Coaching the coaches

A pilot project led by UW’s Angel Fettig helps families of infants and toddlers with developmental disabilities get a head start on challenging behavior.

 

A speech-language pathologist wants to help a toddler with autism communicate — but the child’s parents are too stressed about her constant biting to focus on anything else. An occupational therapist wants to help a toddler who is developmentally delayed learn to use utensils — but the parents fear he’ll stick them in an electrical outlet. A physical therapist wants to work with a toddler with Down syndrome — and the child just won’t stop hitting.

Those are just a few examples of the types of behavioral challenges faced by the early intervention specialists who work for Kindering, an organization that annually helps around 3,000 special-needs infants and toddlers ages birth to 3 in an area that stretches across King County from Bothell to Renton as well as Snohomish County. 

Helping those professionals support families with challenging behavior issues was the goal of a one-year pilot program called Positive Behavior Support for Early Intervention (PBS-EI), led by University of Washington College of Education Associate Professor Angel Fettig.

“Regardless of whether you’re a special educator, a speech language pathologist, an O.T. or a P.T., parents are going to say ‘I have difficulty with challenging behavior — what do I do?’” Fettig said. “But unfortunately, not everybody knows how to address it in the early intervention setting.”

Video spotlight

Professor Angel Fettig, research assistant Shawna Harbin and Kindering special educator Molly Poole discuss challenging behaviors, Positive Behavior Supports, how to better support early intervention specialists and educators, and more in a video podcast.

Kindering Special Education Manager C. J. Stout (who earned his master’s in early childhood special education at the UW) agrees.

“Behavior is fundamental. I think for anybody working in an intervention context, especially early intervention, challenging behavior is often a barrier to treatment across disciplines,” Stout said. “So it’s important for all direct service providers in all disciplines — especially those not well versed in behavior — to have strategies and be equipped to try to support positive behavior.”

Building a community of practice

For the pilot program, Fettig chose a group-coaching model that is one element taken from her work (see sidebar) coaching preschool teachers in Portland and Seattle to deal with challenging behaviors in the classroom.

Fettig’s participants were 20 out of Kindering’s 80 speech-language pathologists, physical and occupational therapists, and special educators from the organization’s three campuses in Renton, Bellevue and Bothell, who each work with about a dozen families with young children with developmental disabilities in their homes. 

Fettig said the participants first attended two introductory workshops covering behavior basics and culturally responsive family-centered practices, followed by a year of monthly 90-minute group community of practice coaching sessions. The sessions used practice-based coaching principles and focused on self-reflection of practice implementation and problem solving to address challenges.

Early intervention and student success: How addressing challenging behaviors helps children get a strong start

  • 3

    Preschoolers (3–5 years old) are expelled at a rate more than 3 times that of K-12 students, with behavioral difficulties contributing significantly to expulsion decisions.

  • 3.6

    Black preschoolers are 3.6 times as likely to receive one or more suspensions relative to white preschoolers.

  • 1/2

    Pre-K teachers who reported having an ongoing relationship with a classroom-based or on-site mental health provider (such as a psychologist, psychiatrist or social worker) were approximately half as likely to report expelling a preschooler compared with teachers who reported no such support.

  • 23

    Only 23% of teachers reported regular classroom access to a mental health consultant (such as a psychologist, psychiatrist or social worker)

PBS has developed over many years, and is a well-known approach in the field of special education. As its name indicates, PBS places a strong emphasis on supporting positive behaviors and, rather than seeing challenging behaviors as "bad," emphasizes that they are generally attempts at communication.

Fettig noted the PBS-EI approach is unique in its emphasis on working with children and their families in their “natural environment” at home — making it perfect for Kindering professionals, who generally serve families in their homes.

Families are key

Fettig, who recently co-authored a Council for Exceptional Children position statement providing guidance to families and professionals in preventing and addressing challenging behaviors, said one important focus of the coaching sessions was to help the early intervention specialists include the entire family, versus a direct focus on the child.

“The idea is that if you go into the family’s home once a week and you just work with the child, then the child is only getting intervention one hour once a week,” Fettig said. “But if you work with the families when you go in for that hour, then the families can use the strategies they learn with their kid throughout the day — at bedtime, during the morning routine, going out for groceries. So the child is getting a lot more service.

