Home Based Coaching – An Important Family and Early Intervention Therapist Partnership
By Kelley Filson, teli Developmental Specialist
How does teli make the family the center of Early Intervention Services?
Over 5 years ago, teli participated in a Pennsylvania Department of Health grant that placed families at the center of the Early Intervention process through a Home Based Coaching model. What better place to provide services and strategies for the parent/ caregiver and child than where they are most comfortable? Conveniently in your home, at day care or at grandma’s house, your routine, your child’s toys and familiar surroundings provide the best possible environment for your child’s development.
Home Based Coaching is now a permanent part of the Early Intervention services as implemented by Allegheny County and supported by the state of Pennsylvania. Your teli therapist works with you to demonstrate Early Intervention strategies to incorporate into your child’s routine using toys and other objects that are in your home. This integration into your day, from getting ready to go out, to having lunch, to having play time, are all opportunities for you and your child to spend quality time together and for your child to learn.
What exactly is Home Based Coaching?
Home Based Coaching is a progressive approach to help a parent be a part of their child’s Early Intervention success. Previously, Early Intervention services tended to be more “traditional”, in that a therapist would come to the home with a bag of toys, sit on the floor and work with the child as the parent or caregiver observed. Over time, studies have proven that by utilizing day to day family activities and routines with parents as part of the process to deliver Early Intervention strategies, children can be more successful. Children as well as parents learn best through experiences with familiar people, places and things. Routine for a child typically means repetition; learning this way has a greater impact because a child is learning through practice.
Why was Home Based Coaching established?
Immersing therapists into the family routine and having them observe the normal sequence of events in the home, can quickly enable them to see a certain behavior or difficulty a child may demonstrate in their usual environment. Through these observations, a therapist can work with the parent to identify what they would like to see their child achieve or learn, or what changes they would like to see in their child’s behavior. The therapist can then work with the parent to devise a strategy specifically for their child to move toward the desired goal. While children react differently to different strategies, this approach allows the parent to collaborate with the therapist as they decide what may work best for their child and family.
So how does a Home Based Coaching Session work?
A therapist’s in-home visit may begin with the observation of the child in their natural routine, such as diaper changing, eating breakfast or putting on their shoes. The in home observation is central to developing Early Intervention strategies that the caregiver and the therapists can arrive at TOGETHER! Consider the following common examples that may sound familiar as part of a family’s normal routine.
Issue: A mother wants her child to stop playing and sit down for lunch. He may immediately fall apart and launch into a full blown tantrum.
Potential Strategies: The teli therapist may ask the parent open ended questions such as “What happened before he began to get upset?” or “What do you typically say to him when this happens?” or “What has helped calm him in this type of situation before?” These questions are meant to help the parent problem solve with the therapist to understand the triggers as well potential strategies that could change the outcome of the situation. Often with the help of this exchange, a strategy such as diverting a child’s attention to his favorite toy or book before lunch, redirecting behavior, giving the child choices and the therapist modeling how to give choices by the parent might be a solution to try to resolve the issue in the future.
Issue: A parent wants their child to use words to ask for a drink.
Potential Strategies: Observing the child, the teli therapist notices that the child stands next to the refrigerator when they want a drink and after a few minutes becomes upset and starts to cry. Mom’s ultimate goal is for her child to use her words, saying “Drink Please.” Together Mom and the therapist discuss and work through potential strategies such as bringing Mom to the refrigerator with her, asking her to show what she would like through a gesture that Mom may model, or by pointing to a picture of a cup that may be on the refrigerator. Depending on the child’s progress, these steps serve as building blocks to the parent “modeling” and repeating the words “Drink Please” and asking questions that require a response.
Issue: A child is jumping on the couch when the therapist arrives. The parent has tried to stop the child by saying “Stop doing that!’ only to the have their child laugh and continue the behavior.
Potential Strategies: Again, the teli therapist may ask open ended questions such as “When does this behavior tend to occur?” or “Does your child enjoy sitting on the couch typically?” Through discussion with the therapist, the parent may realize that they might be more successful redirecting their child to some other activity such as offering to read their favorite book, rather than using trigger words such as “STOP” and “GET DOWN”.
Issue: A child has been diagnosed with torticollis, a condition in which the neck muscles are very stiff and painful to turn, requiring specific exercises that can help the child increase their neck mobility. The child goes to day care and the mother is concerned that the exercises will not be done.
Potential Strategies: The teli therapist visits the day care and notices that the child is facing away from the day care worker. In discussions with the day care worker, together they think of ways to encourage the baby to turn her head in the other direction. The therapist may offer suggestions in regard to positioning the baby to encourage her to turn her head both directions during routine diaper changes and feedings.
In each of these cases, Home Based Coaching through visiting the home or day care environment allows the therapist to understand the issues facing caregivers and gives them the opportunity to talk through alternative approaches to the situation. In most cases, together they can find a suitable solution that makes sense to the parent and will work successfully for the child. Home Based Coaching is helpful for a parent so they learn valuable tools and strategies that can be applied across a variety of challenges they may be facing with their child. Importantly, patience and practice play a huge role in creating resolution and lasting change.
What are the benefits for your child?
Home Based Coaching provides your child with multiple opportunities to learn and grow while:
What are the benefits for the caregiver/ parent?
Home based Coaching provides the parent with numerous opportunities to learn and apply strategies and techniques to help their child develop while:
As a Home Based Coaching Early Intervention provider, teli has been an innovator in Home Based Coaching. The teli expertise and experience in helping the whole family through this method has resulted in countless children achieving their true potential. If you have any questions about Home Based Coaching or Early Intervention, please call teli at 412-420-2400, we can help!