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episode 3
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heartwired
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Transcript
Introducing HeartWired & the Pyramid Model
00:00:22
Speaker
Hi, everyone. Welcome to our next version of HeartWired. i am delighted to welcome my friend and colleague, Naomi Grinney, who's going to be talking to us a little bit more about understanding the pyramid model and really looking at some families and some child and family goals.
Understanding the Pyramid Model Framework
00:00:41
Speaker
So we've done a lot of overview or orientation to the pyramid model framework, but let's do just a really fast dive reorientation. So here's our pyramid model framework.
00:00:57
Speaker
And we start with the bottom, with the yellow, the effective workforce. And really what we're talking about is a well-prepared workforce of early interventionists, all of us, that we're ready to work with families.
00:01:13
Speaker
When we move up to the turquoise or blue level, we're really talking about promotion. The key concepts there are nurturing and responsive relationships, as well as high quality supportive environments.
00:01:29
Speaker
When we move up the pyramid to the green section, we're focusing more on prevention and really thinking about targeted social emotional supports.
00:01:43
Speaker
When we get to the top of the pyramid, we think about, in the orange, we think about treatment. um
Individualized Family Services & Unique Needs
00:01:50
Speaker
And that's more intensive intervention. So Naomi, recently I was talking to one of the trainers from the National Center for Pyramid Model Innovations. And she said, we have these tiers to really think about how we support families, but we would never refer a child or a family as a quote,
00:02:13
Speaker
tier two child. Can you elaborate elaborate a little bit on that? Yeah, and Corey, that's such a great question. Because you know, when we think about kind of the kids and families that we're working with, what we really kind of come back to, right, is this individualized approach, we talk about it in writing our individualized family services plans, we talk about making sure that we are providing supports and interventions for families that are individualized to their needs, right? And so when we um understand a kiddo and and some of the reasons why they might be seeking early intervention services, right, or why that family has reached out to us, we really want to be thinking about, okay, what are the needs of the family? What are the strengths of the family? What's been their journey and kind of experience so far, right? We know that families are the expert on their children, right? They are so invested and responsive into their care.
00:03:11
Speaker
And it also, you know, for us as early intervention practitioners, we really want to make sure that we're understanding what are the unique needs of each of those families, right? And
Connecting Families to Community Resources
00:03:22
Speaker
so when we think about something like, you know, prevention, for example, we've got families that are going to need connections to community resources. We've got families that are going to need private therapies. We've got families that are going to need some medical interventions. And so as we're talking about that, we're really thinking about kind of that child and that family as a whole picture, right? We're not just thinking about, oh, that one piece, right? Where, oh, it's prevention, right? We're thinking about, okay, we're working with the Sanchez family and we really wanna understand what does Joey need, right? What are the specific supports for that family? What's the the dynamic of that family? Where does the family live? What does their community look like? Right. And so it helps us as practitioners, I think, to really make sure that our approach is individualized and that we're also looking at um really thinking about what those family strengths are as well, because sometimes when we think about, you know promotion, im Sorry, when we think about something like prevention, right, we might start to think about, oh, you know, these are the challenges or the difficulties. And so we really want to kind of keep that strengths based approach as well to understand those family needs.
00:04:38
Speaker
You know, one thing I remember, Naomi, is really somebody talked to me one time about On a whole, all families want what's best for their child and really kind of holding that as we think about our work with social emotional development.
00:04:57
Speaker
So we also have talked a lot in Virginia about the Pyramid Model Framework and those key practice areas. And when we think about what we're going to be talking about today, we're really hitting all of those keys. We're we're really diing into diving into partnerships, family-centered coaching, relationships, all of it. We're going to hit all of those keys a bit today.
00:05:27
Speaker
So you might remember when we did our very first orientation to the pyramid model framework, framework we had a couple scenarios. And Naomi's going to help us think about those scenarios. So we have this infant...
00:05:44
Speaker
toddler, child care provider. And when you consider what we know about Tier 1, which as a reminder is about supportive environments, nurturing relationships, I want us to really think about what we see in this picture. The
Supportive Childcare Environments
00:06:03
Speaker
provider is on the baby's level.
00:06:06
Speaker
She's offering a warm positioning with proximity while sharing a book. Looks like there are other toys and some cozy things like pillows and stuffed animals. So they're all gay engaged. So, Naomi, when you think about early interventionists collaborating or working in a child care environment, what kinds of things do they need to think about related to Tier 1?
