Ashley Drungil

Routines-Based Interview

During the Routines-Based Interview (RBI) with mom, I had the opportunity to learn

about the daily routines of the family. To begin, we went over background information that I was

mostly already aware of from previous visits. Mom, her twin daughters, and her husband all live

in the house together and they are involved in early intervention because of a language concern.

Mom and dads main concern is that the twins have not yet developed the same developmental

milestones with their language as their same-age peers. After reviewing this information with

mom, we began to discuss the day-to-day activities that the family experiences.

The first routine that mom and I discussed was how their day typically begins. Mom

reported that herself and the twins usually wake up around 10:00a.m. Mom knows that the girls

are awake because they both repeatedly bang their heads on their bedroom door until mom goes

upstairs to get them. Mom also has a video monitor in the twins bedroom in order for her to be

able to see them. From the video, mom reported that both girls generally wake up at the same

time and they lay around for a few minutes before getting out of bed to go to the door. Once the

twins are awake, mom said that she makes them each a small bottle (35mL) with coconut milk

and probiotics in them. The twins will also snack on fruit until 11:30a.m. when they eat

breakfast, which usually consists of yogurt or Cheerios. When the girls eat breakfast, mom sits

them in the dining room chairs with seats that have trays attached to them. The chairs are placed

in front of the television with a show playing and the girls will sit in the chairs and rock in them

while they watch the show and eat their breakfast. Mom said that she tries to eat whatever she

can throughout the day, although typically, she does not cook meals for herself. When asked on a

scale 1-5 (1 being the lowest), what she would rank their morning routine, mom said it would be

a 5, and there is nothing she would like to change.

 After their waking up and breakfast routine, mom stated that the next routine involves

play, more snacking, and nap time. The girls will play after breakfast and snack on different

fruits throughout this time. When the girls play, it typically consists of running around the house,

jumping on the trampoline, and coloring. Mom said that while the girls are playing, she usually

has a movie on the television and they will eventually stop to watch the movie for a few minutes.

When the twins are watching a movie, show, or video, they enjoy modeling the dances or

movements that they see. Around 2:00 or 3:00p.m., mom reported that the girls will eat a big

snack such as a protein bar before they go upstairs to their room for a nap. The twins will nap for

45 minutes to 2 hours and she knows when they are awake because they will hit their heads on

the door when they are done napping as well. After nap time, mom stated that the twins will eat

another light snack before dinner. The girls enjoy eating foods such as grapes, watermelon,

blueberries, Goldfish crackers, flax seed tortilla chips, and Cheerios. When asked what mom

would rate this part of the day, she said that she would also rate it a 5 and that there is nothing

she would like to change.

The next part of their day consists of more play and dinner time. Play generally looks the

same as it does during the morning routine with running, jumping, coloring, etc. Mom reported

that the girls eat dinner around 7:00 or 7:30pm. Mom said that she tries to make pasta, chicken,

and vegetables for them for dinner to make sure that they are getting the nutrients they need.

When mom is cooking dinner, the girls climb on the counters and stove and are with mom the

whole time, which makes it difficult for her to cook. It is also difficult for mom to get the girls to

eat what she makes for them, which is why mom reported that she will often end up giving them

more snacks for dinner instead. Mom also said that one day they will like a food, such as

chicken, and the next day neither of them will eat it. One of the girls will push the spoon away to

let mom know that she is done eating, and the other will turn her head away to let mom know she
is done. Both of them will also say no when they do not want to eat the food that mom is

offering them. One of the twins is also especially uninterested in trying new foods at dinner time.

Mom reported that she has to find ways to distract the twins when they are eating in order for

them to continue to eat off of the spoon or fork she is feeding them with. Both girls will drink out

of straws or sippy cups, but mom reported that she alternates between straws and sippy cups

every few days. Mom said that she would rate this routine a 2.5 out of 5 for multiple reasons. Her

main concern for this routine is making sure that the girls are getting enough and a variety of

foods. Mom would like the girls to sit and eat a meal without turning their heads and saying

no, and no longer need a distraction to get them to keep eating. After her concerns centered

around the girls getting enough nutrients, she would like them to be able to communicate more

during dinner time to tell mom when they do or do not like something, want more, or are done

eating.
After dinner, the girls will typically play around the house more before it is time for bed.

