Q2: What strategies support an effective Tele-Intervention Session?

<Pam Dawson>
  
Here’s a few tips for setting yourself up for success when you are implementing a TI session. First, conduct a test session. A test session with the parent will allow you to establish rapport. Consider doing the test during the child’s nap time to help you and the parent have a relaxed, conversational interaction. One advantage of Tele-Intervention is that the family is truly in the “driver’s seat” for these sessions because the provider is not physically in the home. Some families may be less familiar, and maybe less comfortable, with this approach so it is important to take time to talk through this aspect of TI from the beginning. Providers should make sure to explain their role as a supporter and coach, and the parent's role as the child's primary “teacher." The test session is a good time for a brief overview of how future sessions will be structured. The test session also allows you to assess technology and bandwidth. Make sure you discuss the quality of the sound and the video, the importance of lighting and background noise. Communication before a session is also important. You can communicate with the family via email, text, or phone call several days before the session. Doing so will allow you to confirm the appointment, send the lesson plan/goals for the session, identify who will be at the session, both on the provider side and the family side and discuss arranging the home environment for the session with the parent. Make sure you set up your environment prior to the session, too. Parent-coaching based early intervention sessions, whether through TI or in person, typically follow a similar format, with each session divided into three main phases. First, reviewing the goals and activities. Second, conducting the lesson and/or activity, and third, debriefing and reflecting. When you review goals and activities it is an opportunity to check in with the parent on how things have been going since your last session. It gives the parent a chance to update you on their successes and challenges during the week, as well as any new developmental milestones or behaviors that have emerged. You can then review your mutual goals for the current session. When you conduct the lesson/activity it is critical that, as an early intervention provider, you establish engagement on the part of the parent during this phase of the TI session. This can be accomplished by a defined “hand off” of the activity to the parent after a period of modeling or demonstration of new techniques by the the provider. As the parent is leading the activity, the provider can provide coaching through observing, commenting and reflecting together. The discussion should include opportunities for integration of the new strategies into the daily routines of the home. After the planned activity, you and the parent will reflect on the session goals, successes and opportunities. Talking with the parent regarding their comfort level with the session and highlight how the parent used the targeted strategies and the child’s responses. You can offer specific next steps for the family to try during the coming week. As a session draws to a close, the early interventionist and parent can jointly determine environment, activities and strategies of the next session. Make sure to discuss together the continuation of goals or the selection of new goals based upon the parents’ comfort level and the present performance of the child. Just as it’s important to provide written follow-up and notes on the session to the parent following an in-home visit, it’s also important to provide the same for a TI session. However, because you are not physically in the home, you will need to do that either through email or U.S. mail.
After each session you can email/mail the following to the parent. A written summary of session through your session notes. Recommendation for carryover during routines based intervention in the home for the coming week. Offer parent support or any coaching information that you, as a coach, have to give both for the previous session and also for the coming week. You can talk about any new materials that might be used during the week to carry over the skill. And you should also provide the date and time of next session.