Video Lending Form Send videotape(s) to: Name: Program/Agency: Daytime Telephone: Street: City: State Zip: County: E-mail Address: Please check your role: B-3 Provider Parent Both   Check here if you would still like to receive the video tape(s) if it is not available for the month you have requested it for (We will send it to you as soon as it is available). Video Selection: Month (in which you would like the video): 1st Choice Video: 1. Because the First Three Years Build a Lifetime:A Four Video Set 2. Family and the IFSP Process:Training in Family-Centered Approach 3. IFSP 4. A Family's Guide to the Individualized Family Service Plan 5. Family Focused Interview 6. Pathways for Early Intervention Service Coordination 7. First Years Together:Involving Parents in Infant Assessment 8. Family-Guided Activity-Based Intervention for Infants and Toddlers 9. Home-Based Early Intervention 10. Family-Centered Home Health Services for Young Children 11. Parents & Professionals:Partners in Co-Service Coordination 12. A New Beginning:Meeting the Special Needs of Children 13. Transition:A Time for Growth 14. Family-Centered Care:Short Version 15. Special Kids, Special Dads:Fathers of Children with Disabilities 16. Siblings 17. Parent to Parent 18. Parent Support Groups 19. Lost Dreams and Hopes:Parents' Concerns 20. Sharing Sensitive Information with Families 21. Telling Your Family Story:Parents as Presenters 22. Family Album 23. Reaching the Family: Cultural Competence for Programs 24. Serving the Family: Special Education Cultural Competence Staff Training 25. Culturally Diverse Families 26. Our Children, Our Hopes 27. Equal Partners:African-American Fathers and Systems of Health Care 28. Johnson Family - Love Across the Generations: Grandmothers Caring for Grandchildren 29. Families with Multi-Problems 30. I Love Somebody:For Parents With Special Needs 31. Caring for Infants Exposed to Crack/Cocaine and Other Drugs 32. Special Delivery: Understanding Your Premature Infant 33. NICU Staff Development:Premie Development: An Overview 34. Your Baby Has Down Syndrome 35. New Parent Video 36. Hearing Development and Hearing Loss:Birth to Three Years 37. Hearing Aid Management Skills for Families of Young Children Who Are Deaf or Hard of Hearing 38. Sign With Me 39. Functional Vision:Learning to Look 40. Can Do! 41. The Newborn, the Family, and the Dance 42. The Nature of Human Attachment in Infancy 43. Comforting Your Fussy Baby 44. Tips for Positive Parenting 45. Managing Your Child's Behavior 46. Cognitive Development 47. Touchpoints 48. Exploring First Feelings 49. Emotional Development 50. Motor Development 51. Positioning for Infants and Young Children with Motor Problems 52. Children With Motor Impairments 53. Pediatric Massage for Children with Special Needs 54. Nurturing Touch:Instruction in the Art of Infant Massage 55. Potty Learning for Children Who Experience Delays 56. Feeding Infants and Young Children with Special Needs 57. Feeding With Love and Good Sense 58. Nutrition for Infants and Toddlers with Special Needs 59. Feeding and Swallowing 60. And You Thought They Were Just Playing:Transdisciplinary Play-Based Assessment 61. Learning Through Play:Strategies for Infants 62. Circle of Friends: Developing Friendships for Children with Challenging Needs 63. Language Development 64. Early Uses of Total Communication 65. Communication with Preverbal Infants and Young Children 66. Speech and Language Delays:What Do They Mean for Your Child? 