1. Family Assessment for a Child Determined Eligible
Section 4
Facilitator’s Notes:
Remind participants that the training content is reflective of best practice and is based on what communities prioritized as their preferred future state.
The next step in the process is family assessment
Handouts used in Section 4: Family Assessment
Case Studies for Noah and Josie
Noah’s MEISR- COSF
Family Assessment for a Child Determined Eligible

2. Key Points Family assessment provides important information that:
promotes the development of meaningful IFSP outcomes and,
informs the strengths and needs that are related to the 3 global outcomes
Facilitator’s Notes:
Review the key points for family assessment in relation to the 3 global outcomes:
Results in the development of meaningful IFSP outcomes
Provides information about the strengths and needs of the child which can then be related to the 3 global outcomes

3. 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
Facilitator’s Notes:
This section of the training, Family Assessment, aligns closely with the four first key principles for Early Intervention Service Provision.

4. Purpose of Family Assessment
An essential practice for assessment and intervention in natural environments is the identification of the routines, activities, and events that occur regularly for children and families at home and in the community.
Gathering information about where families go, what they do, when they do it, and how they engage in the tasks of everyday life is pivotal to the identification of authentic outcomes and the initiation of intervention that has the likelihood of making a difference.
(Bernheimer & Keogh, 1995;Bernheimer & Weismer, 2007; McWilliam & Scott, 2001)
Facilitator’s Notes:
Review this brief summary of the importance of family assessment in the development of individualized plans for children who are eligible for Early Intervention and their families. Stress the fact that there is a direct correlation between learning about the family and providing intervention that will make a difference both in the development of skills and in the child’s enhanced participation in the activities of their family.

5. Family Assessment Is: The responsibility of the CCB EI Program;
Voluntary on the part of each family member participating in the assessment;
For the purpose of determining the resources, priorities and concerns of a parent or other family member related to the enhancement of his or her child’s development; and,
Conducted for an eligible child prior to the development of the initial IFSP
Facilitator’s Notes:
Briefly review the requirements of family assessment.

6. Required Components of Family Assessment are:
Use of an appropriate family assessment tool conducted by personnel trained to utilize the tool;
Facilitation of a personal, conversational interview with the parent and/or caregiver, which:
Is used for the purpose of understanding the priorities and routines of the family;
Is unbiased and non-judgmental;
Uses open-ended questions to support the sharing of information; and,
Is conducted in person.
Facilitator’s Notes:
Review the required components of family assessment.

7. Family Assessment Structure in GO 4 IT Communities
Family assessment conducted after eligibility is established
Separate meeting with most likely provider
Evaluation and assessment information and Family assessment inform:
Individual Child and Family IFSP Outcomes
3 Global Outcomes
During family assessment information gathered is related to the 3 global outcomes
Facilitator’s Notes:
Highlight the point that we should be explaining and talking to families why we do the family assessment and how this information relates to the 3 global outcomes.
Example:
You learn during family assessment that Joe is having difficulty keeping his balance when trying to help with getting his pants while getting dressed.
You respond by noting that this is affecting Joe’s ability to meet his own needs by beginning to dress himself.

8. Roles in Family Assessment
Who can facilitate?
Service Coordinator or Provider
Must be trained on facilitation of tool
Must use protocol
Who can record?
Capture good “meaty” information
Record within routines
Who can ask questions?
Facilitator guides the process
asks questions from the protocol and follow up questions as needed
Additional participants ask follow up questions
Obtains further information about the child’s participation
All questions are open-ended questions, not solely focused on developmental skills
Facilitator’s Notes:
Highlight the point that we should be explaining and talking to families why we do the family assessment and how this information relates to the 3 global outcomes.
Example: “When we talk to you about what your day looks like and the things that Joe does during the day, we will be getting great information about the knowledge and skills Joe has, what he does to make sure his needs are met, and how he is relating with others around him. These are important things to think about for all children. You will hear these referred to in early intervention as the 3 global outcomes.”

