Carlena Lowell Sei 523 Routines Based Interview

Carlena Lowell SEI 523 Routines-Based Interview
Routines-Based Interview Carlena Lowell SEI 523 October 27, 2013
*All names have been changed to maintain confidentiality Introduction On a chilly Thursday morning, I sat down with 19-month-old Barts mother Marge to interview her using the Routines-Based Interview (RBI). Marge and Bart live with Barts older sister Lisa (5), Marges boyfriend Homer, and Homers four children (ages 17, 15, 13, and 6). From start to finish, I was with Marge and Bart for two hours. Marges life pretty much rocks right now, so this interview was wonderful, very positive, yet allowing for us to pull out some concerns along the way. I began the interview by reviewing what the purpose of the interview was and asking her if she had any questions. We then dove into some of Marges major concerns, and then on to descriptions of an average day, various routines, and a bit about weekends. Here I will transcribe these descriptions as told by Marge. I will share the Satisfaction with Home Routines Evaluation (SHoRE) and the RBI Implementation Checklists, one completed by Phyllis (the Primary Service Provider I am closely working with throughout this practicum) and one completed by myself. I reflected on the checklist in my second additional activity and on the whole RBI process in my reflective journal, and will include those reflections at the end of this paper in order to have all of the RBI pieces together in one paper.
Major Concerns for Marge Discussed at the Start of the Interview I began the interview by asking Marge some of her major concerns, this is what she told me, and the order she told them to me in: Bart is not yet verbally saying words. The amount of signs he is functionally using has grown from using more universally to signing eat, drink, all done, Mickey, and more. Marge is afraid Bart will get so used to signing he will not feel a need to use verbal words.
Bart will begin daycare on Monday October 28, 2013 for the first time ever. Mom was recently hired in a new position in a doctors office and her new schedule will be three full days a week, as opposed to working overnights at a hospital, which is what she has done since Bart was born. She is extremely nervous and anxious about Bart attending day care; however, she is in hopes that when Bart sees other children his age talking, he may be encouraged to talk.
Homers oldest son, Milhouse (17), has difficulty in school and with homework. Marge reports he is a whiz when it comes to technology; however, finds difficulty in core academics. He is planning to take the SATs this year.
Bart will sometimes play with chords to electronics and try to stick them in sockets.
An Average Day, Various Routines, and a Bit about Weekends Bart usually wakes up in a great mood, although if Marge takes too long to get him out of his crib he will whine until she enters the room. Sometimes Homer will make and give Bart a bottle with his medicine in it so that Marge can sleep a bit longer. Lisa will get up earlier and hang out with Maggie (15) while she gets ready for school; Maggie often helps Lisa pick out her clothes and will do Lisas hair in the morning. Homer and the four oldest children leave about the time that Bart is waking up as their school days begin earlier that Lisas, who is in kindergarten this year. When Marge goes into get Bart the first thing they do is change Barts diaper. This proves to be a horrible time of day for Bart and Marge. Bart does not like to lay still long enough for his diaper to be changed. Marge explains it as trying to change a cat. At this point, dressing goes similarly to diaper changing. After getting a clean diaper on, Marge and Bart go downstairs to begin laundry for the day. Bart enjoys helping Marge with the laundry; he particularly likes to take the laundry out of the dryer to put in the basket. Marge reports she does several loads of laundry a day given the amount of people that live in the house. This holds true for dishes as well. In the meantime, Lisa finishes getting ready for school; she is fairly independent in the morning. Once laundry is in, Marge, Bart and Lisa are dressed and Lisas snack for school is packed, they are off to take Lisa to school. This time of day tends to be a bit challenging because when Marge tells Bart it is time to take Lisa to school, he would rather run around the house than leave to take Lisa to school. Marge has learned to
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use certain language to get Bart outside and into the car. Marge would have to drive Lisa to the end of their dirt road to get on the bus, so she figures it is just as easy to take her all the way to school, which is about five minutes away. Lately riding in the car with Bart has been better than it used to be. He rides fairly well when he has a toy or something else to entertain himself with. On longer car rides, snacks are helpful. When he was younger, Bart did not like car rides and would get so upset he would sometimes get to the point of being sick. When Bart and Marge return from dropping Lisa off at school, Marge lets Bart watch one to two episodes of Mickey Mouse, his favorite show. While watching Mickey, they will play on the floor together as well. Bart eats breakfast in his high chair at 9:00 am every day. Marge stressed throughout the interview that Bart is a schedule baby and is thrown off when his schedule is not exactly on time, particularly around sleep. Marge discussed difficulty she has had in the past trying to encourage Bart to eat breakfast, as he would just as soon skip this important meal. She said she has recently found cinnamon raisin bread that he loves and will eat for breakfast. After breakfast, Marge cleans some and has Bart come into the kitchen with her, for fear of what he will get into if left unattended in the living room. By the time Bart is done with breakfast, there is a sink full of dishes from everyone else eating breakfast earlier on. To keep him occupied, Marge often gets Bart to wipe the counters while she is sweeping. This generally works; however, sometimes he is not interested and it is a struggle to keep him in the kitchen and happy while she is cleaning up the dishes and sweeping.
