Observation - In Early Intervention

caregiver coaching coaching strategies ei early intervention home visiting occupational therapy parent support physical therapy routines based intervention speech therapy Mar 19, 2024

I want to highlight the importance of a coaching strategy that is frequently underutilized in EI work: Observation. The value of this coaching strategy is emphasized across all of the coaching literature and it makes sense. By observing, we’re able to identify baselines and strengths to scaffold from. Observing prevents us from making recommendations that caregivers might already be implementing. Observing also helps us ask important questions and identify meaningful routines where learning naturally occurs. 

If you've been following my recent work, you'll know that "observation" occurs during the camera part of our Lights, Camera, Action, Cycle (more on that HERE). 

When we start observing, at first it can feel difficult for many EI professionals, because we feel like we should be doing something. Remind yourself that you ARE doing something – observing! When you observe children, caregivers, and their interactions, you’re setting up additional coaching opportunities. After observing, it’s more natural to use other coaching strategies, such as:

  • Giving strengths-based feedback
  • Gathering Information
  • Reflecting on what’s going well or feels like a priority
  • Problem solving on what to try next
  • Guided Practice to add or change an intervention strategy to the routine

When you’re in the middle of a home visit, it’s often busy and a lot of small details get overlooked. This is why I love using video modeling with my families and through our Coach2Coach (C2C) cohorts; it allows us to look and listen again to identify the things that often get missed. We can hone our observation skills over time and with practice. 

Here’s a practice opportunity for you now. Take a look at this photo of a potential family’s living room. Imagine you're there in real life, observing these dynamics in action. Can you imagine observing quietly and then identify 5 or more possible routines? What strengths might you identify? What questions might you ask the caregivers to learn more about possible learning opportunities based around the family’s daily routines? 

Were you able to identify some possible routines that this family engages in? Now take a look again below at some things I’ve spotted and the questions I might ask this family as we consider potential opportunities for routines based intervention:

1. Your puppy is so playful. Are there any moments (like feeding, walking, bathing) where Bella is interested in (or likes to participate in) what you’re doing with the pets?

2. I noticed there are shoes by the door and the kids are in socks. Does Bella know to take off her shoes when she comes in? Can I see how she participates in this activity?

3. Is that her favorite blankie on the couch? When does she want to hold her blanket (e.g. maybe before nap or in the car)? I could inquire further or the caregiver may offer more information. Perhaps the blanket helps Bella to self regulate during a specific part of the day. How does she find her blanket or communicate that she wants it?

4. Tell me about these toys. How do the kids play with them? Does Bella love the Toy Story movies? I might ask more about any possible screen-routines here too. 

5. Bella’s sister has her hair braided so beautifully. What does Bella do while you’re busy doing her sister’s hair? Is there a way for her to participate with you (e.g. maybe bringing mom the hair tie, or brushing her stuffed animal’s hair alongside you)?

6. Tell me about Bella’s pink cup?  How does she let you know when she wants milk?

These 6 insights are pulled just from a single image but the challenge intensifies when conducting an actual home visit amid the bustling sounds, sights, and dynamic movements of everyday life. 

For additional observation tips, you can refer to Dr. Woods' work here: https://fgrbi.com/wp-content/uploads/2020/07/ObservingTip_2020.pdf

You can also use our Observation Checklist to guide you as you practice this coaching strategy.