Prácticas para apoyar a bebés y niños pequeños con discapacidades o posibles retrasos a través de oportunidades de aprendizaje integradas

(En inglés)

Practices to Support Infants and Toddlers with Disabilities or Suspected Delays through Embedded Learning Opportunities

Colin Gasamis: Good afternoon everyone. This is Colin Gasamis. I'm at the National Center for Early Childhood Development, Teaching, and Learning, and I'm excited to welcome you to our inclusion webinar series today. Today we have doctors Ariane Gauvreau and Angel Fettig, who are both at the UW in Seattle, and they'll be presenting today on practices to support infants and toddlers with disabilities or suspected delays through embedded learning opportunities. But before we get started I just want to go over a few platform related housekeeping details.

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Ariane Gauvreau: Hi, everyone. Thanks for the introduction, Colin. My name's Ariane Gauvreau, and I want to start by just reviewing our session objectives for today. So, our goals with this webinar are to really consider where infants and toddlers learn. And as we know, this is really different from their older peers in preschool. We're going to talk about the what, when, and how the components of embedded learning opportunities. And then discuss ways to plan for these embedded learning opportunities within the ongoing routines and activities that infants, toddlers, and their families are going to engage in. And then finally we are going to share some strategies to support this population, infants and toddlers with disabilities or suspected delays across all early learning settings.

Angel Fettig: OK. So, in ... Throughout the webinar today we are going to consider these five important items below — or important terms below. So, family centered practices, which consider shifting our service delivery from only with the child to equipping families with the necessary skills to support children's success throughout the day. The next term we will consider and use throughout is relationship-based approach which centers the concept of children's evolved within the context of relationships with caregivers, other children, and their environment. The next term is activity-based approach which considers that opportunities for learning are embedded within activities children are engaged in throughout the day. The next term is team-based service delivery which ensures us to consider the expertise of parents and other professionals who can support the infants and toddlers we work with. And the last term we will be using throughout the day is individual family support plan, which is also known as IFSP, which is a plan for special services for young children with developmental delays and their families. So, use the chat box on your screen to share your thoughts for the question posted here. Where do infants and toddlers learn? And we will give pause for about 10 seconds for you to respond to this. OK, I see a lot of responses coming in that says "everywhere." That's a great response.

Today, we're going to really provide some strategies that will support you in designing effective ways to embed learning opportunities for infants and toddlers during their routines, and these routines can occur, like you said, everywhere. It can be ... It could occur in a group care setting as well as home and community settings, as well. So, these are the most common environments infants and toddlers learn. One, they learn at home often with parents, grandparents, siblings, relatives, and other caregivers. They also learn in child care or center-based programs, which many of you have shared that it's the setting you work in. They also learn in their communities such as libraries, parks, and other day-to-day activities.

So, unlike older children such as preschoolers and beyond, infants and toddlers may not participate in formal early learning programs. We think about embedded instruction occurring during classroom or preschool routines with older children. But with infants and toddlers it's important for us to consider that their learning environments take place in child care, home, and community settings.

So, it is critical that whether it's at home, child care, or other community settings, we consider the features of high-quality programming for infants and toddlers. We focus on three main aspects of a high-quality learning environment for very young children. The three aspects are responsive care giving, high-quality child and adult interaction, and predictable routines. It's important that we consider why this is different from the foundation for preschoolers and why natural environments are such an important consideration when supporting very young children and their families. Much of infants' and toddlers' day are focused on caregiving routines such as feeding and toileting.

Those responsive caregiving and high-quality child and adult interactions during these predictable routines are critical in ensuring that opportunities for learning are developmentally appropriate for these very young children we work with. So, when thinking about where do infants and toddlers learn, you might wonder how is this different with infants and toddlers when compared to preschool age children in elementary school.

One of the key difference is to consider who are the teachers. For infants and toddlers, the teachers could be parents, educators, or caregivers who provide care throughout the day. It can also be different roles. Many of you have said that you work as a mental health consultant. You work as a specialist around kids with disabilities. So, these are all roles — roles that are very important to consider in supporting infants and young children we work with.

So, let's think a little about what do infants and toddlers learn and what documents or assessments help inform our practice when it comes to planning for these learning opportunities? In order to identify the necessary learning targets we must consider child and family goals. These goals can be identified through several ways: individual and family service plan, also known as the IFSP; individual learning plan; family priorities and concerns; and also through routines-based interview. Not all children may have an IFSP. But providers can collaborate with caregivers to determine learning — learning targets that will promote access, full participation, and independence for the child and their families.

