Plan of Action and Developing Functional, Measurable IFSP Outcomes Section 7 Facilitator’s Notes: In this section, we will discuss how the Global Outcomes inform the development of meaningful IFSP outcomes and how to determine if an individual IFSP Outcome meets quality standards. Handouts Needed for Section 7: Plan of Action and Developing Functional, Measureable IFSP Outcomes Noah’s IFSP Josie’s IFSP Tips and Techniques for Developing Participation-Based IFSP Outcome Statements from BriefCASE (Resource) Criteria for High Quality, Participation-Based IFSP Outcomes (ECTA Center) Worksheet for Rating IFSP Outcomes Rating IFSP Outcomes Activity (ECTA Center) Plan of Action and Developing Functional, Measurable IFSP Outcomes

Key Principles Addressed Infants and toddlers learn best through every day experiences and interactions with familiar people in familiar contexts. All families, with the necessary supports and resources, can enhance their children’s learning and development. The primary role of the service provider in early intervention is to work with and support the family members and caregivers in a child’s life. The early intervention process, from initial contacts through transition, must be dynamic and individualized to reflect the child’s and family members’ preferences, learning styles and cultural beliefs. IFSP outcomes must be functional and based on children’s and families’ needs and priorities. OSEP TA Communities of Practice – Part C Settings Facilitator’s Notes: The development of meaningful IFSP outcomes is primarily related to Key Principles for Early Intervention Service Provision 1 – 5.

Key Points Individual IFSP outcomes should: Reflect the family’s concerns and priorities Be informed by the three global outcomes Contain definable characteristics Be functional and meaningful to the family Facilitator’s Notes: Review with participants.

Using Information to Develop Individual IFSP Outcomes Start with the parent/caregiver’s priorities about the child’s development and the family’s priorities based on information gathered through evaluation, child & family assessment, and global outcomes Consider what is working in everyday routines and activities and what needs to be improved Facilitator’s Notes: Review with participants. Note that the development of IFSP outcomes ALWAYS starts with the priorities of the family/parent. Generally, these are determined through the family assessment process, but all information is considered in their development. It is important to think about what is working well in the daily life of the family as well as what the family has identified as challenging. Both give valuable information in developing a plan that is meaningful to the family.

Individual IFSP Outcomes Ask: “What would your family like to see happen for your child and/or family?” The purpose is to describe the change the family would like to see in their child’s participation, engagement or independence related to the family’s priority 2 types of Individual IFSP Outcomes Child Outcomes Family Outcomes Facilitator’s Notes: When developing individual IFSP outcomes it is helpful to ask the family what they would like to see happen. How will the identified time of day look differently in 6 months? IFSP Outcomes can be either related to the child’s participation in the routines of the child and family or family concerns.

Individual IFSP Outcomes Parent says: We want Romeo to be able to sit up so he can play with his toys and eat meals with us. Facilitator’s Notes: Here is an example of an Individual IFSP Child Outcome. This is based on how the family would like the change in their routine to look. This information is usually gathered during the family assessment, but concerns or changes the family would like to see may come up in discussion in any time of the IFSP process.

Individual IFSP Outcomes This “Romeo will play with toys and eat meals with his family by sitting without much support” Not This “Romeo will improve muscle tone for sitting” Facilitator’s Notes: You write the IFSP outcome related to what the family wants to see – not the skill that needs to be developed. This helps ensure that the outcome is meaningful for the family. Of course, there will be skills that the child will need to develop to meet the outcome and strategies to increase or develop these skills will be noted as strategies on the Plan of Action for the IFSP Outcome.

Individual IFSP Family Outcomes Parent says: “We want to be able to take Romeo with us in the car; we need a travel car seat” Facilitator’s Notes: This is an example of what you might hear from a family that could be an IFSP Family Outcome if they identify this as a priority.

Individual IFSP Family Outcomes: Examples This “Karen and Mark will learn about resources and low cost options so they can obtain a car seat.” Not This “Staff will explore options for financial assistance for travel chairs.” Facilitator’s Notes: You would write the family outcome based on what the family will do – not what the service coordinator or staff will do. This is to help empower the family and reinforce that they do have the capability to meet their child and family’s needs. Of course the staff and/or service coordinator is able to (and should) provide the family with appropriate resources (phone numbers, agencies, organizations or funding options) that they can explore. Family IFSP Outcomes are reviewed and progress noted during IFSP reviews, just as with any IFSP Outcome.

