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.