Here is a little information about IFSPs that can help guide us to understand child and family goals. Now just keep in mind that IFSPs are individual family — individual family support plans that supports children, very young children, who have been identified with disability or at risk for disability. Within an IFSP the child's present levels of development is documented. It also documents family resources, priorities, and concerns, as well as measurable outcomes. IFSP also states the specific early intervention services and the environment in which children should receive these services. Here are some other features of IFSP. But within an IFSP, it also includes the projected dates of the services. You can also find the service coordinator's name on here, which is critical to support teaming efforts.

And lastly, there ... It should include steps to support transition in the IFSP. Another way to really think about target goals is through routines-based interview. RBI, a routines-based interview, — also known as RBI — is a semi-structured interview designed to help families decide on outcomes or goals for their individualized plans by considering child's engagement, independence, and social relationships. RBI provides a rich and thick description of the child and family functioning and to establish an immediately positive relationship between the family and the professional. These then lead to functional goals and global child outcomes.

So, on your screen you will see a list of questions to ask to understand the child and family's daily activities and routines, what might be challenging and what is going well. These are questions that will occur in RBI. You can also use — use these through — throughout the conversation with the parents to gather information. So, RBIs help providers understand what routines the child and family are doing, who is involved, what might be challenging, and what is going well. It can be useful to determine which routines the family may need support with and which routines are good for embedded instruction.

For example, we might find out from a family that mornings are an especially challenging time as one parent is responsible for getting three children ready for school and child care while the other parent must leave very early for work. In this example we see that the morning routine will probably not be a good one for embedded instruction, as one adult is working to get three kids prepared for the day, and that's a lot of work. Another example might be a parent sharing that mealtimes are difficult because their toddler is extremely selective with food and has a hard time staying in their high chair at the table. This may be a good time for us to target instruction around a feeding goal where we can support the parent in modifying their environment and introduce new foods in a developmentally appropriate and non-threatening way. So, many of the routines occurring in the program also occur within the home so it is an opportunity for program family engagement to leverage all of their experiences for child learning. So, use your chat box to share your responses to the following questions. What are the routines that occur regularly in the program you work in? And we will pause again for 10 seconds to see your responses. OK, I see a lot of responses coming in including hand washing, mealtime, tooth brushing to outdoor play, free play time, toileting. So, these are really all the routines that we see in a child throughout the day, whether it's in the center setting or at home setting.

Ariane: Yeah. Great ideas everyone. So, you know, as Angel explained, we've spent a little bit of time reviewing IFSPs, routines-based interview, and ways of determining family goals. And I'm going to talk a little bit more about embedded instruction and exactly what we mean by embedded learning opportunities when we're talking about infants and toddlers, as we think about this a little bit differently than we think about it with preschoolers. So, embedded instruction for infants and toddlers really focuses on following a child's lead with intentional adult guidance and scaffolding, play-based and relationship-based instruction as a multi-component approach to provide intentional and systematic instruction on high-priority learning targets that are occurring within the things that infants and toddlers, their families are already doing. But sometimes it can feel a little bit odd to talk about instruction with such young kids.

So, let's unpack that a little bit. We encourage you to think about the key features of embedded instruction as including the following things: a focus on priority skills, right? Things that the family or care providers or Early Head Start teachers or child care providers want to create, change, or enhance. The importance of teaching skills within the context that they occur. So, many of us talked about diapering being a big routine that we do with infants and toddlers, mealtimes, hand washing, and so, of course it makes sense for us to embed instruction within those existing routines. If I want to support a child in following a one-step direction, I could easily do that within the hand washing or the mealtime routine in a center, for example.

We also focus with embedded instruction with infants and toddlers on teaching within and across activities, routines, and transitions. So, this — this just means ensuring that we're embedding these learning opportunities within the routines that make up the majority of our day. So, things that everyone here identified — feeding, napping, rocking someone to sleep, diaper changing, and tooth brushing — all of those things that we're doing. And then, of course, using authentic activities and materials to support learning. So, the toys and the materials that are already a part of our classrooms, our programs, families' homes.

And then finally, embedded instruction also includes a focus on assessments that will talk to — that we'll talk a little bit about towards the end of the webinar and discuss some strategies for. But we're using ongoing assessment to monitor a child's progress and to understand from families and care providers about the child's development and interest, how things are going with a particular learning target, so on and so forth. So, let's watch some examples. In this next video clip we're going to see a short one-minute clip of an infant and toddler teacher in a child care center supporting kids as they talk through the transitions and the upcoming routine for the day.

[Video begins]

Teacher: You ready? Let's look at our schedule. Let's see. Did we all come to school today? Did mommies and daddies come and sign us in and bring us to school?

Boy: [Babbles]

Teacher: That's Bentley. ♪ Arrival time is over ♪ ♪ Finished ♪ Did we have breakfast this morning? What did you have for breakfast this morning, Armani?

Armani: Uh-oh!