Around 9:30 or 10:00p.m., mom will take the girls up to their room and they will have a dance

party. Mom reported that the herself and the twins will listen and dance to three songs and read a

book before bed. Mom will then leave the room with the girls in their bed and they will

sometimes continue to play alone for a little before they fall asleep. When I asked mom what she

would rate this routine, she reported that she would rate it a 4. Mom said that she would like it if

the girls could calm down more when it is time for bed because they do not like to sit still when

it comes time for mom to read them a book.

Another routine that I asked mom about was bath time, toileting, and changing. Mom

reported that she gives the girls a bath typically two times per week. She said that both the girls

enjoy the water and that they get upset when it is time to get out of the bathtub. Mom also said

that the girls are not interested in potty training. When mom is changing the twins diapers, they
often squirm on the changing table. At the same time, the twins can be helpful during diaper

changes because they will sometimes help take their clothes off and on a little bit, and they will

throw some of the dirty diapers away. Mom said that the girls do not need to let her know that

they need to be changed because she always knows when they need changed. When it comes to

the twins independence during this routine, they can both help mom put pants and shirts on and

off, and they can both take off shoes with Velcro independently as well. Mom stated that she

would rate bathing, toileting, and changing a 4 out of 5 because she would like it if the girls

would not squirm so often while she is changing them on the changing table. Other than that,

mom is happy with this routine and would not like to change anything.
One thing that I learned from the first family meeting is that dad is gone all week for

work, but he returns home on Fridays and leaves again on Sunday evening. When dad is home

mom reported that they keep routines the same for the most part. Mom stated that when dad is

home he is usually moving around the house trying to get things done before he leaves again.

While he is doing so, the twins get upset that dad is not playing with them. Mom said that they

also get upset when dad leaves to go to work. While dad is home, him and mom take the girls to

the grocery store because they buy so many items that it is too difficult for mom to go alone.

Mom stated that they put the girls into a fun cart, such as one that looks like a car, and they are

fairly well-behaved while mom and dad shop. When mom takes the twins other places in the

community, such as a park, they are play with each other independently, without mom. Mom

reported that one of the girls is protective over the other one when they are around other kids,

although, they will both interact with other children. Both girls will also discriminate between

familiar and unfamiliar people, and greet those who are familiar spontaneously. Mom said that

she would rate being out in the community a 4. The reason for this is because the twins will

sometimes cry when they leave fun places, and have occasional behavioral issues in stores.
However, mom also said that these issues are not too concerning to her because they are typical

two-year-old behaviors. Overall, the RBI gave me a better view on the familys day-to-day

activities as well as more information on which routines are going well, and which routines are

more difficult for them.

From this RBI, mom and I were able to come up with two functional outcome statements.

Since the twins have similarities in the areas where they could use more supports, mom and I

decided to write the functional outcomes the in the same way for both. Based on baseline data,

one outcome includes, Child A will communicate 25 times on average throughout weekly 10-

minute play sessions by June 1st. Also, Child A will have the ability to use 4 different signs

during mealtime by May 1st. For Child B, she will communicate an average of 20 times

throughout weekly 10-minute play sessions by June 1st. Also, Child B will have the ability to use

4 different signs during mealtime by May 1st. Since the twins are not as engaged at mealtime as

they are during play, we decided that it would be best to start with signing during this routine.

These functional outcome statements were created with mom based on our RBI discussion and

baseline data that has been collected.

