Real Alignment

Real Alignment: Routines-Based Model and DEC Recommended Practices

Practices in the Routines-Based Model are directly aligned with just over half (53%) of the 2014 DEC Recommended Practices. They are indirectly aligned with a further quarter (26%) of the Recommended Practices. This model, therefore, is a useful vehicle for implementing most of the Recommended Practices.

The Routines-Based Model (RBM) is a way of providing early intervention and early childhood special education, focusing on naturally occurring routines, on family strengths, and on children’s engagement. Some of its well-known components are the Routines-Based Interview (RBI), the ecomap, the primary service provider, support-based home visits, collaborative consultation or integrated therapy, incidental teaching, and the zone defense schedule. The model provides guidance on both home- and classroom-based service delivery, serving children birth to 6 years of age and their families.

The DEC Recommended Practices (Division for Early Childhood, 2014) were developed to provide guidance to practitioners and families about the most effective ways to improve the learning outcomes and promote the development of young children, birth through five years of age, who have or are at-risk (sic) for developmental delays or disabilities. (p. 2)

My colleagues and I have been developing and refining the RBM since the 1980s, so some practices, such as the RBI, predate DEC Recommended Practices—even the original ones in 1991. All RBM components predate the current (i.e., 2014) Recommended Practices (McWilliam, 2010; McWilliam & Casey, 2008). 

To determine the real alignment, not to be confused with wheel alignment, of the RBM with the Recommended Practices, I determined whether each of the latter was directly addressed by an RBM component, indirectly addressed by the RBM, or not addressed by the RBM. The Recommended Practices, which can be downloaded from http://www.dec-sped.org/recommendedpractices, are organized in eight topic areas.

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 Leadership

Most of the recommended practices in this area are not linked to the RBM, which tends to emphasize practitioner-level practices. But our use of implementation science and our methods for program evaluation are linked to the practice related to collaboration with stakeholders on the collection and use of data (L12). Also, our use of the primary service provider (PSP) is directly linked to promoting the efficient and coordinated service delivery from multiple disciplines (L13). The model is indirectly linked with L3, L6, and L9.

Assessment

The RBM addresses needs assessment for program planning, monitoring child progress, and measuring child outcomes, so it is aligned with all but two of the assessment recommended practices (A1, A8). The major assessment tools in the RBM are the RBI (McWilliam, 2012); the Measure of Engagement, Independence, and Social Relationships (MEISR) (McWilliam & Younggren, in press); the Classroom MEISR (ClaMEISR) (McWilliam, 2014); the Children’s Engagement Questionnaire (McWilliam, 1991); and the STARE (Casey & McWilliam, 2007). All of these are directly linked to working as a team with the family (A2) but less so with other professionals. They are also directly linked to conducting assessments that include all areas of development (A4). The RBI and STARE are directly linked to using a variety of methods including observation and interviews (A6). The RBI, MEISR, and ClaMEISR are directly linked to obtaining information about the child’s skills in daily routines (A7), systematic ongoing assessment (A9), and assessment tools with enough sensitivity to detect child progress (A10). The model is indirectly linked to a further three recommended practices (A3, A5, A11).

Environment

The RBM is linked, mostly indirectly (E2, E4, E5, E6), to all the environment recommended practices. The Engagement Classroom Model, which in a previous form was known as the individualizing inclusion model (Wolery, 1997), along with support-based home visits and participation-based goals, directly addresses services and supports in natural and inclusive environments (E1). Family consultation addresses working with the family and other adults to promote children’s participation (E3).

Family

The RBM is linked to all but one family recommended practice (F8). The RBI and family consultation directly address building trusting and respectful partnerships with the family (F1). Support-based home visits are directly linked to four recommended practices. Along with our mantra that we have an ethical obligation to provide families with evidence-based information, they are directly linked to the practice that says almost exactly that (F2). Through family consultation, support-based home visits are directly linked to supporting family functioning and promoting family confidence and competence (F5). By incorporating the five parenting skills in our model, these home visits are directly linked to engaging the family in opportunities that support parent knowledge and skills (F6). The emotional-support component of the home visits is directly linked to being responsive to the family’s concerns, priorities, and resources (F3). The RBI is directly linked to creating outcomes and goals that address the family’s priorities (F4). The RBM is indirectly linked to two family recommended practices (F9, F10).

