Laying the Foundation

A Routines-Based Approach to Enhance Access and Participation for Children with Complex Needs

The I-Team Early Intervention Project, based at the Center on Disability and Community Inclusion at the University of Vermont, created this framework that is meant to lay the foundation for communication and participation for children with complex needs, including Deafblindness. It is the I-Team Early Intervention Projects experience that all children benefit from implementation of a routines-based approach that enhances access and participation by supporting children to feel safe, prepared, heard, empowered, joyful, and engaged. All resources created on this website keep these foundational elements in mind.

Safe:

All children learn best when they feel safe and secure, both emotionally and physically.

Examples:

• Give ample time for child to become comfortable during interactions, take time to build rapport
• Use hand-under-hand support, allowing child to disengage at any time
• Provide supported seating and positioning options that build the child’s sense of security and independence

Prepared:

Children with complex needs may gather information in different ways, which may make new routines challenging. Preparing children for what is to come will allow them to better access the intervention offered.

Examples:

• Provide tactile, sign, visual or auditory information that alerts a child to what is happening next (e.g. visual schedule).
• Give child ample wait time to process tactile, sign, and/or auditory information.

Heard:

Children with complex needs often communicate in subtle ways. In order to feel heard, child’s communication attempts should be responded to with consistency.

Examples:

• Create a communication dictionary as a tool to better understand the multiple ways the child lets us know what he/she is thinking and feeling
• Provide opportunities for reciprocal interactions by responding to any bid for communication

Empowered:

Children with complex needs may have a lot of things done “to them” or “for them”. Instead, provide opportunities for the child to express preferences and interests.

Examples:

• Provide frequent choices that allow the child to have some control within their daily routines and activities
• Consider the amount of support required to maximize independence

Joyful:

All children learn best through play. Embedding play into daily routines allows children to learn within predictable and fun activities and experience repetition with variety.

Examples:

• Understand what the child finds interesting and fun. Incorporate playfulness into daily routines
• Sing songs while changing diaper
• Play peek-a-boo when getting child dressed
• Follow child’s lead in play

Engaged:

Children with complex needs may demonstrate engagement in different ways. Observe child’s current level of engagement in play activities and work toward enhancing engagement.

Examples:

• Bring engaging and interesting activities to the child, with thoughtful consideration of their vision, hearing, communication and motor needs. Encourage self-guided exploration with new materials
• Use “I do, we do, you do” process. First model an activity, then jointly do it, then encourage independence
• Complete "Presence to Contribution" play process