67. We All Belong:Multicultural Child Care That Works 68. Can I Play Too? 69. Early Childhood At Its Best 70. Yes, You Can Do It!Caring for Infants and Toddlers With Disabilities in Family Child Care 71. Access for All:Integrating Deaf, Hard of Hearing, and Hearing Preschoolers 72. Recipe for Success:Creating Inclusive Educational Partnerships for Young Children 73. Regular Lives 74. A Village of Kindness:All for One and One for All 75. Opening Doors to ALL Children:Providing Inclusive Child Care 76. Interdisciplinary Teamwork:A Team in Name Only/Becoming and Effective Team 77. A Child First:Families as a Guide for Respite Providers 78. Preparing Paraprofessional Early Interventionists:Infant Parent Interaction Activities 79. A Credo for Support 80. Celebrate Living 81. Floor Time:Tuning In To Each Child 82. I Am Your Child:The First Years Last Forever 83. Stanley Greenspan Video 84. ABC New Primetime Live: From the Beginning 85. CESA #10 Child Development Days Model (1992) 86. Picture of Health: Parent's Guide to an Autism Diagnosis (1998) 87. Parenthood in America (Audio recordings of seminars) 88. Dreams SPOKEN Here(Two videos on teaching deaf children to listen and to speak) 89. Being a Kid 90. One of the Family 91. Families, Friends, Futures 92. Activity-Based InterventionVideo & Book 93. A Three-Way Conversation 94. Gone through any changes lately? 95. Ketogenic Diet(A Treatment For Pediatric Epilepsy) 96. SOY TU HIJOLos Primeros Anos Marcan Para Siempre-solo espanol 97. Early Identification of Autism: An Interview with Tina Iyana, M.D. 98. The Chicago Longitudinal Study: Linda Tuchman, Ph.D.interviews Arthur Reynolds, Ph.D., about the Chicago Longitudinal Study. 99. Just Being KIDS (Facilitator's Guide to Accompany the Video) 100.Sound and Fury (A Film About the Communication Issues of the Deaf) 101.Smart Beginnings (Every Child deserves a Smart Beginning) 102.Project Craft (Culturally Responsive and Family Focused Training) 103.DEC Recommended Practices Video:Selected Strategies for Teaching Young Children with Special 104.Conversations for Three (CommunicatingThrough Interpreters) 2nd Choice Video: 1. Because the First Three Years Build a Lifetime:A Four Video Set 2. Family and the IFSP Process:Training in Family-Centered Approach 3. IFSP 4. A Family's Guide to the Individualized Family Service Plan 5. Family Focused Interview 6. Pathways for Early Intervention Service Coordination 7. First Years Together:Involving Parents in Infant Assessment 8. Family-Guided Activity-Based Intervention for Infants and Toddlers 9. Home-Based Early Intervention 10. Family-Centered Home Health Services for Young Children 11. Parents & Professionals:Partners in Co-Service Coordination 12. A New Beginning:Meeting the Special Needs of Children 13. Transition:A Time for Growth 14. Family-Centered Care:Short Version 15. Special Kids, Special Dads:Fathers of Children with Disabilities 16. Siblings 17. Parent to Parent 18. Parent Support Groups 19. Lost Dreams and Hopes:Parents' Concerns 20. Sharing Sensitive Information with Families 21. Telling Your Family Story:Parents as Presenters 22. Family Album 23. Reaching the Family: Cultural Competence for Programs 24. Serving the Family: Special Education Cultural Competence Staff Training 25. Culturally Diverse Families 26. Our Children, Our Hopes 27. Equal Partners:African-American Fathers and Systems of Health Care 28. Johnson Family - Love Across the Generations: Grandmothers Caring for Grandchildren 29. Families with Multi-Problems 30. I Love Somebody:For Parents With Special Needs 31. Caring for Infants Exposed to Crack/Cocaine and Other Drugs 32. Special Delivery: Understanding Your Premature Infant 33. NICU Staff Development:Premie Development: An Overview 34. Your Baby Has Down Syndrome 35. New Parent Video 36. Hearing Development and Hearing Loss:Birth to Three Years 37. Hearing Aid Management Skills for Families of Young Children Who Are Deaf or Hard of Hearing 38. Sign With Me 39. Functional Vision:Learning to Look 40. Can Do! 41. The Newborn, the Family, and the Dance 42. The Nature of Human Attachment in Infancy 43. Comforting Your Fussy Baby 44. Tips for Positive Parenting 45. Managing Your Child's Behavior 46. Cognitive Development 47. Touchpoints 48. Exploring First Feelings 49. Emotional Development 50. Motor Development 51. Positioning for Infants and Young Children with Motor Problems 52. Children With Motor Impairments 53. Pediatric Massage for Children with Special Needs 54. Nurturing Touch:Instruction in the Art of Infant Massage 55. Potty Learning for Children Who Experience Delays 56. Feeding Infants and Young Children with Special Needs 57. Feeding With Love and Good Sense 58. Nutrition for Infants and Toddlers with Special Needs 59. Feeding and Swallowing 60. And You Thought They Were Just Playing:Transdisciplinary Play-Based Assessment 61. Learning Through Play:Strategies for Infants 62. Circle of Friends: Developing Friendships for Children with Challenging Needs 63. Language Development 64. Early Uses of Total Communication 65. Communication with Preverbal Infants and Young Children 66. Speech and Language Delays:What Do They Mean for Your Child? 