Instruction

The RBM is linked, mostly directly, to all the instruction recommended practices. All the assessment tools mentions earlier are directly linked to identifying each child’s strengths, preferences, and interests (INS1). The RBI is directly linked to identifying skills to target for instruction with the family (INS2), and, with incidental teaching, planning for and providing the level of support the child needs to participate in routines (INS4). Incidental teaching is also directly linked to embedding intervention within and across routines (INS5), using systematic instructional strategies to promote child engagement (INS6), and using explicit feedback and consequences (INS7). The STARE and goal attainment scaling are directly linked to gathering and using data to inform decisions (INS3). The focused RBI and our behavior-management strategies are directly linked to using functional assessment and related strategies for challenging behaviors (INS9). Participation-based goals are directly linked to implementing the frequency, intensity, and duration of instruction (INS10). Finally, family consultation is directly linked to using coaching or consultation strategies with primary caregivers (INS13). The RBM is indirectly linked to three instruction recommended practices (INS8, INS11, INS12).

Interaction

The RBM is directly linked, because it includes incidental teaching, to all the interaction recommended practices. With our focus on engagement, it is directly linked to promoting the child’s social development (INT2). Our focus on social relationships, along with incidental teaching, is directly linked to promoting the child’s communication development (INT3).

Teaming and Collaboration

The model is linked also to all the teaming and collaboration recommended practices, although not all directly. The PSP and associated joint home visits are directly linked to representing multiple disciplines (TC1) and working with families as a team to exchange information (TC2). The PSP is also directly linked to identifying one practitioner from the team who serves as the primary liaison (TC5). The RBM is indirectly linked to two other recommended practices (TC3, TC4).

Transition

The RBM is not linked to either of the transition recommended practices.

If the DEC Recommended Practices can be considered the most effective ways to help young children with disabilities and their families (I wish they included families in the outcomes of the practices, not just in the implementation of the practices), this real alignment validates the model. The model has other components that aren’t directly aligned with the recommended practices, and one fifth of the recommended practices aren’t addressed by the model. Nevertheless, the alignment is good enough to say that the RBM can keep early intervention 0-6 on the road and not in the ditch.

References

Casey, A. M., & McWilliam, R. A. (2007). The STARE: Data collection without the scare. Young Exceptional Children, 11, 2-15.

Division for Early Childhood. (2014). DEC recommended practices in early intervention/early childhood special education.   Retrieved February 25, 2015, from http://www.dec-sped.org/recommendedpractices

McWilliam, R. A. (1991). Children's Engagement Questionnaire. University of North Carolina. Chapel Hill, NC.

McWilliam, R. A. (2010). Routines-based early intervention. Baltimore, MD: Brookes Publishing Co.

McWilliam, R. A. (2012). Implementing and preparing for home visits. Topics in Early Childhood Special Education, 31, 224-231. doi: 10.1177/0271121411426488

McWilliam, R. A. (2014). Classroom Measure of Engagement, Independence, and Social Relationships (ClaMEISR). The RAM Group. Nashville, TN.

McWilliam, R. A., & Casey, A. M. (2008). Engagement of every child in the preschool classroom. Baltimore, MD: Paul H. Brookes Co.

McWilliam, R. A., & Younggren, N. (in press). Measure of Engagement, Independence, and Social Relationships. Baltimore, MD: Paul H. Brookes.

Wolery, M. (1997). Individualizing inclusion of young children with disabilities in child care: A model demonstration project. Chapel Hill, NC: U.S. Department of Education.

