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Early Childhood Tutorial
Developing & Implementing IFSPs
Session 2: Developing an IFSP with a Family
Outcome and Objectives
Outcome
Understand the purpose and scope of an IFSP as a vehicle for selecting family-desired
supports and services in natural environments
Objectives
Discuss the evidence supporting community-based early intervention and the
importance of providing family/child supports and services in natural environments
Explain the variety of ways that formal and informal family/child supports and services
can be offered
Explain how the identification of a family’s priorities, concerns and resources provides
the foundation for decision-making during the development of an IFSP
Explain the purpose for developing a flexible IFSP with families that reflects their desired
outcomes
Identify the information which must be included on an IFSP, and how to facilitate
discussion with families to ensure all IFSP components are addressed
Identify at least 4 concerns families may voice during the development of an IFSP for
their child
Describe how to assist families to identify their desired outcomes
Identify the components of a functional outcome, measurable criteria and effective
strategies and illustrate with 3 examples
Describe the factors to consider in determining the frequency and intensity of
family/child supports and services
Describe at least 4 decisions to make with family members while developing a flexible
IFSP
Developing an IFSP with Families has four key activities for readers: essential content,
application activities, recommended reading and self assessment. The following chart gives an
overview of the session with suggested time allotments:
1 Early Childhood Tutorial- Developing and Implementing IFSPs
Session 2 - Developing an IFSP with a family
Summary of Activities
Activities Time
allotment
Essential Content about developing an IFSP with families 2 hours
Application 2.1: Reviewing program practices re: IFSP 2 hours
outcomes, strategies, criteria and supports/services
Application 2.2 Sandi: Developing functional IFSP outcomes, 2 hour
criteria and strategies
Application 2.3 Jacob: Developing functional IFSP outcomes, 1 hour
criteria and strategies
Application 2.4 Manny: Developing functional IFSP 1 hour
outcomes, criteria and strategies
Application 2.5 Lurindell: Developing functional IFSP 1 hour
outcomes, criteria and strategies
Application 2.6 Addressing Family Concerns about 2 hour
Developing IFSPs
Application 2.7 Evidence-based practice: Early intervention 2 hours
in natural environments
Recommended Reading 1-2 hours
Self-Assessment Inventory: Developing IFSPs with families 1 hour
Guiding questions:
1. What are our goals? Which aspects of family/community life do family
members want to help their child participate in?
2. How will we accomplish our goals? Which formal and informal supports and
services can help family members achieve their desired outcomes for their
child?
Why this topic was selected
Developing an IFSP with Families focuses on identifying, with families, the IFSP outcomes,
criteria, strategies, and supports/services that enhance a child’s participation within meaningful
contexts for each family. The session describes early intervention as the formal and informal
supports and services that will help each family implement the strategies necessary to reach
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Session 2 - Developing an IFSP with a family
their desired outcomes. This is the heart of the natural environment mandate in the Individuals
with Disabilities Education Act: to support families so that their young children with disabilities
participate in meaningful routines and activities, in and out of their home. (link to mod 3 session
3, pg. 3 informal and formal EI services)
Insert tip box below: Maryland’s IFSP document has specific instructions on the back of
each page for completing each section. A blank copy is available through one of the 24
Local Infants and Toddlers Programs (link to
http://www.cte.jhu.edu/dse_eis/directory1.cfm?DirID=2&location=2) or online. (TBD)
Developing an IFSP with Families draws on the planning discussion with families that guided
a child’s initial evaluation and assessment for eligibility for a Local Infants and Toddler’s
Program in Maryland. (link to mod 1 session 2 a purpose of planning) Information about a
family’s priorities, concerns and resources, together with the data and observations collected
during a child’s evaluation and assessment, lays the foundation for a discussion between family
members and early intervention providers about developing an Individualized Family Service
Plan (IFSP).
Specifically, Developing an IFSP with Families focuses on including families in making
decisions about four key components of an IFSP:
1. functional outcomes for a child and/or family members;
2. measurable criteria;
3. collaborative strategies; and
4. formal and informal family/child supports and services.