9. Combining Family and Child Assessment
The most likely provider can score a child assessment tool, such as the MEISR-COSF, during the family assessment.
The family assessment drives the process, not the child assessment tool
This only works with really good, thorough family assessment
Aids in determining the Global Outcomes ratings
Facilitator’s Notes:
Handout: Noah’s MEISR- COSF
An option than may be used for child assessment is to score an assessment tool while the family assessment is being conducted. It is important that if this option is being used, the family assessment drives the process, not the child assessment. Items on the child assessment tool should be scored as they are discussed during the family assessment. At no time should the family assessment be stopped and questions from the child assessment asked directly. If time allows, additional information may be gathered after the family assessment has concluded.
Review the completed MEISR-COSF for Noah. Note the following:
Organized by the three global outcomes and by daily routines
The skills that would be expected of a child Noah’s age are highlighted
Easy to see at a glance the age level at which the child is demonstrating skills
Excellent tool for age-anchoring a child’s skills within the 3 global outcomes
Shows related functional domain – E=Engagement, I = Independence, S = Social Relationships
Shows related developmental domain – A=Adaptive, CG=Cognitive, CM=Communication, M=Motor, and S=Social/Emotional
Easy to see at a glance if a child is demonstrating age-expected skills and how often these skills are demonstrated for each global outcome
Other communities have experimented with scoring other assessment tools, such as the DAY-C, during the family assessment.
Review with participants. Discuss how this could be used and how it age-anchors the child

10. A Common Thread Among Family Assessment Tools
Conversational Interviewing!
Facilitator’s Notes:
Introduce the concept of conversational interviewing, which is an integral part of how family assessment is facilitated. Point out that listening is the most important part of the process. In a conversational interview, the family should be doing more talking that the interviewer.

11. Conversational Interviewing
It’s Easy When You’re Fascinated with What They Have to Say!
Are you prepared with all the questions that you are going to ask?
Do you have a good idea of what answers you are going to get?
YES?
Then you aren’t participating in
conversational interviewing!
Facilitator’s Notes:
Review information from this slide. Point out that we all respond favorably to having a conversation which someone who seems truly fascinated by what we are saying. We want to bring that same focus to family assessment. Even though it is human nature to want to be prepared, conversational interviewing is a dynamic and fluid process, where you should not be able to anticipate the responses of the family.

12. Structure of the Interview
Opening or Greeting
Greet the interviewee with a smile
Thank them for agreeing to talk with you
Say something to build rapport
“Can you believe this weather?” “Wow, your flowers are beautiful!”
You want this to feel as much like a conversation as possible
Purpose and Providing Information
Explain the purpose of the meeting
Why the meeting is taking place
The expected result of the conversation
Any “ground rules” that need to be covered
Timelines
Interruptions
Mention that you will be taking notes
Facilitator’s Notes:
Conversational interviews look natural, and they are, but they also have structure. Review these and relate how they look in family assessment.

13. Structure of the Interview, cont.
During the interview
Ask the open-ended question, then
Listen
Listen!
Acknowledge what the person is saying
Facial expressions
Head nods
“Uh huh” “Hmm”
Listen for clues that there is more to what they are saying
Body Language
Non-verbal cues
Probe for more information
“Could you please tell me more about that?”
“Can you give me an example of what you mean by that?”
Facilitator’s Notes:
Review – once again, stress the importance of active listening. Listen not just for what is being said, but how it is being said, including body language. Use good open-ended questions when you need to probe for more information. Always bring it back to the family’s perspective. Asking the family “why do you think he is doing that?” not only engages the family and sets them up as the expert on their own child , you may get information that you could not have anticipated that will provide you with insight into the skills or behaviors of the child.

14. Structure of the Interview, cont.
Taking Notes
Write down as much useful information as you can
Remember that you will be reviewing your notes after the interview
Closing
Thank the interviewee for their time and for sharing the information
Ask for permission to follow up as needed
Explain the next steps of the process
Post Interview
Review your notes immediately
Add clarifying information if necessary
Document results of interview
Facilitator’s Notes:
Review these points. Emphasize the point that whenever you are recording information about a family, the family should be seated so that they can view the information, and it should be reviewed with them frequently during the process, to check for understanding and accuracy.

15. The Scale for Assessment of Family Enjoyment within Routines (SAFER)
Strengths
Structured questions help guide the facilitator
Good fit with the Individualized Family Service Plan (IFSP) process
Helps develop conversational interviewing skills
Easier to train to proficiency
Enhanced instructions already developed
Concerns
More difficult to follow the lead of the family
May not gather enough information about the concerns of the family
Facilitator’s Notes:
The SAFER is the tool that has been chosen for family assessment by most communities. This slide shows some of the strengths and concerns of using this tool that were gathered through stakeholder feedback during the process of approving tools for Colorado.
The main concern presented is that while the SAFER is very effective at gathering information about the skills of the child within the context of the routines of the family, it sometimes misses family concerns or priorities that are not directly related to the child. Questions should be asked at the end of the process to assure that this information is not missed. Ask “Do you have any other concerns for your family? They don’t have to be related to Joe’s development.”
You can also used the worry and change questions from the Routines-Based Interview. These are:
When you lie awake at night, what do you worry about?
If you could change something about your life, what would it be?

