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 Final Report

Family Guided Routines Based Intervention (FGRBI) Model

The Family Guided Routines Based Intervention (FGRBI) project was designed to validate a set of procedures for providing early intervention services within natural environments that is consistent with the legal mandates for early intervention services described in the Individuals with Disabilities Act (1997, 2004). FGRBI uses a home based delivery model that works within the requirements of the local Early Steps program. Project staff are enrolled as providers in the local Part C program and work collaboratively with other community providers across disciplines to meet the needs of the families served on the project. The FGRBI model has been developed to increase family involvement, provide intervention in natural environments, and improve collaborative teaming by involving caregivers in the assessment and intervention process, identifying child and family preferred
routines, delineating when, where, and how often to embed outcomes, and integrating intervention across developmental domains into the child’s day.

The following section provides a comprehensive step-by-step description of the FGRBI intervention that highlights how the interventionist works collaboratively with parents to teachthem how to implement the intervention strategies within daily occurring routines and activities. Within the model, intervention is individualized to meet the needs of each child and family. The key ingredients of FGRBI are to prioritize child goals based on developmental assessments and family concerns, identify family routines to target goals, to teach parents to implement transactional teaching strategies and learning supports within selected daily routines, and to support family implementation of intervention. The intervention process is repeated each time the child’s goals or family’s strategies are updated over the course of the intervention. Documentation and supporting materials for each step of the intervention process are indicated by the accompanying forms/resources.

FGRBI Intervention Schedule of Activities
Introduction to Project Forms and Resources
  • Contact family to identify initial meeting times
  • Describe FGRBI process and sequence of activities during home visits
  • Discuss how initial assessments and interviews will be conducted. Identify how to gather and share information. Give examples of how assessment results are typically presented and discuss options/alternatives with families.
  • Answer family questions and provide contact numbers
  • Obtain family permission to contact other
    team members (PT, OT, other Part C services)

Choose from the following handouts describing Natural Environments (NE):
Phase 1: Program Planning Forms and Resources
  • Complete family routines based interview to gather information about parent perceptions of daily routines and activities and Routine Categories Form to identify family
    routines. Score curriculum based measure through parent report and observations of parent-child interaction across routines
  • Share information with caregiver about strategies and supports that they are using that is working to support the child’s participation and engagement in routines.
  • Discuss assessment results by highlighting child’s strengths and preferences, goals or areas of need and parent’s perception of child skills and their priorities.
  • Develop outcomes with family that addresses their priorities and concerns. Identify 1-2 short term objectives for each outcome using the AEPS assessment profile as
    a guide.
  • Once child objectives are identified, review the Family Routine Categories form to identify 2-3 different routines for intervention based on what family using the following
    criteria:

    a) Routine has to occur frequently during
    the day
    b) Routine is highly preferred by caregiver
    and motivating for the child
    c) Includes multiple opportunities for embedding
    outcomes.

  • Identify 1-2 teaching strategies for caregiver to implement across routines usingthe FGRBI Menu of Strategies. Use observationsof caregiver across routines to identify
    strategies that build on what the caregiver is already using.
Phase 2: Intervention Forms and Resources

Each home visit includes three phases:

(a)Setting the stage: Interventionist obtains
updates on child and family as well as identified
outcomes.

(b) Planned Activities: Interventionist joins in
with family on planned routines as well as
spontaneously occurring novel routines. Using
the specific steps listed in the Strategy Teaching
Protocol, share information about the target
teaching strategy. Observe parent-child interaction
in each routine. Share positive feedback
with parents’ use of teaching strategies in routine.
Identify specific instances of strategy use
and child’s behavior. Discuss and problem
solve with parent if adequate strategy use is not
observed in routine.
Once parent strategy is observed in the target
routines, identify and observe new routines to
support generalization across routines. Problem
solve with parent to identify format of data
collection for family to monitor use of teaching
strategy and child goals between sessions.

(c) Plans for next visit: Caregiver and interventionist
jointly identify routines for the following
visit as well as plans for implementation
between visits. Review family data sheets
to ensure opportunities for generalization.
Complete home visit note and update child objectives
as necessary.
Complete fidelity checklist to self-monitor implementation
of key components of FGBRI

Maintenance of Teaching Strategy Use:
Provide caregiver verbal feedback on strategy
use in new and target routines during each
visit. Once a month, complete a video review
session with caregiver following the steps in
the Video Review Protocol. Problem solve to increase strategy use.

Generalization of Strategy Use:
Update Routine Categories form once a month
with caregiver to identify new routines, contexts,
and communication partners for the
child. Identify target routines each time a
strategy is introduced so that teaching occurs
in a variety of routines and contexts.


Repeat process for each new teaching strategy
that is introduced to caregiver.
Phase 3: Community Teaming and Collaboration Forms and Resources
Collaborate with other Part C providers and team members (such as grandparents, childcare providers or medical support personnel) as requested by the family.  
Phase 4: Progress Monitoring/Transition Forms and Resources
Update child goals quarterly (or sooner as necessary) using the AEPS.
Assist family in transition to Part B as needed.		 AEPS (Volume 2: AEPS® Test for Birth to Three Years and Three to Six Years)
IFSP to support transition planning (as needed)

 

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