00:06:36
Speaker
Yeah, and you know, so many of us go and see kids, right, in child care settings, in community-based daycares. And so I love this question because I think that, you know, similar to when we think about families, right, child care providers, they come into this field for a reason. They often care so deeply about the children that they're working with. And they also run into some of the same challenges that we do, right? When we think about being an effective workforce, sometimes um We might not have the resources that we need right we may not have the training that would be beneficial for us and so remembering that childcare providers and individuals who are working with kids sometimes that's also true for them right they may not have all of the materials in their classroom because.
00:07:24
Speaker
there aren't funds that are accessible, right? Or they might be um navigating through a lot of staff turnover because it's, um you know, that's what's happening kind of within their community. And so I think keeping that in mind, right, that childcare providers also and early intervention providers, right,
00:07:43
Speaker
love working with kids, enjoy working with families, want to do relationship building. um And there's also this idea of, you know, we don't know what we don't know. And so sometimes the approach that someone has Is the approach that's been taught to them.
00:07:58
Speaker
Right. And so we're making sometimes that shift between, well,
Partnerships with Childcare Providers
00:08:02
Speaker
this is maybe what my experience was when I was parented, or this is what I learned when I was in school. And maybe that's, there's been some time since that happened. Right. Or I went and attended this training and now we're doing things in a little bit of a different way. And so kind of like we do, you know they are adapting ah and adjusting to to some new information.
00:08:22
Speaker
They may not know that there's tools out there to support their kind of journey, right? And even something like um you know getting on eye level, right? We talk with parents about that sometimes. We say, oh, you know when we're talking to kids, it's so helpful to be on their eye level.
00:08:40
Speaker
Maybe there's a care provider that would love to be on eye level with a child, but there's also something else that's happening, right? And so knowing that the the environment is really different. It's really different when you are a care provider in a room with four or six children than if you're a parent or a family member at home with one child, right? And so thinking about that different environment um ah kind of the flow that happens during the day and really remembering to like, where are the strength areas, right? What can we capitalize on? Is there a specific activity that happens during the day that we can really maximize? Is there um
00:09:18
Speaker
you know, routine that's happening, right? We talk about that all the time. Oh, diaper changes are a great time where you can sing a song to your baby, right? Diaper changes happen in daycare centers and in community-based child care centers all the time, right? And so there's a similar strategy or a similar intervention that we could help to support.
00:09:38
Speaker
um And so I think just, you know, also the same that we do with with our family members, you know, we're really developing that partnership, right? It's not us coming in. It's not us, you know, saving the day, right? It's really thinking about, okay, what are we supporting during our visit, during our session?
00:09:57
Speaker
that a child care provider could use, right? What's something that might be tangible for them? And not only that, but how are we supporting kind of everyone that's within that system? So maybe there's ah a morning teacher and an afternoon teacher. Maybe there's also some admin team members. Maybe there's a center director, right? So there's lots of opportunities to to support kind of that entire team that's working with a child. But I think really also keeping that partnership, right? Because the same with the family. We don't see what's happening before we arrive at the home for our session, right? And so we don't know what's happened in that center before we're coming in for our visit. um And really hearing where that provider kind of is coming from, what they know about the child, what they understand about that child's development. I think provides a lot of opportunities for learning on both ends and for that communication to really be built so that everyone's feeling like they're on the same page with helping that child kind of toward, you know, the goals that we've identified or helping them to meet those milestones that we'd like to help them to meet.
00:11:02
Speaker
You know, and you hit some really nice things when you are comparing and contrasting with a child care provider, but also when you're doing home visits. And what would an early interventionist be looking at? For example, not all families, we just so naturally as early interventionists shimmy on down to the floor and sit on the floor and play.
00:11:25
Speaker
and not all families get on the floor and play with their children, or maybe there's a physical inability to get on the floor. So what should early interventionists be looking for in a home visit that really kind of helps build or supports that quality, supportive environment and those nurturing relationships? Yeah.