Award Acknowledgements

DEC has given me an award, which caused me to thank people who have contributed to the perception of success in my career. At the annual DEC conference, during the awards breakfast, each award winner had a 2-minute introduction (gross violated in some cases!) and 2 minutes to reply. I am notorious for sentimentality when I have to say nice things about people I know, so I planned a list poem as my way of obviating any blubbering during my reply:

Acknowledgements in the Form of a List Poem

From FIPP[1], I thank Dunst[2], Trivette[3], Gallant[4], and Cushing[5],
Who became McWilliam after gentle pushing.

From FPG[6], I thank Bailey[7], Buysse[8], Harbin[9], Simeonsson[10], Odom[11], and Wolery[12],
Who got me to Vanderbilt through crafty cajolery.

Also at FPG, de Kruif[13], Raspa[14], Scarborough[15], Harville[16], and Ridley[17]
My team who contributed richly.

From Vanderbilt[18], I thank Wolery[19], Casey[20], Davis[21], and Hemmeter[22]
For whose lucky students she is the progenitor.
Also Vick[23], Sims[24], Ridgley[25], and Snyder[26],
My all-time best statistical guider.

From Siskin[27], I thank Coleman[28], Casey[29], Spurlock[30], and Boavida[31]
Who’s always up for a fajita and margarita.
Also Jenkins[32], Dance[33], and Love[34],
As teammates, my gifts from above.
If I forget the following, I might end up destitute,
So I also thank Siskin Children’s Institute.

Despite my sense of humor being somewhat lavatorial
I’ve been fortunate to have jobs editorial.

I thank Warren[35], Sandall[36], Bruder[37], and Cole[38],
Also Dunlap[39], Wolery[40], Carta[41], and Bruder[42].
I got my start working pretty much daily
With the honest, smart, kind Donald Bailey[43].

From states and countries with whom I’ve worked,
I thank Bairrão[44], Giné[45], Brown[46], and Bainter[47],
Also Munson[48], Fowler[49], Rooks-Ellis[50], and Hankey[51]--
Implementers all, and only tolerably cranky.
Others from abroad to whom I’m a debtor
I’ll mention when I list those who sent in a letter.

From students and interns, I thank Baqués[52] and García[53]
Among the many to whom I say, “Buen dia.”
Also Theuerkrauff[54], Fernández[55], Morales[56], and Martin[57]
Foreigners most, but none with a tartan.

At Lee Ann Jung[58]’s bequest to a letter formulate
Some people were kind enough to exaggerate.
I thank Jung[59] herself, Graham[60], Younggren[61], and Woods[62],
Also the Kiwis[63]: Woodward, Davies, Williams, Houghton, and Bilbe.
Thanks to Aguiar[64], Tamarit[65], Rutland[66], and Cañadas[67],
The Taiwanese Hwang[68], Kang, Lin, Ko, and Chiu[69],
Plus Dunlap[70], Boavida[71], and Bruder[72]. 

Partners in crime whom I see too seldom
Are my coaches Rush[73] and Shelden[74].

 

Special thanks for friendship, support, wisdom, and knowledge, amongst
All these others to whom I’m indebted,
Stand out Bruder[75], Casey[76], Wolery[77], Bailey[78], and Dunst[79].

Finally, my thanks to the one I can never repay
For her steadfast support, I thank PJ[80].

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[1] Family, Infant and Preschool Program, where I worked from 1983 to 1988.

[2] Carl Dunst, who taught me that families were the most important aspect of early intervention, that you had to have data, and that, if you drink too long at an airport bar, you will miss your flight.

[3] Carol Trivette, who showed that loyalty to a mentor (Dunst) was honorable but that you could carve your own way, and who was essentially a contemporary of mine in the Dunst professional family.

[4][4] Kim Gallant was my co-coordinator of Project SUNRISE, an early friend of my daughter Kirsten’s, and a valued colleague in my learning to be a grown-up professional.

[5] PJ Cushing, who took clogging lessons with me, allowed me to fall in love with her and her daughter Kirsten, and who married me and let me adopt Kirsten.

