Conversations in the Kitchen

Vicky attended the Birth to 3 workshop called Conversations in the Kitchen (2002). She is a speech and language pathologist who also provides service coordination for families of children who primarily have communication needs. As part of a project for course credit, Vicky practiced using a variety of tools for getting to know families’ priorities, resources and needs, and wrote reflections about her experiences. She has given us permission to share her reflections with our viewers. Family names and situations have been disguised to protect the confidentiality of the families.

Thank you, Vicky!

Before I explain my project I would like to share some information about myself. My name is Vicky and I have been employed for about eight years as a speech therapist in a Birth the Three Program. There are two teachers on our team and one occupational therapist. Most children are seen in their homes and a few at daycare. Our team all works out of the same office and we share the files with each other. It is easy for another team member to look over the information and reports from another team member. With going into the homes, we work with a variety of families. The parents have different income levels and education levels. I love my job and it is never boring!!

Using Assessments in Natural Environments

Assessing children and families in their natural environment tends to vary with different families. In my job I have used four different assessment tools to help get to know families better. The Functional Intervention Planning: The Routines Based Interview, Family Interest Survey, Parent Assessment of Needs, and the Hopes and Dreams Exercise were all used. I used all four tools with families that are currently on my caseload. I wanted families to give me honest feedback about the tools. The Hopes and Dreams Exercise was used with a new family to help develop the IFSP. With using the tools, I used the Guiding Principles of Natural Environments. Most important to me was that parents are partners in any activity that serves the child and the fact that the greatest resource to the child is the family.

The Functional Intervention Planning: The Routine-Based Interview was used with a family that I have had on my caseload about eight months. My goal with this family was to find out how their days go and to help try to add more opportunities for communication. Sammy is almost three years old and has speech delays. The dad works very long hours and the mom often feels like a single mom. Sammy has one sister, Heather. Their mother, Linda works days and is very busy. Linda tries to do a lot with the kids and I think she often feels like she is not doing enough. It was interesting using the questionnaire to help figure out key words we could work on with Sammy during his daily routine. I stressed to the mother that she does not have to sit down and have special floor time with Sammy and the fact that she can use daily routines to enhance his communication skills. For each area of the Assessment we pick out two words to work on to add to Sammy’s vocabulary. For instance with dressing she chose to work on the words shoe and socks and with breakfast the words juice and eat. The part that I did not use with the assessment tool was the wording of “what about the hour from hell”. I rephrased that with asking about how busy times go. Linda said she felt comfortable answering the questions from this questionnaire. I felt I learned more information with this tool. I also found three handouts that I thought would work well with this assessment tool. The handouts are “Talking During Dressing Talking During Mealtime and Talking During Bath time.” The handouts focus on vocabulary words around routines. I also found material from the Hanen Program to use as parent handouts.

Next I used The Family Interest Survey with a boy on my caseload named Daniel. When I go for visits the dad is typically home. The dad is very nice but not overly talkative. To me it looks like they could use some financial help as well as developmental services for their child. The Community Interests portion helped with this area. Charlie noted he wanted more information about community resources. For this family I thought dental care and food would be main concerns. Charlie did check that finding out about resources in these areas is a high priority. This led us to the topic of the food pantry, surplus food distribution and the dental program at the Technical College. I thought this tool was a nice icebreaker to discuss these subjects. This seemed to be my window of opportunity to discuss the subjects. I wanted to mention the food pantry before but did not want the family to seem insulted but with this form he was asking me for help and information. I could certainly see using this form with families that are new to the area and that might need help from the county. charlie stated this form was easy to fill out. I shared the information from the tool with the case manager for the family. We are both trying to help this family with resources from the community.

I used the Parent Assessment of Needs with a family that I have worked with about three months. Cody just turned two and has delays in speech only. His mother, Teresa helped me fill out the form. Her feed back was that it was too long. She felt that since Cody’s only delay was his speech so many of the questions did not apply. This family is totally on the ball and does a lot with their children. Looking back I would not use this assessment with most children who only have communication needs.  I think the tool would be good to use with a child with overall developmental delays. It is good how it targets the areas of: movement, interaction with objects, interaction with people, home activities, family activities, community activities, communication and parent assessment and needs. For a child with Down syndrome or Cerebral Palsy I think our team could learn a lot of information using this tool. It targets areas for all disciplines to look at (Teacher, Speech Therapist, Occupational Therapist and Physical Therapist).

The last tool I used was the Hopes and Dreams Exercise. I used this form a little differently than is intended. I used the form with a family whose child turned three in April. The parents do not want their daughter referred to the public school system. Anna has concerns with speech, social and motor skills. Our team went over concerns about Anna’s development and concerns about her not being ready for kindergarten if she does not catch up in her skills. This form was good because mom wrote down her concerns and her hopes and dreams. She focused on Hopes and Dreams for the Family in six months. I thought this section was very helpful because she wrote down ways she could utilize the community and try to enhance her daughter’s skills. I gave her a copy of the form and hopefully she will look at it in 6 months and can see if her daughter is continuing to make progress or reconsider the need for continued services. The mom liked the exercise and said it was good to focus on dreams of the family.