00:11:49
Speaker
Yeah. And that's, you know, Corey, I love that question because I think sometimes we think about like the physical environment. Right. And what I think about often is, you know, those questions about, you know, what do parents know about child development? Right. So many times when I've gone into a home, I've had parents and, you know, I'll be working with say an 18 month old and the parent is talking to me about, know, Oh, and, and it just seems like, you know, when they're throwing their toys, it just, It's just their impulse to throw their toys. it's like, oh yeah, that is what's happening when you work with 18 month olds, right? But if a parent didn't know that, that's what they do. But if a parent didn't know that, it can feel like, oh my goodness, why is my child throwing this toy, right? And so really helping to support what do the parents know? What has been their experience? What are they kind of seeing in their child? And sometimes there's what they don't say, right? So they are telling us, you know, I'm so concerned because my child's not communicating. And what they're not telling us, right, is I'm worried what that means.
00:13:00
Speaker
What does that look like in the future, right? What happens when when we don't know what they need? Or, you know, it's it's also frustrating for me as the parent when I'm maybe playing a guessing game, trying to figure it out. Right. And so kind of looking beyond, um you know, what might be kind of the physical part of that environment, but really thinking about, you know, when a child is crying, does a parent understand why that's happening so that they have the response, right? Especially when we think about like those small babies.
00:13:31
Speaker
Yeah. So like reading those cues and understanding what that means. Exactly. And then we think about things like, right. Okay. If, you know, I've had this happen with parents where they've said, you know,
00:13:42
Speaker
my, you know, my leg has, has been injured. And so getting onto the floor for me is really challenging. Sure. We don't want to cause more pain, right. By getting on the floor. right Would it be possible for you to put your child into maybe a bouncy seat and you sit across from them, right. And we can do that very safely because a child you're supervising them the whole time you're sitting right there with them.
00:14:09
Speaker
you're still getting that face-to-face interaction. Right, you're still eye-to-eye. You're still there. Maybe you're doing it when you're changing a diaper and you're doing that on a changing table. We're not having to bend down on the floor. We're using that table that's there.
00:14:22
Speaker
You're making that eye contact. You're smiling, you're responsive, right? And so I think that there's ways that we can help to support where parents are at and and what they feel like is doable and possible for them without asking them to shift or to do something differently based on what we think should be happening, right? yeah And we can kind of explore with them.
00:14:45
Speaker
Wow, did you see when Susie looked back at you and she was so happy to see your face, right? We can kind of explore that with them. And I think that when um the The beauty is that because we're someone that's coming into the home, we might see that home really differently. So we can see all of the places where that's something we could do.
00:15:08
Speaker
There's another place that we could have those opportunities. Yes, exactly. Yes. I love that.
00:15:19
Speaker
Well, let's go ahead and talk about um our next little vignette. We have in this picture, we have Jin. And Jin is 26-month-old, and he lives with his mother, Asako. And Jin is a high sensory seeker. He's always on the move.
00:15:40
Speaker
he doesn't It doesn't seem to register if he steps on small toys like Legos. Last week, Asako found him trying to climb from the kitchen counter up on top of the refrigerator.
00:15:55
Speaker
um He's never slept through the night. And Asako, as you can see in this picture, is feeling frustrated, exhausted, overwhelmed. So when we think about tier two, remember the focus is on prevention with some targeted social emotional support.
00:16:14
Speaker
So there's a lot to consider in this vignette. Where might you start with this family? Yeah, you
Strategies for Active Children
00:16:22
Speaker
know, I think um being able to first kind of recognize, right, that when you are a parent or a caregiver or kind of supported, supporting raising a child, right? That is a 24 seven type of job, right? And so sometimes um what I know what I've heard from parents is like, oh, you know, nap time was so great because it it allowed me to, you know, get done something that I needed to get done, or it allowed me to take a pause you
00:16:55
Speaker
um you know, I was able to get some rest. Right. And so when we think about something like not sleeping, that has such a huge impact, right. and And everything and everything right on our house, on our kind of mental wellbeing on all of it. And so when you and, and little friends, right. Jen is a really busy little friend. And so when he is very busy, that also doesn't allow for a lot of downtime, right. He's a problem solver. He's a go-getter trying to climb to the top of that refrigerator. Right. And sometimes it can also feel like, okay, well, you know, as a, as a parent or a caregiver, I'm just having to kind of put out the fire or, or stop this behavior from happening. Right. And so maybe starting to think, okay, if we know that Jen really enjoys movement, he really likes to keep his body active.
