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Application of Basketball
Strategy to Home Visiting
Robin McWilliam
Robin.McWilliam@gmail.com
www.ramgroup.info
Outline
• Game strategy: Purposes of home visiting
• Game plan: Stages of a home visit
• Hoosiers rule: Family consultation
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Game Strategy: Purposes of Home
Visiting
What do we hope to accomplish on home visits?
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Purposes of Home Visiting?
To accomplish these things, what do we have to
do?
Key ingredients?
What do we have to be sure we don’t do?
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What We Hope to Accomplish
• Building families’ capacity for when we’re not
there
– All the intervention occurs between visits
• Helping families with their needs
– Child needs
– Child-related family needs
– Family-level needs
• Providing support
– “Support-Based Home Visits”
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Support
Support
Emotional
Material
Informational
Emotional
Material
Informational
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Not
• Providing intervention to children
– “Involving” parents
• Focusing almost exclusively on child needs
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What We Have to Do
Key Ingredients
• Assess functional and family
needs
• Consult collaboratively with
families
– “Family Consultation”
• Discuss child needs in context
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Not
• Ask families only for their
main concerns
– Assess only child performance
• Solve problems for families
• Discuss child skills without
context
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Support
McWilliam, R. A., & Scott, S. (2001). A support approach to early intervention: A threepart framework. Infants & Young Children, 13(4), 55-66.
• Emotional
• Material
– Positive
– Responsive
– Oriented to the whole
family
– Friendly
– Sensitive
–
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McWilliam, R. A., Tocci, L., & Harbin, G. L.
(1998). Family-centered services: Service
providers’ discourse and behavior. Topics in
Early Childhood Special Education, 18, 206221.
– Basic goods
– Equipment
• Informational
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–
Robin McWilliam
Disability
Resources
Child development
Interventions
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Stages of a Home Visit
Stage
Arrival
Vanderbilt Home Visit ScriptExpanded
Family agenda?
Review
What we will do until next visit
Family consultation
Questions before “ask to
suggest” (Have you ever tried
_____?)
Family demonstration +
feedback
Home visitor demonstration +
optional practice
Feasibility question
Transition to next topic
Matrix
Family consultation
(See above)
Wrap up
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Next-Steps Form
Focus of next (this) visit
What we did today
What we will do until next visit
Focus of next visit
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Vanderbilt Home Visit Script
(Expanded)
This script incorporates the short, original version
of the Vanderbilt Home Visit Script (McWilliam,
2010) with the eight steps of demonstration
(McWilliam, 2010). To use this script, one needs a
functional list of outcomes/goals, preferably
developed with a Routines-Based Interview and a
routines-by-outcomes matrix, in which the target
routines for each outcome/goal are indicated.
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VHVS
1. How have things been going?
2. Do you have anything new you would like to talk
about?
3. Which goal or time of day would you like to
talk about? Show the family the matrix.
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VHVS
4. If this is a child outcome/goal,
a) How has the child been doing during X time of day? If the
parent chose a goal, ask about it during a target routine.
If the parent chose a routine, ask about overall
functioning in the routine and then a specific target skill.
b) What have you been doing to help him/her?
c) What would you like to see him/her doing?
d) What is he/she doing now?
e) What have you tried with him/her?
f) How successful has that been?
g) Have you ever tried _____?
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VHVS
h) If yes (they have tried it before),
i. How well did it work?
ii. Do you need more information?
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VHVS
i) If no (they haven’t tried it before), use the Eight Steps of
Modeling
i. Speak to the adult about your suggestion
ii. If it seems as though the parent doesn’t understand, ask
him or her if he or she wants you to demonstrate.
iii. Tell the parent what you’re going to do.
iv. Do it.
v. Tell the parent what you did and point out the result of
the strategy.
vi. As the parent if he or she would like to try it.
vii. If the parent says yes, observe; if no, don’t insist on it.
viii. If the parent said yes, praise the parent and give him or
her a limited amount of constructive feedback.
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VHVS
j) Do you think this will work?
k) Continue with other skills in the same
routine or other routines targeted for this
skill.
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Family Consultation
• Joint problem solving (solution finding) with the
family
– Ask questions to get
•
•
•
•
•
Background
Already tried
Context
Immediately desired behavior
Reason
– Offer possibilities (“ask to suggest”: Have you ever
tried _____?)
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Why Not Just Give Suggestions?
• Your input should be
added value…
• So you need to
know background
• You should not be
the hero of the visit
• Think about
feasibility and
implementation
• Partners work
together
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Using more in
routines
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5 Rules of Family Consultation
1. Ask about a target skill or a routine
2. Get description with 4+ questions
3. Work with family to find a solution (i.e., solve
a problem)
4. Ask whether feasible
5. Ask whether family is confident in carrying out
the intervention (i.e., the solution)
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Routines-Based Model
for Early Intervention 0-5
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The Routines-Based Early Intervention
Approach
Component
Practice
Understanding the family
ecology
Functional, family-centered
intervention plan
Ecomap
Integrated services
Support-based home visits
Collaborative consultation to
child care
Primary service provider
Family consultation + 3 supports
Integrated therapy + coaching
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Routines-Based Interview (+
participation-based outcomes)
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Key Home-Visit-Related Practices
1.
Use family consultation (instead of expert consultation);
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–
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Keep discussion of child functioning centered on routines
Work with details of child functioning (EISR; “dig deeper”)
Joint problem solving/solution finding rather than suggestions
Hoosiers rule
Use functional, family-chosen child- and family-level outcomes as the home-visiting agenda;
Respond to families’ priorities of the day;
Prepare families for parenting during the rest of the week;
Help families with parenting skills (reading, talking, playing, teaching, managing behavior);
Use informal and community supports to meet needs;
Address family-level needs also with family consultation
Provide or ensure emotional support
Document what happened and what will happen and leave with family
Use routines-based assessment to help families choose 10-12 outcomes to be addressed on home
visit
Support families in all areas of child and family functioning, using additional “team members” as
necessary
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Take-Home Messages
What was the most important thing to you
about this approach to home visiting?
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Take-Home Messages
1. All the intervention occurs between visits, so
2. We should use home visits to build adult
family member’s capacities and
3. Meet family-identified needs.
4. Engage in joint solution finding by asking
context questions. (How many?!)
5. Discuss child functioning in routines.
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