Teacher: We had applesauce and had cereal. ♪ Breakfast time is over ♪ I see it's torn. It's OK. Finished. Did you brush your teeth, Armani? Darwin, did you brush your teeth this morning? ♪ Tooth brush time is over ♪ ♪ Finished ♪ Let's see what's going to happen next. Let's look. [Gasps] Now it's time to go take a walk. We're going to go have some active time. Let's go to the door. Let's go to the door so we can take a walk. Are you ready? Let's go to the door. Time for active ...

[Video ends]

Ariane: So, here we see some nice embedded instruction. We see an educator reviewing the schedule with three toddlers describing what they've done, and then talking about what activity is coming next. We see all the kids showing some emerging language and communication skills as they attend to the teacher's words and they respond to her questions. But we specifically see the teacher ask Armani "What did you have for breakfast this morning?" And we know that Armani is working on expanding her language by answering questions. She also asked Armani, "Did you brush your teeth this morning?" A more simple yes or no question that's designed to provide another opportunity for this toddler to practice and expand her language.

And then, of course, we see this teacher demonstrate some really lovely transition strategies and target learning activity with an emphasis on expressive language for Armani that's easily embedded in, you know, an ongoing routine of kind of reviewing what's coming up and what the class has already done. In this next video clip, we're going to see another example of a center-based program, a speech and language pathologist is working with a young child also on some communication goals during mealtime.

[Video begins]

Teacher: That's one of my favorites. All gone. Yes, we have applesauce!

Child and teacher: Oh yay!

Teacher: It’s applesauce! Aaaaa!!! Applesauce! Nice lookin’! Applesauce! All gone. Yes. We have applesauce!

Child and teacher: Oh yay!

Teacher: It’s applesauce. Aaaaa!!! Applesauce!

[Video ends]

Ariane: Sorry, everyone, it looks like we're having a little bit of trouble with that clip kind of playing smoothly. So, let me tell you a little bit about what Mary, our colleague, was doing there. So, you see they're sitting with a group of toddlers during mealtime. And what Mary is doing is — is really trying to support this little boy who's initiating an interaction and supporting his expressive communication as he asks for what he wants, and we see her doing a lot of really lovely labelling of applesauce and also encouraging his eye contact. We see Mary in that clip kind of waiting and when the child responds she offers immediate feedback. She then models the expanded language before and after his response. Embedded instruction related to that IFS table of expanding language. So, in both of these videos we see educators being really responsive to the needs of toddlers and embedding instruction on their specific goals during these naturally occurring activities.

So, let's reflect on that a little bit. Why is this especially important when we think about supporting infants, toddlers, and their families? We encourage you to use your text box there and reflect on this. Why is embedded instruction particularly important with this age group? Yeah, excellent point. So, we see Rachel noting that we want lots of opportunities for infants and toddlers to learn during the day, lots of practice. Thank you, Roberta, great point. Someone else noticed — notes that they're learning so fast, every day they're gaining new — new skills. Heather B., you're absolutely right. We want multiple exposures to these learning opportunities for infants and toddlers. Yes, everyone, spot-on responses here. We really see the benefits of embedded instruction and studies that have focused on this is that we know there's little we have to do as providers, right? This requires a really minimal change to existing routines, that we are working with what we already have. And we know that this maximizes the motivation by following young children's interests in the things that they are showing us that they're really interested in doing and playing with. We also know that this highlights functional skills and really promotes generalization.

So, if we want a child to learn to follow directions it makes a lot of sense to do that during a transition, as maybe the group is coming in from outside back into the classroom. So, really when we think about embedded learning opportunities we encourage you to consider the what to teach, the when, and the how to teach. And we think about this as — as — as kind of cyclical process. So, essentially the priority learning targets might come from our IFSP, from a routines-based interview, from an individual learning plan, and this informs when we're going to teach things. Is this a goal that we can easily embed within diapering or tooth brushing or mealtimes? And that's going to give us some information on, "OK, well, how exactly am I going to teach it? Do I need to arrange my environment in a certain way? Do I need to include some specific materials? How am I going to help the child learn this skill?" And that's going to encourage us to think about, "Well, OK. Now that I figured out how to teach it, how am I going to assess the child's progress and figure out if our instruction is really working?" And a big difference with infants and toddlers is that this process is highly, highly collaborative with families and child care providers. Whereas with preschoolers and older children we might be doing this with our educational team.

But as many of you know, I know we have a lot of home visitors joining us today, this really emphasizes the importance and the role of families. So, we really want to emphasize that the child's learning target should seamlessly embedded — be embedded within to — within — excuse me — the activity to retain or to transition, and this really helps us ensure high-quality teaching and embedded instruction for young children and encourages us to think about learning targets that consider their abilities, their priority skills, their preferences, and their support needs.

