*3.2. What Is Different during COVID-19?*

During the lockdown, professionals who typically work in schools, clinics, or other service delivery environments now find themselves making videoconferencing calls to children and their families. This strange situation allows us to learn lessons from early intervention (birth to five), where professionals have been visiting homes for decades [5,7]. They therefore have methods for working with families in the context of everyday routines. These methods, if done correctly, are largely transferable to videoconference calls. By done correctly, we mean using the visits to build the family's capacity to "intervene" with their child throughout the week [7]. Incorrect home visits would be professionals working directly with the child for, say, an hour and expecting that tiny dose to be generalized and applied to the rest of the week. The older a child is, the more that kind of tutorial-type visit could work. With young children, it does not. The RBM has numerous strategies that have already been disseminated as applicable in early intervention through virtual visits in several countries [8]. In this paper, the authors propose to expand RBM for families of children with disabilities of all ages.

Virtual visits during the lockdown are different from home visits at other times for a few reasons. First, the adults often get no break: they are forced to be at home with their children with no additional help. Weekends are great but the longest weekend ever

is not! Especially vulnerable to this stress are adults who are caring for and entertaining children alone, such as single parents or the partners of essential workers. Similarly, for some siblings, having no time away from their brothers or sisters can be exhausting. This situation is obviously exacerbated if one of the children has challenging behaviors. Second, in many households, privacy is unobtainable. Third, life can be boring at home, with day after day of no change, especially children who have difficulties with attention or independent play or who are simply the products of the modern age can become easily bored—and every parent knows how trying it is to have children who say they are bored.

The lockdown has created a quite-different environment, but professionals working with children of all ages with disabilities are trying to support children and families through videoconferencing. One place to begin is to reassess needs.

### *3.3. Assess Needs with a Virtual Conversation*

During the lockdown, technology is fundamental to carry on everyday life. Everyday life is what this article is about, and technology is our way of connecting with families' everyday lives.

With children's and families' lives disrupted by the lockdown, the functioning needs of the child and the families' needs are different. We can consider a routines-based conversation, family-level questions, and support the family to choose their goals.

Professionals can ask families about their day-to-day life, beginning with waking up and all the way to adults' going to bed. At each time of the day (i.e., routine, as we define it), we ask the family to describe the child's engagement, independence, and social relationships in that routine. Structuring the conversation by routines is natural, in that families can walk you through their day, and contextual: we hear about children's functioning, and when and where the skills are needed. We ask families what children are interested in as well as what they can do. When those abilities and interests do not match the demands of the routine, we have diminished functioning. We note these concerns as we are talking to families, but they are not goals. If we have a good, in depth conversation we will uncover many such concerns—more than needed for our goal plan—and the Routines-Based Model is notorious for already having long lists of goals. The routines-based conversation is based on the well-known, evidence-based Routines-Based Interview (RBI) [9–11]. During this Routines-Based Conversation, if the child in question is old enough to participate meaningfully, this contribution can add to the richness of the discussion. The family should make the determination whether the child's participation would be helpful or disruptive. One of the tenets of the RBM is the question "Whose child is it?".

In addition to the conversation about child functioning in routines, the conversation can include the time, worry, and change questions, a hallmark of the RBI: do you have enough time for yourself or yourself and another person? When you lie awake at night, worrying, what do you worry about? If you could change anything in your life, what would it be?

These powerful questions have two benefits. First, they show the family that you care enough to ask these questions about the adults' well-being. You can also ask them of the child, if appropriate. Second, they go beyond daily routines to deeper, more emotional needs, which is precisely why some professionals try to avoid them—professionals who are not used to dealing with emotions or who mistakenly think that they need to fix any need mentioned. As we said earlier, families at this point are not choosing goals.

After asking the time, worry, and change questions, we might recap the conversation so far, in just a few minutes, to remind the family of the concerns. This is a reminder: it is not a time to rehash the whole discussion or to try to make the family feel good about their routines. The purpose of a recap is to remind them of concerns.