Mealtimes have become easier for Marge because until very recently Bart had a severe lactose allergy. He was not able to ingest anything made with any milk product, which is in a lot of foods Marge has found. It is easier now because she does not have to carefully watch everything Bart puts in his mouth. They started the transition slowly a few months ago to see if he is now tolerant of lactose. He seemed to do fine, and now has a much less strict diet. After breakfast and clean up, Bart goes down for a nap. This is where Marge explained further just how much of a schedule baby Bart is. If he lays down in his crib between 10:00 and 10:15 am, spends fifteen minutes or so babbling himself to sleep, and is asleep before 10:30 am, he will sleep until between 1:00 and 1:30 pm. If he does not get to sleep before 10:30 am, he will sleep for only 20 minutes. The same is similar for his night time bed routine, which will be explained later. This is a solid pattern Marge has observed. While Bart is napping, Marge will continue with the housework. She will clean up the living room, finish the dishes, and do more laundry. She waits to vacuum until he wakes up so the noise from the vacuum doesnt wake him. Marge explains housework in a household with two adults and six children is never ending; however, she likes it as she likes organizing and taking care of her house and family. If she finishes the cleaning and Bart still is not awake, she might sit and watch a TV show with a cup of coffee some rare down time for Marge. When Bart wakes from his nap, he and Marge do the difficult diaper changing routine. She often ends up changing his diaper while he is standing up if the situation allows
because it is easier than trying to get him to lie down. Until now, Marge has always bought diapers in bulk at Sams Club because it is cheaper than not. However, she is considering changing to pull-ups for Bart because she thinks it may make diaper changing easier. Unfortunately though, pull-ups do not come in bulk packages. After this, Bart will eat lunch that Marge has prepared prior to him waking up. After lunch, Marge gets everything ready to go for when she needs to leave to go get the older kids from school, and then takes Bart outside to play, which he loves. They play until it is time to get the older kids from school, at which point they do not even need to go back inside the house, they can just get in the car and go because of Marges prior packing. When they get home from getting the older kids from school, the older kids usually get snacks, but they are old enough to fend for themselves. A few minutes after returning home with the older kids, Marge leaves to go get Lisa from school. Maggie lives with Marge and Homer every other week. On the weeks she is there, Bart will stay with her while Marge goes to get Lisa from school. One the weeks she is not there, Marge takes Bart with her to go get Lisa. Marge explains this as the hardest part of her day. While waiting for Lisa to be dismissed from class, Bart will run up and down the hallways; he is always antsy and will never stay still. Marge said there are other children there the same age who are sitting nicely with their parents, while she is chasing Bart around. She has learned to time picking Lisa up just right to diminish any down time Bart has to run around.