Functional outcomes are the cornerstone for providing early intervention supports and
services to families and children in natural environments. Functional outcomes specify where
each family “wants to go” and direct early intervention providers to focus their expertise on
ensuring that a child participates in specific contexts within family and community life.
Traditionally, IFSP outcomes have represented domain specific skills (e.g., Aman will push up
on hands and knees to crawl, or Gina will improve expressive language that require formal
services from a professional in a specific discipline. For example, a physical or occupational
therapist would typically work with Aman to help him learn to crawl, and a speech-pathologist or
special educator would help Gina learn to use signs to communicate in formal therapy or play
“sessions.”
Measurable criteria are indicators for families and early intervention providers to help them
recognize when identified functional outcomes have been achieved. Likewise, collaborative
strategies clarify how early intervention providers and family members will work together to
include children in family and community life. Thus, for Aman, rolling over is the way he will get
around his family’s home to play with his older brothers. For Gina, signs will be paired with
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initial sounds to help her express her desires for a drink of milk or more apple during mealtimes
with her family.
Essential Content: What early intervention providers and families
need to know about developing an IFSP
Developing an IFSP with a Family is part of the Early Childhood Tutorial about the IFSP
process developed by the Maryland State Department of Education for early intervention
providers, and any interested readers.
Other sessions available: (link to outcomes/objectives in Mod 1 and 2 for each session below)
The following topics are covered in Developing an IFSP with a family:
a. Evidence for providing family/child supports and services in natural environments
b. Overview of developing flexible IFSPs with families
c. Concerns families may have while developing an IFSP
d. IFSP discussions with families: Who, where, when, how and who
e. Decisions to make with families about what to include on an IFSP
f. The role of service coordinators during development and implementation of an IFSP
g. Functional outcomes: Guiding early intervention supports/services
h. Assisting families to identify functional outcomes
i. Measurable criteria: How we know we have achieved outcomes achieved
j. Family-specific strategies identify how functional outcomes will be achieved
k. Identifying early intervention supports and services
a. Evidence for providing family/child supports and services in
natural environments
Insert tip box below: Evidence-based early childhood practices for parents, providers
and researchers is posted online by The Research and Training Center on Early
Childhood Development. (link to www.researchtopractice.info)
Evidence-based practices help early intervention providers to make sound decisions about how
to support families in achieving their desired outcomes for their children (Dunst, Trivette, &
Cutspec, 2002). Providing evidence-based practice is an expected responsibility in multiple
professions including early intervention, medicine, occupational and physical therapy, speech-
language pathology, nursing, education, and mental health. (link to Appendix A)
The following points summarize why it is important to provide family/child supports and services
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in natural environments.
A child’s relationships with primary caregivers organize all his or her early
development.
“The idea is that we are born to form attachments, that our brains are physically wired to
develop in tandem with another’s, through emotional communication, beginning before
words are spoken.” (Schore, 2003, p.16)
Insert tip box below: Click here for supporting references.(link to corresponding section in
Appendix B)
Young children need a relationship with at least one emotionally invested, predictable
caregiver who is available to each child and understands how to provide meaningful
stimulation through daily experiences. A strong, secure attachment to a nurturing caregiver
also has a protective biological function, helping a young child learn from, and withstand,
the ordinary stresses of daily life. Repeated, positive care-giving experiences make a
decisive impact on a baby’s brain development across all areas of development.
Extensive research in early child development and learning, reviewed in From
neighborhoods to neurons: The science of early childhood development (link to
www.nap.edu/execsumm/0309069882.html) emphasizes the:
1. importance of early life experiences, as well as the inseparable and highly
interactive influences of genetics and environment, on the development of the brain
and the unfolding of human behavior;
2. central role of early relationships as a source of either support/adaptation or
risk/dysfunction for a child;
3. powerful capabilities, complex emotions, and essential social skills that
develop during a child’s earliest years of life; and
4. capacity to increase the odds of favorable developmental outcomes for children
through planned interventions. (National Research Council & Institute of Medicine,
2000, p. 1).
Children are active participants in their own development, based on their drive to
explore and master their environment.
