Tuesday, July 9, 2013

After the RBI: Actual Intervention


A colleague told me recently that my models were good for needs assessment but professioanals needed to know what to do during actual intervention. Ouch. The Routines-Based Interview (RBI) has become well known and implemented, but people stop there. They don’t go on to finish the book, so to speak. Here, I explain that it’s what happens after the RBI that’s really important—and that intervention is a huge part of my models, Routines-Based Early Intervention (RBEI) and the Engagement Classroom.


The RBEI model (confusingly close to “RBI”) consists of five components: understanding the family ecology (ecomap development), family-centered needs assessment (RBI), integrated service delivery (primary service provider), support-based home visits (family consultation), and collaborative consultation to child care (individualized within routines). The ecomap and the RBI often go together. To master these is to master finding out what families’ real priorities are for their children and themselves, based on an in-depth exploration of functioning in everyday contexts. The result is a long list of goals designed to increase children’s meaning participation in their routines and to meet family-level needs. But that’s it. And yet that is the springboard for effective interventions. Therefore, in my way of thinking, the RBI is necessary but not sufficient. It is very hard, for example, to use good family consultation, also known as coaching, if you don’t have meaningful, functional things to discuss with the child’s caregivers such as parents and teachers. The RBI sets the stage and was always designed for that purpose; see the original book (now out of print, so good luck), Family-Centered Intervention Planning.
What the RBEI model has to offer after the RBI is a method for organizing service delivery (the primary service provider), a method for conducting home visits (family consultation), and a method for visiting children in their group-care settings (collaborative consultation). These methods are well articulated, they come with supporting materials (e.g., checklists), and they are being successfully implemented in numerous places around the world.

Engagement Classroom

The Engagement Classroom model is a package of practices also but for the running of a classroom. It doesn’t cover all the things a teacher has to consider. For example, it is designed to be used with almost any curriculum and with almost any developmentally appropriate approach. (Although currently I’m inspired by its application with the Reggio Emilia approach.) The Engagement Classroom model features (a) inclusion, (b) incidental teaching, (c) integrated specialized services, (d) functional needs assessment (i.e., the RBI), (e) the zone defense schedule, and (f) engagement data collection. Again, the purposes of the RBI in this model are to assess functional needs by looking at child behaviors in everyday contexts of the classroom (and home) and to produce a set of family-chosen goals pertaining to those needs. Once we have those goals, incidental teaching and integrated services (i.e., therapists and itinerant early childhood special educators) occur meaningfully. Everybody is on the same page, and the focus is on function—engagement, independence, and social relationships (EISR) in the routines of the child’s school day (and home time). The classroom has some organizational features to promote this functioning, such as children of all abilities, the organization of adults, and the organization of classroom space. Adults are trained to focus on EISR.

Price of Success

The success of the RBI has improved the development of intervention plans and has give professionals a tool for working closely with families in that process. The popularity of the interview has overshadowed the other parts of the RBEI and Engagement Classroom models, or perhaps mastery of the first course (i.e., the RBI) has been so filling that the main course has been forgotten about. The metaphor stops there, because a first course is optional, whereas we have found the RBI to be almost a prerequisite to the intervention parts of the models.


Mary said...

Now this is a "summer vacation" I'd love to experience: meet with people from a different culture and discuss supporting families! I'm so very jealous!!
In addition to what you wrote, I'd add that during the RBI you also gain a lot of information about what/when/ and how the family has intervened in the past, how they felt it went with regard to the outcome they had in mind, but most importantly, how they felt about the whole process. I learn a bit about how the family works together. It's a great time to articulate both why whatever they did was intuitive, supportive or beneficial for their child, but also that you honor them for their efforts. We learn (in another way, without directly asking them) what is valued by the family, skills the parents already have (eg breaking down tasks, their ability to sustain efforts, to manage daily life....)and more about who they are as individuals as well as their respective relationships with the child. I often find that intervention begins the second I walk through the door, because there is often something happening in the first few minutes that is "so right" I have to tell the parent why I'm struck by what I just saw.

Jessica M said...

I would agree with your insight of what's happening in Early Intervention. The RBI is completed and people are getting pretty good at it, but then what happening next....