So, let's talk a little bit about planning for this embedded instruction. As Angel mentioned earlier, a big part of this — of this planning involves figuring out what infants and toddlers are doing during the day. What routines are they already involved in. So, we start by identifying and clarifying these routines — maybe with a systematic tool like a routines-based interview — and then look to what sources we have that might be giving us information about the child's learning targets, the what of the instruction, what they need to learn, what we want to teach them to support them in assessing the range of different settings and materials.

And then finally, that helps us think about the how. How are we going to specifically teach this — this goal. What materials do we need, and so, on and so forth. So, let's think a little bit about the routines that we all mentioned earlier today and brainstorm some of the easily embedded targets — learning targets within these routines. So, everyone mentions all of these common routines that we do with very young children and families everyday things like diapering, feeding or mealtimes, maybe block and figurine play within a free choice or at play time, or outside, playground, motor, outdoor play, whatever your program calls it. So, these are some learning targets that Angel and I have brainstormed as, you know, easily being able to fit into those existing routines.

So, for example, diapering as we all know is a really important and very common routine that we do in early learning settings and has the advantage of us often being one-on-one with a kid, right? So, this presents a unique opportunity for us to work on some embedded instruction perhaps around responding to name or supporting the child in requesting either "up," to be picked up to go to the changing table, or "all done" when they want to be finished with the diaper change, or that kind of back-and-forth babbling communication with a caregiver that we want to support all young children doing. And then the same thing with feeding. So, if we consider a mealtime, right, this is a really natural routine for us to work on requesting "more," "more crackers, please," "more juice," "all done," "I don't like that," whatever communication targets the child has. And then, of course, adaptive skills like drinking from an open cup or using utensils, spreading, things of that nature, and then we see some more examples for block play, identifying animal sounds, commenting on what they see in the environment, engaging in imitation either the imitation of a teacher, imitation of a peer, and then some examples for playground or outdoor play.

So, what we're hoping to accomplish with this slide is just to demonstrate all of these examples, kind of show us learning targets that can be easily embedded into the things that are already happening in our homes and communities and don't involve a lot of extra work or planning or kind of gathering of materials on providers' ends. So, let's take that a step further. So, we invite you to join us and think a little bit about how you might plan for embedded instruction. So, I know many — for many of us, this is probably a routine that we are doing every week with our class. But let's think about imagining that you're leading a toddler room and you have decided to embed like a music day, music circle, music time once per week. So, you go around and you gather a bunch of materials, instruments — things like maracas, bells, drums, shakers, and some scarves — and you bring in a speaker to play some songs from your smartphone. Use your chat box and share ... OK, given this music routine, what types of learning goals could we really easily embed during this time? What are some common learning goals that you might be working with your infants and toddlers on and how could we embed those goals into a music circle or a music time.

Please use your chat box to share your brilliant ideas with us. Yeah, fine and gross motor skills, Marjorie, excellent point. Some are mentioning receptive language skills. Yeah, asking a kid, "Do you want the purple scarf or the pink scarf?" Making a choice. Great point, Jenny. Debbie H., points out a lot of different vocabulary opportunities. Following directions, counting. Someone else mentioned the concepts, kind of talking about the difference between playing an instrument really fast or really slow. Yes, absolutely, everyone is spot-on here. Angel and I were thinking along the exact same lines — imitation with objects — encouraging children to imitate our actions with a noise-producing object or a scarf. Clapping, stomping; touching different parts of their bodies. Pointing to request an object. Following directions like, "Stop" and "go" or "slow down" or "go fast" as you play an instrument and encourage children to do the same. And then, of course, maybe interacting with their peers, encouraging kids to pass out materials to one another so they have opportunities to accept an item from their peers or give an item to their peers or request something that they would really like to play with from a kid that might be in charge of the — the, you know, instrument basket, or so on and so forth. Yeah. Excellent points, everyone. Thanks for your participation there.

So, now we've kind of done a little bit of brainstorming. We've talked about, you know, how to identify goals and the activities in which we can embed this instruction. Now we're going to start talking a little bit more about creating embedded learning plans, so really being kind of systematic and planful about documenting strategies for supporting infants and toddlers. So, when we think about embedded learning plans, we're really focusing on kind of four main things. The what — so what's the learning target. What are we trying to teach here. The who — who's involved, is this a plan that is gonna be kind of followed through by a parent or a child care provider or a home visitor. And this is especially important when we're creating plans because as everyone here knows, you know, when we're working with infants and toddlers, we, as the provider or the home visitor, are often not the ones implementing the plan. It's often another adult in the child's life.