Sometimes, after getting Lisa from school, Marge, Lisa, and Bart will go out back of the school to play on the playground. Mom describes as a good time to let the kids run and get some energy out. When they arrive back at home, Marge will start preparing dinner. Before doing so, she will put a movie on for Lisa. Bart will play in the living room with Lisa while mom is cooking dinner. Lisa is very good about letting Marge know if Bart is doing something he is not supposed to be doing. Marge noted it is easier to prepare dinner when the older kids are home to help with Lisa and Bart. Bart will sometimes show interest in helping Marge make dinner; he likes to sometimes stir biscuit mix or potatoes. During dinner, a rule in this household is that all phones stay in the other room. Every night, all the children sit at the table with Marge and Homer when he is home, which is about half the time. Homer works until 7 pm two nights a week, and until 5 the other nights, but his job is an hour away from home. While eating dinner, each member of the family discusses three good things that happened to them that day. When it is Barts turn, the older children will talk for him. This is Marges favorite time of night. After everyone is through eating, each kid is responsible for clearing their own plate plus one other thing from the table. This is an efficient way to start the cleanup process for Marge. While Marge washes Barts hands and face, Maggie will go up and start Barts bath water. After his bath time, which always goes fine, Marge will put lavender lotion on Bart and get him dressed for bed. Bart used to love this time of night; recently though, he has begun to fight Marge and it is very difficult for her to get lotion on and get
him dressed. Lisa is independent and will get dressed on her own. They finish at about the same time and head to the living room. Marge will sit in the middle of Bart and Lisa on the couch and read them a story. It now takes a little longer because Lisa is beginning to read sight words, so Marge encourages her to read the words she knows in the book. After the book, Lisa is able to watch a little TV while Marge gathers Barts night time necessities: his bottle with his medicine, his Mickey blanket, and his binky. She then takes him to bed and tucks him in. It generally takes him 15 to 20 minutes to fall asleep. Just like with his nap, if he is asleep before 7:30 pm, he falls asleep easy and will stay asleep. However, if he falls asleep after 7:30 pm, he will cry and yell for a couple of hours before finally falling asleep. After putting Bart to bed, Marge will put Lisa to bed. Once both children are in bed, Marge will finish doing dishes and other cleaning until Homer gets home from work. Marge looks forward to Sundays all week. The day begins with a big family breakfast. All the kids are to be up and at the table with no phones by 9:00 am. In the afternoon, Marge and Homer love to watch football. They consider that their time to have fun with something they really enjoy during the week. They have the older kids do the dishes and laundry on that day, and Maggie will watch Lisa and Bart closely. They are all together in the house, but the kids spend time in the game room playing together, while Marge and Homer and a couple of friends make nachos and wings and watch football in the living room. After football, Marge and Homer often take the kids outside to play.
Summary and Prioritization of Marges Concerns 1. Bart starting daycare 2. Taking Bart to school to pick Lisa up 3. Bart not vocalizing Marge explained the rest of the concerns are manageable and she tries not to stress about the too much. Milhouses difficulty with school Bart playing with chords (the older kids take the socket protectors out and leave them on the floor, then Bart will pick them up and put them in his mouth) Bart now being able to open doors, and what he can get into behind said doors (e.g. Lisas toys with small pieces) Diaper changing Dressing Getting Bart out the door in the morning to get Lisa to school on time The after bath time when Bart needs to get lotion, a diaper, and dressed in pajamas Lack of down time for Marge (although she does enjoy taking care of her house and family, she does not have much time to herself at all)
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Two Questions 1. When you lie awake at night, what do you worry about? Marge needed no time to think about the answer to this question; she was quick to respond with money. She worries about being able to pay bills, due dates of bills, if a certain check is going to overdraw the checking account, and supporting an eight person household. She also worries that her children will not wake up in the morning. She explained she knows it sounds morbid and awful, but it is something she worries about because she does not know what she would do without her children. 2. If theres anything youd like to change about your life, what is it? Marge said if she could change one thing about her life it would be the constant worry about finances. She would like to be able to get by without worrying and having the financial burdens swinging over her head.
