Questions Providers Ask...
Q. Is "natural environment" equated with the child's home?
A. A child's home is usually one "natural environment," but children typically have other locations that are natural for them as well. Older toddlers may experience recreation and socialization in a variety of community environments.
Q. What should I do if I feel the home is an ineffective environment for working with the child?
A. It may be difficult to meet a child's developmental needs in a chaotic or difficult home environment. However, it is unlikely that a few hours of Birth to Three services away from that environment will have much impact. Service coordinators may need to focus as much effort on helping the family connect with needed supports as on providing direct service to the child.
Q. Isn't it a little bit naive to think that all community settings offer quality services and supports to young children and their families?
A. The variable quality to supports and services available is a concern of all parents with young children. With the help of a service coordinator, a family may have better information about how to judge the quality of a setting. Birth to Three staff should be an asset in helping community providers address the developmental needs of all children. If a selected location is inappropriate to address the outcomes identified in an IFSP, then another location should be found. A natural environment must also be safe and nurturing, encourage child development, and be accessible to the child and his family.
Q. The (Connecticut) mission statement talks about "choice" as well as about natural environments. What if a family wants to choose a specialized setting for Birth to Three services?
A. The (Connecticut) mission statement also values "best practice" which discourages us from offering choices in isolated clinical settings which research has suggested are less effective than the use of natural environments. Service coordinators need to make sure that families understand that supports and services are available in a variety of home and community settings.
Q. How can I get all this information about the family's routines and resources to develop this plan when I've just met them and I've got a million other questions and forms for them?
A. Because the process of developing the family's plan requires a relationship between the family and provider, the initial IFSP may be awkward and in some ways incomplete. However, this first plan still offers the opportunity for the provider to assist the family in exploring what outcomes will truly make a difference in their lives. The plan will propose how these outcomes can be supported through interventions that build on daily routines in natural environments. The IFSP can always be modified after the provider and the family know each other better. Plans can be written initially which are short term and give the family and the provider a chance to see what is workable and how the child responds.
Questions Parents Ask...
Q. How can I tell if a place where Birth to Three services are provided is a natural environment?
A. The descriptions below can be used to identify places that are natural environments:
A location is a natural environment if:
- It is a location where this child would go if he did not have a disability;
- Other children go to this location who do not have disabilities;
- The location is in a part of the community where children and families without disabilities spend time when they are not being treated or tested for illness or health issues?
A location may not be a natural environment if:
- It is a location where people usually go because they have disabilities or medical issues;
- It was chosen because it had specialized equipment;
- It was chosen because it was convenient for specialists who work with the child.
Q. What about a public hospital?
A. Hospitals, clinics, rehabilitation centers, classrooms, or other places where only early intervention or medical services are delivered are not natural environments. Sometimes these locations are well suited for a specialized evaluation or a single visit, but they would usually be inappropriate for ongoing services.
A location alone does not guarantee a natural environment. It matters whether you and your child are participating with the people who use that environment.
Q. How can I evaluate participation?
A. The following questions help identify when full participation is occurring in a natural environment:
- Is the primary intent of the activity the treatment of disability or to meet the needs of all children?
- Are children with and without disabilities participating in the same activities?
- Are children with and without disabilities interacting with the same adults?
- Is the child with disabilities removed from the area where other children are in order to receive specialized treatment?
- Are all children using the same toys and materials?
- Is the defined outcome of the participation to establish relationships with non-disabled peers that extend beyond the structure of the Birth to Three program?
- Are there any physical barriers between the area the children with disabilities use and the rest of the space?
Meeting the Challenges
Challenge:
Parents may expect therapeutic or clinical services or "baby school" rather than a system based on IFSPs that reflect the day to day needs of families.
Strategies:
Birth to Three service providers can:
- train agency staff who regularly answer the telephone and individuals who make initial contacts with families about how to present the concept of services based on and provided in the family's natural environments.
- share with one another innovative practices that help families sort out complex choices among multiple providers and settings.
- inform newly identified families about addressing Birth to Three outcomes in natural environments and support families as they identify what settings and services will best meet their individual needs.
Challenge:
Some members of the broader community think that the needs of young children with disabilities can only be met by highly trained professionals in specialized settings away from typically developing children.
Strategies:
Birth to Three service providers can:
- set the tone for community program staff. If interventions are presented as the domain of therapists, occurring outside the regular program routines, then a community program will not take responsibility for the child. If supports are integrated into the regular routine and staff are engaged in development and problem solving, they can take ownership in the child's plan.
- publicize how offering high quality supports and services in natural environments can result in meeting outcomes identified in the IFSPs.
The above information was Developed by the Connecticut Birth to Three Natural Environments Task Force
For a more complete listing, visit the Connecticut Birth to Three System website at www.birth23.org.
Source: Connecticut Birth to Three System, 460 Capitol Avenue, Hartford, CT 06106, (860) 418-6147