67. We All Belong:Multicultural Child Care That Works 68. Can I Play Too? 69. Early Childhood At Its Best 70. Yes, You Can Do It!Caring for Infants and Toddlers With Disabilities in Family Child Care 71. Access for All:Integrating Deaf, Hard of Hearing, and Hearing Preschoolers 72. Recipe for Success:Creating Inclusive Educational Partnerships for Young Children 73. Regular Lives 74. A Village of Kindness:All for One and One for All 75. Opening Doors to ALL Children:Providing Inclusive Child Care 76. Interdisciplinary Teamwork:A Team in Name Only/Becoming and Effective Team 77. A Child First:Families as a Guide for Respite Providers 78. Preparing Paraprofessional Early Interventionists:Infant Parent Interaction Activities 79. A Credo for Support 80. Celebrate Living 81. Floor Time:Tuning In To Each Child 82. I Am Your Child:The First Years Last Forever 83. Stanley Greenspan Video 84. ABC New Primetime Live: From the Beginning 85. CESA #10 Child Development Days Model (1992) 86. Picture of Health: Parent's Guide to an Autism Diagnosis (1998) 87. Parenthood in America (Audio recordings of seminars) 88. Dreams SPOKEN Here(Two videos on teaching deaf children to listen and to speak) 89. Being a Kid 90. One of the Family 91. Families, Friends, Futures 92. Activity-Based InterventionVideo & Book 93. A Three-Way Conversation 94. Gone through any changes lately? 95. Ketogenic Diet(A Treatment For Pediatric Epilepsy) 96. SOY TU HIJOLos Primeros Anos Marcan Para Siempre-solo espanol 97. Early Identification of Autism: An Interview with Tina Iyana, M.D. 98. The Chicago Longitudinal Study: Linda Tuchman, Ph.D.interviews Arthur Reynolds, Ph.D., about the Chicago Longitudinal Study. 99. Just Being KIDS (Facilitator's Guide to Accompany the Video) 100.Sound and Fury (A Film About the Communication Issues of the Deaf) 101.Smart Beginnings (Every Child deserves a Smart Beginning) 102.Project Craft (Culturally Responsive and Family Focused Training) 103.DEC Recommended Practices Video:Selected Strategies for Teaching Young Children with Special 104.Conversations for Three (CommunicatingThrough Interpreters) Alternate Video: 1. Because the First Three Years Build a Lifetime:A Four Video Set 2. Family and the IFSP Process:Training in Family-Centered Approach 3. IFSP 4. A Family's Guide to the Individualized Family Service Plan 5. Family Focused Interview 6. Pathways for Early Intervention Service Coordination 7. First Years Together:Involving Parents in Infant Assessment 8. Family-Guided Activity-Based Intervention for Infants and Toddlers 9. Home-Based Early Intervention 10. Family-Centered Home Health Services for Young Children 11. Parents & Professionals:Partners in Co-Service Coordination 12. A New Beginning:Meeting the Special Needs of Children 13. Transition:A Time for Growth 14. Family-Centered Care:Short Version 15. Special Kids, Special Dads:Fathers of Children with Disabilities 16. Siblings 17. Parent to Parent 18. Parent Support Groups 19. Lost Dreams and Hopes:Parents' Concerns 20. Sharing Sensitive Information with Families 21. Telling Your Family Story:Parents as Presenters 22. Family Album 23. Reaching the Family: Cultural Competence for Programs 24. Serving the Family: Special Education Cultural Competence Staff Training 25. Culturally Diverse Families 26. Our Children, Our Hopes 27. Equal Partners:African-American Fathers and Systems of Health Care 28. Johnson Family - Love Across the Generations: Grandmothers Caring for Grandchildren 29. Families with Multi-Problems 30. I Love Somebody:For Parents With Special Needs 31. Caring for Infants