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Experiencias de L’Alquería… y Algo Más
Dra. Margarita Cañadas y Dr. Robin McWilliam
05/01/2023Cañadas y McWilliam (2015) 2
Contact
[email protected]ñ[email protected] Copy of this PowerPoint will be at ramgroup.info
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Outline
How to assess your staff’s typical practice and what they consider ideal
How to develop an individualized plan, according to the Routines-Based Model
How to conduct a support-based home visit
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How to assess your staff’s typical practice and what they consider ideal
FINESSEFamily FINESSE
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FINESSE
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Family FINESSE
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Family FINESSE
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How to Develop an Individualized Plan, According to the RBM
Construct an ecomap with the familyConduct a Routines-Based Interview (RBI/EBR)Write participation-based child goalsWrite family goalsCollect baseline data on
Child functioning in routinesFamily quality of life
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Construct an Ecomap With the Family
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Conduct a Routines-Based Interview (RBI/EBR)
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The Routines-Based Interview
Go through each “routine” (i.e., time of day or activity) Get a sense of family’s and child’s functioning Write down significant information Star the concerns Recap concerns with the family, showing them the starred items Ask what the family would like to concentrate on Write down these outcomes Ask them for the priority order
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Structure
05/01/2023
Home RoutinesWaking up
Changing diaper/bathroomGoing to kitchen
BreakfastParent getting dressed
Going outIn shopsLunch
Going to parkOther family members
coming homeDinner preparation
DinnerBathTV
Bedtime
“Classroom” RoutinesArrivalCircle
Free playSnack
Small toysCentersOutsideMusicStoryLunchNap
CentersDeparture
Within Each Routine1. What does everyone else do?2. What does this child do?
a) Engagementb) Independencec) Social relationships
3. How satisfactory is this routine?
3. How well is this routine working for the child (“goodness of fit”)
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Write participation-based child goals
What does the family want the child to be able to do?
At what times of day did this need arise?How will we know the child can do this?
How often? How many? How much? How far?Over how many times of day?For how long?
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Write Family Goals
Usually, 1 criterionFamily will have information about sleep problems in
children with autism by January 1, 2016Jill will enroll in a class to complete her high-school
education by January 1, 2016
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Kathy and Leon will have one date night a month for three months in a row.
Family will get a new car that fits Michael’s travel chair by February 1, 2016
Nina will feed Peter via tube without fear, on a 1-5 scale, at a level of 4 for 3 consecutive weeks
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Baseline data on child functioning in routines
Measure of Engagement, Independence, and Social Relationships (MEISR)“Mai-ser”[Autism: “oh-tis-m”]
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Family quality of life
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FaQoL Factors
Family RelationshipsAccess to Information and ServicesChild FunctioningOverall Life Satisfaction(Total Score)
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How to conduct a support-based home visit
Next-Steps FormVanderbilt Home Visit Script-ExpandedMatrixSupport-Based Home Visit ChecklistFamily Consultation Flow Chart
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Next-Steps Form
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VHVS-E
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Mat
rix
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Completed Matrix
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Support-Based Home Visit Checklist
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Fam
ily
Cons
ulta
tion
Flo
w
Char
tHow’s it going w/
each outcome?
Not much improvement
Child is improving Child can do it
Get detailed description
Ask for demo of child func, if
nec
How’s intervention
going?
Ask-to-Suggest
Offer to demo (8 modeling steps)
Description
Implementing
Demo by parent?
Refine skill Tweak implementation
Why?
Hard to fit in intervention
Child not responding Forgot
Change interv or routine
Change or persist
Try matrix
Need help?
No
Yes
End intervention
Not implementing
End intervention?
Yes
Up the ante
No
Yes
Behavioral Consultation in Home Visits
Encourage
R. A. McWilliam © 2009
Don’t know how to
implement intervention
Intervention previously planned?
No
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How’s it going w/each outcome?
Not much improvement
Child is improving Child can do it
Get detailed description
Ask for demo of child func, if
nec
How’s intervention
going?
Ask-to-Suggest
Offer to demo (8 modeling steps)
Description
Implementing
Demo by parent?
Refine skill Tweak implementation
Why?
Hard to fit in intervention
Child not responding Forgot
Change interv or routine
Change or persist
Try matrix
Need help?
No
Yes
End intervention
Not implementing
End intervention?
Yes
Up the ante
No
Yes
Behavioral Consultation in Home Visits
Encourage
R. A. McWilliam © 2009
Don’t know how to
implement intervention
Intervention previously planned?
No
05/01/2023Cañadas y McWilliam (2015) 36
How Do I Begin?
FINESSE IIDiscuss routines with family (include MEISR, if
you like) and find out what family wants child to be doing 6 months from now
Get training on RBIwww.ramgroup.info