[6] Frank Porter Graham Child Development Institute (Center, while we were there), possibly the most productive center of research, implementation, and training in the field of early childhood—at the great University of North Carolina at Chapel Hill, my twice-over (bachelor’s and doctorate) alma mater. I worked at FPG from 1988 to 2002.

[7] Don Bailey, who hired me to work at FPG, taught me to work as a team member in research, and guided me in how to be a professional in this field.

[8] Virginia Buysse, who was a contemporary of mine in the doctoral program, struck a slightly different but equally valuable path in our field, and remained committed to evidence.

[9] Gloria Harbin, who allowed me to study service “utilization” (should have been “use”), taught me about policy, and wrapped me in uncomfortably loving hugs of huge friendship.

[10] Rune Simeonsson, the son of Swedish missionaries to China and the person who gave me the opportunity to travel overseas (Egypt, Portugal), who showed me that geniuses can survive in early intervention, and who famously said that class discussion was “pooled ignorance.”

[11] Sam Odom, who gave me many opportunities, who worked at UNC twice (he’s still there), and who showed me how one could shape a career in this field.

[12] Mark Wolery, who came to join Bailey and me at FPG, after we’d worked with him on various projects, and who showed that observable, measurable behavior was what we could actually do something about.

[13] Renée de Kruif, a Dutchwoman, graduate student at UNC, who was a brilliant research assistant, unbelievable copyeditor of the Journal of Early Intervention, and longtime friend.

[14] Melissa Raspa, who I first liked because of she’d been a field hockey player, but who subsequently worked closely with me and remained a good friend through the years, especially joining me in trying excellent restaurants.

[15] Anita Scarborough, who coordinate my teaching styles research grant and went on to get her doctorate.

[16] Katie Harville, who was my assistant but who contributed enough to be a co-author on a qualitative study. She also followed me to Vanderbilt for a short time.

[17] Stephanie Maher Ridley, who coordinated my engagement project and eventually returned to FPG.

[18] I worked at Vanderbilt Children’s Hospital as the Chief of the Child Development Division in the Pediatrics Department of the School of Medicine from 2002 to 2008.

[19] Mark Wolery was on the search committee for my position at Vanderbilt. We had breakfast every Friday morning at Noshville.

[20] Amy Casey, who worked with me for 10 enjoyable years, as my research assistant, student, project coordinator, and research colleague. She was my most enduring colleague.

[21] Jacque Davis, who coordinated the IES grant Pat Snyder and I (with Robyn Ridgley) had.

[22] Mary Louise Hemmeter, my fellow award winner, on the faculty at Peabody College and another frequent flyer.

[23] Jennifer Vick, who coordinated the deaf-blind project and was a loyal friend during trying times.

[24] Jessica Rasmussen Sims, who helped Amy Casey and me with various projects. Possibly the ideal research assistant.

[25] Robyn Ridgley, on the faculty at Middle Tennessee State University, and a reliable and smart fellow investigator on the IES grant with Pat Snyder.

[26] Pat Snyder, who joined me at Vanderbilt and continued to collaborate after she moved to the University of Florida. She taught me more about research design and analysis than anyone.

[27] Siskin Children’s Institute, where I have worked since 2008.

[28] Gayle Coleman, who started at Siskin when I did and who directs the Early Learning Center. A real partner in the implementation of the Engagement Classroom Model.

[29] Amy Casey, who was a Research Scientist and beloved by teachers and pretty much everyone else at Siskin.

[30] Lisa Spurlock, an inspired physical therapy assistant, who is one of the best collaborative consultants with teachers I know.

[31] Tânia Boavida, my postdoctoral fellow, who has worked on my models in Portugal and now the U.S. for years. She came from Portugal with her husband and baby to do research with me for 18 months.

[32] Amy Jenkins, who coordinates our Home- and Community-Based Early Intervention Program at Siskin Children’s Institute. So competent, I don’t have to worry about a thing with that program.

