Intervención temprana y preparación escolar para bebés y niños con necesidades especiales

(En inglés)

Early Intervention and School Readiness for Infants and Toddlers with Special Needs

Female Webinar Operator: Good day and welcome to the Early Head Start National Resource Center's "Early Intervention and School Readiness for Infants and Toddlers with Special Needs" webinar. To ask a question over the phone, please press star 1 on your telephone keypad. If you are using a speakerphone, please make sure your mute function is turned off, to allow your signal to reach our equipment. Today's webinar is recorded. At this time, I would like to turn the webinar to Sam

Atoloco. Please go ahead.

Sam Atoloco: Hello, everyone. My name's Sam Atoloco. I'm here with iLink technical support. If you have any questions, as today's presentation goes on, please ask those questions through public chat and they will be jotted down and we'll have time later in the webinar to answer those questions. If you have any technical issues with the software or, you know, asking, any public chat, or anything like that, please go to the public chat in the lower left-hand corner, click the private tab, and then double-click on my name and feel free to ask me any questions, technically, based on the product. Again, anything based on subject knowledge, please ask those in the public chat and we'll get to them later in the day. I'll now turn over to Sandy Petersen with the Early Head Start National Resource Center. Thank you.

Sandy Petersen: Welcome to today's webinar presentation. We're so glad you've joined us. My name is Sandy Petersen and I'm the director of Outreach, Research, and Innovation at the Early Head Start National Resource Center and I'll be your moderator. We have an agenda packed with lots of information that we hope will be helpful to programs supporting infants and toddlers with special needs.

Let's take a few moments to review the webinar objectives. Our objectives today are: To discuss school readiness as it relates to infants and toddlers with special needs being served by Early Head Start programs and to discuss the partnership between Early Head Start and Part C of IDEA. I would like to introduce our faculty for today's webinar.

First, we have Angie Godfrey, who is the Infant-Toddler Program specialist with the Office of Head Start. We're so glad to have you with us, Angie. We also have Dr. Mary McLean with the National Center on Quality Teaching and Learning. She is also the Kellner Professor of Early Childhood Education and director of the Early Childhood Research Center at the University of Wisconsin-Milwaukee.

Welcome, Mary. And M'Lisa Shelden is director of the Family, Infant and Preschool Program in Morgantown, North Carolina. The FIPP program is a National Center of Excellence program serving children birth to five.

Welcome, M'Lisa. We're so fortunate to have all of you here for this important discussion. We'll begin by hearing from Angie, who will highlight the relevant Head Start Program Performance Standards.

Angie, could you talk a bit about the Performance Standards and how they apply to the work programs are doing every day.

Angie Godfrey: Thank you so much, Sandy, and I'd just like to join you in welcoming everyone here today. We're very excited about this webinar and you're going to be hearing a lot of great information from the folks on the webinar; so welcome, to all of you, for being here. Those of you who've heard me talk before on webinars know that I like to open with the standards. The Head Start Performance Standards really are our guideline for the work that we do across all services to children and we know that there are Performance Standards around serving children, infants and toddlers with special needs.

It can be confusing sometimes because, for many years, 1308 has been around. 1308 are actually the standards for serving children three to five years old with special needs. Early Head Start came along. We don't have a special section, but incorporated throughout the standards are the opportunity to provide quality services for children with special needs in your program.

All Early Head Start programs, just like all Head Start programs -- at least 10 percent of their enrolled population should be children with special needs, infants and toddlers with special needs. And, again, all programs should be partnering with Part C, Part C of IDEA, to ensure that children receive a diagnosis and an individual family service plan and services that are specific to their development and their special needs. And that brings me to 1304.20 Child health and developmental services and 1304.21 Education and early childhood development.

We know that there are requirements for individualizing for children with special needs and, through both of these broad regulations, if you dig down deep into those regulations, there are specific requirements for working with children and their families to support them and to provide them appropriate services and to support their successful development.

So, those are the two that I would have you continue to explore. You're going to learn much more in- depth and specific information as we move through the day; so, I am going to welcome you once again and turn it back to Sandy. Thank you, Sandy.

Sandy: Thank you, Angie. I would like to set a foundation for our webinar by telling you a little about the laws that authorize our services and how we are thinking about school readiness.

So, let me tell you that I hope that you're looking at a slide that is showing you the Head Start Act and the Individuals with Disabilities Education Act are two separate laws, but each references the other, in terms of providing services.