16. Let’s Take a Closer Look at the SAFER
Designed to develop functional intervention plans
Identifies the independence, engagement and social competence of the child
Identifies the concerns and priorities of the family
IFSP outcomes generated are:
Functional
Identify the useful skills the child needs to succeed in his typical environment
Transdisciplinary
Do not focus on one specific developmental domain or provider type
Do not have to be addressed by a professional of a specific discipline
Facilitator’s Notes:
Review the reasons that the SAFER is an effective tool for family assessment. Note that all participants in family assessment should have an understanding of the use, structure and administration of the tool in order to fully participate, but allow the family to drive the process.

17. SAFER Enhanced Instructions
Power Point format
Overview of tool
Page by page instructions for administration
Use of the guidance questions
Documentation instructions
Suggestions for individualization of guidance and follow up questions
Transitioning to the next activity
Found on EI Colorado website under “Family Assessment”
May be used in training
Facilitator’s Notes:
Most communities have chosen the Scale for Assessment of Family Enjoyment within Routines (SAFER) for family assessment. Enhanced instructions for this tool have been developed and may be used in training.

18. Example of SAFER Enhanced Instructions Instructions for Administration: Page 1
This page provides general information and instructions for use of the SAFER as a tool for family assessment
Family assessment is conducted only with the agreement of any family member participating
Important points:
Questions under each routine are guidance questions only
Professionals are encouraged to develop additional questions to follow up and gain additional information about the unique experiences of each family
Questions for childcare are included for those families whose children participate in caregiving environments outside of their immediate family
Family responses to guidance questions are documented in narrative format
Concerns noted by the family are documented (stars may be used to identify concerns)
Each routine is rated on a 1-5 scale, with one noting “not at all satisfied”, and 5 noting “very satisfied”
After the completion of the tool, the family identifies which of their concerns they would like to have addressed as IFSP outcomes
Facilitator’s Notes:
This is an example of how the enhanced instructions for the SAFER are formatted. They are in a PowerPoint, with additional questions and considerations noted for each page of the protocol.

19. A Cold Fact About Family Assessment
For each routine or time of day, the following characteristics of the child’s participation should be identified:
E – Engagement
How engaged and interested is the child in what is happening?
I – Independence
How much does the child do by themselves within the activity?
SR – Social Relationships
How is the child interacting with those around him during that time of day?
A new acronym – EISR (pronounced icer).
These characteristics can be measured using the MEISR-COSF
Facilitator’s Notes:
Handout: Noah’s MEISR-COSF
Family assessment is focused on EISR - the Engagement, Independence and Social Relationships of the child within the routines of their day. Although you do not generally ask these guidance questions directly, you should, at the end of the discussion for each routine, know how the child is engaged and interested, how much they are doing by themselves and how they are interacting with others present during that time of day.
These are the factors that determine how the child is participating.
The MEISR-COSF (Measurement of Engagement, Independence and Social Relationships) assessment tool is aligned with the 3 global outcomes, measures these three things (EISR) for each routine discussed and allows you to see at a glance whether the child is demonstrating age-expected, immediate foundational or foundational skills.

20. Identified through Family Assessment
Activity 4.1
Strengths and Needs
Identified through Family Assessment
Josie
Facilitator’s Notes:
Activity 4.1
Handouts:
Josie’s IFSP
Materials Needed:
One highlighter per participant
In small groups or with a partner:
Review the family assessment information on Josie’s IFSP
For each time of day identified, review the skills that Josie is demonstrating and the challenges that Josie is experiencing
Highlight Josie’s strengths and underline her needs
Ask group for examples of Josie’s strengths and needs and which time of day or routine the skill is associated with.
Remember, we are always looking at functionality, not isolated skills.

21. Final Thoughts
Taking the time to learn about the life of a family and the participation of their child within the typical activities of their day
Requires a shift in thinking
Takes time
Requires good conversational and listening skills
Builds relationships
Gives us information that can’t be gained in any other way!
Facilitator’s Notes:
Review with participants. Families are so remarkably complex that we just can’t begin to provide or implement a truly effective plan without knowing the marbles that this family is balancing to make it through the day!