 3-4 on the SupportBased Home Visiting Checklist completed by the implementation team or peer review.
Working Draft
The Importance of Family Strategy Use to Promote Child Development
• Families are considered the “engine of change” (Brooks-Gunn, Berlin, & Fuligini, 2000, p. 562)
• Bronfenbrenner (1999) contends that family use of intervention strategies must be considered both an outcome of intervention and a level of intervention
intensity
• “...those adults who are most consistently available and committed to the child’s well-being play a special role in promoting competence and adaptation that
cannot be replaced by individuals who are present less consistently or whose emotional commitment is not unconditional” (National Research Council, 2000, p.
389)
•
“...the time has come to stop talking about parent involvement and to commit to learning how such involvement can be accomplished across a range of family
constellations, circumstances, and values” (Mahoney, Robinson, & Perales, 2004)
Study
Hart & Risley, 1999
Shonkoff & HauserCram, 1987
Ketelaar, Vermeer,
Helders, & Hart, 1998
Mahoney, Boyce,
Fewell, Spiker, &
Wheeden, 1998 (Infant
Health and
Development Program,
IHDP; Longitudinal
Study of Early
Intervention, LSEI; Play
and Learning Strategies,
PALS; Family- Centered
Outcomes Study, FCOS)
Sample
42 families interacting in
everyday situations with
1- to 2- year olds (typically
developing)
Children enrolled in EI
before 36 months
Design
Longitudinal study; monthly, hourlong observations
Intervention
None
Meta-analysis of 31 selected EI
studies
Various studies
Children with cerebral
palsy and other motor
disabilities
• IHDP: 298 lowbirthweight
premature infants
• LSEI: 238 dyads in,EI
(child mean age = 31
months
• PALS: 21 teen motherinfant/toddler dyads
• FCOS: 47 mother-child
dyads
Reviewed 10 studies that examined
the impact of parental role in motor
interventions
Re-examined data of four
independent intervention
research studies:
• IHDP: 3 IHDP sites, Randomized
Control Trial
• LEI: Multisite
investigation; 6 sites with
interaction data
• PALS: pre-post with
control group
• FCOS: 12-month, fieldbased investigation
Compared infant motor development
when parental involvement was high
and when low
Various studies
Torres & Buceta, 1998
24 infants (0-2 years) with
Down syndrome
Trivette, Dunst, &
Hamby, 2010
910 families (children
ranged from 1 to 89
months; 85% with or at
risk for delays or
disabilities)
Meta-analysis SEM
Child/Family Outcomes
• More time parents talk to child, more rapid vocabulary growth and
IQ at age 3
• Across family SES
• “Extra, optional talk” a quality indicator
• Parent involvement showed significantly greater effects than
interventions without
• Focus on parent strategy-use more effective than other ways
parents participated
Across studies: • Significantly better child outcomes with parent
involvement and strategy use
• IHDP: home, center,
and parent group
• LEI: various
• PALs: 3-month; 24
sessions, 30 minutes
each
• FCOS: 36
community-based
programs
• Maternal responsiveness significant predictor of child development
• E.g.,IHDP:Mother-childinteraction6times more of variance in child
development than intervention group assignment
• Intervention effects unlikely without quality parent interactions
• Authors conclude that, when EI not only worked with parents but
also helped them learn more effective ways of interacting with their
children, general development was promoted
Portage 3x per week
for one hour; parents
instructed how to use
the program at home
None
• Motor development increased when parents highly involved
• Motor development decreased when parent involvement low
• HOME variable part of definition of “involvement”
• Capacity-building help-giving and family systems intervention
practices were significantly and directly related to parenting parent
well-being
• Parent well-being was significantly related to parent-child
interaction and child development
Working Draft
Effective Practices in Early Intervention for Families and Their Infants and Toddlers, Bonnie Keilty, Ed.D. July 13, 2010 New York City LEICC Meeting
Select Bibliography
Bernheimer, L., & Weisner, T. (2007). “Let me just tell you what I do all day...”: The family story at the center of intervention research and practice. Infants and Young Children, 20, 192-201.
Bruder, M.B. (2000). Family centered early intervention: Clarifying our values for the new millennium. Topics in Early Childhood Special Education, 20, 105-115.