And then thirdly, we're thinking about materials. What do we need to teach this. Do we need anything specific, do I need a noise producing object. Is this something that I want to do at the snack table because I want to have a spreadable food or, you know, ensure that the child has access to an open cup, whatever the goal might be. And then finally, data collection. How do I know that my instruction is working, the child is making progress on this goal, and what's a sustainable way for me to collect that data?

So, let's look at some examples. We're going to look at two examples in the next slides. One example is an embedded learning plan for home that the family works on with the home visitor. And then we're going to look at an example of an embedded learning plan created in collaboration with a child care provider. So, here we have Yazmin's plan. So, Yazmin is an 18-month-old girl who receives birth-to-3 services in her home. Her mother, Rosa, has been working with a home visitor to embed their IFSP goals into their daily routines. One of Yazmin's goals is independent crawling or scooting. So, Rosa and the home visitor discuss ways of working on this skill at home. By placing her favorite toy on a large cushion on the floor, they encourage Yazmin to crawl up on the cushion and grab the toy. With the cushion as a modification, Yazmin's able and motivated to move towards her toy. They practice this a few times together during a home visit and then talk about two other times of the day when they can work on this together. So, when Rosa, the mom, and Yazmin, the daughter, can work on this skill. This is the important part of the plan. So, Rosa identifies morning as being a good time for them to practice the skill because they're already kind of hanging out in the TV room, watching TV, playing with toys, it's a quiet time of day, and then again in the evening after dinner for the same reasons. The family tends to kind of hang out in the living room where Yazmin's toys are, where it's easy to grab a cushion from the sofa, and they decide to practice crawling using that modification. So, again it's important to note that a key aspect of this plan was Rosa, the mother, identifying which routines she could easily and realistically embed this instruction within. Because she shared that morning was good since she and Yazmin are already kind of hanging out and watching TV in the family room. Same thing in the evening. That was where the home visitor decided to focus their efforts. In order for this plan to work the home visitor needed to really work with the mom to identify the best times of day for this instruction to occur given the family's resources and the existing routine.

So, let's look at another example, another child. This is Matteo, and this is an example of an embedded learning plan in a family child care setting. So, Matteo's a toddler who attends a family child care about five days a week and receives IFSP services from an occupational therapist within this setting every other week. So, the O.T. comes to the family child care setting every other week and works with a provider there. Matteo's parents, Dara, the child care provider, and Kate, the occupational therapist, identify the following priorities for Matteo – They want to work with him on cruising along furniture, pointing to toys or objects that he wants, and approximating one word phrases. But there are six other children in the program, so Kate and Dara identify the realistic routines for this embedded instruction. And Dara notes that mealtime and diapering are especially good routines and she is already supporting children individually during those routines. Important to note, Dara is someone who is supporting a lot of kids in the family child care setting so it would be unrealistic for her perhaps to provide an embedded instruction with Matteo when she's managing, you know, the learning and the support of five other children at the same time.

So, in talking with — with Dara and with Kate, the O.T., they decide to work on pointing and approximating words during mealtimes and diapering. And then Dara also notes that Matteo is typically one of the last kids to get picked up, so it's easy for her to work with him individually towards the end of the day. So again, as we saw with Yazmin's example, a key component of this embedded learning plan was collaboration with the family and with the care provider to determine where are our resources, what might be a good time of day to provide this instruction, and how can we ensure that this was gonna be a sustainable and ultimately implementable plan.

So, another tool when we think about supporting and planning for instruction, embedded instruction, is the use of something called an activity matrix. Now let's look at an example.

There's also some resources that we're going to share at the end of this presentation. If you have other questions regarding activity matrices and would like some tools.
But I'm going to show some examples of activity matrices that can be used in a center-based program like a child care center or an infant and toddler program and then an activity matrix for use at home. So, here we see a sample matrix that we might see — be seen in a center-based program. Notice on the left column we see the morning routines — play time, diapering, feeding, and then again play or outside time.

Now this is for Sasha, a young girl who has two communication goals, using two-word phrases and pointing to request. So, Sasha's team and her family have identified some phrases to target during these routines. We see these in the second column. They've also included a short plan for how to provide this instruction. And this is nice because there's multiple daycare providers who are new and are still getting to know Sasha and getting to know the routine. So, we see some little hints for how providers can work on these skills with Sasha. And then in the third column we see plans for embedded instruction on Sasha's second communication goal of pointing to request. This embedded instruction requires materials. So, the team have planned for how to include these. They just add a small basket of toys next to the diaper changing station and they plan to hold up two things and encourage Sasha to choose which one she would like to play with or hold during the diaper change. We also see that the team plans on working on pointing outside since Sasha loves to play with sand toys in the sand table. So, they plan to place her favorite sand toys on a shelf right above the sand table which is visible to kids but kind of out of their reach, then the teacher monitoring the table will encourage Sasha to point to the item she'd like to play with and then get them down once she requests.

