Need
Professionals feel pressure from families or other professionals to provide more direct, hands-on therapy than they currently provide. The Routines-Based Model actually promotes hands-on only for demonstration. How do we explain this?
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- Children benefit from the most intervention they can receive.
- Who’s available to provide this intervention? Not weekly visitors. Instead, regular caregivers (e.g., adults in the family, teachers).
- Professionals therefore spend their precious weekly visits empowering caregivers with techniques they have acquired through their specialized training.
- The more professionals that families work with, the lower their family quality of life, so we use a primary service provider.
- We change primary service provider only when absolutely necessary (research shows the longer a family works with a provider, the more family centered the family perceives the service to be).
- When the primary service provider needs help, he or she gets help from team members with the relevant expertise.
- The primary service provider attends to all the child’s needs and the family’s needs, ensuring nothing falls between the cracks like it does in traditional multidisciplinary service delivery (different professionals visiting the caregiver regularly).
- We don’t pile on services to address each need. We add joint home visits (“consults”) when primary service providers and caregivers have questions needing extra expertise.
- Professionals use collaborative consultation to fit their expertise into caregivers’ routines; they don’t push their methods into caregivers’ lives.
- Caregivers now have the capacity to provide intervention to children throughout their awake time all through the week, so, children receive maximal learning opportunities.
- Increasing direct, hands-on therapy would not necessarily increase this intervention time; in fact, it would decrease it, because the family would think intervention occurred one hour a week instead of the 98 hours a week when they or other natural caregivers are with the child.
- We use this primary service provider, functional, family-centered approach because a professional should attend to the whole child and family in naturally occurring routines in life.
- Caregivers
now have the capacity to provide intervention to children throughout their
awake time all through the week, so, children receive maximal learning
opportunities.
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