00:17:47
Speaker
What are some ways that we can support him doing that safely? Right. What are some ways that. You know, we're not going to try and kind of change that, right? We're not going to say, well, he just won't climb because that doesn't seem to be very realistic. He wants to move. But let's think about some ways, maybe inside the home, maybe outside the home, that we can help to teach him how he can do it safely.
00:18:12
Speaker
Right? Work all those wiggles. Work some of those wiggles out. Right? all of those wiggles out. And some of that is also talking with Asako to see what she's comfortable with. Right? Because every parent is going to have a different level of comfort. Every parent is going to have different preferences for how they're supporting their child's needs. And so it's, it's both, right? It's not an either or, but it's really both people in that home environment. Because if we just said to a Saco, oh, it's, we'll just let Jen climb wherever he wants.
00:18:46
Speaker
That's not going to feel good for her. And so she's not really going to be able to relax and embrace that happening. And so I think really heard, gro she she won't feel heard at all. yeah Yeah, just allow him to do something that doesn't feel safe. Exactly. that's why i'm under you I'm wondering, Naomi, you know, we talk in Virginia, kind of we have um developed this format on how we write our goals, both our long term goals, our short, short term goals. And And I'm wondering if we could think about that a little bit. So we use this acquisition context and criteria, and we really think about how we're going to um write those. So I'm wondering if we could think, if you could help us think um how to write some goals for Asako and Jen. And
00:19:41
Speaker
you know, as we were kind of putting together our information, we tried to highlight this so that you can watch the colors. Green is acquisition, purple is context and criteria. So I'm wondering if you can um talk through these a little bit.
00:19:58
Speaker
Yeah. And, you know, I think one of the things that is really kind of helpful to think through is, you know, what what is it that we want for kids kind of to be able to do, right? So I think sometimes when we write goals, we, some of us might think about, you know, what behavior do we want to kind of stop?
00:20:20
Speaker
What do we want to prevent from happening? But when we think about, right, that it's almost like when we, when we, um, so Sometimes we might have this kind of ah urge to, you know, if if we know that a kiddo is going through a really ah challenging situation, right? And we might want to say like, oh, well, let's just stop the crime, right? Well, what that what that does is that kind of interrupts their emotional process.
00:20:46
Speaker
And so what we're thinking instead is, okay, we can tell that they're having a harder time because they're expressing kind of this distress that's happening. What skillset can we help to teach them in this moment? And so when we think about something like sleep, right? We can't, I don't think anybody in the history of people has ever gone to sleep because another person has told them to, right? Like, I don't think that that's ever happened.
00:21:10
Speaker
But what we can do is think about, okay, what are those routines? What are those activities that we're doing to help promote that sleep so that hopefully over a period of time, kind of all of the pieces get connected?
00:21:24
Speaker
right, for Jin and kind of in his body and um how his, you know, his brain is is operating, that all of those pieces get connected. And so when we think about kind of the long-term, right,
00:21:36
Speaker
When Jen is really kind of ready for bed, when he knows that that routine is happening in his day, when maybe a Saco has said, Jen, it's time for bed, that he really understands what that means, that he's participating.
00:21:52
Speaker
So maybe he helps to get his pajamas. Or maybe he wants, you know, a song that Asako sings to him at night. Or maybe he knows that we brush teeth before we go to bedtime, right? And so that he will be kind of an active participant. And that when Asako says things, or maybe she also points toward his bedroom or toward wherever he's sleeping, right? That he'll know, mama said bedtime. And she was pointing toward the door.
00:22:24
Speaker
I know what that means, right? And we we also think about who's the person that's participating in bedtime with him? Well, that's mom, right? And she's the one that's kind of part of that bedtime routine. And so it's not that Jen is you know grabbing his pajamas and trying to climb to the top of the refrigerator with them, right?
00:22:43
Speaker
Jen is getting his pajamas and maybe allowing mom to help change his pajamas or maybe he'll hold the toothbrush while mom is also brushing his teeth. And then we also think about that we, you know, for a lot of our kiddos, right? When, when they can do something one time, that's fantastic. And we love that. But we also want to see that they've owned that skill a little bit, which means they're able to do it over a period of time. And so we're really thinking about kind of, yes, ah you know we narrow into that goal, but if we were to kind of expand out a little bit, what does that full picture look like, right? And you know what's what's kind of not written here is when, um and this is hard to kind of capture in a goal, but when Jen is kind of engaging in that way, in that participation, right
00:23:35
Speaker
Asako's frustration level is presumably less because she's not trying to chase him to the top of the refrigerator with his pajamas. And so he's also responding to that, right? They're able to engage in some co-regulation there, which then also sets up well that transition into bed.
