Table Of ContentFamily-Centered Early Intervention
Visual Impairment Services
Through Matrix Session Planning
Mindy S. Ely, Kateri Gullifor,
and Tara Hollinshead
E
arly intervention visual impairment ser
vices are built on a model that values family
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©2017 AFB, All Rights Reserved Journal of Visual Impairment & Blindness, March-April 2017
involvement. Legislative provision for Printing House for the Blind, n.d.; Dote-
these services is found under Part C of the Kwan & Chen, 2014; Petersen & Nielsen,
Individuals with Disabilities Education Act 2005). We organized these ideas into several
of 1997, the Infants and Toddlers with Dis steps that could be taught to scholars with sub
abilities Act. An early intervention profes sequent evaluation for fidelity of implementa
sional is a teacher of visually impaired stu tion. In this paper, we will describe the method
dents or an orientation and mobility (O&M) we call matrix session planning, followed by a
specialist who provides Part C services. The discussion of the advantages and challenges
goals of service, referred to as child and scholars experienced as they used the matrix
family outcomes, are based on priorities session planning method with families.
identified by the family.
In a white paper entitled Family-Centered DESCRIPTION OF THE MATRIX SESSION
Practices for Infants and Young Children PLANNING METHOD
with Visual Impairments, Hatton and col Matrix session planning pulls together par
leagues (2003) describe the benefits of a ent priorities, family routines, and identi
family-centered approach. It allows parents to fied strategies in a way that helps families
guide their child’s development while honor and early intervention professionals outline
ing the family’s culture and values. In addi a plan that can both highlight long-term
tion, parents work directly with their child, goals and focus on what can be done today.
strengthening the parent-child relationship First, the early intervention professional
and supporting parent-child communication. interviews the parents to learn about their
The graduate certificate program at Illi concerns, hopes, and dreams for their child.
nois State University offers experienced We have found the Routines-Based Inter
teachers of visually impaired students and view (McWilliam, Casey, & Sims, 2009) or
O&M specialists specialized training in the Parent Assessment of Needs from Par
early intervention visual impairment ser ents and Their Infants with Visual Impair
vices. As we developed this program, we ments (Chen, Calvello, & Taylor Friedman,
were sensitive to the fact that family- 2015) to be helpful interview protocols.
centered practices are quite different from This professional also completes a func
the traditional teacher-directed instruction tional vision assessment. From the inter
to which most scholars were accustomed in view and assessment, outcomes are identi
their teaching or O&M instruction of visu fied. These priorities are entered in the
ally impaired students. A teacher-centered left-hand column of a matrix with one out
approach assumes that the teacher is the come per row (see Table 1).
expert. In contrast, family-centered prac Next, family routines are identified in one
tices involve the family in determining the of two ways. The family may identify specific
direction and focus for the intervention daily routines as being difficult for the child,
session. or a desired outcome may naturally fit into a
Consequently, we sought a method for specific routine. Identified routines are listed
teaching scholars to provide services that across the top row of the matrix.
would integrate family-centered practices into Then, the parent and provider brainstorm so
their work with families of infants and tod lutions using the child’s strengths, preferences,
dlers with visual impairments. The approach and adaptive needs. These solutions are based
we developed is based on delivery and planning on information from the interview and assess
models described in recognized resources ment. The ideas are entered into the matrix in
within the field of visual impairment (American the corresponding row and column.
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Journal of Visual Impairment & Blindness, March-April 2017 ©2017 AFB, All Rights Reserved
Table 1
An example of matrix session planning for achieving desired outcomes through activities that can
be conducted throughout the day.
Desired outcome Snack time Bath time Play time
Encourage the Position the Move a yellow duck Explore a variety of high-
use of vision caretaker on the across water for contrast textures (blocks,
to explore child’s left tracking balls, etc.)
Place snacks on the Search for high-contrast Play hide-and-seek with
child’s left items that sink noise-making toys
Improve reach Provide small pieces Place a high-contrast toy Place a high-contrast toy slightly
and grasp while of snacks on the slightly out of reach on out of reach on the left side
looking table for the child the left side
to feed him-or
herself
Using the completed matrix, the profes parents’ concerns to form the outcomes while
sional and family choose one strategy from taking their daily routines into consideration.
the matrix that will become the focus for the As a result, family life was at the center of
intervention session. Since the matrix was their child’s plan. When using matrices, var
built using a collaborative process represent ious families identified priorities such as help
ing the priorities of the family, family mem with bedtime and mealtime routines, promo
bers are willing to join their child in trying the tion of sibling interactions, and development
new ideas. This willingness allows the early of independent walking. Problem-solving
intervention professional to play the role of with the family to find solutions that fit into
coach, demonstrating specific strategies when their daily routines kept family members in
necessary. volved while ensuring that solutions were
The matrix should be small to avoid over centered on their unique desires for their
whelming the parent. Two outcomes and child’s development.
three daily routines are sufficient in the The matrix session planning method also
beginning. Over time, strategies can be helped families and scholars consider a vari
added or deleted from the matrix as needed. ety of daily routines in which outcomes could
Similarly, outcomes and daily routines will be practiced. For example, one family ex
change. pressed the desire for help in encouraging
their child to visually attend to her environ
ADVANTAGES ment. The scholar worked with the family to
Reflection proved valuable in identifying ad identify several activities that they could use
vantages and challenges of the matrix session to encourage the child to visually attend in
planning method for planning and providing various routines such as the nighttime routine
early intervention visual impairment services and trips to the grocery store.
