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Embedded Interventions

Embedded Interventions (into the child's everyday routine activities)

Interventions occur during home and community routines, activities, and other times of the child's day that are specifically identified by family members as activities in which they would like supports. Embedded interventions occur when, where, and how the routine activities usually occur, as well as with the individuals who usually take part in the routine activities. Interventionists limit changes in the way the routine activity happens, and suggest only those changes necessary for the child to successfully participate and learn. Agreed-upon developmental strategies are not only tailored to the unique strengths and needs of the child, but also fit the individual family's routine activities, and the family's own cultural values, where strategies will be used in between visits. Embedded interventions have also been called activity-based, activity settings and learning opportunities, participation-based, and routines-based interventions.

What's the Difference? Comparing Traditional Approaches vs. Embedded Coaching Practices

Embedded Interventions: Reflect on your practices….

How close are you to applying embedded intervention approaches in your work? Consider each practice carefully to see the difference between traditional approaches and embedded intervention approaches.

Traditional Approaches Embedded Intervention Approaches
Rely solely on assessment information gathered from tabletop testing and/or general developmental tasks that are known not to generalize well to a child's functioning in everyday life Understand each family's routines and activities, and how the child currently functions during those times, to individualize intervention approaches to the child and his/her family
Identify generic intervention approaches common for all children or children with a specific disability label or developmental characteristic Identify intervention approaches that fit the individual child's multiple learning characteristics (e.g., interests, temperament, strengths, needs) and each family's culture, values, and ways of being
Schedule intervention visits based on professional availability Schedule intervention visits at the time when the routine activities, identified by the family as the time the routine activities occurs when they would like support, usually occur. That way, the professional can see how that routine activity really looks and what developmental approaches best fit
Bring materials into the home for the intervention visit, and then leave with those materials Use materials the family already has available or bring materials the family can use as adaptations within their routine activities, which then belong to the family
Change the way the routine activity usually occurs, including the people (e.g., ask that siblings be occupied with some other activity) and arrangement (e.g., move the activity to another room) which are usually a part of the routine activity Incorporate developmental approaches within the routine activities as they usually, and will, occur with the family in between intervention visits (e.g., have siblings participate in the routine activity as they usually do and keep the activity in the room where it usually happens)

Collaborative Coaching: Reflect on your practices….

How close are you to applying collaborative coaching approaches in your work? Consider each practice carefully to see the difference between traditional approaches and collaborative coaching approaches.

Traditional Approaches Collaborative Coaching Approaches
Focus on professional priorities for child development Focus on family priorities for child development, integrating professional opinion within the family's priorities
Give the family specific strategies to promote child development Discuss with the family potential approaches or strategies, together refine them so the final approaches and strategies are collaboratively decided
Create strategies that require the interventionist, or another person not usually a part of the activity, to help the family member successfully apply the strategy Create strategies that the family member can easily use when the interventionist, or another person not usually a part of the routine activity, is absent
Give the family a way to apply the strategies when the family already has a way to do so (e.g., suggest a turn taking game) Ask the family for ideas on how best to apply the strategies (e.g., ask the family for any face-to-face interactive activities they like to play)
Work directly with the child while the parent either watches or “assists” by engaging the child in the activity Interact with the child for the explicit purpose of demonstrating to the family how to use a strategy, by explaining to the family the steps of the strategy and the child's response (or asking the family to identify the child's response)
Leave without knowing if the family clearly understands the agreed-upon approaches and can effectively use those approaches, and/or assume the family feels comfortable with the approaches agreed upon Have the family practice the strategies during the visit so both family and professional know the family can and will use them in between visits. To do this, family and professional(s) provide feedback and their thoughts about the potential and strategies

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