Sunday, December 5, 2010

RBI With Recent NICU Graduates

Question: I work specifically with families that have babies coming out of the NICU. They most times are eligible based on an established condition due to being “at risk” for developmental delay. They don’t always have delays or the family doesn’t have concerns. In talking about our program at the initial visit we emphasize supporting them in their daily activities and routines, however during the interview everything is fine. This often results in a struggle to develop IFSP outcomes. I will say when there are clear concerns and issues it is much easier to develop routines based outcomes.

Answer: The two important things to remember are that this is a plan for the family, not just the child, and that it’s about what child skills come next. So, as you’re going through the day, make sure the interviewer is asking the parent about what would make that time of day easier or better for him or her, what the parent’s hours from Hell are, and what things the parent would like to be doing that he or she hasn’t been able to figure out. When asking about child engagement, independence, and social relationships, find out what the child is currently doing of course, which will be quite rudimentary for a child just out of the NICU. The questions then aren’t about what the child isn’t doing but what he or she will do next. This requires interviewers really to know their infant development. As options for what the child will learn to do in each routine get listed, they should be starred on the notes. As you know, these are then recapped, and the family is prompted to pick them as outcomes, if necessary. Between desires for what the parent wants to be doing and the myriad things the infant will learn to do, you should end up with a pretty meaty IFSP.

If you haven’t seen these books, they might be of interest: Working With Families of Young Children With Special Needs and Routines-Based Early Intervention. They both have chapters on the RBI.


linda sullivan said...

I am involved in an early childhood inclusion committee in Rochester NY. We are working with our Early Intervention program toward exploring ways to develop integrated developmental groups for toddlers who typically received services at home. We recognize the importance of natural environments as well as the value of exposure to typical peers. Our Early Intervention program feel strongly that there need to be more options for families. We are finding that the reimbursement rates in NY do not support this type of program. We are currently in the process of developing a draft (white paper) justifying the need for such groups. Any thoughts or suggestions you might have would be greatly appreciated.

sample said...

Yes, I totally agree with this. The parents are the first ones to have good skills. They should be mature enough to teach there child ..thanks for this valuable answer!!

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