“Given the drive of young children to master their world, most developmentalists agree
that the full range of early childhood competencies can be achieved in typical, everyday
environments….All forms of early childhood intervention are most effective when they
counteract obstacles to growth and promote the expression of a child’s natural drive
toward mastery.” (National Research Council, 2000, p.27)
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Insert tip box below: Click here for supporting references. (link to corresponding section in
Appendix B)
Infants are aware of the effects of their own behaviors, and prefer consequences that they
can control directly versus those that are uncontrollable. A young child’s ability to create his
or her own knowledge depends on having an environment which provides opportunities for
growth and supports individual interests. Learning is enhanced when children’s interests
engage them in interactions that provide opportunities to practice existing skills and explore
their environment. Finally, when early intervention is provided in a family’s environment
rather than unfamiliar settings (e.g., clinics and intervention centers), many more
opportunities are created for parents to interact effectively with their children at home.
New motor and communication behaviors are learned and used when a child has
repeated opportunities for practice in meaningful situations with generalization of
skills across different settings.
Insert tip box below: Click here for supporting references. (link to corresponding section in
Appendix B)
Motor behaviors must be retained and practiced in different contexts to be considered
“learned” and used spontaneously in response to specific environmental demands. Even
when children are taught specific motor or communication skills during traditional
intervention sessions, they must then practice these skills over and over in familiar settings
in order to use the skill competently.
“A child who learns to walk between parallel bars, on a balance beam, or in a quiet
therapy room, for example, must transfer or generalize to walking on a carpet at home
or in a crowded hallway at school if walking is to be meaningful.” (McEwen & Shelden,
1995, p.35)
Principles of motor learning include promoting age-appropriate functional tasks, embedding
movement within a physical and sociocultural environment, and fostering active exploration
of the environment. Meaningful input across multiple domains of development, not just in
motor or language areas, is also critical and encourages a young child’s learning. This
learning typically occurs in the context of an ongoing care-giving relationship and
dramatically improves a child’s memory of the action/event and provides a framework for
updating it.
The knowledge and resources of early childhood specialists can be shared with a
child’s key caregivers through adult-adult relationships that support caregivers in
their daily roles and responsibilities caring for their children.
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Supporting and enhancing the knowledge/experience of those who spend the most time
with very young children--- parents, brothers and sisters, friends, extended family, early care
and education providers--- dramatically increases the impact of early intervention.
Strategies implemented at home or child care by family members and other care-givers can
lead to generalization of a child’s emerging skills in various family and community activities.
Information embedded in an emotional context appears to stimulate neuronal circuitry more
powerfully than information presented in isolation of a meaningful context.
Insert tip box below: Click here for supporting references. (link to corresponding section in
Appendix B)
For very young children, relationships with key caregivers provide ongoing and numerous
opportunities for learning within an emotional context. For example, a child who becomes
interested in letters and words through daily reading with a parent and associates “the joy of
being in her father’s lap, seeing beautiful pictures, and hearing a wonderful story” is more
likely to understand the meaning of letters than a child who is taught to recite the letters of
the alphabet by rote (National Research Council and Institute of Medicine, 2000, p.156).
b. Overview of developing IFSPs with families
Once a child’s eligibility for early intervention has been established by a Local Infants and
Toddlers Program in Maryland, an individualized family service plan (IFSP) is developed. (link to
mod 1` session 1 who is eligible?)
The following overview gives a summary of the critical steps in developing an IFSP with a
family.
1. Revisit a family’s priorities, concerns, and resources;
2. Review data collected during a child’s evaluation/assessment;
3. Identify functional outcomes with parents;
4. Select measurable criteria to define when an outcome has been
achieved;
5. Describe strategies for achieving each outcome;
6. Discuss which formal and informal supports/services can assist families
to achieve desired outcomes; and
7. Assess progress towards achieving family/child outcomes as well as
overall family satisfaction with their participation in early intervention,
once an IFSP is implemented.
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1. Revisit a family’s priorities, concerns, and resources. The conversation for selecting
IFSP outcomes and family/child supports and services is guided by parents’ comments
about family/child interests, resources, and priorities for the activities and routines in which
they want their child to participate guide. This discussion should begin with a planning
conversation with families in preparation for a child’s evaluation/assessment. (link to mod 1
session 2 a purpose of planning)
Insert resource box below: A routines-based interview can guide this discussion
(McWilliam, 1992; in press). (link to
www.vanderbiltchildrens.com/uploads/documents/cci_rbi__form_rev.pdf )
Family/community activities and routines are the context for natural learning opportunities in
which young children develop social competence, master their environment, and acquire
information and experience. In preparation for developing an IFSP, families and early
intervention providers discuss where a child and family spend their time, along with the
activities they do in these settings, would like to do, or improve upon (Rosenketter &
Squires, 2000).
