Blended EI Services Via Technology 2/1/2019

Blended Early Intervention

Services Via Technology

Southern Ohio Council

A Council of Governments

What is EI?
How are children and families eligible?
Diagnosed Developmental
Condition Delay
Diagnosis with high 1.5 SD or more in at
probability of resulting least one area on
in developmental delay approved evaluation
tool

OR
Does not score a delay on the tool but Informed Clinical
Opinion determines eligibility

The Impact of
Early
Intervention

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The Mission of
Early Intervention

to provide supports and

resources to assist family
members and caregivers to
enhance children’s learning and
development through everyday
learning opportunities

2008

http://ectacenter.org/~pdfs/topics/families/Finalmissionandprinciples3_11_08.pdf

EARLY INTERVENTION TRADTIONAL/ EVIDENCE-BASED MODEL

MEDICAL MODEL
EMPHASIS “Fixing” Skills Learning through everyday
routines and activities
PARENT Passive observer Expert on their child
INVOLVEMENT
Actively engaged
SETTING Clinic or classroom Home or other natural
environment
TOOLS Toy bag, structured Child’s own toys and other
therapy activities items

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Early
Intervention …and now
then…

Evidence-Based
Practices

http://ohioearlyintervention.org/

Evidence- Natural
Based Coaching Teaming Learning
Environments
Practices
Family-Centered

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Coaching

Core Team: Service Coordinator, Developmental Specialist, Physical

Therapist, Occupational Therapist, Speech Language Pathologist

Teaming
using the
Primary
Service
Provider
Approach

Natural
Learning
Environments

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Families
Front and
Center!

http://www.cdd.unm.edu/ecln/FIT/fit-focus-video-library.html

What does ASHA say about EBEI?

It is the position of the
American Speech-
Language-Hearing
Association (ASHA) that
speech-language
pathologists have a central
role in providing services
and supports for families
and their infants and
toddlers with disabilities as
members of the early
intervention team. American Speech-Language-Hearing Association. (2008b). Roles and responsibilities
of speech-language pathologists in early intervention: Guidelines. Available from
www.asha.org/policy

the

Family
Service
Plan
(IFSP)

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How is EI
funded
in Ohio?

Career Opportunities and Certification

Requirements for SLPs

SOCOG Pilot Project

• Five counties participating with
access to SLP, OT, PT services
• Dedicated to Core Team for
participating counties
– Pike, Vinton, Meigs, Scioto,
Adams, Brown
• Provide teleservices
– Limited on-site/in person visits

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Telepractices
• Application of telecommunications technology to the delivery
of speech language pathology and audiology services at a
distance
– Assessment
– Intervention
– Consultation

• Services must be equivalent to the quality of services provided

in person & adhere to rules

Show me the research…

• Many states are incorporating
telehealth within their Early
Intervention/Individuals with
Disabilities Education
Improvement Act (IDEA) Part C
programs
• Working to improve access to
services and overcome personnel
shortages.

Show me the research…

• Creates access
• Natural environments
• Provide early intervention services
• Connect caregivers and on-site
providers with remote providers
for consultation and collaboration
• Facilitate IFSP team collaboration
through remote participation in
team meetings

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Show me the research…

• TRS (timely receipt of services)
• Natural environment
• Child and family outcomes
• Early identification
• Meeting 45 day timeline
• Transition planning

Where else is it happening?

• National Center for Hearing Assessment

and Management Utah State University
http://www.infanthearing.org/index.html
• Hearing Services in Ohio
• Connections (FCLC)-Akron
• Schools
• ECHO programs

Types of Telepractices

• Synchronous (client interactive)

• Asynchronous (store-and-forward)

• Hybrid

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How can we use video? (Edelman, 2016)

• Evaluation & Assessment
• Progress monitoring
• Collaborate & Share information
• Modeling
• Team Consultation
• Self-reflection
• Evaluation & Assessment
• Supervision/reflections

How can we use video? (Edelman, 2016)

• Illustrate strategies
• Tell a story
• Give a tutorial
• Orient families to resources/materials
• Consultation & Coaching
• Share information
• Professional development
• Collect information
• Documentation

Remember…
• ALWAYS obtain the family’s written consent before capturing
video, still images, or sound.

• Consider how, where, and how long files will need to be stored
and backed up depending on rules (HIPPA, FERPA, ASHA, Ohio)

• Need to comply with codes & rules related to each discipline

including privacy (HIPPA)

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Benefits
• Provides access
• Decreases travel
• Increases use of family-centered coaching
strategies
• Allows for flexibility with changing family
schedules/needs
• Promotes natural environment
• Intensifies family involvement
• Opportunities to work as a team
• Promotes developmental progress

Challenges
• High quality internet connection
• Confidence/comfort with technology
• Quiet, dedicated workspace with
privacy
• Adequate training & skill
development for technology and
intervention
• Recognize it may not fit all families
• Reimbursement
• Costs: startup, maintenance, tools
• Security & file storage

Checklist for Providers

Knowledge of computers/equipment
Able to trouble shoot
Organized & attentive to technology
Training in model of intervention
Clear communication/coaching skills
Flexibility to adapt
http://www.infanthearing.org/ti-guide/implementation.html

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Checklist for Providers cont.