[33] Azusa Dance, our research manager, who amazingly keeps up with all my travel plans, keeps the Center for Child and Family Research running, and who fits us in between musical shows in which she stars.

[34] Deidra Love, who is our Early Intervention Behavior Specialist, and who is an exemplary home visitor.

[35] Steve Warren, my predecessor as Editor of the Journal of Early Intervention; I was his Editorial Manager and copyeditor. He taught me how to be an editor.

[36] Susan Sandall, chair of the DEC publications committee when I was JEI editor, and a strong advocate for the journal’s being a voice for research.

[37] Mary Beth Bruder, who was one of my associate editors on JEI.

[38] Kevin Cole, one of my associate editors on JEI.

[39] Glen Dunlap, Editor of Topics in Early Childhood Special Education and one of my associate editors. He writes the best acceptance, revision, and rejection letters I’ve ever read.

[40] Mark Wolery, a former editor of TECSE and JEI, who warned me, “You don’t become an editor to make friends.”

[41] Judy Carta, the editor of TECSE when I was JEI editor; we co-existed so well that we built each other up.

[42] OK, I mentioned Mary Beth Bruder twice in this category because she’s also Editor of Infants & Young Children, whom I help in my role as international editor. She maintains a high standard for this journal and encourages contributions from overseas.

[43] My first job on JEI was with Don Bailey, and I served as the copyeditor and editorial manager. We were never on time, but the issues were fantastic!

[44] Joaquim Bairrão, who first invited me to Porto, beginning my 15-year love affair with Portugal. He had a brilliant mind, a rapier-sharp wit, and a joie de vivre, and we still miss him all the time.

[45] Climent Giné, who is one of the worlds’ foremost authorities on family quality of life for families of people with disabilities, a kind man, and a wise soul.

[46] Cindy Brown, in charge of IDEA services for children 0-5 in Maine, who has a can-do attitude and has installed effective practices in the Pine Tree State.

[47] Sue Bainter, who has led Nebraska’s adoption of the Routines-Based Model, with grace, intelligence, and perseverance.

[48] David Munson, a former principal, who learned all about early intervention to lead his program in Billings, Montana, to become an exemplary implementer of the Routines-Based Model.

[49] Roy Fowler, who helps Maine implement the Routines-Based Model, especially the RBI. We first met in Germany, when he was with EDIS.

[50] Deborah Rooks-Ellis, on the faculty at the University of Maine, who coordinated my involvement with Maine and the RBI bootcamp and subsequent training, while rearing her children covering a vast array of ages.

[51] Cindy Hankey, who has led Nebraska’s adoption of the Routines-Based Model. Note that I said the same about Sue Bainter. They are partners in this effort, with Cindy bringing a delightful Canadian-Minnesotan-Scandinavian sensibility to the partnership.

[52] Natasha Baqués Aguiar, a doctoral student at Ramón Llul University in Barcelona and a former international intern with me, who is the most relentless positive and optimistic person I’ve ever met. She’s also smart and diplomatic.

[53] Pau García Grau, who taught himself English from rock music and movies; he’s a doctoral student at the Catholic University of Valencia and a talented researcher with a huge work ethic—my kind of colleague.

[54] Friederike Theuerkrauff, a former international intern from Germany, who studied integrated therapy and continued the stream of extremely pleasant and smart interns through our center.

[55] Rosa Fernández Valero, also from UCV, who has grasped the Routines-Based Model and displayed a talent for writing case studies to demonstrate the model.

[56] Catalina Morales Murillo, from Costa Rica and a master’s student at the University of Tennessee at Chattanooga, who is our senior graduate assistant, a tireless worker, and a devoted member of our team. And we are devoted to her.

[57] Natalie Martin, who I found waiting tables, helped her get hired at Siskin, in a teaching position, and then she joined us in the Research Center. A truly pleasant colleague, smart, and hard working. Now an SLP graduate student.