00:23:55
Speaker
So that's such a calmer routine. yeah you Yeah. Yeah. Because everybody knows what's happening, right? And everybody yeah knows what to expect in that routine rather than pajamas, teeth.
00:24:07
Speaker
songs, let's go, right? Yeah. Oh, this is what we do in that routine. Yes. So we've really hit that acquisition. What is the skill we're looking for? So Jen's going to help with things like changing his clothes, choosing his lovey, reading a story. You mentioned a song. The context is bedtime and with his mom.
00:24:29
Speaker
And we would be able to say when we're doing progress monitoring, If he could do that every night for two weeks, probably he's nailing that. So we're going to hit, you helped us write some short-term goals. And I'm just going to let you kind of talk through those because the the idea is that short-term goals really can be written the exact same way. But maybe you could talk a little bit if there's anything else you'd like to highlight on these short-term goals. Sure.
00:24:58
Speaker
And, you know, when we think about kind of if you look at the progression of that, right, we're starting to talk about when when Jen is waking up at night, because we know that that's something that's happening now. And so we don't want to assume kind of with the first short term goal that all of a sudden he's not waking up. Right. So we're kind of meeting him where he's at. And we're saying when he's waking up. Right. But we're we're shifting just slightly to say maybe right now. so I was imagining in my head that when he wakes up, it's a little bit more frenetic, right? So he maybe isn't able to call for mom. Maybe he's crying. Maybe there's some screaming. Maybe his his body is responding differently. And so when he's waking up, he kind of has that knowledge of, I can call for my mom and my mom's going to come help, right? And so when he's when he's kind of saying that word like mama or you know which whatever kind of word he has for Asako that
00:25:49
Speaker
He can kind of call her. She understands she's coming in. She's providing that responsivity, right? Then we kind of think about, okay, we know that there's kind of a calmer entrance into bedtime, right? Because we've got that really beautiful routine that we're working toward.
00:26:05
Speaker
When he's going down, he's in that more regulated state. And so he's able to, right? He's had a beautiful song sung to him. He's in his nice cozy pajamas. He's getting into his bed.
00:26:17
Speaker
that he's in that calmer state. So he's going to be able to make that transition to to put himself and to kind of engage with that sleep. And then we also are looking at, you know, when he wakes up, right, he's going to kind of shift from needing maybe some more support from Asako to then being able to put himself back to sleep. So when he wakes up, he feels calmer,
00:26:40
Speaker
He doesn't feel as distressed and he can make that transition on his own. Now we might be staying in that space, right? Where we're just really working on that first short-term goal for a while.
00:26:52
Speaker
And that's okay, right? I think sometimes when we, even when we look at short-term goals and we say, oh, this is, we've written this for a little bit of time out from now, right? We're still kind of focusing on that, right? We're still kind of focusing on, okay, well, it's June, That that goal is coming in December, right? But I think for us as interventionists and providers, being able to kind of stay in that space where, depending on where he is kind of coming in, we might just need to really spend some time working on Dr. Emily Helderick- Practicing calling right right maybe we need that week. Emily Helderick- yeah taking that time to allow that scaffolding exactly that's going to move. Emily Helderick- So I think that's just an important thing for all of us to keep in mind right even when we're you know a service coordinator is calling to check in with a saga to say how are things going right.
00:27:40
Speaker
We're practicing calling mama from a different room. That's a completely new skill set that he didn't have before. And so even doing that practice work, that's a huge kind of movement toward achieving that goal.
00:27:56
Speaker
I love that. So what I'd like to do next is really think about, we've been talking a little bit more in Virginia about writing family goals. And we really, again, can use that exact same acquisition, context, and criterion. And you really helped us think about maybe a goal for a SACO. So maybe you could help talk through this one.