So, Early Head Start. IDEA, the special education act, requires that states, in their application for funds, explain how they are going to collaborate with Head Start and Early Head Start and that they will join a Head Start advisory council in their state, that they are committed to having statewide services, coordinated services. The Head Start Act also talks about IDEA and there is a section of IDEA that references the program for infants and toddlers, that's called Part C, and it provides early intervention services.

In the Head Start Act, we are told that we should be using, we should be partnering with Part C, that we should be using the Individualized Family Service Plan, that we need to participate in transition planning in providing any needed services and that we should actually be involved, when the child turns three, in their transition and in their development of an individualized education plan, if they will be continuing special education services in preschool.

The Office of Head Start definition of "school readiness," with which you should be familiar. The Early Head Start National Resource Center and the Office of Head Start put together a different definition of "school readiness" because infants and toddlers are laying a foundation in their first three years.

We're not as concerned about content as we are about their processes of learning. So, Angie, would you read our definition?

Angie: Thank you. Yeah, the Office of Head Start definition of "school readiness" is that "Children are ready for school, families are ready to support their children's learning, and schools are ready for children.

Sandy: Thank you. When we looked at what school readiness should be for infants and toddlers, we're talking about a developing capacity, so we're looking at self-regulation, we're looking at the ability to develop close relationships. We want children to demonstrate curiosity and be able to explore the people and objects in their world. We want them to develop a sense of self-confidence and to communicate effectively.

This, I think, might be familiar to you. This is pictures of the neuronal connections, the neuronal pathways that are built in the first two years of life. And the important thing to know is that the connections are built from experiences and early intervention provides specific experiences aimed at the part of the brain that most needs support for that child's disability.

So, that's where our specialists come in and help build a strong brain. School readiness for infants and toddlers with disabilities, of course, begins with building a strong foundation in the brain, as it does for all infants and toddlers. It involves developing close relationships; establishing a communication system; gaining knowledge from their environment; and having the families engaged in their child's learning and development.

So -- the foundation for school readiness for children with special needs is really the same as it is for all infants and toddlers. But M'Lisa and Mary are going to give you some good concepts and strategies for how to get there. And we'll start with M'Lisa.

M'Lisa Shelden: Thank you, Sandy. And I would just like to add my welcome to everybody. I've been seeing the names as you all are joining in; so, we've got folks from all over the country and Puerto Rico; so, we're really excited. I'm going to actually start with a general concept that I hope and, actually, I know, will be familiar to many of you and we'll talk about how those apply for children who have special needs and then, Mary's going to get more specific around special adaptations and accommodations that we can make.

So, the slide you're looking at, I hope, is hitting home with many of you and I would just like to build on what Angie and Sandy were both saying about children who are at risk for developmental delay or who have identified special needs really do learn very similarly, the same way that all children learn. Sometimes, it just may take a little bit longer; we may need to have more opportunities for repetition, but the way we go about it is really the same for all children.

So, if you look there at that first step: Identifying child interests and their everyday routines and activities that are happening, because we know that's how young children learn, by participation. And so, whether we're working with a family in the home visiting component of Early Head Start or in a classroom setting, we need to know what those opportunities look like and then, we want the child to have as much opportunity as possible during activities and doing things that the children like to do.

And, often, for children who have delays or identified needs, we get this sort of opposite way of thinking: "Oh, if the child can't do a specific skill, then we need to do block practice or a lot of practice of that skill and what the literature and research tells us is that, really, that block practice may help initially, to get an idea of what the function looks like, but, really, the way children learn is through opportunities to practice, during those everyday routines, with the adults and with the other children they would be with. So, we want to stop looking at therapy for children with delays as a special event, but really think about "What are the ways we can maximize the child's learning throughout every day?" -- just like we're doing with all children.

So, thinking about maximizing and increasing child participation and then, the way we, as adults, respond to children, which we already know is absolutely key in mediating their ability to learn new skills. And so, what we're focused on, as the role of thinking about children who have these needs, is really thinking about all the different ways that they can participate. So, if you take a look at the next slide, it just talks about the goal of what intervention looks like is actually thinking deep and wide, so thinking about, deep within activities, how we can maximize participation; and then, taking those opportunities wider.

