Mother with baby.

What Routine? – A Table Talk Wednesday Recap

Written by Julie Higginbotham, Senior Case Coordinator, Mecklenburg County CDSA

Well, folks, we had another amazing Table Talk Wednesday event here in Mecklenburg County, and this time, we met to discuss family routines.  Facilitated by Stacy Campbell, Speech-Language Pathologist with Speech Center, and Nancy Higginson, Sr. Case Coordinator with the CDSA, we had a nice mix of providers and CDSA staff to share in this conversation.  We started off with a virtual “Family Feud” of routines when the group was asked about what families are doing during the day – eating meals, changing diapers, bathing, napping, and transitioning to outings are some that were mentioned right off the bat.  Pretty typical daily activities, right?  Even more interesting answers came out when the group was asked what parents are typically doing when we arrive for visits.  Household chores, taking care of older kids/new babies/pets, talking or texting on the phone, working from home, playing on the computer, and even watching “Dr. Phil” are all wound into the other, more obvious, daily routines.  When you look at the bigger picture, you may see that parents don’t involve kids in everything they do during the day, and that’s OK.  The main idea here is that, even when families don’t think that they have a set “routine” during the day, they have activities that happen routinely.

That’s good to know, but how do you discuss routines with families to get the best picture when writing outcomes or providing ongoing, routines-based support to achieve said outcomes?  Well, the group came up with several different ways to address routines with families to provide the most functional and natural supports for children and families.

  • Rapport is key.  This has been an ongoing theme across so many topics in early intervention, and it was one of the first mentioned during the discussion.  There are several things that need to happen in order to be as supportive as we can be.  First of all, setting up our role during visits is important because it helps the family understand theirs.  We’re asking them to step outside of their comfort zone and show us how they do things or try something new that may be helpful as they are interacting with their children.  It can be hard to take when people want to give advice about our own parenting styles, and there’s a level of trust there that needs to be established so parents see us as being on their team.  Secondly, parents often don’t realize that they are already doing great things to support their children because they automatically go through their day, doing what they need to do.  If we can point out strengths that we either see in the moment or hear about as we ask questions, we are taking huge steps in the right direction for families to let us give them some feedback and suggestions.
  • Our visits aren’t about sitting and giving the family strategies.  Families need to see that we aren’t there for “therapy time” and that the house doesn’t need to be spotless and “set up” for us to be there.  We want to integrate into whatever the family is doing at that time, and whatever they are doing is OK with us.  One person talked about a speech therapist who watched a tree being cut down outside because that’s what the family was doing when she got there – what a great opportunity for language development, engagement, and being supportive of a child and family’s interest!  If we go in with our own plan, toys, and list of things the family needs to be working on, how often do we miss out on the little opportunities that we want to encourage parents to notice as well?  Follow that up with some joint planning with the family to talk about what they’re doing and what they want to try makes for a well-rounded, supportive visit.
  • You can’t forget about culture.  This is another recurring theme that affects all aspects of early intervention.  Our job in supporting families isn’t to make their routines look like ours or to turn them into something that we find to be more functional for the family.  When you think about culture, you may be thinking that families who speak English are more similar to each other and are more different than families who speak Spanish or other languages.  While there may be some truth to this that can help lead you in the right direction, one household’s culture is one household’s culture, regardless of what language is spoken in the home.   We need to be aware of what the family expects from the child – for some families, the expectation could be that the child shouldn’t talk before they’re 2 years old, or that the child should stay on the bottle for a while longer.  While we want to be providing information about appropriate development and next steps, we need to be respectful of the family’s priorities and concerns.  How about the family that has different religious beliefs from you?  If we don’t ask the family to give us more information, we could accidently go in to promote language skills and talk about Santa Claus or ask a child what he’s going to be for Halloween.  The bottom line is that we need to be asking questions carefully and showing families that we want to support their priorities the way they want us to, not the way we think we should. 
  • Family circumstances shape the way we support children and families.  What happens when a family is homeless, or if there’s not much space available for your visits?  How about the parents who give in when the child throws a tantrum, but they live in a motel and have to be careful about how much noise they make?  Maybe a child lives in more than one home during the week, or there’s a new baby in the house that has changed the dynamic in the family recently.  We need to be flexible to address routines and priorities that fit into their current circumstances.  It’s easy for us to see that a child needs certain skills to be more successful in certain routines, but that might not be where the family is ready to start.  Families even have their own motives for being involved in the program – they could have a child with some significant needs, and they just want to be able to do things as a family.  Another family could be focusing on transitioning the child to baby food because the formula is just too expensive.  Yet another family could be getting pressure from pediatricians or others that think their children should be doing more.  When we listen to a family tell their story, we need to really hear it from an objective and nonjudgmental perspective and be ready to start where the family is ready to start.
  • Families are human, too.  They forget about visits.  They forget to wait for their child to imitate the words when they give them snacks.  They remember to let their kids walk inside after they’ve already carried them through the front door.  They smile politely as we talk about new things for them to do while they’re thinking, “Sure, when I find a spare second, that sounds like a great idea.”  It’s easy to jump to the conclusion that a family isn’t engaged or that they don’t care about helping their children develop, but in reality, they already had full days before we came along.  When we work outside of a family’s natural routines, we are adding to their plate of things to accomplish, and change is hard enough without having to find time to fit it into the day.  It’s not about 20 minutes of structured time, it’s about making the things that families do, day in and day out, a little smoother.

These are just a few of the great discussions that we had during this event.  It was yet another example of how well we all work together to support each other so we can bring our best to children and families.  Our next Table Talk Wednesday is coming up on October 16th, and we’ll be focusing on working with parents in Taking It Off the Runway….It’s an Interaction Style, Not a Model.  We’d love to have you join us if you’re in the area!


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