Developing High Quality, Functional IFSP Outcomes Early Childhood Technical Assistance Center Training 1

Training Objectives o Gain an understanding of the criteria needed to develop and write high quality, functional, participation-based Individualized Family Service Plan (IFSP) outcomes o Rate the quality of the outcomes 2 Functional Assessment Meaningful IFSP Outcomes

Using Information to Develop Outcomes o Start with parents’/caregivers’ priorities about child’s learning/development and/or family’s needs o Consider what’s working and what’s challenging in everyday routines and activities o Consider how the child’s developmental skills, needs and disability influence the child’s learning and participation in everyday routines and activities 3

Relationship of Outcomes to Placement and Services First… develop IFSP outcomes based on functional, authentic assessment information Then… determine placement, services and supports based on what is necessary to meet the outcomes/goals 4

Requirements for IFSP Outcomes IFSP must include: o A statement of the measurable results or measurable outcomes expected to be achieved for the child and family (including pre-literacy and language skills as developmentally appropriate for the child) o The criteria, procedures, and timelines used to determine the degree to which progress toward achieving the results or outcomes is being made and whether modifications or revision of the expected results or outcomes or services are necessary 34 CFR § (c 5

IFSP Outcomes o IFSP Outcomes: “What would your family like to see happen for your child/family?” o Two types of outcomes o Child Outcomes o Family Outcomes 6

IFSP Child Outcomes Two types of child outcomes : o Participation-based o Routine/activity-based Child outcomes should: o Enhance learning through functional participation in everyday activities (child is learner/actor) o Be important and meaningful to the family/caregiver (priorities) o Expand activity settings so child can be competent o Be based on child’s interests 7

IFSP Family Outcomes Two types of family outcomes: o Participation-based o Resource-based Family outcomes should: o Enhance capacity of (family is learner/actor) o Support accessing community resources and supports (service coordinator supported) o Be important and meaningful to the family/caregiver (priorities) o Be based on family’s interests 8

Developing IFSP Outcome Statements 9

Third Word Rule 10 The third word of IFSP child outcome statement should be a contextualized action that is functional. Example: “Kim will eat with her family at mealtime eating the foods they eat.” Shelden, M. L., & Rush, D. D. (2009). Tips and Techniques for Developing Participation-Based IFSP Outcome Statements. Briefcase, 2(1). Retrieved from

IMPORTANT IDEA IFSP outcomes need to be functional; however, many providers struggle to define what makes an outcome “functional.” When determining if an outcome is functional consider: 11 o does this outcome support the child’s participation in everyday activities? o does this outcome support the fundamental belief that children learn best through their participation in everyday activities and routines with familiar people?

12 Three skills that are when developing outcomes are: o the ability to understand how to gather information from families throughout the process o the ability to conduct a functional assessment that gives a clear picture of the child’s abilities and needs in the child’s natural, everyday settings, activities and routines o the ability to use the information to develop outcomes CRITICAL High-Quality, Functional IFSP Outcomes

Another important idea Throughout the process of gathering information from families, special attention should be paid to the information the family shares about what’s working well for them, as well as what is challenging 13

High-Quality, Functional IFSP Outcomes o Necessary and functional for child’s and family’s life o Reflect real-life contextualized settings o Crosses developmental domains and is discipline-free o Jargon-free, clear and simple o Emphasize the positive, not the negative o Uses active words rather than passive words 14

Criteria Definitions Necessary and functional for child’s and family’s life Supports participation in community life and family activities Based up on what is important to the family Supports child’s progress towards outcomes It is not based on what the practitioner thinks 15

Criteria Definitions Reflects real-life, contextualized settings – Everyday activity settings and routines for the child and family Includes typical routines such as meal time Also includes routines and activities specific to the family. Test items are not real-life or contextualized 16

Criteria Definitions Integrates developmental domains and is discipline-free o Written to describe the child’s participation in routines and activities Promote the child’s skill development in multiple domains Addressable by any member of the IFSP team o Written so that child and family are the “actors” o Early interventionists and therapists are not the actors in the outcome 17

Remember… The outcome should state: “Annabelle will help her dad with the laundry by pulling up and standing at the dryer on her own and putting clothes into the laundry basket with her dad close by," Rather than "Annabelle will pull to a standing position at the couch and maintain her balance." 18

Criteria Definitions Is jargon-free, clear and simple Understandable by family and the general public. Doesn’t include professional jargon or practitioner “speak” 19

Remember… The outcome should state: “David will reach up and grab the toy when he is playing with his mom” or “Carrie will ask for a cracker when she is having lunch with her family” Rather than “David will increase his “range of motion” or “Carrie will improve her articulation skills” 20

Criteria Definitions Emphasizes the positive, not the negative Focus of the whole outcome is positive States what the child and family will do o Doesn’t state what the child will not do or will stop doing Any negative words creates a negative statement 21

Remember… 22 The outcome should state: “Johnny will chew and swallow food when eating with his family” Rather than “Johnny will not spit out food when eating with his family”

Criteria Definitions 23 Uses active rather passive words Use words (such as eat, play, talk, walk) that encourage a child and family’s active participation Words that indicate what the child or family will do Passive words reflect a state of being or a change or lack of change in performance