So, what we learn might work to, for example, help a child hold a spoon, then how might we use that same idea when we're outside, playing in the sandbox; or helping a child with washing himself in the bathtub? We want to think about what we learn and maximize that with all the adults, so that we have consistency and opportunity throughout every day.

So, the next slide just really helps us think about our focus and this is something, again, thinking about those everyday activity settings, "Who are the people who are involved?" and, during that participation, that's how children develop new skills and behaviors. And so we're imagining...For example, I'm a physical therapist, so, as a physical therapist, if I'm in a home, working with a family; or if I'm in a classroom, supporting teachers there; my targeted support is really that adult, so that they understand how to support the child within those everyday routines and activities.

So, the next slide just drives home what those evidence-based characteristics are, everyday learning for children; and focusing on child interest, using those everyday opportunities for practice; and then, all of the adults knowing how to respond in a way that promotes the child's opportunities to maximize independence and function is really what we're targeting. So, I thought it might be helpful: I included a slide about what the original work.

It's the next slide and it was the National Early Childhood Technical Assistance Center, some work that I was involved with and, to this day, I really find this information very helpful, that focuses on what practices look like in natural settings and thinking about all the important aspects. And so, there are seven key principles. This is actually, now, the Early Childhood Technical Assistance Center Access Center, but in your resources associated with this webinar, you've got the direct connection to the Internet, the URL address, so that you can pull this down, and all the information is free and accessible. And so, this, in here, and it's a little bit interesting, as we think about the focus is really on the caregivers, the teachers, the parents, the other family members, to know how to enhance child learning. And we're not wanting to turn teachers and parents into therapists, but we're wanting to help them know how their parenting and how their support during the child's day at childcare or the Early Head Start classroom or in the Head Start classroom is really going to help the child maximize learning.

So, the next few slides just take us through looking at what goes...So, these are the seven key principles that are up on the slide you see now and, thinking about, as Sandy guided us through those IFSP outcomes and IEP outcomes, are targets for what we want to see happen, but we really have to individualize this and so one of the things I want everyone to know... I know we've got some early intervention and early childhood special education folks on with us today and we have a lot of Early Head Start and Head Start teachers...that you need to expect to be involved in the IFSP and IEP meetings.

Your opinions matter and, if I am going to be targeting my support to help you, as a teacher, in a classroom, you want to tell me what you need help with, right? You don't want me deciding for you. So, that collaboration, upfront and in and ongoing way, is absolutely critical for the success of the child and making this work for all of us.

So, take a look at the next slide...I thought you'd rather look at some pictures that would make you smile, here -- and think about what the children in these pictures, what skills they might be learning, just by participating and enjoying the experience of what's happening. And think about how those natural learning opportunities will lead to new skills being developed.

So, interest-based activity settings, and then, the next slide talks about how learning occurs, so we see this little guy reaching up with his interest in the birdfeeder and, as the slide says, learning occurs more rapidly when children are doing things that they're interested in and they like to do. So, this young man was a little bit behind in his walking, but, through these experiences that he was having in our Early Head Start classroom, through thinking about ways that -- he wouldn't even really be thinking about walking here, right? He's thinking about "Wow, what's in the birdfeeder?" and all of the things that are being talked about as he's experiencing this. So, instead of pulling him aside for physical therapy, what we want to do is focus on the teachers and family members, so that they know how to support the child in ways that are going to help him learn to walk.

So, the next slide focuses on some pictures, again, where learning opportunities are focused around everyday events. So, I hope you're hearing me say that children that have identified delays or disabilities are really more like all children than they are different and we just might have to focus on some specific aspect, so that their participation can be enhanced.

And the next slide just shows some experiences where the adults are really taking the opportunity to engage with the children in a way that promotes their learning and their enjoyment. And I wanted to take just a second to remind everybody. I know a lot of Head Start and Early Head Start folks have been focused on learning a lot about parent-family-community engagement and we have a lot of new resources and supports out there to help us with that and thinking about children with special needs is really along the same line -- so, maximizing engagement of parents and family members, whoever those important adults are, is absolutely critical in the learning.

So, the next slide just kind of bullet-points a few key elements related to caregiver responsiveness and I think you guys might get a kick here, out of that picture. That's a dad enjoying some afternoon time with his youngest daughter and he's dressed up, just like she is, and they're doing some things together where she's following her lead and he's talking to her about how things are going and, without thinking about speech therapy, he's really supporting this child's ability to communicate and he's doing that in a way that keeps her engaged and helps her use her words to communicate.