2. Review data collected during a child’s evaluation/assessment with families. A
comprehensive evaluation and assessment collects information from multiple sources about
a child’s and family’s interests, strengths/resources and challenges/concerns. (link to
essential content Mod 1 session 3) These sources include quantitative tests as appropriate,
and qualitative methods such as natural observation of a child with family members in
familiar situations. This data is helpful when determining how to enhance a child’s
participation in specific family and community activity settings.
3. Identify functional outcomes with parents. Outcomes are the changes that families
would like to see for their children or themselves as a result of their participation in early
intervention. Functional outcomes, written in language understandable to each family,
identify the desirable knowledge, skills and/or behavior that a child or family members will
acquire to ensure a young child’s successful participation in daily life (Pretti-Frontczak &
Bricker, 2000). (link to section g “functional outcomes” in this session)
Functional outcomes promote three critical areas for a child’s participation in family and
community life (McWilliams, 2002): social competence, mastery of the environment, and
engagement for learning.
Examples
Social understanding and expressing emotions
competence forming friendships
interacting with family members/peers
becoming a member of a social group
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Mastery of the caring for one’s self
environment navigating spaces and places
using tools, toys and objects purposefully in
specific activity settings
Engagement for focusing on information from one’s
learning body/environment
adapting to familiar and novel situations in
specific activity settings
4. Select measurable criteria to define when an outcome has been achieved.
Measurable criteria enable all team members to know when an outcome is achieved to the
satisfaction of parents. Criteria that is measurable, i.e., can be seen or heard in a specific
context, and specifies how frequently a family hopes a certain action or behavior will occur.
(link to section h “measurable criteria in this session)
5. Describe collaborative strategies for achieving each outcome. Strategies clarify how
intended outcomes will be achieved; not which early intervention services will be provided.
Collaborative strategies build on a child’s and family’s interests and surroundings and
involve routines/activities, materials/toys/pets, interactions, hobbies/leisure and one’s
environment. (link to section i in this session) They identify how early intervention
services/supports and other community resources will assist family members in reaching
their intended outcomes. Talking about strategies with families provides an opportunity to
think about the “places and spaces” where a child can practice and generalize skills. This
conversation leads to the next step in developing an IFSP: identifying formal and informal
services/supports.
Insert tip box below: Family members and early intervention providers should discuss
the variety of formal and informal supports and services that can be helpful to families
and children in reaching desired outcomes (Trivette, Dunst & Deal, 1997). (link to Mod
2 session 3 page 2 inf/formal services)
6. Discuss the formal and informal supports/services which can help families achieve
their desired outcomes. Before identifying any formal early intervention services on the
IFSP, it is critical to consider “Who has the expertise to support family members in
achieving specified child and family outcomes?” Otherwise, the conversation is very likely
to focus on how frequently therapy and special instruction should be provided (Hanft &
Pilkington, 2001).
7. Once an IFSP is implemented, periodically assess progress towards achieving
family/child outcomes as well as overall family satisfaction with their participation in
early intervention. Ongoing assessment of progress and family satisfaction can be
initiated by prompting families to think about:
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Insert tip box below: An annual meeting must be held to evaluate a family’s IFSP and a
periodic IFSP review must be held every six months or sooner, if requested by a family.
(Link to mod 2, session 1d)
How much progress a child/family is making toward attaining their desired outcomes;
Level of satisfaction with this progress, and their participation in a Local Infants and
Toddlers Program; and
Modifications, if any, to services and supports.
c. Concerns families may have while developing an IFSP
It is important to anticipate, and address as appropriate, concerns that family members may
have during the development of their IFSP. Many questions related to a child’s rate of
development and future independence cannot be answered completely during a child’s first few
years. Keep in mind that some parents may not feel comfortable asking the following questions
or talking about concerns that they are only beginning to think about, particularly with early
intervention providers they have just met.
