Written by Julie Higginbotham, Senior Case Coordinator, Mecklenburg County CDSA
Scheduling is one of the more challenging parts of our work sometimes because we’re never in one place for very long – and that’s when it’s just a regular week! Now that the holiday season is right around the corner, it’s about to get even busier. In one of the first EI Excellence blogs, Sunscreen, Check. Flip Flops, Check. IFSP, Check. Wait, What?, we talked about helping families plan for traveling over the summer and how it’s possible to support families’ outcomes as we talk about ways strategies can be used outside of the home. Some of these same ideas can be applied to travels and changes in routines that families may encounter during the holidays.
This time of year, families may have conflicting priorities with travel or holiday activities, and we are also in the middle of cold and flu season. There are often some days/weeks that families cannot meet as scheduled. If we’re seeing families weekly for visits and there is a cancellation, you can just go twice the week before or the week after to make up for that visit, right? Well, hang on a minute – let’s think this one through a bit more…..
We know that early intervention is not a clinical model in which we are the ones providing “treatment” and that the whole point is for families to be able to learn things, try them out, and talk about how things are going when we come back, right? Well, if the IFSP team has decided on weekly supports to address the family’s priorities, what changes in those few weeks that makes them need more support? Think about it – if you usually go on Mondays, and the next week you can go on Monday and Tuesday to make up a missed session, how many questions will the family have overnight? Even if you can work it out so that there are a few days in between, that’s a more intense service with a shorter amount of time to work on new activities and strategies in their routines. Here are some scenarios that you might run into, along with some ways to discuss them with families.
- “Can you fit us in somewhere else next week?” Whenever we have cancellations, this is always a great way to try to work it out – try finding a place during the same week to meet with the family. Maybe you have some families who don’t travel or don’t celebrate certain holidays, or you have another family who decided to cancel and you have an opening. That can actually give you a chance to see different routines, especially if the time changes, and you may end up with additional outcomes or strategies that can be added to the IFSP when you’re done.
- “Can you just come twice next week to make up this session?” Yep – there it is, just out there on the table to discuss. While it would be easier to try to find a place to squeeze them into your already-packed schedule, this can go another way. How about having a conversation with the family to find out what their priorities are and go from there? If the family says that they just want to make up the session, focus more on how you can give them information that would be helpful and on how capable the family is throughout the week when you’re not there. We want families to feel confident and competent in their abilities and not feel as though things have to come to a halt if there are times that a visit can’t be rescheduled within the week.
- “But I can always tell when Johnny misses therapy for a week because he is so wound up!” This can also be come out as, “But Sally does so well when you’re here, and we want to make sure that she continues to make progress.” We hear this a lot, especially if Johnny is an active little boy who really likes rough-and-tumble play, and the family’s priority is for him to be calmer so he can participate in certain routines, or if Sally has been quiet for so long, and she’s finally starting to express herself more. A question that we have to ask ourselves is whether or not we’ve been giving the family enough information about what they can do while we’re not there, rather than providing that hands-on therapy that gets the family through the week until you come back the next time. Sure, it’s great when we know that we have the ability to make things better for a family, but what are they going to do on Christmas morning when Johnny gets overstimulated by all of the activity, and you’re not coming back for another week, or if Sally finally called her mother “Mama” and won’t say it again until you come back? As you’re coming up on weeks where either you or the family isn’t going to be available for your regular visits, you can start to plan ahead with the family to be sure that you’re addressing the regular outcomes and support the family around activities outside of their routines that may be causing them some stress as they’re thinking about them.
- “What happens if I have a question or need some help with something?” Families may be OK with missing the visit for the week, but they may be worried about what to do if they have a question before you come back for your next visit and feel that 2 visits in a week would help. This is an excellent time for some teaming – maybe you’ll be away, but the service coordinator can check in with the family during that time. Maybe there’s another provider on the team that can also follow up with the family during one of their visits and follow up on something specific that you’ve been discussing with the family. Some folks are OK with families contacting them when they’re off, and some aren’t. It’s good to have a conversation when you feel it might be necessary so you can set up that boundary and protect your rapport with the family, as well as your own time away from work.
This time of year is busy for us all, including families. If we’re really taking the time and talking to families, planning together during visits to address their priorities, and making our work as functional for families as possible, there are lots of ways to support children and families when there is a bit more space between visits because of holidays, illnesses, and general life happenings. Think about it – families want to do the best for their children, so if trying to squeeze more visits in will help their children make progress, they’re willing to do it, even if losing that time will make things a little crazier for them. Let’s come up with some ways to balance this out and help families see their worth in their child’s life, too.