The next slide -- just briefly, I just wanted to point out and make sure everybody was aware of the new Division for Early Childhood Recommended Practices for Early Intervention and Early Childhood Special Education. And, again, in the resource packet, you got your direct connection there for more information. I'm sure some of you have read these and, probably, many of you also contributed with feedback and review and everything that we're talking about, today, is also more specifically talked about in the Recommended Practices; so, if you haven't seen them, and especially if you haven't seen the new ones, I encourage you to go there and take a look.

I did also include a tool for you all to take a look at the link to the tools in the resource packet and what supports looks like in classrooms settings and there's a checklist there that we put together that will help you. If you're a provider who's going into a classroom setting or if you're a teacher who has specialists coming into your setting, we identified sort of the basics of what you should expect and what it would look like. And you'll be seeing things on there and, hopefully, you've already seen these types of things, but if a specialist is coming into your classroom, they're not pulling the child out or pulling the child to the side or bringing in toys and materials to work with the child separately from what you are offering in the classroom, but, really, those supports should be coming in to maximize that child's participation and helping you, the teacher, know and to really make sure that you know you're doing the best that you can for that child, to maximize that child's opportunity for skill development.

So, I had just one more thing here I wanted to bring up, and this is kind of a topic that's pretty hot, right now, across the country: In early intervention, for years, we've been talking about not bringing in toys into families' homes, but using the toys and materials that are available within that home and with that child. And going, at times, where family members are talking about they need support; so, instead of coming in with a play activity, we're really thinking about what the family needs support around, and that might be bath time, mealtime, going to Walmart, riding in the car to go visit Grandma. Whatever that is, we're focused on supporting that.

And so, I wanted to elicit a challenge to the home visitors out there who are a part of Early Head Start or maternal-child health home visiting to think about doing that yourself: Not taking in toys and materials or activities, but really thinking about an approach that helps family members understand how to maximize child participation in the home environment or in the community where they go out every day.

So, as we support families who cross those Early Head Start, early intervention Head Start, early childhood special ed, we can be sending a very strong message to all of those care providers that this is really about helping them know how to do their best to support the child within those everyday routines and activity settings. So, I think, again, it's not something that is probably brand-new, but

thinking about what you know in a different way and I just, sometimes, I think a lot of us probably didn't go into early childhood to be thinking about wanting to work with adults, but it's a really interesting concept, when you think about the most important predictor in the life of a child are those parents and those adults who are with that child every single day -- so focusing our supports on what the adults know how to do to help the child grow and learn.

Sandy: Thank you, M'Lisa. I appreciate you bringing up the toy bags, because our home visitors in Early Head Start are concentrating on using the home environment as the learning environment and supporting the parent, rather than interacting with the child -- so, I think we have very similar approaches and goals here. So, you've given us some great concepts to consider as we think about our programs and our children.

Mary, let's bring you in to the discussion, to help us think about how we can provide adaptations to these natural environments, experiences, routines, and materials.

Mary McLean: Thank you. I'm happy to be here. Thank you, Sandy and Angie and M'Lisa. You've provided a very strong message about the importance of including young children with disabilities in Early Head Start programs and, at the same time, ensuring that we're working to figure out how to maximize the opportunities for children with disabilities in those settings. And there's a number of ways that changes can be made in environments and in activities to help infants and toddlers with disabilities learn.

And, as M'Lisa said, not only in center-based programs, but also in home-based programs. So, we're going to talk about five things. We're going to talk about the environment and simple changes in the environment; we'll talk about daily schedules; we'll talk about activities and routines; and possible changes in materials; and then, we're going to talk about changes in instruction. And, of course, when I say "instruction," I'm talking about the interactions that happen between adults and children, as they participate in activities and routines throughout the day.

So, we'll start with thinking about environment and we can make changes to environment in simple ways that, in either home or in a center, that will help to facilitate independence for a young child and also facilitate learning. So, you're looking at pictures of environments and these environments have already been made child-friendly, right? We have child-sized furniture and we have things for infants and toddlers to do, but if there's a child with a disability in one of these settings, there also may be other simple changes that can be made in the environment to facilitate that child's independence and that child's learning.