I used the Hopes and Dreams Exercise a second time with a new family; I am seeing Chris for speech only concerns. I used the exercise with a family on the third visit. We discussed the child's development and goals for the child. This so nicely took us into the IFSP on the next visit. Basically, we took information the parents shared from the Hopes and Dreams for My Child in Six Months and turned those into the goals of the IFSP.

Before I started using all the different assessment tools with families I thought I would find a favorite tool. Well, after using them all I found out that each tool tends to have their own purpose and target areas. It depends on the family when deciding what tool I would use. The teachers in our Birth to Three program have used FACETS. I do feel FACETS is a very helpful tool and can be used with about any family. I hope our team can start using some of the other assessment tools with other families. The part I liked best was the fact that the tools seemed to empower families. Parents wrote down their concerns, interests, strengths and needs. To me this is part of Best Practices. That is to build on what parents are doing and to make them the goal setters. Our team has a goal to revise our IFSP soon and what I have learned will help with the process. To be continued in September.

Reflections and Applications of the Family Guided Approaches to Collaborative Early Intervention Training and Services (FACETS)

One of my goals regarding “Conversations in the Kitchen” was to use a new tool to get to know the children we work with better. I can’t believe that I haven’t used the Family Guided Approaches to Collaborative Early Intervention Training and Services (FACETS) earlier. I started to use FACETS with a few families in March and plan on continuing to use this information tool. The tool was given to families that have been in the program a few months and have an active IFSP. I gave the parents the FACETS sheet in their homes. We discussed the purpose of the form and getting to know their child better. We started to fill out the form together but I left it at their home so they could add to it. The parents then returned it on my next visit. This was done so that families were not rushed. When I picked the forms up we went over the information and discussed their child. Parents also gave me feedback about this information tool.

With all of the families I learned more about the children. Currently, families are given an application at the time of enrollment. On the application there is a place where it talks about likes and dislikes of the child but it is more general and not as family friendly looking as FACETS. Most parents jot down a few notes on our application about their child. Our team is planning on looking at our IFSP form and perhaps we could also revise our current application to include materials from FACETS. With FACETS parents seemed to give more information about their children. The fact that different areas are broken down really helps (e.g.. eating and toys). The information from FACETS is valuable for the IFSP. FACETS seems to break the ice to have the team discuss strengths and weaknesses about a child. I have used FACETS with several children so far. Here is a log of some of the more interesting cases.

Oliver is a two year old boy who has been in our program about six months. FACETS helped us talk about diet and food allergies. When mom wrote down several salty foods as dislikes and possible allergies it got us talking about his current rash. Currently, Oscar’s mom is keeping a food diary on him. She was also given information on common foods kids are allergic to.

Devin is a 34-month-old boy. We just started with Calvin and FACETS information was helpful both for myself and to pass on to the school therapist. Information is good to share with all the disciplines from dressing to language development. The mother stated that it helped her to focus on positive things that Calvin is doing. She focused so much on him not talking and seemed to over look some of the positive things going on in his life.

Renee is an 18-month old girl who recently started in our program. Renee’s mother tends to be very quiet. When I asked Chris about Renee’s likes and dislikes she stated “Oh she likes just about anything”. A couple visits later I gave Chris the FACETS form to fill out. We discussed the purpose of the form. It was left at the house and the mother was told to feel free to start writing things down and that we could go over it the next time I come for a visit. Surprisingly, Carrie wrote lots of good information on the form, she filled in every box! For Chris I think she felt more comfortable to take a simple questionnaire like FACETS and to fill it out on her own time. Possibly the whole Birth to Three process was overwhelming to her at first. Maybe FACETS is better for some people to take and fill out in private so they don’t feel on the spot. It seemed with Carrie, she was more apt to share information. She seemed to be more prepared when we went over it on the next visit and we had a good conversation.

Gavin is a two year old boy with who I have been working about 6 months. Gavin’s mother, Betty, is very outgoing and friendly. I learned the most about Gavin’s food choices and what frightens and calms him. I asked Barb what she thought about FACETS and she stated that she enjoyed filling the form out. She said that since Gavin is her third child she got out of the habit of writing in his baby book. She asked for a copy of FACETS to ad to his book. I plan on giving her a few blank copies to fill out later.

The thing I personally like about FACETS is that it is such an easy form for most families. The pictures are very attractive and simple. For parents who do not read or write it would be easy to fill out with them. I like how the areas are broken down for parents. Sometimes when parents hear “how is your child doing?” it seems too general for some parents and FACETS is a step to help break developmental areas down.

I have shared my finding with co- workers. We have used FACETS with children we share on the caseload. It seems no matter the professional field there is good information for everyone. I am going to be working with a new child in May 2003 who the teacher has been seeing for a few months. The teacher recently filled out FACETS with the parents and it has been very helpful for me in getting to know this child. Our team has all used FACETS before and like the form. I could really see FACETS help us develop a new form on our application. Too be continued in September!