Preservice Education: Perspectives about Integrating Caregivers

A disconnect is present between philosophical desire to actively involve caregivers in early intervention (EI) and implementation by EI providers. Preservice education may shape beliefs and build knowledge and skills supporting active participation of caregivers. Two graduate clinicians in speech-language pathology completed a practicum with a two-year-old child, Sam, and his family with half of the sessions including active participation by the caregivers. Analysis of progress notes, individual reflections, and interview transcript yielded clinicians reporting beliefs in collaboration with caregivers and building relationships with caregivers as key to involving caregivers. The clinicians demonstrated knowledge regarding intervention techniques with differences in progress notes based on the presence of the caregiver in sessions. This practicum opportunity promoted development of beliefs, knowledge, and skills about actively involving caregivers in early intervention. 1. Introduction Early intervention (EI) principles emphasize family-centered models that encourage active participation of families in the therapeutic process for children ages birth to three years old [1, 2]. Two types of family-centered EI models, relationship-based and participation-based models of intervention, highlight the integration of intervention into caregiver-child interactions differing from traditional models directed by clinician and focused on clinician-child interactions [3–5]. While these models are not new, there has been continued discussion regarding conceptualization and implementation [5, 6]. Dunst [6] discussed the historical foundations of collaborative partnerships between families and EI providers beginning in the 1980s and the 1990s. Successful implementation of collaborative partnership includes instructional practices focused on promoting caregiver responsiveness to child-led behavior, assisting caregivers to establish an environment that enables skills to be practiced and helping caregivers to encourage existing skills [6]. Evidence of disconnect exists between philosophical principles and implementation [7, 8]. Reported observations of EI providers indicate limited focus on promoting caregiver-child interactions while self-report data from EI providers report moderate levels of confidence and frequency in teaching caregiver [9–11]. Investigators reported that EI providers are generally more focused on their role as experts to influence the course of treatment rather than the role of caregiver [8]. EI providers have described active roles of the caregiver to