For example, we might take low-to-the-ground bins or baskets and put toys in them, or books, to make toys and books more accessible. Or we might think -- if we have a child who uses a walker, we might think a little bit: "How can I maybe slightly rearrange the furniture, so that it's easier for the child with the walker to get around in this environment?"

The main thing to do is just to think about the needs of the particular child and think about the environment and then consider what might be done. How can we adapt the environment, maybe just slightly, in a way that would facilitate that child's independent functioning and also acquisition of skills in the environment?

We can also make changes to daily schedules that might be helpful to a child with a disability and one thing we can do is have a schedule, a schedule that is made out of pictures, and maybe even pictures of the child himself or herself, so that looking at the pictures in a picture schedule helps the child get to know the routine -- over time, of course, but helps them to get to know the routine and to be able to anticipate what's coming next and that can be very helpful in helping a child get settled into a routine and activity.

And then, if there's a particular time of the day that seems to be problematic, it might be a good idea to just think about how things are currently sequenced and, maybe by shortening an activity, maybe by changing around two things that typically happen, we might be able to facilitate, again, the child's independence or the child's success in making their way through a particular activity. And that's true for children and parents at home, as well as for children at a center-based program.

And we think about the routines and the activities that exist, either in the home or in the center-based program, and so we'll talk about the home, first. And M'Lisa mentioned this. You're talking about the activities and the routines that take place throughout the day with the family and then thinking about "How does this child participate in those activities?" And, maybe, there's a way that we can change this activity just slightly, or maybe we can just remember to bring in practice for that extra skill during an activity and, that way, parents know and remember what it is they might focus on within an activity.

For example, a parent might say, "Oh, bedtime is a great time to read a story and that's when we'll provide a story," or "Playing outdoors is a great time to work on movement skills."

So, even just taking the time to think about the activities throughout the day and how this child participates in each of those activities or routines and what can we do to facilitate a particular skill that the child is working on. We can do a similar thing in a center-based program that has a number of children in it. So, for example, in the upper-left-hand corner, you see a little boy and you see that he's in a swing with two other children and the teacher is actually working on communication with him as she starts to push the swing. She looks at him, she looks at him expectantly, and she may even have to model the word "push," but when he says "Push," then she's going to push the swing and when it stops, she's going to look at him again, expectantly, and, hopefully, he'll say "Push" and she'll push the swing.

So, that's one example of embedding just a little bit of practice, a little bit of work, on a skill that's been targeted for him. And the best thing about a center-based program: we have children, of course, doing activities, but it's very possible -- in fact, it's likely, that the children in a particular activity aren't learning exactly the same thing, so, you know, even though they're engaged in the same activity, they might be learning just slightly different things and, yet, we can still have an activity and still individualize things. Again, we call that "embedding," so we're embedding learning within ongoing routines, ongoing activities, with all the children in a center-based program. And the next slide will show you a tool that can help in thinking about, just as we talked about talking with the parents about: "What's going on during the day and what would you like to facilitate, what skills would you like to facilitate in various activities and routines?" -- the activity matrix helps, in a center-based program, to plan that a little bit.

So, what you see on the left side is the schedule with the activities of the day on the left column; and, then, we have a column for each of three children and, in there, we've put things that these children are working on, things that they're learning to do and "What's a likely activity where this particular skill might occur and we can facilitate that skill within the activity?" And this is just a reminder. Some teachers put this on the wall, so that they can see it most easily and so that other people coming into the classroom -- maybe the speech-language pathologist, the occupational therapist, also can see it as well, so that everyone's aware of, you know, "If I'm working with this group, what am I going to work to facilitate with a particular child?"

Next slide, please. The next thing we can do is think about materials that are in the home or in the classroom and how we might be able to adapt them to be most helpful for a child with a disability. And what you see on the left is an adapted tricycle. This is a pretty sophisticated example of adapted material. This is a tricycle that a child can use their arms to actually make the trike go, if it's more difficult for them to use their feet to do that.

So, that's adapted materials, but also, on the right, we have some very common, everyday materials and the point here being if we think about this particular child and what this child is working on learning, or what he needs to learn to do to be more independent, and maybe slightly changing materials will help that child.

So, maybe that child needs a cup that has a lid on it, or maybe he needs a small cup, or maybe he needs a cup that has a straw in it. So, there are lots of varieties of materials and ways that we can change materials that, once again, in typical routine, typical activities, will help a child perhaps be more important -- or I'm sorry, more independent or perhaps will help that child learn a skill that he's working on. So, in talking about ways that we can change instruction or, if you will, our interactions with children on a typical basis, there are three things that will be helpful.