So again, it's very important to note that whenever we're developing matrices for other people to use — such as child care providers or parents or other caregivers — it's crucial that we work collaboratively. And within this matrix we see the educators and the therapists and the parents working closely to determine the best times of day for Sasha's embedded instruction and ultimately her child care providers determining the best time of the day where they will actually be able to implement some of these strategies.

Now this next example is an activity matrix that we might be using with a family to support embedded instruction at home. So, here we see the home visitor working closely with Yazmin parent — Yazmin's parents to determine the best home routines for embedded instruction. Now this family said the evenings were best because mornings are a little hectic and getting everybody ready and out the door for school and so, the home visitors shared some strategies for how parents could work on these things during dinner, bath time, and evening play time before bed.

And now these next slides kind of deconstruct the matrix in a little bit more detail. So, we see here that Yazmin's goal during dinner time is around sitting at the table. So, being able to kind of join her family — Yazmin's got a couple of siblings — and sit at the table, have a meal with her family, and trying new food. So, we see that the home visitor suggests that the parents use some of Yazmin's favorite toys and activities — which at the moment are stickers and farm animals — as a way to make this routine a little bit more positive and fun for her. And we also see the home visitor adding in some reminders for increasing praise and really reinforcing Yazmin for being at the table with her toys during mealtime. And we also see that the home visitor notes that keeping the toys at the table is perfectly fine for now. And we can phase these out later once Yazmin is able to join in kind of sit little bit more independently. So, we see a little modification here of an activity matrix for home with this note section that can be really empowering for parents, where we kind of say, "Hey, don't forget, like, it's OK for Yazmin to have things at the table," or, you know, "Don't forget to give her a lot of praise when she first joins you."

Now here's an example of how we might support a family with a matrix for planning – for increasing communication during bath time. So, we see that Yazmin's working on talking about objects that are in her environment. And this matrix includes some extra information on how her parents can work on these goals. We see some kind of sample questions here. Mom and Dad can label toys, body parts, colors, and shapes as Yazmin plays in the bath tub with her sisters, and they can encourage her to request the things she wants to play with by asking questions such as, "Do you want bubbles or the boat?" "Do you want the red or the yellow cup?" So, sometimes, again, that can be really empowering for parents, giving them some examples of things they might ask or — or say or — or do with their children.

And then the final example here is around evening play time. So again, the family had identified that this was a good routine for them to work on, some embedded instruction related to Yazmin's IFSP, and the specific learning targets here were around following directions. These are routine directions like, "Clean up," "Come here," and, "Get the toys" — baby doll, bubbles, whatever. And the home visitor kind of notes that Yazmin is really interested in her animal books lately. Remind Yazmin that when she follows directions, mom or dad will read her animal books before bed. So, you might say, "Hey, Yazmin, first clean up the toys, and then we'll read 'Big Red Barn'." Remember to use lots of behavior-specific praise when Yazmin follows directions.

For example, "Nice job, Yazmin! You are cleaning up the toys." So again, here we see the home visitor kind of leaving some hints for mom and dad by saying, "Hey, remember, first you need to clean up the toys and then we'll do what you really like to do, which is read 'Big Red Barn' " or whatever — whatever book is the preferred book at that time. So again, when you're developing an activity matrix — especially for infants and toddlers, we really encourage you to think deeply about the importance of collaboration with other programs, providers, and families. So, since we are often not the ones that are providing this instruction, rather we're the ones supporting this instruction, working with other adults to figure out the best times of day, what is realistic given the resources is — is hugely important to the success of these plans.
For example, if I'm a daycare provider and I'm working in an infant room and my assistant takes a lunch break from 12 to 1, it's probably very unlikely that I will be able to provide a lot of one-on-one embedded instruction or support to any of the four infants in my room. But maybe I have an assistant and a parent volunteer on Monday mornings. So, it's a much easier time and I can easily modify some things that are routine and work on embedded instruction around rolling or crawling or pulling to stand with one of the children in my program.

Angel: OK, so Ariane shared a lot of strategies regarding how you embed instruction to support children's learning and I see comments in the chat box regarding the usefulness of activity matrices. So, once we have figured out our learning targets or goals and develop plans for embedded instruction and created an activity matrix, the final step is determining if our instruction is effective. So, we need strategies for assessment, data collection, and understanding if infants and toddlers are learning new skills or if we need to change some aspects of our instruction to support their learning. So, here is one simple example from the new "Building Blocks," a book by Sandall et al, 2019. This is a very simple data sheet that provided teachers, child care providers, or families an easy way to note if embedded instruction is working. So, in the first column we can simply write the learning targets, such as increasing communication or drinking from an open cup or requesting – saying "up" to get picked up. The second column labelled "plan" is where teachers or teams can write in what they plan to do, such as work on saying "all done" and "up" during play time or intro – or introduce an open cup with a little bit of juice and help Hannah drink from it during snack.