“Kindering is one of the programs that has embraced that fully,” Fettig said, “So the providers were all there knowing that their client is the family, with a focus on the adults — not just the child.”

Parent Coaching 411

Professor Angel Fettig discusses how to support the social-emotional development of young children and reduce challenging behaviors for those with or at risk for disabilities.

Sharing knowledge

The monthly coaching sessions included a lot of sharing of challenges and strategies among the early intervention specialists, with Fettig guiding the conversati on, offering suggestions and providing handout materials — all based on PBS principles.

Kindering Speech-Language Pathologist Theresa Sergotick said participating in the project helped her think of challenging behavior as just another form of communication, and gave her more confidence about addressing behavior issues with families.

“Since starting the groups I’ve personally been more open and forward with letting families know that behavior is something we can talk about and work on during our sessions,” Sergotick said. “I’ve become more comfortable letting families know that I’m someone in a role that can talk about behavior management. I don’t think a lot of families think of a speech therapist as someone who can help them with that.”

Chanel Richards, another Kindering speech-language pathologist, said participating in the program helped her think of dealing with behavior issues as a regular part of her work.

“It has made me think of behavior support more often,” Richards said. “As a speech-language pathologist, I often encounter challenging behaviors — but didn’t always think of it as my area. However, this has helped me rethink that. It has also helped me find more ways to support parents with behavior and do that in a more systematic way. I also think it’s always helpful to reflect — and this group gave me time to do that with my colleagues.”

Moving forward

“I really treat this project as also my way of learning,” Fettig said. “A lot of it is really understanding how flexible or inflexible the model I’ve developed is to individual family nuances. Family culture, families’ experiences around trauma, their philosophy about intervention. The coaching and community of practice sessions are a natural place for those things to come up.”

Fettig said her next step is using what she’s learned from the pilot study to seek funding for a large-scale implementation and evaluation of the method — with an emphasis on working with early intervention agencies like Kindering who support children and families with diverse needs.

“I believe everyone who touches a child’s life has a role to play in addressing challenging behaviors. What makes me feel good is that there are people who consistently come and value the coaching sessions,” Fettig said. “There are people who consistently bring in the behavior challenges they see — and see the space as a place where they can address the challenges. That’s particularly gratifying.”

What’s the big IDEA?

Early help for kids with disabilities has long-lasting effects

Resources for the kids and families served by Kindering originates with IDEA — the Individuals with Disabilities Education Act, a federally-funded program administered by individual states.

Part C of IDEA was designed specifically to provide early intervention for infants and toddlers from ages birth to 3. Anyone can refer a family to the program, which is available to all children with developmental disabilities, with many referrals coming from pediatricians.

IDEA aims to reduce costs for early intervention, help families meet the complex needs of their children — and maximize children’s chances for success in school and beyond.

The big picture

The Tiered Coaching Model aims to personalize coaching

Associate Professor Angel Fettig’s work with Kindering is an offshoot of a larger, federally-funded, multi-year project working with preschool teachers in Portland and Seattle with co-principal investigator and UW Associate Professor Kathleen Artman Meeker.

While that project also includes the goal of helping teachers address challenging behaviors, its bigger goal is to create a flexible and highly adaptable “multi-tiered” coaching approach that considers individual teacher characteristics and needs around professional development. The model will allow coaches to hone in on the very specific needs of each individual teacher or provider they’re coaching — regardless of the subject matter.

“We are designing a coaching model that’s independent regardless of what you are coaching the teachers on,” Fettig said. “The idea is that anyone who wants to use this tiered coaching model can take it and use it for any topical area they want to coach on.”

Fettig says the process included conducting a profile analysis of more than 100 teachers, including stress, satisfaction with job, likelihood of staying at the job and discipline efficacy. Then, a coach will match a teacher to a specific tier of coaching — one tier of which is group coaching similar to the community of practice sessions being used with the Kindering professionals.

Fettig said the hope is that the model will be useful in many different coaching scenarios. 

“We want to develop a model of coaching that’s geared to the individual teacher — and not just focused on their implementation of academic goals.”