One is to think about maybe breaking down a task into smaller steps, another one is the use of assistive equipment and devices, and the third one is the use of adult assistance; so, we're going to walk through those three ways that we can adjust interaction.

So...The first one is breaking down a goal into smaller steps. Sometimes, we have a target, a particular target; we want a child to learn to do something and it may be too big a step and so, rather than saying: "The child can't do this," or rather than saying: "Well, we'll have to do this later" -- maybe if we break it down into smaller steps, we can begin working on it.

For example, if we have a child who needs to learn how to share and take turns and, currently, he will take turns with an adult -- very briefly, but he will do that; we might want to start with practicing taking turns with the adult in various activities and various games and things, and then move to working on very brief turns with a peer. And so that's one way of saying: "We can't do this whole thing now; but maybe we can start with a little bit, the first step toward a task."

Another really, I think, common example is learning to put on a sock and, you know, it's difficult for children to learn to put their socks on; but, maybe, if we put the sock mostly on his foot for him, then he just has to pull up the sock. And then, we can gradually put less and less of the sock on his foot for him and he'll do more of the task, until he actually is able to do the whole task. And so now, we're going to look at some adaptive equipment and devices that might be helpful.

One very important thing for children with disabilities is to have a system of communication. All children need to have a system of communication to communicate with adults and with other children in their lives, so for some children, that system may be sign language; for other children, it may be a picture- pointing system like you see here; or some children actually learn to use electronic communication devices. And, of course, this would be with the guidance of a speech-language specialist who would be of great assistance here, but the most important thing is that there are systems that are available, that can help children have a system of communication in their home or in their classroom setting.

The next slide is going to show you a child who has a physical impairment and we've got, actually, assistive equipment here, but it's not sophisticated; it's very simple and available equipment that we can use. This child basically has a cardboard box functioning as a table to support the book and the book holder in front of him. And, in this way, and also, with the addition of clothespins onto cardboard pages of a book, he's able to turn the pages of a book by himself.

So, this has greatly increased his independence. Now, he can sit and look at books by himself, rather than needing somebody to turn the pages for him. Visual support for some children is very important. So, this child has a visual impairment and what you see here is a lightbox or a lightboard and, with the help of that lightbox, she's able to distinguish shapes. She can see what shapes look like, as long as she has the lightboard in the background to help her see the shapes.

Sensory support. So, some children have difficulty with self-regulation and, if we can provide sensory support. This is a sensory swing and this is something that an occupational therapist would help you with, would be familiar with, and it's rather sophisticated; it's actually a thing that, you know, hangs from the ceiling. There are other ways to provide sensory support as well, and the provision of sensory support can be very helpful for some children, in learning how to make their way through the day and encouraging them and allowing them to interact as much as possible in typical activities and routines.

And the last thing we're going to talk about is providing adult assistance and this is the one that probably is the one we think of, first. We think: "Well, he can't hold his cup, so I'll hold his cup for him," or "he can't put his jacket on, so I'll put his jacket on for him," or "he can't sit here, so I'll put him in my lap and have him sitting there." And that's fine, but the problem with too much adult assistance is that it doesn't increase the child's independence. So, while adult assistance may be absolutely necessary some of the time, we want to be careful that we don't rely too much on adult assistance. Instead, think about how we can change environments, how we can change materials, how we can change routines, how we can change interactions with children, in a way that will facilitate their independence and help them to learn skills.

And the last things I want to say is I'd like to refer you to, in the resource section that you have, there is a book called "CARA's Kit" that will provide you with a lot more ideas about adaptations that you might be able to make in your home-based services and also in center-based services. Thanks.

Sandy: Thank you so much, Mary. You've given us really practical ideas. I've been listening to you, but keeping an eye on the chatroom and people are thrilled with the down-to-earth adaptations that you're making, things that they're looking at and knowing that they can do. So, this has been really an inspirational presentation for us, so thank you very much.

We've given you lots of information and the chatroom, the chat space, has been very busy, so I would like to kind of pick up from comments and questions there and I'm going to start with a couple for you, M'Lisa, because we have home visitors who don't agree with you about that toy bag. They're saying they need to bring it in or there is nothing there for the child. Could you speak to that, please?

