Helping Families Transition Out of First Steps

Dr. Katie Herron interviews long-time First Steps Service Coordinator and Research Assistant about how to help families transition out of First Steps.

Transcript

Welcome to the Early Childhood On-the-Go Podcast, where the Early Childhood Center team shares ideas and strategies for professionals and families.  Dream big, start early. Hello, and welcome to the podcast. My name is Katie Herron and I'm here with Educational Specialist Charissa Darland. Today we are going to talk about transition. Children go through lots of transitions. Today we're going to focus on the transition from early intervention to whatever comes next. Charissa, let's start by talking about you. Could you tell us a little bit about yourself? Absolutely, so, I have been a service coordinator for about ten years and prior to my position here at IU. I'm also a mom of a kid who's about to transition out of First Steps. Okay. So earlier this year, one of your projects was putting together a series of handouts on transition and particularly they were based on a transition to kindergarten tool kit that the Indiana Department of Education developed, and they took the identified values from that tool kit and talked about what those would look like if we looked at them from the point of view of the transition out of early intervention. So, I'm wondering if we could talk through some of those, particularly, I wanted to start out by asking, you know, early childhood professionals, they know the paperwork and the steps that are needed to transition from one system to another, but it takes more effort to truly engage families in the process. So, I'm wondering over your experience and your time as a service coordinator and your experience as a parent - what are some ways that you suggest professionals collaborate with families around transition? You know, I think as professionals, we get into certain habits. It's really easy to stick with those habits and say, put everybody into the resources we’re most familiar with. Or that have been around the longest or even perhaps resources that most families use, because we assume that if so many families use it and it's accessible, that that's what's best for a particular family. And it might be true, but it might not. So, start with asking a question that helps a family think about what they really want out of transition, which one question could be, “What skills do you want your child to have by the time they're in kindergarten?”  You know, if the answer is, “I want them to learn their numbers and letters,” preschool could be a priority. If the answer is, “My kid has just so many behavior issues. I cannot imagine them being in classroom where they had to participate with other kids and follow adult directions.” And maybe the family wants some playgroups or sports teams or something that can help a child learn turn-taking skills. I'll use my own daughter as an example. She receives physical therapy and occupational therapy, which are both stand- alone services with the school system, so she probably won't qualify for their programs. But if I were to take her to an outpatient therapy, it's 20 minutes of therapy a week and with her sensory processing difficulties, it might take her 20 minutes before she's even ready to participate. So, if I were to really realize solely on that, it might not be an effective option. On paper, it might look like, “Oh, private therapy is a good option for you.”  But it might not be. So, to really ask the family what they want to get out of their transition and take those individualisms into account so you're not sending them up for something that they can't use or don't find helpful. I love that because, you know, we call it an Individualized Family Service Plan (IFSP) and we talk a lot about individualization, but I think when we have so many families we work with, it's really easy to go with kind of a basic model for everyone. It's fast and it's what we know and what we're most comfortable with. So, I love the idea of expanding and stretching a little bit around what would work for families. And I feel like a lot of what you're talking about really would depend on knowing the family well, knowing what questions to ask and building enough of a relationship where they're going to answer you truthfully as well. So, I'm curious. I know one of the pillars or foundations around transition is good, clear communication. Are there some things that you've learned about how professionals can communicate with families to support that kind of communication? Yeah, I think you need to be very clear about program requirements. For instance, when I worked at Head Start years and years ago, there was this 80% rule. Children had to attend 80% of the time or they would lose their spot, which it sounds like, oh my gosh, missing 20%?  That's excessive. But when you think about how often kids get sick at this age, or how parents might want to keep their kids home on days they have their own time off, and then they want to spend time with their kids. There are limitations there and there are limitations to every program. You know, not every developmental preschool has peer models, for instance. And especially when you’re new to the professional field, there's this temptation to make it look like you know it all. But you can work in this field for 20 years and things and resources change so often that you don't know it all. And I think one of the best ways you can communicate with families is to be open and just say, “You know, I haven't run into this before. Let me see what I can find out and get back to you.” And then also remember that 8% of Indiana adults are considered illiterate and you might not know which adult you're working with that falls into that category. I had a friend that went through her master's program, and nobody had any idea that she had this disorder where she couldn't read and retain information. So, you just never know. Because reading illiteracy is everywhere in our society, and people who struggle with it have gotten really good at hiding it. You might give them applications to places and they won't fill it out because they can't. And as a service