The final section is where we can write specific notes such as the count — how many times something happens. Notes on any details or products if we are working on a fine motor goal such as scribbling, stamping, and other activities. Now, we can simply circle "yes" or "no" to log where the plan works or not and what the team plans to do following — the following week. This might include making changes to their instructions, providing more opportunities on the goal, or continuing their plan — if it's working. This example is designed to help participants understand that ELOs are embedded learning opportunities that are easily incorporated into existing routines in the family child care. This form was evolved by Matteo's family child care provider, an occupational therapist, and expands on the current form used for logging diaper changes and feedings. So, Matteo attends a family child care five days a week and receives IFSP services from an occupational therapist within the setting every other week. Matteo's parents, Dara, his family child care provider, and Kate, the occupational therapist, identified the following priorities: cruising along furniture, pointing to toys or objects he wants, approximating one word phrases. There are six other children at this daycare so that — so Kate and Dara identified some realistic routines for embedded learning opportunities.

The process of working together with a child care provider to identify which routines are actually feasible and realistic for providing instruction is a crucial step. Dara notes that mealtimes and diapering are especially good times since she is supporting children individually at this time. They plan to work on pointing and approximating words during mealtimes and diapering. Dara are also shares that play time at the end of the day is also good as Matteo is usually the last child picked up and she can focus her attention on him one-on-one. They plan to practice cruising at this time.

So, here are a couple ... These are couple of examples where will — that will support you in gathering data to see if embedded learning opportunities and if your goals have been met. So, we are now to the end of our presentation and want to give you a moment to think about questions you might have regarding the topic today, so please feel free to ask questions you might have into the group chat and we will pause for a little bit to wait for those questions to come in.

So, I see that there have been several questions about whether or not the — the progress sheet or the data collection sheet is posted or available. These are things that we can make available and share as well. These are also things that you are more than welcome to take and adapt to make sure to fit your program and the families you work with.

Ariane: Yeah, we ... You know, as Angel mentioned, that evaluation sheet comes from the third edition of "Building Blocks" and we are currently working with Brookes to get a lot of these – a lot of the resources that are inside this textbook onto their websites, where it's kind of taking a little bit longer than we all hoped. But if you continue to kind of search back and actually just do a quick Google of "Building Blocks third edition," the website will pop up and there is a specific learning module related to infants and toddlers or something on activity matrices and the evaluing — evaluation sheet would be — would be linked to that website, as well. But we will work with the team to also get that pushed out once that website is live.

Angel: So, we see a question asking how can we convey the importance of embedded learning instructions to maybe a colleague or a staffer who you work with who might not think this is important or think that the child might not be mature yet to embed these learning opportunities. And that's a great question. And, you know, it can be very challenging, you know, with developmental perspectives and teaching young children. But I think it's important to note that children are learning as young as they are born and, you know, really thinking about how do we support their continual learning during these times of importance and also really thinking about sometimes it might appear that they're immature but, in fact, opportunities for learning that we're embedding there really ... Kids that are learning even though they might not be showing signs or, you know, reciprocating some of their interactions that you're having.

Ariane: Yeah, yeah, I would absolutely agree. Emphasizing everything that people talked about earlier when we're just getting started that infants and toddlers are learning all the time and embedded learning opportunities really kind of help us just use — use the time that we have with infants and toddlers really productively and perhaps modify the environment or be systematic about our instruction.

Angel: And I think one of the things that we mentioned at the beginning is really to highlight that infants and young children learn through the context of relationships. And so, a lot of these interactions we're having with embedded learning opportunities are also our ways of building relationships with children to set them up for success for learning, as they continue to grow and develop. So, that is, I think, it's a critical point that you might be able to point out to your colleagues about the importance of relationship building and how this really sets the foundation for the kids.