When family concerns do arise, early intervention providers can:
1. Encourage family members to talk about what is on their minds;
2. Listen, before making suggestions, in order to understand and show respect for a
family’s beliefs and values;
3. Provide information, as appropriate, to address specific concerns;
4. Review with families their informal support networks; and
5. Offer to link families to support networks, such as parent-parent programs through a
local infants and toddlers program or other organizations.
Some examples of concerns that may arise as parents think about desired outcomes for
themselves and their child:
About a child’s development….
Will my child ever be able to …..?
Why isn’t my child developing like other children?
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I don’t know what my child can do.
I’m not sure about my child’s diagnosis, so why do all this now?
About participating in early intervention…
Will this help me/my family cope, learn what to do about……?
What if all this doesn’t help my child to ….?
I don’t know if I accept the results of my child’s evaluation/assessment.
What assurance is there that this approach will make a difference?
About schedules, services and supports…
I want more/less time/services for my child.
There are too many /not enough people coming to my home.
I/my partner work and aren’t home during the day.
d. Considerations for scheduling IFSP meetings with families: who,
where, when, how and who
Who participates in IFSP meetings? (link to Mod 2 session 1e)
A flexible, individualized IFSP for each child/family should be developed by the people who
really know a child and/or have spent some time evaluating and assessing a child’s
strengths and needs.
Participants Description
Family Parents/legal guardians (must attend)
Other family members/friends, as requested by parents, if
feasible
Early Service coordinator/interim service coordinator must attend
intervention
providers Qualified personnel (at least one) directly involved in a child’s
evaluation/assessment (must attend) (link to note below)
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Session 2 - Developing an IFSP with a family
Providers who will provide EI supports/services, as
appropriate
Community Advocate, as requested by parent
agencies/links,
as appropriate Representatives of community agencies and programs, as
requested by parent.
Note: If the early intervention provider(s) directly involved in conducting a child’s
evaluation and assessment are unable to attend the IFSP meeting, he or she can
participate in one of three ways: by a telephone conference call, having a
knowledgeable authorized representative attend, or making pertinent records available
for discussion. (link to Mod 2, session 1e)
Where are IFSP meetings held?
An IFSP meeting must be held in a setting that is convenient for the family. (link to mod 2
session 1d, pg 8 how are meetings conducted). This includes a family’s home or another
setting where they feel comfortable (e.g., relative’s home, meeting room at a public library
or religious site).
When are IFSP meetings held?
The first meeting to develop an initial IFSP for a child eligible for a Local Infants and
Toddlers Program must be conducted within an initial 45-day time period which starts with
the initial referral from a parent or other source. The time of day for the IFSP meeting must
be convenient for the family. (link to mod 2 session 1d)
Arrangements for IFSP meetings, including the periodic and annual reviews, must be made
with a family and other participants before the meeting to ensure that they will be able to
attend.
How will families be notified about IFSP meetings?
Prior written notice must be provided to the parent(s) within a reasonable time, as
determined or agreed to by the parent(s). The notice must be written in the native language
of the family, or other mode of communication used by the family, unless clearly not feasible
to do so. (link to mod 2 session n)
e. Decisions to make with families about what to include on an IFSP
The IFSP is intended to be a flexible document that identifies how early intervention providers
and community resources will support a family in their efforts to help their child learn from and
12 Early Childhood Tutorial- Developing and Implementing IFSPs
Session 2 - Developing an IFSP with a family
participate in everyday activities. It is a family’s guide for reaching their intended outcomes,
rather than a lengthy treatment plan for early intervention providers with specific outcomes for
each discipline.
The IFSP includes family-selected outcomes for a child, and family members themselves, if
desired. Functional outcomes are the foundation for the entire IFSP, and describe a child’s
and/or family’s actions/interaction within a specific context or activity setting. After functional
outcomes are selected, criteria and strategies for achieving each outcome are discussed. Only
then can the discussion turn to selecting the formal and informal supports and services which
can help a family achieve their outcomes. This includes but is not limited to formal early
intervention services such as educators, therapists, counselors, nurses and social workers.