00:28:21
Speaker
Yeah, and this
Goal Setting for Families with Active Children
00:28:22
Speaker
is, you know, I think um I'm so glad that we're making this shift in Virginia because I think so often, you know, we write our goals for for the kiddos, right? And the kiddos are kind of the ones in our program. But kiddos exist and kind of operate within the context of their families, right? And so when we maybe aren't always thinking about those family goals, we might kind of miss something or there might be something that we can really help to strengthen within that that entire family that also supports that child achieving those goals that we have, right? And so I love that we're just making this shift because I think that um as parents and caregivers and you know providers who are working with children, There's also ways that our behaviors can shift, that we can learn some new skills and strategies, that we can think about children's development in some different ways. And so we really are kind of strengthening on both ends, which, you know, is in all likelihood is leading to some of those kind of improved outcomes for kids and families. And so when we were looking at this kind of goal for Asako, you know, we kind of thought back to, okay, Jen is,
00:29:33
Speaker
really active and he loves moving his body. And we want to give him some opportunities to do that. And so, you know, to think about, okay, Jen's, you know, ideas for how he can move his body include climbing to the top of the refrigerator.
00:29:51
Speaker
So we thought let's have Saco identify some ways that she feels comfortable and that are safe for Jen to be able to move his body and explore.
00:30:01
Speaker
So that she can then help to shape that for him, right? So if he's climbing to the top of the refrigerator, rather than saying, Jen, we don't climb to the top of the refrigerator, we're using a redirect, right?
00:30:16
Speaker
Jen, we can climb on the pillows. come on, climb on the pillows together. Right. And so it's an opportunity to still recognize that need and then also give him that opportunity in a way that feels safe and doable. And sometimes that might mean inside the house, right? Maybe we're talking about kind of the the jumping on pillows. Maybe it's, we're going to go outside and go for a walk around the neighborhood. Right. And so there's lots of different ways that even, you know,
00:30:45
Speaker
as a provider that's coming into the home, we could practice that, right? We could say, what's what's something that you thought about today, Asako, as a way, you know, that Jen could um could expend some of that energy, right? Oh, you you thought about going for a walk in the neighborhood? Do we want to try that together today?
00:31:03
Speaker
do we want to practice that, right? And that also gives us an opportunity to practice, you know, some safety directions. It gives us an opportunity to maybe do some games, right? I think about like red light, green light. how we could make it kind of fun and playful for Jen, but also as a way that a Saka was feeling more comfortable about that exploration so that she is more participatory and engaged with him.
00:31:28
Speaker
i love that. Let's take a look at um of an example of ah um another long-term. I think you might've hit some of um some of these already, but is there anything you'd like to add about this?
00:31:43
Speaker
Yeah, I think um giving, you know, thinking maybe more about, again, we, you know, we kind of narrow in the lens or broaden the lens depending on the situation. But I also think about maybe during routines, right? Because for some kiddos, like let's say that, you know, Jen really enjoys climbing and that's not only on the refrigerator, but it's also on the table or on the counter, right? And he might want to do that during a mealtime.
00:32:09
Speaker
What's a way that we could help to support that, right? Do we give him maybe a lot of opportunities for movement before a mealtime? Could we maybe take a break during a mealtime so that that's a really kind of opportunity like, oh, let's walk, walk, walk, walk. walk walk walk Let's walk, walk, walk back to the table, right? So what might be some of those more creative ways that we can help to support kind of not only within his playtime, but also within some of those routines, because often for parents and for caregivers, those routines are also really important to have happen during the day.
00:32:42
Speaker
yeah I like that you really, you kind of honed in on Asaka identifying the strategies, but also looking at those safety things that that you mentioned, like that's definitely going to be one of her priorities.
00:32:56
Speaker
Yeah.
00:33:02
Speaker
hey Let's take a look. um
Supporting Traumatized Children & Foster Families
00:33:05
Speaker
This little one is Birdie and she was recently removed from her parents care following a CPS report regarding abuse and neglect. um She's been with her new foster family for about three weeks. And mealtimes are frequently very difficult as Bertie seems very food already oriented, but she becomes agitated if the food doesn't come fast enough that as she thinks it should. um She likes to spread her food, which is disconcerting to her foster mom who really values cleanliness. When I saw this picture is thinking, oh my goodness, white curtains, white curtains for a mom who really values
00:33:53
Speaker
cleanliness and spaghetti kind of hard match so birdie is often inconsolable um she resists common comforting like a lovey or rocking and singing songs um what might she be considering for birdie and her new foster mom yeah i just you know i i think one of the first things that comes to mind is you know trauma right like Bertie has been through an experience that she doesn't have the words to be able to express. She may not fully understand what's gone on. um and you know, from her perspective, she is now kind of separated from the people who had been caring for her for her whole life, right? The people that she's attached to the people that she feels safe and comfortable with. And so that's a huge adjustment.