coordinator, in particular, I went through an entire year with a family before I found out this mom couldn't read. And so everything I had given her up to that point, she didn't have access to. Never assume that everybody has access to information in a normative way, just always ask. Yeah. So that's got me thinking about what are all the different ways that we can share information with families because you just pointed out that some families, they're not from a print culture and that's not something that's going to resonate with them. And it might look like they don't care or that they are disengaged in the process when it could be, in fact, that they're not comfortable with the information in the way that you provided it. So, are there alternatives? Like how do you get around that? I think, again, asking is a huge part of that. Not everybody, for instance, wants hard copies of information. If you bring an application to Head Start, not everybody's going to be able to access that the same way. And alternatively, not everybody is comfortable with email, electronic files, you know. And I think remembering that transitions can be a very overwhelming time for families, not just for First Steps, in the world in general, but you have birthdays coming up, you have preschools or other programs that your kids could get into, and I think you understand that on some level as a professional, but when you experience it, it hits differently. And there's this temptation to give family information and just let them be responsible for it. Because you have so many kids and families that you serve and it's hard to do anything, but just let it go. But you don't realize to the full extent that the family's life is being uprooted in so many ways. And how many times do you during times of stress miss something? I think we were just talking about this earlier. I think back to when my son was born, and I kept setting the stove on fire. I was like, that's not me. I don't forget that there's something on the stove, not typically, but stress does something to your mind, so it's not as simple as saying, “Well, if they really wanted it, they would have filled out the application, or they would have done X, Y, or Z,” because if it were that simple, they wouldn't need us. And I'm not saying you need to spend all your time on one family because that's not realistic, but to remember that families do need to be treated like they're going through a time of great stress.  Give them grace and understanding so that they might not retain all the information that you anticipate them retaining. It might be that you need to set up some time to help the family fill out that social developmental history, just so it gets done in a timely manner so that LEs can get what they need to get done on their end. I'm thinking about those informal supports, too, because I could see value in, you know, we know service coordinators have very high caseloads, and sometimes, you know, maybe there isn't time to sit down, but has there ever been a conversation with that family around informal supports, you know, do they have a helpful older sibling that they rely on or a family friend that has older children that has been through some of these things where because it doesn't always have to be those formal supports and resources, and that can be super helpful too. Speaking of informal, I mean, I guess this could be formal or informal, but a lot of my connections were informal. And that's just connecting with other families. One of the things during the transition process, and like you said, transition is stressful. You're changing systems, and this is brand new for everybody involved, except for the professional, which, you know, which is why sometimes those professionals do forget a little bit, that this is brand new for most families. One of the things that's most helpful is talking with other families about what their experiences have been. So, you're finding families with similar diagnoses or maybe have been through similar systems. And you're getting a chance to find out what did they do? What were their experiences? Where did they end up? Because I think it's easy to imagine transition as this pipeline from early intervention straight into developmental preschool. And if we're doing a one size fits all, that is kind of what it looks like sometimes. But we know that transition is really kind of like a  spider web, right? I mean, we're going from early intervention, and you could go in all kinds of different directions and piece things together in different ways, depending on what your individual needs are. So, hearing from lots of different families can give you a sense of what that actually looks like, and that was incredibly important for my family when my son was transitioning because professionals didn't always have that information at their fingertips. I'm curious. Do you have thoughts, either as a professional or as a family member, about how you can connect families with others? And you know there used to be this thought process and I think it's still prevalent a lot in the medical world, that you don't want families to join support groups. You don't want them to look up anything on their own, et cetera, because the stories are the worst of the worst and you'll just rile everyone up, but it turns out that it's not the case. You know, families are often the best guide for other families who are going through similar processes. and I remember, my sister's daughter had intense special needs, and I invited my sister to a webinar training we had about Medicaid waivers and how to use them. Everybody in the office was just so excited about this webinar because Medicaid had changed so much over the past decade, and the training itself was not helpful at all. So, in the end, I turned to my sister, and I said, “Tell me about your process of getting your daughter enrolled with a waver.”  