More Changes and Challenges in EI

I feel encouraged hearing that "paperless" is working well for other counties out there!

A few questions to Chelsea in Louisville - does every therapist bring a computer to each home so that your therapy notes are written there? Does this now eliminate parent signatures on weekly notes and do the parents get copies of the notes after the session?

I think the idea of the IFSP online sounds great, but I'm concerned about how computerized therapy notes would work for us. We leave a copy for the family every week and it has our full summary, recommendations for the family to work on with their child, the date and time of our next session, etc. Parents rely on our notes for a variety of info, so I would be concerned if they were not able to receive a copy immediately after each session.

I have been working in the Early Intervention Program for about the past 15 years in Illinois.  I  have seen so many changes in the EI system.  I am very intersted in the IFSP and daily notes online system.  This would help us eliminate so much paperwork at the office!  I have storage rooms just full of old files.  I wish Illinois would convert to this system.

Our early intervention program has recently (in december 2008) gone paperless.  We do all out paperwork: treatment notes, IFSP's, assessments, logs of communication, online.  The database is supposed to eventually be available to parents to review in the furture, but is currently accessible to the service coordinators and therapists.  Therapists are required to maintain reliable internet access, but are not compensated for this requirement.  IFSP's are entered in real time, typically, during a meeting, into the database IF the coordinator has obtained wireless internet access on their own.  If not, it has to be entered on the coordinators time.  Therapists have the option of bringing their own laptop into family's homes to write up their treatment note and post it to the online database.  I have chosen not to obtain wireless internet access for my laptop (it's around $50 a month).  As a result, when billing is due, I upload all my treatment notes to the database every two weeks, which takes about 2 hours.  I like this system because it gives me access to the other therapist's progress on a plan, without requiring a zillion phone calls.  There are many kinks being worked out, and I'm still hazy on the ins and outs, as training was poorly done.  I think all in all it is a better way to keep records.

Hi Laura ~ Unfortunately we don't have a set form with routines listed that we use in our county. Basically, we simply follow a "typical" infant/toddler day - meals, snack, nap time, bedtime, diaper change, bath time, play time, daycare, playdates, local trips to playgrounds, restaurants, library, etc.

I hope this answers your question. I think you raise an important point to try to create a format outlining routines in some form. The tricky part would probably be that routines can and will vary from family to family.

Would it be possible to get a download of the form for routines you use with families?  Would be helpful to me (and others).

Hi Stephanie! I really appreciate you doing this blog.  I am a student at Penn State looking into EI as a potential focus in Grad School.  I was wondering if there would be anyway I could get in contact with you by e-mail for a possible interview/reference.    I have been trying to touch base with a local EI Professional from my area for a paper I am currently working on.  I could not find your e-mail on your blog anywhere, but mine is NME5011@psu.edu.  If there would be anyway you could contact me with your e-mail, that would be greatly appreciated.

Monika ~ We are also starting to incorporate a more "bag free" philosophy into our therapy model - thanks for bringing this up - it's inspired the post I'm writing for this Tuesday. I like the quotes from the Cook and Sparks book. Thanks!!

Latisha ~ Interesting idea with the calendar. We have started to do a similiar "data keeping" practice using a notebook with all the goals we are working on as a team written out on a chart and we comment on the goals each week as we work on them. This just started. Although it's extra work, I like it because I think it helps to keep everyone on the same page. I think we need to start having the parents write in it as well - it would be helpful to track progress during "daily routines" when therapists are not present.

Yes, thank you for this great blog, Stephanie!  I think you have hit on a hot topic for us new EI providers as well as the established ones.  I was inspired by Mary's (from Waukesha) excellent points, and would like to add to a comment I left last week.  In my area, the wording of the IFSP goals are provided by the parents.  We service providers can then write measurable short term goals and objectives to help the family reach the long term goals.  I am a "bag free" therapist and do not plan activities for the child/family.  I try to work with the family to fit the goals into whatever they happen to be doing at the time of my visit, or into an activity (walk to the park, snack time, play with favorite toys, etc.)  that we have decided on together.  I admit this has been a challenge at times when the parents are used to, or expecting, a more clinical approach.  I always keep two quotes from Cook & Sparks excellent book, "The Art and Practice of Home Visiting" (Brookes Publishing), in the back of my mind:  "we need more skills than just 'dumping the clinic on the living room floor' ", and "it isn't the contact hours, it's the intervention the child receives that creates changes" (McWilliams, 2005).

I haven't heard about computerized IFSPs yet, and I suppose "non-billable time" will always be an issue in home based intervention...

Hi Stephanie! Thank you so much for doing this blog. I am just getting into EI in NYC part-time as I also work in the schools. It is very difficult to provide families/caregivers with activities that can be used in the home in a half-hour.  We have to keep a calendar at the home where each service writes down an activity that the family has to do and write a plus or minus sign and a comment on why it worked or did not work. I haven't had the chance to do it yet as I had a complicated case but I'm not sure families will take the time to fill it out. The service coordinator will collect it at the end of the month.  Our IFSPs are not computerized yet in NYC but the CPSE in the Westchester area are computerized and codes are entered for goals, etc.