00:34:49
Speaker
Right. That's a huge adjustment that she's made. and her foster mother has also made a huge adjustment because Birdie is a new kiddo in her home. She is coming in with her own strengths and preferences and, and that with small children, right? Those strengths and preferences can't always be communicated easily. And so there's a lot of trying to figure out and problem solving and a little bit of guesswork that's involved. And sometimes the same that, you know, happens with parents, with grandparents, with aunts and uncles, with care providers.
00:35:25
Speaker
You don't always know what someone's temperament style is going to be. And so sometimes there's there's an adaptation or an adjustment. Sometimes um people are more easily able to adapt. Some people's kind of style is a little bit more. um, strong and, and rigid in that way. And so there's a lot that's being asked right in this moment on both ends, right. For Birdie, for her foster mother to be able to kind of make these adjustments and kind of figure each other out.
00:35:54
Speaker
Right. And I think too, about, you know, a meal time for anyone who's ever, um, maybe had difficulty with meals or mealtimes have felt stressful or it's been overwhelming during meals, right?
00:36:07
Speaker
If we were only feeding kids once a month, right? We would feel a lot further, I think, from that stress. But mealtimes happen multiple times a day, every day. And so it's hard to kind of ignore that stress that you're feeling around a mealtime when even as that mealtime has ended, you're already thinking about when it's going to happen again. Right. And so you kind of two hours. Right. Exactly. Yes. So it's hard to feel like, you know, you have that break or maybe that escape from that stress. And that can create, you know, a lot of feelings of discomfort as well. And so I think those are just some important considerations that, you know, when we're kind of supporting families, also recognizing like what's been the story kind of before we've become involved, because for Birdie, you know, she's been through an experience that is not,
00:36:58
Speaker
um uncommon, but is certainly, you know, can be different from some of the other kids that we see and work with. Yeah, yeah. Well, as we think about an outcome for Birdie, I'd really like you to walk through the outcome. But I also am wondering when you think about a situation much like this, um you know, Virginia is using some infant mental health endorsement. But do you think um an early interventionist with a situation like this has to be endorsed or has to have
00:37:35
Speaker
some sort of specialized training in order to suit this family. so I'm going to put the goal up and then maybe you can talk a little bit about who might support this family in this one.
00:37:48
Speaker
Yeah. And I, you know, I think, um I think the great, great thing about Virginia is we have so many amazing early interventionists across our state. And, you know, I think the thing that's really important is For all of us, right? I'm not a physical therapist, but I do understand, you know, motor development, right? And sometimes when I've worked with kiddos where their primary concern is motor development, I've found myself, let me learn a little bit more about this particular challenge that this kiddo is having, because that's new for me, right? Let me understand a little bit more about kind of how the family learns, right? And what their their style is. Let me understand a little bit more about some of the the things that they've tried before. Right. And so even though I'm not a physical therapist, I can take that opportunity to kind of learn more. Right. And say, okay, this isn't something I've seen before. I can still support this family. And so I think sometimes, you know, when we think about being therapeutic, we think that we have to be a therapist in order to do that. And we don't, we can be therapeutic from wherever we are.
00:38:59
Speaker
Because we can be empathetic, we can be responsive, we can listen, we can demonstrate compassion. And so I think certainly if you have you know, um a mental health professional or an infant mental health endorsed member of your team, they'd be a great person to team with. They'd be a great person to reach out to, to ask for their perspective. But I absolutely believe that all of us as early intervention practitioners could come in and be responsive and empathetic with this family, that we could seek to understand the perspective that they're coming with, that we could listen to their concerns. And so I'd really encourage um all of us kind of as practitioners, it's ah it's a way that we can expand our skill set too, right? When we are working with a family and we think, well, I haven't worked with this before. That's an opportunity for us, right? We go back to that base of the pyramid when we're the effective workforce and we're learning and kind of continuing to grow our skills.