Exposed to Crack/Cocaine and Other Drugs 32. Special Delivery: Understanding Your Premature Infant 33. NICU Staff Development:Premie Development: An Overview 34. Your Baby Has Down Syndrome 35. New Parent Video 36. Hearing Development and Hearing Loss:Birth to Three Years 37. Hearing Aid Management Skills for Families of Young Children Who Are Deaf or Hard of Hearing 38. Sign With Me 39. Functional Vision:Learning to Look 40. Can Do! 41. The Newborn, the Family, and the Dance 42. The Nature of Human Attachment in Infancy 43. Comforting Your Fussy Baby 44. Tips for Positive Parenting 45. Managing Your Child's Behavior 46. Cognitive Development 47. Touchpoints 48. Exploring First Feelings 49. Emotional Development 50. Motor Development 51. Positioning for Infants and Young Children with Motor Problems 52. Children With Motor Impairments 53. Pediatric Massage for Children with Special Needs 54. Nurturing Touch:Instruction in the Art of Infant Massage 55. Potty Learning for Children Who Experience Delays 56. Feeding Infants and Young Children with Special Needs 57. Feeding With Love and Good Sense 58. Nutrition for Infants and Toddlers with Special Needs 59. Feeding and Swallowing 60. And You Thought They Were Just Playing:Transdisciplinary Play-Based Assessment 61. Learning Through Play:Strategies for Infants 62. Circle of Friends: Developing Friendships for Children with Challenging Needs 63. Language Development 64. Early Uses of Total Communication 65. Communication with Preverbal Infants and Young Children 66. Speech and Language Delays:What Do They Mean for Your Child? 67. We All Belong:Multicultural Child Care That Works 68. Can I Play Too? 69. Early Childhood At Its Best 70. Yes, You Can Do It!Caring for Infants and Toddlers With Disabilities in Family Child Care 71. Access for All:Integrating Deaf, Hard of Hearing, and Hearing Preschoolers 72. Recipe for Success:Creating Inclusive Educational Partnerships for Young Children 73. Regular Lives 74. A Village of Kindness:All for One and One for All 75. Opening Doors to ALL Children:Providing Inclusive Child Care 76. Interdisciplinary Teamwork:A Team in Name Only/Becoming and Effective Team 77. A Child First:Families as a Guide for Respite Providers 78. Preparing Paraprofessional Early Interventionists:Infant Parent Interaction Activities 79. A Credo for Support 80. Celebrate Living 81. Floor Time:Tuning In To Each Child 82. I Am Your Child:The First Years Last Forever 83. Stanley Greenspan Video 84. ABC New Primetime Live: From the Beginning 85. CESA #10 Child Development Days Model (1992) 86. Picture of Health: Parent's Guide to an Autism Diagnosis (1998) 87. Parenthood in America (Audio recordings of seminars) 88. Dreams SPOKEN Here(Two videos on teaching deaf children to listen and to speak) 89. Being a Kid 90. One of the Family 91. Families, Friends, Futures 92. Activity-Based InterventionVideo & Book 93. A Three-Way Conversation 94. Gone through any changes lately? 95. Ketogenic Diet(A Treatment For Pediatric Epilepsy) 96. SOY TU HIJOLos Primeros Anos Marcan Para Siempre-solo espanol 97. Early Identification of Autism: An Interview with Tina Iyana, M.D. 98. The Chicago Longitudinal Study: Linda Tuchman, Ph.D.interviews Arthur Reynolds, Ph.D., about the Chicago Longitudinal Study. 99. Just Being KIDS (Facilitator's Guide to Accompany the Video) 100.Sound and Fury (A Film About the Communication Issues of the Deaf) 101.Smart Beginnings (Every Child deserves a Smart Beginning) 102.Project Craft (Culturally Responsive and Family Focused Training) 103.DEC Recommended Practices Video:Selected Strategies for Teaching Young Children with Special 104.Conversations for Three (CommunicatingThrough Interpreters) Please remember that these videotape(s) are due back to us by the last day of the month in which you have borrowed them. Thanks! If you are unable to use this order form, please e-mail shaw@waisman.wisc.edu In addition, feel free to print out this form, fill in the appropriate information by hand and mail it to: WPDP Waisman Center-Room A109 1500 Highland Ave Madison, WI 53705