Remember… The outcome should state: “Charlotte will sit next to her sister and play with the toys” “Abigail will talk with her family during meals” Rather than “Charlotte will tolerate her sister’s presence at playtime” “Abigail will increase her communication during meals” 24

Developing Child Outcomes What parent states: “I wish he could sit without as much support when he eats and plays – it is hard work holding him all the time.” 25

26 “Romeo will improve muscle tone for sitting.” Not This “Romeo will play with toys and eat meals with his family by sitting without much support.” This Child Outcome: Example

Developing Family Outcomes What parent states: “We want to be able to take Romeo with us in the car; we need a travel car seat.” 27

28 “Staff will explore options for financial assistance for car seats.” Not This “Karen and Mark will explore options for financial assistance for car seats and secure one.” This Family Outcome: Example

IFSP Outcomes Rating Activity Now it’s time to check and see how much you learned about understanding of the criteria needed to develop and write high quality, functional, participation-based Individualized Family Service Plan (IFSP) outcomes. Download and print a copy of the Worksheet for Rating IFSP outcomes. Please rate each outcome statement by writing “yes” or “no” in each quadrant of the table, based on whether the statement meets each of corresponding criteria. When you are finished, check your answers by continuing with the PowerPoint 29

Lily will go fishing with her family and hold her own pole 30 Necessary/ Functional Real-life Contextual Settings Crosses Domains/ Discipline- Free Jargon-FreePositive, Not Negative Active, Not Passive

Lily will go fishing with her family and hold her own pole 31 Necessary/ Functional Real-life Contextual Settings Crosses Domains/ Discipline- Free Jargon- Free Positive, Not Negative Active, Not Passive Yes This is a participation-based, functional, high-quality IFSP outcome!

Davis will talk more and pronounce words better Necessary/ Functional Real-life Contextual Settings Crosses Domains/ Discipline- Free Jargon-FreePositive, Not Negative Active, Not Passive 32

Davis will talk more and pronounce words better Necessary/ Functional Real-life Contextual Settings Crosses Domains/ Discipline- Free Jargon-FreePositive, Not Negative Active, Not Passive YesNo Yes 33 Remember to include real-life situations that promote skill acquisition in more than one developmental domain

Robin will stop having tantrums at separation from primary caregiver when going to daycare 34 Necessary/ Functional Real-life Contextual Settings Crosses Domains/ Discipline- Free Jargon- Free Positive, Not Negative Active, Not Passive

Robin will stop having tantrums at separation from primary caregiver when going to daycare 35 Necessary/ Functional Real-life Contextual Settings Crosses Domains/ Discipline- Free Jargon- Free Positive, Not Negative Active, Not Passive Yes No Yes Use “Mom”, “Dad”, or “Grandma” instead of “primary caregiver”, and state the outcome positively by saying “say goodbye calmly” instead of “stop having tantrums”

Marcus will play in the backyard getting around on his own using his walker Necessary/ Functional Real-life Contextual Settings Crosses Domains/ Discipline- Free Jargon- Free Positive, Not Negative Active, Not Passive 36

Marcus will play in the backyard getting around on his own using his walker Necessary/ Functional Real-life Contextual Settings Crosses Domains/ Discipline- Free Jargon- Free Positive, Not Negative Active, Not Passive Yes 37 This is a participation-based, functional, high-quality IFSP outcome!

Lanesha will gradually stop eating baby food and eat more solid foods Necessary/ Functional Real-life Contextual Settings Crosses Domains/ Discipline- Free Jargon-FreePositive, Not Negative Active, Not Passive 38

Lanesha will gradually stop eating baby food and eat more solid foods Necessary/ Functional Real-life Contextual Settings Crosses Domains/ Discipline- Free Jargon-FreePositive, Not Negative Active, Not Passive YesNoYes NoYes 39 Remember to create an outcome where the child and family can be actively involved in the success of the outcome through their daily activities or routines. Focus on what you want Lanesha to do-not what you want her to stop doing.

Thomas will put up with lying on his stomach for 10 minutes without crying Necessary/ Functional Real-life Contextual Settings Crosses Domains/ Discipline- Free Jargon- Free Positive, Not Negative Active, Not Passive 40

Thomas will put up with lying on his stomach for 10 minutes without crying Necessary/ Functional Real-life Contextual Settings Crosses Domains/ Discipline- Free Jargon- Free Positive, Not Negative Active, Not Passive No Yes No 41 It would be more functionally appropriate to have activities that encourage to play (i.e.: Thomas will play with toys on the floor rolling, reaching, and grabbing). Again, the focus should be on real-life settings, and the outcome should be framed positively and actively.

Ahmet will get to eat what he wants during meals by pointing or looking at the choices his parents provide Necessary/ Functional Real-life Contextual Settings Crosses Domains/ Discipline- Free Jargon-FreePositive, Not Negative Active, Not Passive 42

Ahmet will get to eat what he wants during meals by pointing or looking at the choices his parents provide Necessary/ Functional Real-life Contextual Settings Crosses Domains/ Discipline- Free Jargon-FreePositive, Not Negative Active, Not Passive Yes 43 This is a participation-based, functional, high-quality IFSP outcome!