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When you conduct a Routines-Based Interview with a family
having two children in early intervention, you conduct one interview but end up
with two plans. Here, I talk about the implications of having two children in
the program for conducting the ecomap; asking about routines; the time, worry,
and change questions; the recap; and goal decision making.
Ecomap
Who lives in the home, informal supports, and intermediate
supports are largely unaffected by the number of children in early intervention
in the family. Some formal supports might, however, pertain to one child only,
in which case that should be indicated on the relevant box. One strategy is to put
the initial of the child in question somewhere in the box. For example, maybe
only one child receives speech-language services (by which we mean, the family
and the primary service provider receive consultation from an SLP!). You create
a box for that service and, perhaps, the therapist’s name and write in the
child’s initial.
Routines
When we interview the family about children’s functioning in
routines, we constantly check in with what each child’s engagement,
independence, and social relationships are like. If the parent reports “they”
do something, you might double-check that they both do it the same way. Not
every time. If the parent has already established that they do a number of things
the same way, you can often assume “they” really means both of them.
Notes
When the parent reports that one of them does not do something
the other does do, use a clearly visible initial and draw the star. By this
time, we’re really hoping they have different initials! Not Joshua and Jason!
But you can go to the first and second letters, if you’re that unlucky. The
clearly visible initial will become important for the recap and goal decision
making. Generally, I would not draw a line down the paper, with one column for
one child and one for the other child. The flow of the recap will go better if
you intermingle the children. If you are interviewing and taking notes, it
becomes burdensome to make two sets of notes. Ultimately, however, it is your
decision. Ensure you keep the conversation on the routine and what the children
and other family members are doing.
TWC Questions
The time question is rarely about the children, although,
occasionally, a parent will say he or she wants more time with a child—one of
the siblings in early intervention or perhaps another sibling altogether. The
worry and change questions might be about one child only, in which case that
would be treated the same as in the notes for the routines conversation, with
an initial.
Recap
We still want the recap to fall in the 5- to 7-minute
window. Much beyond that, and it’s hard to keep paying attention. The recap
mentions what the children are not
yet doing or what one or the other is
not yet doing. This is why the designation of which child is related to a
star/concern in the notes needs to be clear, so the recap can proceed smoothly.
Goal Decision Making
You need two sheets of paper or two columns for the informal
goals the family decides upon. Some child goals will be shared, so they will go
on both pieces of paper. For example, if the parent says, “I want them to use a
cup with a spout,” you would write use a
cup with a spout on both pieces of paper. Later, when it is time to decide
on criteria for progress monitoring and attainment, those criteria might be
different. One child might have more delays than the other, for example. Some
child goals will be idiosyncratic, so they will go on only the piece of paper
pertaining to that child. Family goals will go on both pieces of paper. For example,
if the parent says I want time for myself—two hours once a week in the evening—that
would go on both pieces of paper.
What about the ideal of having 10-12 goals? We count up all
the shared goals (each shared goal counting as one goal) and add the
idiosyncratic goals, aiming for a total of 10-12. After all, it’s one family
addressing these goals, and the strategies for shared goals might be different
for the two children.
Families love the fact that the Routines-Based Model,
including the RBI, recognizes that parents of more than one child have multiple
responsibilities. This sensitivity begins with the RBI, where we combine
questions, until we have to separate plans. Each child has to have an
individual plan, but the procedures described here integrate the needs
assessment and intervention planning as much as possible.
