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Early Intervention in Natural Environments

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Reference Documents

Instruments

Description

  • This model for providing services to infants and toddlers with disabilities and their families has been known by a number of names:
    • Routines-Based Early Intervention, as in the eponymous book published in 2010
    • Early Intervention in Natural Environments
    • The Five-Component Model
    • The McWilliam Model
    • The Siskin Early Intervention Model
  • The model hinges on five components' five dimensions of providing services, each accompanied by one major practice:

  • Implementation of this model requires administrative support (including policies), ongoing training at the local level, and a commitment by practitioners.
  • To explain this model to doctors, other professionals, and families, the following explanation, which we call  "the script", is useful:
    Children deserve the most intervention possible, provided in the most relevant places, at the most relevant times, by the most relevant people. Therefore, in this approach, professionals work with the child's natural caregivers, who are generally parents and child care providers or teachers. Parents and other caregivers learn to make the most out of the learning opportunities that occur throughout the day, every day. This results in much more intervention and more meaningful intervention than, for example, weekly sessions in a therapy room. The child's best "interventionists" are those adults who are with the child throughout the day.

Research

  • Much of the model is based on the work of Carl Dunst and colleagues. Other researchers influencing the model are Mary Beth Bruder, Pip Campbell, Richard Roberts, and Juliann Woods.
  • Although not yet evidence based, the coaching approach as described by M'Lisa Shelden, Dathan Rush, and Barbara Hanft has influenced the model.
  • Our own preliminary research on the RBI showed that it produced more functional outcomes/goals, a greater number of outcomes/goals, and greater satisfaction with the IFSP development process (manuscript in preparation). McWilliam, R. A., Casey, A. M., & Sims, J. (in press).  The Routines-Based Interview: A method for assessing needs and developing IFSPs.  Infants and Young Children.
  • Grant: Vanderbilt Kennedy Center, Family Research Program, Faculty Pilot Studies, "Routines-Based Interview to Plan Interventions and Measure Family Quality of Life." $17,268 (1 year)
  • Much of the research on a consultative approach when visiting children in child care and preschool settings is found in McWilliam, R. A. (Ed.) (1996). Rethinking pull-out services in early intervention: A professional resource. Baltimore, MD: Paul H. Brookes.
  • We are currently recruiting participants for a study on the three-tiered, response-to-support approach for home visiting in early intervention. Contact Robin McWilliam, Ph.D., if interested in trying out this approach.
  • The Families In Natural Environments Scale of Service Evaluation (FINESSE) has been used in international comparisons of countries' programs. Rantala, A., Uotinen, S., & McWilliam, R. A. (2009). Providing early intervention within natural environments: A cross-cultural comparison. Infants & Young Children, 22, 119-131.

Consultation, Training, and Technical Assistance Opportunities

  • Early Intervention in Natural Environments
  • Routines-Based Interview and Ecomaps
  • Primary Service Provider or Transdisciplinary Model
  • Home Visiting or Intervening in Routines
  • Consultation to Child Care
  • Functional Outcome Development and Writing

The types of consultations available are conference presentations; workshops; ongoing training, technical assistance, or consultation; and meetings. Once dates have been arranged, written guidelines about the types of consultation, room arrangements, audiovisuals, handouts, introductions, videotaping, expenses, logistics, and contacts will be provided. Contact Robin McWilliam, Ph.D., for more information about consultative services.

Future Directions

  • Research is needed on the model as a whole, especially in contrast to other approaches to service arrangement and delivery. Such studies, however, are highly unlikely to be funded, regardless of the clamor for them. In the meantime, research is needed in the individual components of the model.
  • Studies on the RBI, following the initial study, will be conducted.
  • The three-tiered, response-to-support model for home visiting will continue to be studied. Home visitors interested in hearing more about participating in this study should contact Robin McWilliam, Ph.D.
  • Updated studies on methods of service delivery in group-care (i.e., classroom) programs by therapists and itinerant early childhood special educators are planned.

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