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Satisfaction with Home Routines Evaluations (SHoRE)
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RBI Checklists
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6.2 RBI Implementation Checklist Reflection After implementing the RBI, Phyllis and I met to discuss what went well, what went not so well, and we filled out the checklist together. A few pros of my first RBI implementation are: the conversation flowed smoothly, it was much easier to identify concerns than I thought it would be, and my level of comfort as an interviewer. A few things that could have be done differently: I had to back track because part way through the interview I realized I was not asking her to rate her level of satisfaction, I asked too many yes/no questions, and I interjected bits about myself too often. I had forgotten if I was to use numbers in association with the satisfaction ratings, so I used the terms not at all satisfied, satisfied, very satisfied, or in between. To prevent things like this happening in the future, I plan to type up a small cheat sheet of sorts so that if I need a bit of reminding or prompting in the future, I can quickly glance at that. As far as the yes/no questions, that is something I have forever struggled with. It was only in my last few years of teaching preschool did I become proficient in asking the children open ended questions and limiting my yes/no questions. I must now train myself to do the same with the adults in the families I work with. The first step is to realize I do it, now I need to put energy into focusing on using open ended questions. The final con, interjecting bits about myself too much, happened because I am so comfortable with this family. I have come to know them fairly well over the past few months. It is my feeling that I would not interject as many personal details if I were implementing the RBI with someone I did not know as well. However, now that it has been brought to my attention, I will make a conscious effort to keep my chatting to a minimum.
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The only component of the checklist that Phyllis and I disagreed on was number 3. She did not hear me ask if the mother had any questions before we got started, and I am positive I did ask. 5. +/- Sometimes my attention turned to other conversation. 6. +/-, 12. +/-, & 27. +/- Many of my follow-up questions were yes/no questions. 8. +/-, 9. , & 10. +/- My follow up questions did not necessarily always pertain to these things. I plan to work on my wording for future RBIs I complete. 14. +/- & 15. +/- For the first part of the interview, I forgot to do this. When I remembered, I back tracked and did have her rate the routines we already discussed. 19. +/- I could have done this more. 21. I did not do this, it is in my notes to do next time. 23. +/- After the discussion with Phyllis, I realized perhaps I asked too many questions about other people in the family.
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Overall Reflection I completed the Routines-Based Interview (RBI) last Thursday with my family. Overall, I feel very good about the way in which it went. I am at the point now where I am comfortable with the family, so I think this implementation of the RBI likely looked different from what it will when I do it with a family I do not know as well. Although I am comfortable with the family, I was fairly nervous about completing the interview. I was nervous that I would forget things and that I would not have enough time to complete it. I was, however, able to complete it within two hours. I did indeed forget some things, for example, what follow up questions to ask, which led me to ask too many yes/no questions, and I forgot to ask about the satisfaction rating of routines (which I corrected part way through the interview). There is a lot to this interview, so in the future I would like to write things to remember, and take it with me in order to quickly and discreetly reference if I get stuck. On this I will write the order of things, such as *questions, *concerns, *routines, etc., as well as some of the common RBI questions. By even just writing them out, I think it will help me in remembering to do and ask these things. In completing the checklist, I scored myself with 89 points, and Phyllis scored me with 88 points. I feel this is excellent for my first try at the RBI; however, some of the things I omitted are crucial, for example, numbers 8, 9, and 10. Therefore, I want to ensure I know how to go about obtaining this information in future interviews. I found it incredibly useful to debrief with Phyllis after I was through with the interview. She was able to bring things to my attention I would not have otherwise considered. This is one of the checklists we went through item by item together, which I
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found this helpful to my reflection process. I was able to think about each component, and also get her insight to each one. Before I conduct my next RBI, I will refer back to this completed checklist in order to remember the items I struggled with so I can work toward improving them. Although there were things I missed, I am happy with the way in which my first RBI went. I could have done better on some things, but I was able to complete it and meet McWilliams goal of 85% or better (albeit only by a point or two!).
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Carlena Lowell SEI 523 Routines-Based Interview

Routines-Based Interview Carlena Lowell SEI 523 October 27, 2013