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Early Intervention Speech Therapy

Addressing the Issues: Data Collection in Early Intervention

Published March 27, 2009 9:27 AM by Stephanie Bruno-Dowling
In a recent post, I mentioned that data collection in our county has changed. As a result, readers have also started writing in to share their own experiences.

One reader's comment from New York read, "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....The service coordinator will collect it at the end of the month". This reader also mentioned that she was not sure if the family would take the time to fill out the calendar along with the service providers.

I use this illustration because it exemplifies what my own situation has become over the last several months. For the last two to three years that I have been working in EI, the emphasis placed upon data collection was minimal. I'm not saying that this was ok; however it was the reality. We were required to write our therapy note at the end of every session, which includes the following information:  date/time of session, child's name, goals/objectives addressed, a summary of the session in paragraph form, suggestions for parent carry-over, parent concerns, therapist prep for the following week, the date/time/place of next session and both therapist and parent/guardian must sign the form.

Our therapy note does not lend itself to charts, grids, measurements and numbers.  

In the past, our "clinical judgment" and recommendations based on weeks of one-on-one therapy sessions were enough to increase service frequency and/or recommend an additional service. However, during recent months, all of this has changed. Now, we need hard data with numbers and percentages to back everything we say; however our paperwork has not changed. The form layout is the same, so the challenge is how to keep effective numbers and notes without taking time away from the children.

What we have started to do with several children is leave a notebook in the home. As a team, we created a chart where each goal is documented and each time we treat, we record the progress. So far, so good! The families have not been participating in the documentation, despite our gentle encouragement; however I have to admit that I now feel better prepared for upcoming annual reviews.

I would like to be clear that I am not criticizing the new emphasis on numerical data. I recognize the importance and understand the necessity. My critique is simply that if data collection needed to change, then therapists should have be trained on exactly what the county now wants and requires. In addition, it may have been wise to change the physical layout of our therapy notes. Long term, it would save extra time for treatment, extra money for the county, and a great deal of uncertainty and frustration on the part of the service providers and families.

I welcome your comments and experiences. Please share how your data collection is handled in your county and whether or not you feel it is effectively working for both therapists and families!

4 comments

In my current position we have just moved to the primary service provider model with consults, so the focus is still on service delievery and training for providers.  I echo Tessa's frustrations for the lack of training and the inability to provide a consistent quality of service throughout the county.

I write a home visit note similiar to the one that Stephanie described and along the side of the note I usually keep a language sample or my traditional data collection checks for a certain skill if it applies.  Then in the body of the note I describe the goals and performance for the parent, along with ideas for the week and parent concerns or updates.  At times I will leave a checklist for the parent to use to track a skill or help them remember to practice as well.  This has worked well for me and at this point we have not had any problems with regulations on data collection as long as our goal reviews indicate progress.

In family centered practice, using numbers and percentages is frowned upon and for most families it is unrealistic to expect them to keep data like that (except our ABA families) it is unnatural.  It is a confusing mix of messages and expectations to say focus on daily routines and coach parents, but make sure you take accurate data on a goal or skill.  If it is family centered the parent should be giving you the data on the progress of a goal and it becomes can the child do it or not, how much help do they need to be successful and how consistent are they and I don't think a parent is going to tell you they do it 8 out of 10 opportunities or 80% of the time.  

Kim, EI - SLP April 12, 2009 10:14 PM
ME

Being an effective clinician is not the same as being an effective data collector. When data collection takes precedence, we may lose site of our primary goal, that of improving the meaningful communicative and developmental skills of young children in their relationships with their families.

I recently left early intervention, after ten years of firm commitment to these kids and families. In my state, support for therapists in EI is poor, funding is inadequate, training for paraprofessionals has emphasized a strong anti-therapy bias in developmental "specialists", whose education is poorly designed and regulated.

I miss the families, I miss my specialty, but I can't see how increasing clinical "data" improves services when it does not include data about recruiting and retaining skilled, committed, trained professionals in the field.

Tessa April 4, 2009 9:56 AM
NM

Lisa, Thank you for your comment and I definitely agree with you. I and many of my coworkers have all offered suggestions and the willingness to help design a new form. We were actually presented with a new form today which was designed without the input of our therapy team. As therapists we have some concerns and suggestions for improvement. I will keep you posted on upcoming changes!!

stephanie bruno, blog author April 1, 2009 8:39 PM

Stephanie,

This is an opportunity for you to make suggestions about new therapy note formats that do what the county wants and are easy for the EI therapists to use. If they haven't given you anything maybe it's because they aren't sure what to do and you, being the expert, can lend your expertise. Afterall, wasn't clinic in grad school all about collecting data? I think you're in a great position to make things work for everyone!

Lisa Durstin, SLP March 30, 2009 6:26 AM
VT

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About this Blog


    Stephanie Bruno Dowling, M.S. CCC-SLP
    Occupation: Speech-Language Pathologist
    Setting: Early Intervention in Delaware County, PA
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