to infants and toddlers with visual impair Further, the matrix session planning method
ments and their families. Given the scholars’ empowered families to use the identified
experience with the method, three themes strategies. Using this approach, parents were
emerged: planning, intervention, and reflec actively involved in developing the ideas re
tive practices. corded on the matrix. During the session, they
were encouraged to choose a strategy from
Planning the matrix and introduce it to their child. After
The matrix session planning method pro the session, they implemented the strategies
moted family-centered practices by using the within their normal daily routines. In fact, one
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©2017 AFB, All Rights Reserved Journal of Visual Impairment & Blindness, March-April 2017
scholar reported a situation in which a grand rienced success, they gained confidence, and
father who was present during an intervention a stressful situation was eventually resolved.
session was persuaded to participate. The Scholars reported that the matrix also al
mother had identified play as a priority. Use lowed them to highlight and organize strate
of musical instruments was identified to en gies. As various ideas were discussed during
courage active play and was entered into the a session, the matrix provided an organized
matrix. During the next intervention visit, the means to document strategies. In addition, it
scholar learned that the grandfather had proved easy to manipulate and change as nec
begun to use this strategy with the child. As essary. When the child achieved a skill identi
the grandfather demonstrated play with his fied within the matrix, the family and scholar
together could consider the next step in achiev
grandson during this subsequent session, the
ing the desired outcome. Conversely, as was
scholar was able to point out the numerous
described in the bedtime routine example, a
developmental skills that he was helping his
strategy might be found to be ineffective for the
grandson develop as they played the piano.
child and might need to be adjusted. In that case,
The active involvement within this family
the family adapted the strategies on the matrix
allowed the scholar to communicate the sig
throughout the week. During sessions, the
nificance of their role in guiding their child’s
scholar offered specific suggestions as the
development.
week’s progress was discussed. This discussion
Intervention resulted in a collaborative exchange that helped
the family reach their goal.
Development of the matrix gave families an
opportunity to voice their successes and con
Reflection and follow-through
cerns. When creating a matrix centered on
The format of the matrix is a direct reflection
priorities and routines as identified in the in
of the Individualized Family Service Plan
terview process, the family is validated in
(IFSP). The outcomes identified in the IFSP
their concerns and successes. The matrix is a
are presented in the matrix through strategies
direct response to the accomplishments and
that will be used to help achieve these out
challenges that the family has already voiced,
comes. Scholars reported that using the ma
supporting family-centered practice.
trix as a daily lesson plan helped them to align
The matrix session planning method can be
their practice with the IFSP outcomes. This
viewed as a road map to outcomes outlined by
gave purpose and direction to each session
the family. The matrix helped the family and
and ensured that the session was driven by the
the scholar break down outcomes into smaller
IFSP through use of the matrix.
steps. For example, one scholar found that a
The matrix proved a useful means to doc
family had difficulty with their child at bed ument growth and progress toward a family’s
time. This priority was based on a highly desired outcomes. For example, one scholar
stressful part of the family’s routine. They used the matrix to document the many strat
needed help in breaking the routine into man egies that were found to be helpful for a child
ageable pieces with identified strategies for with cerebral visual impairment. The scholar
success. The scholar used the matrix to strat and the family were able to use the matrix to
egize a variety of possible solutions including guide and facilitate intervention. The family
a formal bedtime routine. The family inde then followed through by implementing these
pendently used and revised the bedtime rou strategies in their daily life. The family’s efforts
tine and subsequently discussed their progress were reaffirmed by the child’s progress and the
each time the scholar returned. As they expe matrix served to document small milestones
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Journal of Visual Impairment & Blindness, March-April 2017 ©2017 AFB, All Rights Reserved
achieved between visits, which also allowed the tomed to working with school-aged popula
scholar to celebrate success with the family as tions. Because of the systematic nature of the
they reviewed the matrix at each visit. matrix session planning method, scholars
were able to reflectively evaluate their prog
CHALLENGES ress. In addition, the framework facilitated
It can be difficult for families to take an active measurable feedback from instructors and
role in intervention sessions. Although the mentors. Such a model is likely to prove help
matrix session planning method is designed to ful for others seeking change toward family-
encourage family participation, scholars found centered practices when working with infants
that many parents needed help in knowing how and toddlers with visual impairments.
to get involved. Therefore, when identifying Although adherence to recommended prac
outcomes and strategies, scholars found it help tices are a high priority, family outcomes are
ful to have a variety of ideas prepared in case the the true goal. In using the matrix session
parent struggled to offer ideas. Once the family planning method to help scholars shift their
became accustomed to the matrix session plan practice, we were encouraged by benefits to
ning method, however, they had an easier time families. Increased parental engagement was
contributing ideas. For example, the parent of a an underlying theme in scholar experiences.
child with cortical visual impairment was ex Several scholars saw empowered parents who
cited to show the scholar the birthday gifts she were identifying and implementing strategies
had purchased that met her daughter’s visual to meet their child’s developmental needs
needs. This is an important part of developing outside intervention sessions. In addition,
empowerment in the parent as they begin to scholars reflected on experiences that rein
intentionally think of strategies to help their forced the relationship between the child and
child develop in the areas that they have prior the family. This method proved successful in
itized. guiding our scholars in implementing family-
On the other hand, some families chose not centered practices by using family priorities
to use the matrix on their own, referring to it to guide a collaborative partnership between
only when the scholar was in the home. Per the scholar and the family.
haps they felt the format was overwhelming
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©2017 AFB, All Rights Reserved Journal of Visual Impairment & Blindness, March-April 2017
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