[58] Lee Ann Jung, who nominated me for the award and roped in others to join her. She was an inspirational early intervention program manager in Alabama, became a stellar doc student at Auburn, and has been a productive faculty member at the University of Kentucky. Most important, we have been friends since her student days.

[59] Lee Ann has taught me about survival with grace when faced with dark forces, about taking on new academic interests and excelling in them, and about leading a balanced life. She is also fiendishly smart.

[60] Steve Graham, who, with his wife, Karen, has been best friends to PJ and me. His letter of nomination was moving. Steve is generous, humble, and hugely accomplished. He also asks way too many questions when ordering at restaurants.

[61] Naomi Younggren, who has led the Army’s early intervention program to be a model of exemplary practice. We have collaborated for years, and she is brilliant at professional development. We’re working together on a book about the MEISR.

[62] Juliann Woods, who has influenced the field in many ways, including the importance of routines-based intervention, and who was kind enough to nominate me.

[63] Julia Woodward, who got the ball rolling with implementation of the Routines-Based Model in the Northern Region of New Zealand and who is one of the kindest people imagineable; Jo Davies, National Practice Leader Early Intervention; Helen Williams, Southern Region; Julie Houghton, Central South Region; and Kathryn Bilbe, Central North Region. These last three plus Julia are advisors in early intervention  for their regions. They are getting it done! New Zealand is a full implementer of the Routines-Based Model.

[64] Cecília Aguiar, who I have known for over 10 years, beginning when she was a student. She is now the faculty member of my postdoc. She is a careful researcher, genuinely smart, hard working, and a beautiful person in every way.

[65] Javier Tamarit, the head of family quality of life efforts for FEAPS, a federation of over 2,000 agencies in Spain. A real mover and shaker. For example, he obtained over 700 participants for a study Pau García and I are doing.

[66] Julie Rutland, whom I helped when she was a doctoral student of Lee Ann Jung’s, and who has inspired me with her often hilarious tales as the parent of a child with special needs.

[67] Marga Cañadas, an occupational therapy faculty member at the Catholic University of Valencia, who has single-handedly coaxed early intervention programs in Spain to get out of their clinics, take on home visits, and start working with families. Another parent of a child with special needs, it’s incredible how much she accomplishes, while deflecting credit to others.

[68] Ai-Wen Hwang, who has conducted the only randomized control trial of the Routines-Based Model, in Taiwan (and found it effective). I will meet her and her team this month.

[69] Caya Chiu, who with Hsiu-Chin Lin and Chiou-Shiue Ko is teaching good stuff at the National Taipei University of Education. Caya is a colleague of Climent Giné and Natasha Baqués, on the Family Needs Assessment.

[70] Glen Dunlap, who knows thousands of people, has always treated me with kindness and generosity beyond what I deserve. Our paths have crossed a number of times, which has been good for me.

[71] Tânia Boavida is the purveyor of the Routines-Based Model of the future.

[72] Mary Beth Bruder is a currently relevant reminder of the strengths of the old school of early intervention experts.

[73] Dathan Rush’s sense of humor is only outdone by his sartorial taste.

[74] M’Lisa Shelden, with Dathan, is out to change the world, as am I—and we do so in happy parallel. We often feel as though it’s us against the establishment.

[75] Mary Beth has advised me, cried with me, and laughed with me for almost 30 years—a long and valued friendship.

[76] Amy was the easiest person possible to work with: She’s smart, hard working, and has a ready laugh. For two such different people, we were highly compatible.

[77] I am among the legion whose career Mark looked out for. In about 30 years, our paths have crossed numerous times, and we had many a Friday breakfast together in Nashville.

[78] Don was like a laissez faire parent: He encouraged me and gave me opportunities, starting in 1988, but he let me learn on my own and form my own lines of research.

[79] Carl was the first person of note to believe in me and he taught me how to be a scientist, although I could never reach the standards he set.

[80] My wife of 30 years, the mother of our children Kirsten and Sonny, and the grandmother of Tinsley.