And she walked everyone through the steps, and it was so informative and so helpful and as professionals when we are educated, we think we know things, right? But lived experience is also a form of education that takes into account all the imperfections and inaccessibilities of life, where my formal education goes off at best practice in an ideal world. So, it's helpful to have somebody who's been there and has gone through it and said, “Hey, here's what's available and here's how it actually works.” Yeah. I think that's incredibly valuable and something that when we get busy and are moving fast, we sometimes forget. We have multiple resources, and I know we've mentioned them before on this podcast, but they're great supports, you know, as you transition into the school system, if that's a choice that a family is making, InSource is a great source of support. And we've got Indiana Family to Family (INF2F) as well. So those are things we can link in the notes. By the way, we'll also link the amazing handouts you made in the show notes so that folks can access those if they'd like to. But, you know, one of the points you were just making is around how valuable family knowledge is, and the capital that we have in the families that we serve, the knowledge they've gained through hard-lived experience. I wonder, as we work with families from all different backgrounds and all different prior experiences before entering First Steps or early intervention, what are some ways we can show respect to their lived experience and their culture and their preferences and all of those things as we work with families during the transition process? I think one of the biggest things is to respect the family's autonomy. You know, we all have preconceived notions and biases and ideas of what “good parenting” entails or what a home and routine should look like, what we feel is best for a child or family. And these biases come from our lived experiences. As a professional, you have to acknowledge that every family has a different perspective based on their own lived experiences, their own cultural beliefs, their own backgrounds. You have to believe that the family's ability, they have the ability to act in the best interests of their child to respect the decisions they make along with the path that they choose for their family. You might, for instance, have a family with a kid with intense needs who doesn't want to go through the school system or private therapy or anything, you might think to yourself, “What are you doing? This kid obviously needs X, Y and Z.”  But do they? The family might have a different perspective. So, to truly believe that every family wants what is best for their child and that they have that agency and autonomy to choose what's best for them in their circumstances in their family. And that can be hard. Yeah, absolutely. I hope everyone rewinds and hears that a couple of times because that was a powerful couple of sentences. I just have to ask, because you mentioned at the beginning that you have a child transitioning out of First Steps. I'm wondering, as you've started to go through this process, you haven't had your transition meeting yet, right? We have actually. Oh, you have. Okay. As you've gone through this process, even including the transition meeting, what are some things that have worked well? And is there anything that you kind of wished had happened? I know you know a lot already because of all your work with First Steps. But still, what worked well and was there anything that you're like, “Oh, I kind of wish that that had been offered or done.”  The funny thing is I've been a service coordinator, again for a decade, and even I lost the social developmental history paperwork that the LEA sent me.  So, it's on the couch, kids spilled something on it, did I put it somewhere to dry, and no clue, no clue where it is. And then I was going to get back to them tomorrow and the day after, and I think one of the things that was helpful was that the LEA sent me the paperwork virtually for me to fill out and return. And I'm sure at the time she was thinking, “Oh my gosh, Charissa seriously like, you know better.”  She didn't say that. She said, “Oh sure, here you go, no problem,”  even though I know that the timeline was a problem. I know these things. And I often think about how we as professionals handle those kinds of situations because it's so easy, I do this myself. You think, “Oh my gosh, can you just not be at your home? But you have to think about what's your goal. If your goal is to make things better, then how do you go about doing that? And I think to acknowledge that families, into families, that it’s okay to be imperfect. Here's the expectation is X, Y and Z, but nobody expects you to be able to do X, Y, and Z perfectly. Just show support to them. Likewise, I think some of the things that, not necessarily with my daughter, but some things I think that I've done in the past that were not helpful is that when families have come with some concerns, sometimes it's very easy to brush off those concerns and say, “Oh, well, that's just normal child development, or that's just natural things that will happen” because there's a lot of natural things that happen, normal child development that you still don't want to continue. Really take those family concerns seriously and say, “Okay, well, if you want your kid to do X,Y, and Z, then we are here to support you, regardless. Yeah, absolutely. I'm just sorry, I'm just I'm sitting here thinking about giving families grace, and giving ourselves grace and how that's earlier today we were talking about this term psychological safety and this idea of building solid foundations with our families so that they would be safe to tell us those imperfect things or the fact that they can't find their social emotional history form or whatever it is and so I think that might be a teaser for future episodes where we dig into a little bit how we build those relationships in the first place so that all those imperfections that we all experience, we don't feel like we have to armor over them, and pretend that they don't exist because we're not totally sure we can trust the person across the table from us. So, Charissa, thank you so much for being here. Thanks for having me, Katie. Absolutely. Thank you, everyone, for being with us and we will see you next time. Thanks for listening to the Early Childhood On-the-Go podcast from the Early Childhood Center team at Indiana University. Learn more at IIDC.Indiana.edu/ECC/