Willing to learn new technologies
Knows how to prepare the home environment or problem solve
with the family
Identifies activity settings, strategies, learning opportunities with
the family
Demonstrates strategies modeled & discussed during sessions
Provides feedback and reflection with the family
Revises outcomes and activity settings as needed
http://www.infanthearing.org/ti-guide/implementation.html

Setting up the Session: Preparation

• Email/call /text the family to confirm

the session
• Assure that the parent has access to
tools
• Prepare your equipment and establish
the connection
• Provider/family have cell phones
ready…in case!

An Overview of Using Technology in EI

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Components of a visit
• Joint Planning
• Observation
• Action/Practice
• Reflection
• Feedback
• Joint Planning
• Intervention

https://ohioearlyintervention.org/up_doc/Co
achingHandoutForFamilies.pdf

Video Sample

A visit with the Primary Service Provider (PSP)

During the Session

• Are you recording?
• Allow for lag time
• Ask if they are having any problems
• Review the previous joint plan and child & family outcomes
• Review what has happened since the last visit
• Explain modeling & have families practice strategies
• Clearly communicate feedback
• Strategically provide feedback
• Reflect with the family after practice

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Ending the Session

• Review the joint plan for the next
session
• Determine what action steps you
& the family will take between
visits
• Provide information or make
recommendations as needed
• Schedule the next session

Video Sample

A joint provider visit

Reflection
 Joint Planning
Observation
Action/Practice
Reflection
Feedback
Joint Planning

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When did the intervention happen?

Teaming using video

Is it right for my agency/area?

• The National Center for Hearing Assessment and Management
parent-provider partnerships through tele-intervention
http://www.infanthearing.org/telehealth/index.html
• The American Speech Language Hearing Association
http://www.asha.org/practice/telepractice
• Telehealth Resource Centers (TRCs)
http://www.telehealthresourcecenters.org/
• Ohio Association of County Boards of Developmental Disabilities
YouTube Videos
https://www.youtube.com/playlist?list=PLTpgXrDG6dnLtd6vDFT_
rZQvcSASrVaEJ

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Questions & Thank you!

Tiffany Madden, MA/CCC-SLP Maggie Gons, MA/CCC-SLP

Early Intervention Program Consultant Speech-Language Pathologist
Ohio Department of Developmental Southern Ohio Council of
Disabilities Governments (SOCOG)
[email protected] [email protected]
(513)735-8271

Additional Resources
• www.ohioearlyintervention.org

• www.ectacenter.org

• www.fipp.org

• www.dec-sped.org

• https://members.oacbdd.org/jobs

• www.hanen.org

References
• Behl, D.D., Blaiser, K., Cook, G., Barrett, T., Callow-Heusser, C.,
Brooks, B.M., Dawson, P., Quigley, S., & White, K. (2017) A
Multisite Study Evaluating the Benefits of Early Intervention via
Telepractice Infants & Young Children, 30 (2), 147-161.
• Measuring Costs and Outcomes of Tele-Intervention When Serving
Families of Children who are Deaf/Hard-of-Hearing [PDF]
• TI Assessment Practices for Children who are D/HH: Results from a
participant survey [PDF]
• Constantinescu, G. (2012) Satisfaction with telemedicine for
teaching listening and spoken language to children with hearing
loss [PDF]. Journal of Telemedicine and Telecare 2012; 18: 267–
272.

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References
• Baharav, E., Reiser, C. (2010) Using Telepractice in parent training
in early autism. Telemedicine and e-Health v.16 (6) 727-731.
• Cason, J. (2011) Telerehabilitation: An adjunct service delivery
model for early intervention services [PDF]. International Journal
of Telerehabilitation.v. v3 (1) 19-28.
• Kelso, G.L, Fiechtl, B.J., Olsen, S.T., Rule, S. (2009). The feasibility of
virtual home visits to provide early intervention. Infants and Young
Children, v.22 (4) 332-340.
• Mashima, P.A., Doarn, C.R. (2008). Overview of Telehealth
Activities in Speech–Language Pathology [PDF]. Telemedicine and
e-Health v.14 (10) 1101-1117.
• McCarthy, M., Munoz, K., White, K.R. (2010). Teleintervention for
infants and young children who are deaf or hard-of-hearing.
Pediatrics. 126 Suppl 1:S52-8.

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