Bruder, M.B. (2001). Inclusion of infants and toddlers: Outcomes and ecology. In M.J. Guralnick (Ed.), Early childhood inclusion: Focus on change (pp. 203-229). Baltimore, MD: Brookes Publishing.
Campbell, P. (2004). Participation-based services: Promoting children’s participation in natural settings. Young Exceptional Children, 8, 20-29.
Cook Pletcher, L., & Younggren, N.O. (2013). The Early Intervention Workbook. Essential Practices for Quality Services. Baltimore, MD: Brookes Publishing.
Crawford, M.J, & Weber, B. (2014). Early Intervention Every Day! Embedding Activities in Daily Routines for /young Children and Their Families. Baltimore, MD: Brookes Publishing.
Dunlap, G., Ester, T., Langhans, S., & Fox, L. (2006). Functional communication training with toddlers in home environments. Journal of Early Intervention, 28, 81-96.
Dunst, C., Bruder, M.B., Trivette, C., Raab, M., & McLean, M. (2001). Natural learning opportunities for infants, toddlers, and preschoolers. Young Exceptional Children, 4(3) 18-25.
Dunst, C., & Dempsey, I. (2007). Family-professional partnerships and parenting competence, confidence, and enjoyment. International Journal of Disability, Development and Education, 54, 305318.
Dunst, C., Hamby, D., Trivette, C., Raab, M., & Bruder, M. (2000). Everyday family and community life and children’s naturally occurring learning opportunities. Journal of Early Intervention, 23, 151164.
Dunst, C., & Trivette, C. (1996). Empowerment, effective helpgiving practices and family-centered care. Pediatric Nursing, 22, 334-343.
Guralnick, M. J. (1997). Second generation research in the field of early intervention. In M. J. Guralnick (Ed.), The effectiveness of early intervention (pp. 3-20). Baltimore, MD: Paul H. Brookes
Publishing Co.
Hanson, M.J, & Lynch, E.W. (2013) Understanding Families. Supportive Approaches to Diversity, Disability, and Risk. 2nd ed. Baltimore, MD: Paul H. Brookes Publishing Co
Jung, L.A. (2003). More IS better: Maximizing natural learning opportunities. Young Exceptional Children, 6(3) 21-26.
Jung, L. (2005). Can we all fit? Squeezing in better support with fewer people. Young Exceptional Children, 8(4) 19-27.
Jung, L., & Grisham-Brown, J. (2006). Moving from assessment information to IFSPs: Guidelines for a family-centered process. Young Exceptional Children, 9(2) 2-11.
Keilty, B. (2010). The Early Intervention Guidebook for Families and Professionals: Partnering for Success. New York: Teachers College Press.
Keilty, B. (2008). Early intervention home visiting principles in practice: A reflective approach. Young Exceptional Children, 11(2) 29-40.
Kim, J., & Mahoney, G. (2004). The effects of mother’s style of interaction on children’s engagement: Implications for using responsive interventions with parents. Topics in Early Childhood Special
Education, 24, 31-38.
McWilliam, R., & Scott, S. (2001). A support approach to early intervention: A three-part framework. Infants and Young Children, 13, 55-66.
McWilliam, R. (2010). Routines Based Intervention: Supporting Young Children and Their Families. Baltimore, MD: Brookes Publishing Co.
Maryland State Steering Committee for Occupational and Physical Therapy School-Based Programs. (2008). Occupational and Physical Therapy Early Intervention and School-Based Services in
Maryland. A guide to practice.
Rush, D.D, & Shelden, M.L. 2011). The Early Childhood Coaching Handbook. Baltimore, MD: Brookes Publishing Co.
Shonkoff, J., & Hauser-Cram, P. (1987). Early intervention for disabled infants and their families: A qualitative analysis. Pediatrics, 80(5), 650-658.
Trivette, C. (2003, June). Influence of caregiver responsiveness on the development of young children with or at risk for developmental disabilities. Bridges: Practice based research syntheses, 1(3).
Asheville, NC: Research and Training Center on Early Childhood Development, Puckett Center.
Wilson, L.L., Mott, D.W., Batman, D. (2004). The Asset-Based Context Matrix: A tool for assessing children’s learning opportunities and participation in natural environments. Topics in Early Special
Education, 24, 110-120.
Woods, J., & Kashinath, S. (2007). Expanding opportunities for social communication into daily routines. Early Childhood Services: An Interdisciplinary Journal of Effectiveness, 2, 137-154.