Ariane: Yeah, we see another question that is very important to address, wondering if the child hasn't met the goal do we change the goal, what do we do? Fantastic question. So, let's say we're working with Matteo, we're doing — working with him on cruising and we're just not seeing progress being made. There's a couple of different things we would think about. We would think about, "OK, is this something that we need to provide more opportunities for Matteo to do," perhaps just working on cruising, like, in the morning and in the evening. Is it enough for him to make — to be making progress. So, we might think about more opportunities for — for embedded instruction on cruising. We might also think about modifying the environment a little bit. Perhaps cruising is a little bit too complex for Matteo right now, and we want to continue to work on just helping him kind of pull to stand and feel really stable holding onto the coffee table or a pillow or — or something like that. So, we might think about modifying the environment, modifying the goal, or perhaps increasing reinforcement. So, thinking about, "OK, well what's Matteo really like to do? Maybe we need to think about embedding – bringing over some of his favorite toys or encouraging a favorite caregiver or parent to kind of get right down on his level and encourage him if he's pulling to stand, or encourage him to kind of scoot his little body across the coffee table to come and join me at the end, whatever that might be. So, we wouldn't say, you know, if someone's — if a — if an infant or a toddler isn't making progress on their goal to abandon the goal and change it, but rather spend some time reflecting with the parent or the child care provider on what might be happening with this goal and is this something that we need to slightly modify, change, do we need to add reinforcement, do we need to provide more opportunities, and that, often once we do a little bit more reflection, can help us figure out what needs to change.

Angel: So, I also see a question around how do we support families in implementing some of these strategies when they're saying that they don't have time to do it. And I think that's a great question and we commonly face that in our work. And I think one of the key things to really consider is really thinking about, you know, that routines-based interview to consider what are some routines that is appropriate to embed some learning opportunities. You know, like, not every opportunity — not every routine throughout the day is going to be the right fit for embedding some of these just because of the chaoticness of that specific routine. So, really being able to highlight when those routines are appropriate, talking to families — to families to figure out what's doable and really consider families' resources and understanding of these strategies as well, right? We have to make sure that we're providing strategies that are doable for families within their means and resources. And then starting somewhere small, right. So, I think providing five strategies within a routine is not — probably not the best way to go, particularly for a family who's saying "I don't have time," but perhaps providing something that's very straightforward, very simple, that families can do very quickly in one routine in the day and guide the families in seeing the successes and the learnings that they see in their kids, that might provide some gratification and confidence and competence in the families to move forward with more opportunities.

Ariane: Mm-hmm. Yeah, that's a great question. I think we have time to maybe answer one more quick question before we ensure everyone has — has ample time to do our evaluation. We see another wondering about how do we support staff in understanding embedded instruction. Great question. If there's, you know, nothing else we want people to take away from this webinar is that embedded instruction is so dependent on providers and child care teachers and other early learning providers and families that are working with kids. So, we describe embedded instruction as, you know, learning that is happening within the ongoing routines and activities in which young children are engaged.

And, you know, to — to piggyback off what Angel was just saying about supporting and kind of promoting confidence in families, I think a big — a big role of ours is to do the same thing with our staff members, right? And — and ensure that people are feeling confident being able to provide this instruction for a young child within an ongoing routine. So, the way that I usually come at it when — when I was teaching in home visiting and then working with a lot of different child care providers was to kind of explain a little bit about how we would do this with one kid, and an Angel mentioned with families, start really small, say, "Hey, you know, we really want to support this child in pointing to request and we know that when we can really support her in pointing we'll probably see some of these challenging behaviors and the whining and the crying that we're seeing a lot of during mealtime decrease.

So, let's talk a little bit about what that would look like," and then I might model a couple of times and show the staff members exactly how this can look in the setting and then encourage them to give it a go, right, encourage them to try it out. We know that that kind of in vivo, in the moment, practice of a new skill is really, really important when we think about supporting caregivers or families in embedded instruction in settings when we're not there and then really celebrate the successes when — when this person is doing things the right way and we're starting to see the child engage in the skill really, really highlight, like, "Whoa, you did it! That was amazing. Look at how, you know, Ariane was able to point when you gave her two choices. That was fantastic."

And — and always encourage their involvement and their perspective. Like, "Do you think this is something you could work on a couple of times during snack time. I wonder, would it be possible for you to do this during story time or during music," and see if that adult might be willing to kind of have a conversation with you about the other times of day where we could provide more embedded learning opportunities for a child. So — so much of this, you know, involves with ... As we hope we've conveyed collaboration with other team members and families because embedded instruction should be happening — as we all mentioned — across the infant or the toddler's day, right, not just when we're doing a home visit, not just when the child is in our Head Start classrooms, and so on and so forth.

Angel: OK, so to wrap up, I want to review what we have discussed. So, we discussed the following main points today. So, we considered where and when infants and toddlers learn and how this takes places in homes and communities not always structured learning, early learning programs. We reviewed the what, when, and how components of embedded learning opportunities, specifically we talked about ways to determine what infants and toddlers need to learn when we can provide this instruction, and how we plan to teach these goals. We also emphasized that embedded instruction or teaching within ongoing routines and activity — activities is the most effective strategy.

We also learned about ways to plan for embedded learning opportunities using activity matrices, and looked at one example from — for use in a group setting and one example for use at home. And overall we shared strategies to support infants and toddlers with disabilities or suspected delays across all learning settings. We hope these strategies will be effective in your practice.

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