tlc competency session2jeffline.tju.edu/cfsrp/tlc/pdfs/tlc_competency_session2.pdf ·...

1/10/2011

1

TLC Transdisciplinary Interventions 2010‐2011

Child Interventions

• Define and describe transdisciplinaryinterventions

Outcomes for the TransdisciplinaryInterventions Competency

interventions • Identify the goal of various types of child

interventions• Describe adaptation and assistive

technology interventionsP t hild’ ti i ti d l i i


• Promote child’s participation and learning in family-selected activities and routines in family’s natural environments;

1/10/2011

2

CUSTOM Specialized, Individualized

Levels of Intervention

DIFFERENTIATED

Needed for Some but not all Children

UNIVERSAL Used with ALL


Used with ALL Infants

&Toddlers

Two Categories of Child Interventions

Directed to the Child by Another person

Adaptations/AT Directed to the EnvironmentAnother person

(e.g., caregiver, another adult-provider, child, sibling)

to the Environment


1/10/2011

3

To help caregivers “fix”

Use Adaptations and Assistive Technology

To help caregivers fix activities and routines that are going poorly

To provide opportunities for l i d ti i ti


new learning and participation in activities and routines that are going well.


1/10/2011

4



1/10/2011

5

• Environmental Accommodations• Adapt Room Set‐Up

Facilitating Children’s Participation and Learning/Adaptation Hierarchy

• Adapt/Select Child Equipment• Equipment/Adaptations for Positioning• Adapt Schedule (e.g., change the time of the activity/routine)• Select or Adapt Activity (e.g., change the steps in the activity/routine• Adapt Materials (e.g., use AT)• Adapt Requirements or Instructions (e g change


Adapt Requirements or Instructions (e.g., change expectations for a child’s response) ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐From Campbell, P., Milbourne, S., & Wilcox, M. (2008). Adaptation interventions to promote

participation in natural settings. Infants and Young Children, 21,(2), 94‐106.

Continuum:Adaptations to Activities and Routines

An activity or routine may be adapted to accommodate special needs. For example:

dd d • Add periodic movement activities to a story time activity to help children who have difficulty paying attention.

• Do the initial pieces of a routine for a child & let them do the end parts – e.g., dress a child up to the point of pulling up long pants


• Start dinner earlier for a child who needs longer to eat than the rest of the family.

• Allow a child to “walk” to mealtimes by being a duck so that the child is on task

1/10/2011

6


11

Continuum:

Adaptations to the Environment

• Adaptations to the environment change the setting. F l :For example:

• Rearrange the furniture in the room so that a child in a wheelchair can move about freely.

• Adapt or add equipment (e.g.,use a slant board to help a child participate in coloring

i i i d


activities, use wedge to provide supportive seating during circle activities).

1/10/2011

7


Continuum:

Adaptations to MaterialsMaterials used in an activity or routine, when adapted,

may help a child participate. For example:y p p p p• Make the pencil thicker by putting a foam curler

around it or by wrapping the pencil with play dough or silly putty to help a child who has problems gripping pencils/crayons.

• Use assistive technology—as in the case of using


as n the case of us ng a simple switch interface to help a child with motor difficulties activate a toy.

1/10/2011

8



1/10/2011

9


Continuum:

Requirements and InstructionChanging the requirements of an activity or a routine, or

the way you provide instruction for them can enable a the way you provide instruction for them, can enable a child to participate. For example:

• Use photographs to show each step rather than simply speaking the instructions.

• Reduce the number of steps a child is expected


steps a child is expected to perform to change requirements.

1/10/2011

10

TLC Transdisciplinary Interventions 2010‐2011http://www.challengingbehavior.org/do/resources/teaching_tools/ttyc.htm

Beginning view of Turn over picture as Hand the child the picture of

Circle Time Sequence

Beginning view ofcircle mini schedule

Turn over picture as activities are completed

Hand the child the picture of the next place to go


Lentini, R., Vaughn, B. J., & Fox, L. (2005). Teaching Tools for Young Children with Challenging Behavior. Tampa, Florida: University of South Florida, Early Intervention Positive Behavior Support.

http://www.challengingbehavior.org/do/resources/teaching_tools/ttyc.htm

1/10/2011

11

Hand Washing Sequence


Adaptations/AT Planning & Brainstorming

Environmental Modifications (Room, Child Equipment)

Equipment for Positioning

Adapt/Modify Schedule

What’s happening now?

What would you like to see happen?

Adapt ActivityAdapt Materials

Adapt RequirementsExpected Outcome


1/10/2011

12

Use a Functional Assessment Planning Process

• Ecological Inventory • Partial Participation Process• Functional Assessment Activity Analysis


• Activity Analysis

Context of Learning & Participation

Physical Environmental Settings • Physical Environmental Settings –– House

• Subsetting(s)

• Activities/routines• Steps in Activities/routines


p• Opportunities to use or embed AT or other interventions

1/10/2011

13

Activity Analysis/Functional Assessment

What are the Steps? What Adaptations Might Help?

What Might the Child Be Able to do Fully Independently Eventually?

What Strategies Can Be Used to Promote Independence?