Developing IFSP Outcomes Step Example Step 1: Determine the functional area(s) Eating and Chewing Step 2: What routine(s) does this affect? Meal time (lunch, dinner, restaurant) Step 3: Child will participate in (routines in question)” “Alicia will participate in lunch, dinner, and eating with the family at restaurants …” Step 4: “by ---ing” (address specific behaviors) “ … chewing her food” Facilitator’s Notes: These are the steps to go through when developing an Individual IFSP outcome, using an example. The IFSP Outcome will be “Alicia will participate in lunch, dinner, and eating with the family at restaurants by chewing her food. Additional criteria will be added on the plan of action page to make the outcome measureable so that it is easy to see at glance when the outcome has been how accomplished.

Mark will sit in the bathtub Jane will play with her toys Tips and Techniques for Developing Participation-Based IFSP Outcome Statements from BriefCASE March 2009 (Padlet) Apply the “third word rule.” The third word is child-focused and participation based Mark will sit in the bathtub Jane will play with her toys Avoid passive words such as tolerate, receive, increase or decrease, improve, and maintain Facilitator’s Notes: Handout: Tips and Techniques for Developing Participation-Based IFSP Outcome Statements from BriefCASE (Resource) These are tips for developing participation –based IFSP Outcomes. This article can be found in the resources.

IFSP outcome statements are discipline-free Tips and Techniques for Developing Participation-Based IFSP Outcome Statements from BriefCASE March 2009 IFSP outcome statements are discipline-free IFSP outcome statements are jargon-free The family measures progress on the IFSP outcomes statements Use a special occasion or life even such as a birthday, holiday or real-life point in time such as when grandmas visits this summer or by the time school starts this fall (for the siblings) as the timeline on the IFSP outcome statement Facilitator's Notes: Review these points with participants. Discipline-free means the outcome is written about improving a routine or time of day for the family. Certain times of day, like getting dressed and ready for the day, involve multiple developmental domains and may be addressed by providers of multiple disciplines. The IFSP team determines which provider or provider(s) are most appropriate. Jargon-free – uses language that the family understands. Family measures progress - Practitioners often express a concern regarding measurability of participation-based outcomes. Many practitioners have had prior experience with writing Individualized Education Program (IEP) outcomes that have historically required specific measurability criteria (e.g., three of five times for five consecutive days; 100% of the time; within six months; or every time she wears her coat to school). When writing quality IFSP outcome statements, the parents determine whether or not the IFSP outcome has been achieved. When developing the outcome statement, it is important to discuss the outcome in such a way that everyone involved feels comfortable with how progress will be measured. Using family occasions as milestones for achieving the outcome. These are ways that families can measure progress without having to keep tallies of itemized skills for an outcome measurement.

Activity 7.1 Rating IFSP Outcomes Facilitator’s Notes: The following activity is to help IFSP teams evaluate IFSP Outcomes based on 6 criteria. Activity 7.1: Introduction Handouts Needed for Activity: Criteria for High Quality, Participation-Based IFSP Outcomes (ECTA Center) Worksheet for Rating IFSP Outcomes Rating IFSP Outcomes Activity (ECTA Center) – this is all the information needed for the placemat activity. This should be printed and prepared ahead of time. Cards and placemats can be laminated and cut but it’s not necessary to have them laminated in order to do the activity. Rating IFSP Outcomes