M'Lisa: Sure, Sandy. Thanks. I've been watching the chat, too, and it seems I did somewhat light it up with the comments about the toy bag, so I'll be brief. I think it really is about taking a step back and thinking about what our role is and, by design, our role is to build the capacity of the important people in the lives of the child, not to supplant that and not to become one of those important people in the life of the child and be the resource.

So, when I think about home visits, I'm thinking about not being the event, but as I go, I'm thinking about supporting parents, supporting teachers, in doing what they would be doing if I weren't there. So, it's one of the reasons my visits aren't at the same time every week -- because different things happen in the life of the child. And there are a lot of families that haven't prioritized, for lots and lots of reasons, or don't have the time to sit down and play with their children, but being playful, during diaper changes, during mealtimes, during the things that they have to do, is a great way to get them engaged, because they're going to do those things or, if they don't, there are issues of neglect or abuse.

So, we start with those have-to things. Then, I'm thinking about ways that they can be helping their child learn as a part of all those opportunities and practices. Because I know there are homes that don't have the resources and so we take in those activities, even if we're facilitating the parent to be playing with the child during those times. What I always think about is: "How often is this happening for the child?" And if the only time this is happening is when I go, it's not going to happen enough and so my job is to put as much effort into those adults as I would to the child to generate that learning and support. And I have to be creative enough, which, a lot of people were talking about being creative. I have to be creative enough to match the adult learning styles and priorities and concerns and strengths and abilities of those adults as I would with the child.

Sandy: Sounds simple. [Laughter] Thank you. Mary, is there anything you would care to add to that, around making adaptations in the home?

Mary: Well, you know, I think it's a similar process. Now, you're thinking about the activities and the routines throughout the day, so you're talking with the family about, you know, "What do you do, from the time you get up until the time the child goes to bed and how is the child engaged in those

activities?" And then, thinking about what special challenges there might be with any of those particular activities, but also thinking about: "What is it that we're wanting the child to learn next and how might those skills be embedded into the activity?" So, you know, it's similar in home-based but different in home-based as well, with a focus on: "What does the child need to learn and how can we facilitate that learning?" By changes to the environment, changes to the materials, changes in the way that we interact with the child.

Sandy: Thank you. There is so much rich content in the chatroom that we will need to find a way to capture that and have that information available to you. Questions about the webinar -- The webinar and the resource materials will be housed in the ECLKC, in the Early Head Start section, so we're not ignoring all of this; we're just going to run out of time. And before we do, if I could ask each of you, Mary and M'Lisa, would you have one final message for our participants, about serving infants and toddlers and preschoolers with special needs and their families? What would it be?

Mary?

Mary: Sure, I'd be happy to go first and I think the best advice, overall advice, I can give is to think about abilities, first. Also, you have to think about the child's challenges as well, but think about the child's abilities and how we can build on those throughout the day, through ongoing activities, ongoing routines and interactions with those around. Those are the things we have to build on. We build on abilities; we don't build on disabilities; so I think that's good advice.

Sandy: That's a great thought.

M'Lisa: I was just going to say I think it's great advice and I think I would probably just second that with that can-do attitude of: "We can figure this out. This child can be a part of those everyday routines," and what that role can look like and thinking about their strengths and abilities, like Mary said.

And I would add, too, since the chat has been so hot with the topic: think about the strengths and the abilities of the adults as well. Even though environments may be challenging, that can-do attitude really will make a difference. And we have a saying here in our program about, you know, if we're going to make assumptions and we're going to think about things in terms of how we would like to do it, one of the things we always say is: "We're going to presume competence." Presume competence in the children and presume competence in those adults in their lives. And it's amazing how much further you can get when you have that frame of mind in your head when you go in.

Mary: Good point.

Sandy: Okay, I would like to thank Angie and Mary and M'Lisa. You have given us such a positive view of inclusion and of our work and how to go about it, so I thank you so much. I thank everyone who has called in and joined us, the enthusiasm that is obvious in the chatroom. Please remember that you have a viewer's guide and additional resources that would be worth spending some time on and in the next day or so, we will be sending you an evaluation of this webinar and it would be very helpful to us if you would fill that out and return it. So, again, thank you, everyone, and we really appreciated your participation.

Female webinar operator: That does conclude today's webinar. We thank you for your participation.

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