"Daily Routines" and Other Changes in EI
In today's post I'd like to discuss an issue that has become quite pressing within the county where I work as a speech therapist in early intervention. Part of why I raise this issue is to see if other therapists out there across the country and world-wide have been focusing on this element of therapy as well.
Generally speaking, one of the main goals of early intervention therapy is to help the child be able to function independently within their "daily routines". Although this has been the main focus for as long as I have been working in EI, the emphasis on the "daily routines" element has recently increased. This term has become the focal point of our goal writing, data collection and therapeutic plan and although it makes sense in theory, it is often difficult to assess, treat and analyze.
Recently in an IFSP (Individualized Family Service Plan) review meeting, I needed to write a new speech goal for a child who is receiving speech-only services. Her main need for therapy is articulation-based. Her language skills are solid but she is still very difficult to understand.
The goal I proposed was the following, "Child's name will improve her ability to use words to express her wants and needs across all environments". The immediate response from the county coordinator at the meeting was that this goal is too "clinical" and we are no longer able to say "across all environments". Instead we need to say "in daily routines". I would like to say that this was simply the opinion of this particular coordinator; however I have heard stories like this from my coworkers, so I can safely assume this is now a regulation of our county.
Now, I am not one to create a fuss; however the reason why I chose the wording I did was because this particular little girl is doing pretty well in her daily routines. She needs help mainly with articulation both at home and at her little school program, hence the term "across all environments". As a side note, I never realized that this was a "clinical" term?!
In general, numerous other changes and guidelines have been recently instituted into our paperwork; however no training has been provided nor has there been any official notification of changes being made. Instead, we as therapists are told what we are "supposed" to be doing and saying while in review meetings with parents.
As therapists, I believe we can play the game much better when we know the rules, but if the rules keep changing, how is anyone supposed to be successful? How are we supposed to be prepared as well as an effective resource for parents if proper training and education regarding new guidelines are not being provided?
So, my question for readers is this....is this struggle one that you are seeing in your own county or district as well and if so, how are you addressing it?