*3.5. Emphasize Meaningful Participation in a Plan*

Participation has come to be acknowledged as a critical dimension in the definition of disability [4]. The impairment in a person is only as handicapping to that person as it affects the person's ability to function meaningfully (i.e., participate) in his or her environment [4,13]. We therefore take needs the family identifies and develop them into participation-based goals and family goals.

Participation-based goals put the emphasis or purpose of a skill the child needs to achieve on engagement in a routine. For example, if a parent says she/he wants the child to use two-word combinations, in the RBM, this would have come from a discussion about a need in one or more routines. A goal like this could be for a young child or an older child with significant communication delays. An important point is that the need came from a need for meaningful participation in a routine. Needs in routines should be authentic.

A participation-based goal might therefore read as "Javier will participate in breakfast time, going outside time, and hanging out time by using two-word combinations." This goal tells us the skill, using two-word combinations, and the purpose: to participate in those three routines. It is a perfect participation-based goal but it is not measurable. When professionals want goals to be measurable, they can keep the goal and add acquisition, generalization, and maintenance criteria, as in "We will know he can do this when he uses three two-word combinations at breakfast time, going outside time, and one hanging-out time in one day for four consecutive days." The acquisition criterion is the frequency of two-word combinations: three. The generalization criterion is the routines: three of them. The maintenance criterion is amount of time: four consecutive days.

In addition to child goals, the list of goals must include at least one family goal. Family goals are necessary because of what, in the RBM, we call the two-bucket principle: a mother can fill her child's bucket only to the extent her bucket is full. Some family goals are related to the child, such as getting information about the child's disability. Other family goals are not directly related to the child, such as time for parents alone or fulfilling individual dreams.

Planning is important, and then professionals help families with that plan. The next section addresses how to help families tackle that plan.

#### *3.6. Use Family Consultation in Virtual Visits*

How do you help families confined with their children with special needs? If you have been using the RBM, this process is not a big challenge, because the RBM is all about building families' capacities to meet child and family needs: it is not about direct, hands-on work. This section describes how the virtual visit is focused on a plan, develops strategies with caregivers, and involves three types of action.

The videoconference visit is focused on the previous visit and on goals. By the end of the previous visit, the professional had documented what the parents had decided to try, as strategies, with their child. For older children, it might be what the child was going to try doing, with or without assistance. Families, including the child, if appropriate, had also determined what they wanted the focus of this visit to be.

Therefore, the professional would know what the topic was. Families should also be given the opportunity, however, to determine the agenda for the visit, so professionals should ask two questions: how have things been going (a general question)? Has anything new happened since our last talk?

These questions allow the family to bring up topics that might not have been previously planned. If the family has something they want to talk about, that sets at least the beginning of the agenda. If they do not, the professional reminds the family about (a) strategies they were going to work on since the last meeting and (b) what the family said they wanted the focus of this visit to be on.

When discussing what the family had been doing, they reflect on how the intervention has been going. This discussion might lead to the family and the professional tweaking the strategy. The amount of context the professional had had previously would predict how many questions he or she would ask during this strategy tweaking: if the professional had much context, he or she might not need to ask many questions. If the professional did not have much context, he or she should ask many questions to ensure his or her suggestions were relevant. Some children with disabilities are trying strategies themselves, but they are still functioning in home contexts, during this quarantine time. So, families are still integrally involved in the execution of these strategies.

Professionals' suggestions are the result of finding solutions or problem solving. Traditionally, professionals made recommendations to families quickly, based on good will and experience: Most of us professionals are quick to come up with helpful suggestions for families (Example of professional recommendations provided here https://naturalenvironments. blogspot.com/2014/07/self-regulation-in-working-with-families.html (accessed on 4 April 2020)). We should ask questions before making suggestions, and this process can involve the child, if appropriate (Access to RBM resources provided in Supplementary Material S1).

While determining solutions (i.e., developing strategies) we can incorporate, in virtual visits, three types of action. First, we can see what the child does. The family can show us what the child typically does or is now doing. In addition, the child might say, "Look what I can do", or the professional might ask the child to show what he or she is doing in that routine. Second, the family can show what they are doing or are considering doing. For example, the family might say, "Look what I've been trying to do when I take Ted to the grocery store", and they show a video clip of a trip to the grocery store. Third, the professional describes a strategy, after asking at least four questions. The professional can be as explicit as possible about the idea and can even demonstrate with a doll. Importantly in the RBM, we always check in with the family with two questions, especially important online: Do you think this strategy will work? As busy as you are at these times of the day, do you think you'll be able to carry out these strategies you've chosen?

Before hanging up, the professional and family, including the child, if appropriate, review what was discussed on this virtual visit, review what the family is going to do between this visit and the next, and the family says what they want the focus of the next virtual visit to be. At this point, the professional can use a Goals x Routines matrix to remind the family of the goals on the plan. In the RBM this information is recorded on the Next-Steps Form (NSF).

We have just discussed two pieces of paper, the NSF and the matrix. When visits are through videoconferencing, the professional and the family will need to work out the best method of seeing this paperwork and other materials. If they are using Zoom or Skype, they can share screens. They might take screen shots, scans, or photographs and send them via email or other social media.

Family consultation, therefore, can work well in a virtual visit, focusing on the family's agenda and on goals they have selected. Nevertheless, supporting families virtually can be stressful and exhausting. Hence, the following section, address the importance of looking after yourself.