After conducting the RBI and reviewing the process, I was able to reflect and think

critically about what had occurred during the discussion with mom. One course competency that

I feel was addressed throughout this process is to match the familys priorities and needs with

outcomes and strategies. After completing the RBI, then using it to form outcome statements I

was able to better understand that with the RBI, this identification of individualized needs is

essential for individualized family service plans (IFSPs) and individual education plans (IEPs) to

be meaningful (Mcwilliam et al., 2011). Completing these two steps together gave me a better

understanding of how to implement this competency into practice by using the RBI to guide the

goals and strategies. Another course competency that I targeted includes building trust and
rapport to create a partnership with families. The definition of partnership according to the text is

a relationship in which families (not just parents) and professionals agree to build on each

others expertise and resources, as appropriate, for the purpose of making and implementing

decisions that will directly benefit students and indirectly benefit family members and

professionals (Turnbull, Turnbull, Erwin, Soodak, & Shogren, 2014, p. 161). Throughout this

process, myself and the family were able to build on each others expertise because mom gave

me information that I will continue to be able to use when creating outcomes and strategies to

give to the family. By using course competencies, I was able to determine what I should plan to

obtain from the RBI process with the family.

After reviewing the RBI I conducted with mom, I found some aspects that I liked, as well

as aspects that I would add or change in the future. One aspect that I thought went well was the

fact that during interactions with mom I paraphrased what she had said. Based on the text,

paraphrasing is extremely useful in clarifying content, tying a number of comments together,

highlighting issues by stating them more concisely, and-most important- communicating interest

in and empathetic understanding (Turnbull et al., 2014, p. 193). I was able to use paraphrasing

for most of these purposes throughout our discussion. I also used open-ended questions during

our interaction to find out information without giving an answer along with it. I used open ended

questions because they allow family members and professionals to share and talk more (Turnbull

et al., 2014, p. 194). For example, I would ask what happens next? instead of do you eat

dinner after that? because I did not want to assume that is the sequence of events in their

routines. Related to collaboration and partnerships, this process has enhanced my knowledge on

the fact that caregivers are the experts on their child. In other words, parents and family members

hold an abundance of information on their child, and as a professional, it is my job to work with
families to obtain this information and use it to individualize services. I have had the opportunity

to experience myself and a parent work together to foster positive experiences within the family.
To expand my RBI, I could have asked more questions about when mom finds the time to

care for herself or spend time with dad throughout the day. After seeing the end-product, I felt

that I did not know much about what mom does, other than take care of the girls. Finding out this

information may have led to a family outcome. One way I could have improved my collaboration

with mom would be to explain he RBI process more in detail. When I asked mom to tell me how

their day typically begins, she went through some of the routines following that as well. I think

that I could have explained that we would go through each routine one at a time. However, I did

go back to get details on the routines that mom went through and I did not have the chance to ask

questions about at the time she was describing them. When going through the RBI, one

competency that was not fully met was suspending judgements on others values and beliefs. This

competency was not fully met because I feel that my culture and the culture of the family I

completed the RBI with are somewhat similar. I would like to gain more experience working

with families from cultures that greatly differ from my own. This experience would allow me to

better reflect on my own values and beliefs, and seek to understand others with different values

and beliefs as well.

After reflecting on my strengths and areas for improvement, I have developed a plan for

making changes for the future. In the future, I will think of more questions directed towards what

the family or caregivers do throughout routines for themselves. I will then include these

questions on the sheet I use to write down the routines, along with other key questions to

remember. This will apply to my practice because I will be getting more information about the

family as a whole in order to know how I can better support them. I will also come up with a

small script to use of how we will go through the routines of the family, instead of only
explaining what we are doing and why. Also, I will start to seek out more opportunities to work

with families with different cultural backgrounds than my own at my internship. I can ask my

supervisor if she has any culturally diverse families that I could observe her complete an RBI

with. These opportunities will assist me with improving my unmet competencies. From my

experience with the RBI process, I have learned more about family professional collaboration,

and how I can apply what I have learned to my work as a professional in the field of early

intervention.

References

Turnbull, A. P., Turnbull, H. R., Erwin, E., Soodak, L. & Shogren, K. (2014). Families,

Professionals, and Exceptionality: Positive Outcomes Through Partnerships and Trust

(7th ed.). Upper Saddle, NJ: Pearson Education, Inc.

Mcwilliam, R. A., Casey, A. M., Ashley, D., Fielder, J., Rowley, P., DeJong, K., Votava, K.

(2011). Assessment of family-identified needs through the routines-based interview. In

McLean & Snyder (Eds.), Young exceptional children monograph no. 13: Gathering

information to make informed decisions: Contemporary perspectives about assessment in

early intervention and early childhood special education.