I am a huge fan of coaching as a core component of intervention. Having been involved in Early Intervention for many years, coaching has been a central element to my practice. Coaching has also been a huge aspect of what I do in higher education as well. My classes have always been very hands on and my students receive coaching as they practice various intervention techniques. I am also a huge fan of Pivotal Response Treatment (PRT) and coaching caregivers is an ongoing aspect of PRT for children of all ages.
That being said, becoming comfortable with coaching takes time and lots of practice. Often students and clinicians feel a bit intimidated when it comes to coaching caregivers; however, caregivers are coming to us looking for answers and strategies. Some research has indicated that simply modeling for caregivers, in other words, working with a child while a caregiver sits nearby watching, isn’t enough (Infants & Young Children). Therefore, it is imperative that we become effective and efficient coaches.
One of my favorite coaching models reminds us that coaching occurs in a continuous loop. It is an ongoing process. First, start with observations and discussions with the caregiver (i.e., assessment!). What is working for them? What isn’t working? What are their expectations? Are they satisfied? Second, as the clinician, you are going to demonstrate the evidence based strategy and then immediately coach the caregiver through the intervention as they engage with their child. In other words, if there are materials involved (e.g. toys, markers, clothes), the caregiver and the child spend the majority of the time with the materials. You are the coach. The caregiver then continues to implement the strategy while you provide SPECIFIC feedback and guide the practice. An example of specific feedback might be, “I like how you held the toy up by your face to encourage more engagement” or “Remember, when he reaches for the apple, shape his finger into a point and help him point to the apple”. You are then going to observe (take data) and talk again about what is working, what needs to be tweaked, etc. Then the cycle starts all over again.
This coaching loop can support a variety of goals: increasing engagement in routines, requesting, imitation, play skills, etc. As a clinician, you are assessing and taking data as required while the caregiver gets to focus on the interactions and implementation.
(Note - I have been using this coaching graphic for over 15 years and i don’t know if there was an original source.)
As a supervisor of both speech pathologists and behavior analysts, I use the same coaching loop to support supervisees as they learn new intervention techniques. For example, I can assess how a student is implementing a receptive task, demonstrate how I want them to do it, then coach them through with specific feedback followed up by guided practice. Then the process starts all over again.
Coaching is a fantastic and necessary tool to add to your clinical tool box. I am sure there are a lot of great coaching resources on the internet. Feel free to leave some of your favorite links in the comments!