00:39:59
Speaker
We have an amazing opportunity in Virginia. We've got so many different training opportunities for all of us. That's a great way for us to build those skills. um And when we shift a little bit, right, to thinking about the goals, these are also things like when I look at, you know, a two to three word phrase, right, that Birdie can use that phrase, I think about, well, that would be ah a great opportunity for a speech pathologist, for a developmental specialist to come in and help support, right? Because they talk with families about that all the time. Fantastic. Fantastic.
00:40:33
Speaker
They would be so great at at coming up with those words, maybe a sign that she could use, right? So we think about this goal and we think about, okay, where might kind of the the frustration be building, right? And it might be that there aren't those words yet to be able to kind of know what's happening, right? Does she want to eat? Is she hungry? Maybe she's not hungry, right? And so even if we started with some signs,
00:41:03
Speaker
Right. Even if we started with more or all done, that would be an amazing opportunity to build some of that communication. Right. And, you know, we think about, OK.
00:41:16
Speaker
Well, what does she want to eat or when she's done eating? Those are great opportunities. Right. Often we'll see kids and they like kind of push the food off of their tray. Right. and that's how we know. They are all done because the food is no longer on their high-tech tray. you know, giving her that opportunity to, you know, oh, you can also do this or you can say all done and the food can also move off your tray that way, right? And then again, we think about that kind of criteria where if she can do it once at a mealtime, that's fantastic. We really want her to be able to own that.
00:41:54
Speaker
Right. We really want her and for her foster parents to be responsive. Oh, she said all done. Okay. That means we move that food. Right. And it's kind of that pattern that over time, there's, there's some of that trust that's developed right in that communication.
00:42:09
Speaker
I said, I was all done and the food got moved. Okay. Well, that's building a trust. And, and again, thinking about Birdie's history, building that trust is so, so critical.
00:42:22
Speaker
Yeah. You know, Naomi, you um you hit something that is just so powerful to me that I just kind of want to reiterate the idea of being therapeutic without having to be a therapist, without having to have specialized initials after your name. I really love that. So as we kind of wrap up, I kind of wanted us to think about how we could put it all together. All these words that we've talked about. And I'm wondering if you might kind of take us down the home stretch and hit a few of these and um get us to the end of our our heart wired.
00:43:02
Speaker
Yeah. and you know, I love that we kind of think about and And we're being so proactive in the state, you know, how we're responding to kiddos that are coming into our programs, how we're helping identify kiddos and in the community that can use our support, right? It could benefit from our services.
00:43:23
Speaker
I love that we are developing partnerships with community agencies, with community services boards, with pediatricians, with Family members right we're doing all of this to kind of support these kiddos. Emily And when we think about this work right at at the core of so much of what we do is the relationships that we build right and and I i always kind of go back to that as an interventionist.
00:43:48
Speaker
thinking about, you know, what am I doing to really build this relationship? And I think that when we when we keep that perspective in mind, you know, we're able to build that trust. We're able to collaborate. We're able to um kind of support the family's process. We're able to provide opportunities to get a family connected with resources, right? But we really kind of tie everything back to that relationship and,
00:44:15
Speaker
And so often, right, what we hear from families is, I love the relationship that I have with my service coordinator, with my speech pathologist, with my PT, right? We sometimes see families that want to keep working with those providers because of that relationship that's been established. And so for us to think about, you know, we all have that capacity to support families. we all have that ability to build relationships.
00:44:41
Speaker
um And we also all have the ability to kind of grow our skill sets as early interventionists so that we are able to provide that therapeutic rapport. um And I'm just, I'm so glad that we're having this conversation and that we're in this space to be able to think about You know, where can I kind of grow my knowledge? Where can I build my own skills?
Pyramid Model Resources Reminder
00:45:05
Speaker
Because ultimately the people that benefit from that are the kids and families that we work with and that we support every day.
00:45:12
Speaker
Absolutely. I don't think you could have wrapped us up any better. So we do want to remind everybody that all of the Pyramid Model Framework resources are available on the Infant and Toddler Connection of Virginia website. You can do a search and find Pyramid Model Framework, and this HeartWired will also be available there. So I want to say a special thank you to Naomi for joining us and helping us.
00:45:42
Speaker
And also behind the scenes, we've had Seth from our Virginia Early Intervention Professional Development Team who made our slides look fabulous and did all of the background support. So I hope everybody has a good day.
00:45:57
Speaker
Thank you.