Go to reading area Gait trainer so she can get there independently

Walk to book area with walker

Select book Place books that she likes Get up and down from walker up high enough so that she can reach them from standing

p f mso she can select books that are placed on lower shelves

Reach and grasp book Place books in upright position so that she can grasp them with two hands

Reach and grasp book with one hand

Bring book close enough to her so that she can turn pagesTurn pages of book

Books with thick (cardboard pages); Velcro on book with page turner

May be able to turn pages independently

Look at pictures; Follow Adult can ask her to


Look at pictures; Follow story

Adult can ask her to name pictures or answer questions

Put book away and go to next activity area

Use gait trainer to move to bookcase; leave area

Example of CCIP for Activity not Going WellActivity/Routine: Playing at the Neighbors Location: Neighbor’s house

Is this activity/routine going well: NO

What is the current situation? Max grabs toys from his friend Sam, or Max will cry and use gestures to see if he can get what he wants. Once he starts crying we have to leave because he cannot calm down. Max is not using any words at the neighbors, but at home he uses some words and signs such as mama, more dada, eat, and all doneWhat outcome is addressed in this activity/routine? Max will participate in play with Sam when we are at the neighbors by using his words to ask for a toy or turn for at least 15 minutes with less than 2 crying episodes.

ACTIVITY/ROUTINE PROBLEM ADAPTATIONS WHAT THE CAREGIVER WILL DO TO TARGETED CHILD STEPS (Y/N) TEACH HIS/HER CHILD COMMUNICATION

BEHAVIOR

Getting ready to go to neighbor’s house and walking across the street

No 1. Picture story of sequence including entering the playroom with his friend (Sam)choosing and naming a toy

2. Change the schedule so that Sam is NOT already playing when Max arrives

3. Pictures of toys that

Go over the picture story sequence with Max.Take the picture story to the neighbors

Max will look at picturecards and listen

Going into the house No

Entering the family room where neighbor child is playing

Yes Review picture story again with Max and Sam

Max and Sam walk into the playroom together

Choosing a toy to play with Yes Say the word for favored toys (e.g., ball, car) and ask Max to say the word

Max makes a toy choice using the picture story


are available; Have a limited number of toys (no new or special ones) but two of the most favored items

4. Have duplicate toys for favored items

5. Picture card with “my turn” picture

6. Adults stay and visit in the playroom

and attempts word production

Playing alongside the neighbor child, each with own toy

Yes Remind Max of the toy namesI play alongside the children for a short time, producing the picture story to remind Max of his selections to avoid a possible problem.

Play with a toy that Max has chosen and not grab Sam’s toy

Asking neighbor child for a turn with a toy

Yes WithMax, hold the picture toward Sam and say “my turn” and have the neighbor caregiver help Sam give the toy to Max.

Allow hand over hand with the picture card, and attempt to say “my turn”

1/10/2011

14

A Planning & Documentation Web

• Represents multiple activity/routine categoriescategories

• Plans for generalization to occur to planned activities

• And/or documents where generalization has occurred

• Allows for estimating the number of


• Allows for estimating the number of opportunities that will be provided per day


1/10/2011

15

ROUTINE/ACTIVITY

Expect

ed #

Learn

ing

Opport

unit

i

Ord

er

of

Imple

menta

tion

Date

Im

ple

mente

d

What Will Adult Do?

BATHTIME 15 5Hold our washcloth and toys for PG to

reach towards when seated in bath seat

MORNING ROUTINE (getting up, getting dressed, etc.)

0

BEDTIME (getting ready for bed, going to bed sleeping)

20 1 4/22/08

Create opportunities to: reach toward: books to choose, pictures in books, pictures when named, pictures for

going to bed, sleeping)/ / p , p

comprehension; to turn pages; grasp or bat page turners

MEALTIMES (appetite, level of assistance)

15 2 4/30/08Create opportunities to reach toward

spoon, desired food, cup, etc. PLAYTIME (Indoor Play) 0

STORY TIME 10 3 5/12/08

Create opportunities to: reach toward: books to choose, pictures in books, pictures when named, pictures for

comprehension; to turn pages; grasp or bat page turners

OUTDOOR PLAY (riding a bike, playing outside, playing on playground equipment, swimming)

0

AT HOME CHORES (cleaning, preparing meals, watching TV, caring for pets, etc.)

0

Create opportunities to reach toward


LEAVING THE HOUSE 5 4Create opportunities to reach toward coat, hat and then assist in putting

on; to caregiver to be picked upTRAVEL TIME (riding in a car, bus; walking, etc.)

0

RUNNING ERRANDS (grocery store, mall/store shopping, banking, wash/cleaners)

0

OUTINGS (visit a friend/relative, eat at a restaurant/fast food, go to museums, amusement parks, zoo)

10

Create opportunities for reaching that match context – reach toward

animals, reach toward ---- or reach toward and touch

TOTAL75

Teach child interventions to caregivers

Pl nn d T chin ith Pr ctic Planned Teaching with Practice (Caregiver practice with provider feedback)Planned Teaching without Practice Discussion


Problem-Oriented ReflectionDemonstration with Narrative

1/10/2011

16

What Have You Learned?


tlc competency session2jeffline.tju.edu/cfsrp/tlc/pdfs/tlc_competency_session2.pdf ·...

Documents