Criteria for Rating IFSP Outcomes – Handout and Activity The outcome statement is necessary and functional for the child and family’s life. The wording of the statement is jargon-free, clear and simple. The statement reflects real-life contextualized settings (e.g., not test items). Place Outcome Statement Card Here to Evaluate The statement avoids the use of passive words (e.g., tolerate, receive, improved, maintain). The outcome is discipline-free. The wording emphasized the positive. Facilitator’s Notes: Activity 7.1: Activity Instructions: Small Group Activity This rating activity is designed to be used in multiple ways with different types of groups. Groups that are either familiar with the IFSP or groups where participants are mixed in their experience in early intervention may use this activity. In situations where there is a varying level of experience and understanding of the early intervention process, it is suggested that less familiar participants sit at tables with others who are familiar with the IFSP process, so that they can work through the criteria together. In groups of 3 – 6: 1. Provide a copy of the Criteria Defining High Quality, Participation-Based IFSP Outcomes to each participant. Review this document with partcipants. 2. Give one placemat and one set of 22 IFSP Outcome Cards to each group. Be sure to shuffle the cards so that outcome statements are not in the order they are on the answer key. 3. Have each group put a card in the center of the placemat so that the printed grid on the card matches up with the placemat 4. Within each small group, have the participants discuss and rate the outcome statement by writing “yes” or “no” in each quadrant, based on whether the statement meets each of corresponding criteria. Encourage participants to refer to the Criteria Defining High Quality, Participation-Based IFSP Outcomes while completing the ratings for each statement. Criteria Defining High Quality, Participation-Based IFSP Outcomes 5. Repeat for each card. 6. Have the participants separate the cards into “high quality” statements and “substandard” statements. Statements that fail to meet all criteria (all those with a “no” in any quadrant) go into the “substandard” pile. 7. Distribute the Answer Key to Rating IFSP Outcomes (Appendix D on page 25). Ask your participants to compare their answers with the answer key. 8. Debrief with the group, asking questions such as: • Where did you get stuck with an outcome statement? (Listen for varying interpretations of the criteria.) • How might this activity help you in your work and within your team? • What additional supports do you need to help you successfully identify whether or not an IFSP Outcome is of high quality and is participation-based? Those using the activity to fit the context of the participants and their learning needs may add other questions to the debriefing. NOTE: The criteria described in the bottom center box of the placemat should not be rated during the training activity. Be sure to tell participants that these are criteria to be considered when the child’s IFSP and assessment information is available, but for the purposes of the activity, they are reference information only. Alternate Activity: A blank Worksheet for Rating IFSP Outcomes (Appendix E on page 28) of the activity has also been provided for the IFSP Outcome Cards. Provide copies of the worksheets to participants or groups with or without using the placemats or cards. Encourage participants to refer to the Criteria Defining High Quality, Participation-Based IFSP Outcomes (Appendix A on page 9) while completing the ratings for each statement. In this version of the rating activity, participants write “yes” or “no” in each box under the criteria to rate outcomes. Participants can then compare their answers with the Answer Key to Rating IFSP Outcomes (Appendix D on page 25) When the child’s contextual information is available, the following IFSP outcome criteria can also be evaluated: The outcome is based on the family’s priorities and concerns The outcome describes both the child’s strengths and needs based on information for the initial evaluation or ongoing assessment.

Which Global Outcome Is It? Facilitator's Notes: Activity 7.1 , Continued On Colorado’s IFSP form,the related Global Outcome is marked at the bottom of the IFSP Plan of Action Page in order to show families how the Individual IFSP Outcomes relate to the 3 Global outcomes. The determination of the primary Global Outcome that the IFSP outcome is related to is based on what the family’s priority; what they want to see happen and why this outcome is important to them. Does the family want the child to further interact with others during the activity (Global Outcome 1), or do they want the child to become more independent in the activity (Global Outcome 3)? Thinking about the priority of the family can help in this determination. Small Group Activity Review the Outcomes that were determined to be high-quality, participation-based outcomes. Ask participants to determine which of the 3 Global Outcomes the outcomes would impact. Answer Key: Responses may vary based on interpretation and because the family is not available to check in with! Global Outcome 3 Global Outcome 2 Global Outcome 1

Activity 7.2 Case Study: Josie Write a functional IFSP outcome and determine the appropriate corresponding global outcome Facilitator’s Notes: Activity 7.2 Considering the evaluation and family assessment information, the family’s concerns and priorities and strengths and needs from the Global Outcomes, write a functional IFSP outcome and identify the related global outcome for Josie. Handouts Needed: Noah’s IFSP Josie’s IFSP In small groups of 2-4, including a provider and service coordinator in each group, if possible : 1. Review Noah’s IFSP Plan of Action page as an example 2. Review information recorded on the IFSP, including the family’s concerns and priorities 3. Enter priority of family as written 4. Complete IFSP Outcome as follows and in this order: Document IFSP Outcome – What the family would like to see happen (column one) Document Measureable Criteria – Where are you starting? (column three) – briefly document what the routine identified by the family as that they want to change and what the routine looks like now Document Measurable Criteria – How will you know when the IFSP outcome is achieved? (column 4) – add the measurable information that will let the team and family know when the outcome has been accomplished Document Strategies, Activities and Learning Opportunities (column 2) – brainstorm a couple of strategies to support the family in meeting the outcome Identify Global Outcome the IFSP outcome is related to. To aid in this decision, consider the priority of the family. Is the priority more closely related to the child’s independence within the routine, social interaction, or obtaining and using new skills? 5. If time allows ask participants to share the IFSP outcome that they wrote for Josie and her family