approach when I look back at my professional career I've had the good fortune to have it span the evolution of early intervention as I see it from the mid 80s to now and when I look back it was much more of a clinical setting muchmore of a rehab medical model where the families brought their child to the clinic two or three times a week andwould be in a classroom or individual setting and when I look back on that I realized that the onus of the responsibility for making a difference in that child skills really fell very heavily upon my shoulders because I didn't have the opportunity or at the time the responsibility to share with the family what it was that I was looking for the changes to be made at home and then things changed in the 90s and we made changes to go into the natural setting