(link to Mod 3 session 3 pg 2)
The critical decisions to make with families when developing an IFSP are identified below.
IFSP Decisions Mandatory Components of an IFSP
(link to mod 2 session 1c)
Why we are Outcomes identify what will happen for a child/family
providing EI
How we will know Criteria, procedure and timelines to measure progress towards
we have achieved achieving outcomes
outcomes
What is needed to Methods/strategies
achieve IFSP .
outcomes
Who will provide Formal services/supports from a Local Infants and Toddlers
family/child supports Program, including service coordination and the name of the
and services service coordinator
Community linkages to related agencies providing formal
supports/services to children and families may be identified (e.g.,
health, transportation, housing and informal supports/services
such as child care, recreation events, and children’s programs)
Where family/child Natural environment(s) where family/child supports and services
supports and will be provided (including a justification if any supports/services
services will be cannot be provided in a natural environment)
provided
When, and for how Frequency and intensity of family/child supports and services
long, family/child (number of days or sessions, length of each session, group or
supports/services individual basis) with initiation and projected duration dates
will be provided
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f. The role of service coordinators during development and
implementation of an IFSP
Insert tip box below: Service coordinators and other early intervention providers must
place families at the center of team decision making.
The intended outcome of effective service coordination is for families to understand the formal
and informal resources in their community so that they receive appropriate supports and
services to meet their child’s and family’s needs. Family members must also be supported in
their efforts to enhance their child’s health, development and participation in family and
community life. This includes successful transition to other community resources, as
appropriate, at age 3 years. (Research and Training Center on Service Coordination, 2002).
As identified in the Individuals with Disabilities Education Act, (link to Mod 2 session 1m) service
coordinators play a pivotal role in developing and implementing IFSPs with families by:
Assisting parents of eligible children to gain access to the early intervention services
and other services identified in their individualized family service plan;
Coordinating early intervention and other services (such as medical services for other
than diagnostic and evaluation purposes) that a child needs or receives;
Facilitating the timely delivery of available services; and
Continuously seeking the appropriate services and situations necessary to benefit
the development of children participating in a Local Infants and Toddlers Program.
Responsibilities of service coordination
A service coordinator’s responsibilities include the following activities during first contacts,
developing an IFSP, and coordinating ongoing activities with families:
First contacts with families
Visit family informally to gather information and develop rapport.
Obtain release of information to facilitate sharing of information and
notify referral source that initial contact with the family has been made.
Maintain communication with referral sources and other contacts,
as requested by a family.
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Plan with families for evaluation/assessment of their children.
Assist families in identifying their priorities, resources and concerns.
(Resource: Routines-based assessment planning checklist for service
coordinators) (link to www.vanderbilt
childrens.com/uploads/documents/ccd_rba.pdf)
Developing an IFSP
Facilitate and participate in the development of an initial IFSP.
Coordinate the completion and dissemination of the initial IFSP
document, following confidentiality and time frame guidelines.
Ongoing activities
Develop and maintain interagency contacts.
Coordinate and monitor the delivery of services.
Facilitate and participate in periodic review and annual evaluation of
the IFSP.
Inform families of the availability of advocacy services.
Assist families to identify their priorities, resources, and concerns
throughout the IFSP process.
Facilitate communication between the family, early intervention
providers and other formal and informal services/supports.
Promote collaboration and problem solving among all team
members.
Maintain current information regarding services available in the
community
Adapted from the Nebraska Early Development Network, 2004. (link to
http://www.answers4families.org/ifspweb/coordination.html)
Providing service coordination
While the IDEA requires that service coordination be provided as an active, ongoing process, it
does not specify how it should be implemented. Two primary models for providing service
coordination are used in Maryland:
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1. Blended model of service coordination: the service coordinator is also a
direct service provider for a family, and manages the responsibilities and
activities as well as early intervention services.
2. Dedicated model of service coordination: the service coordinator fulfills only
the responsibilities and activities described above.
g. Functional outcomes: Guiding early intervention supports/services
Insert tip box below: Functional outcomes should be meaningful, family-desired,
specific and “do-able.”
Functional outcomes point to where a family “wants to go”. They provide direction for
collaboration between family members and early intervention providers about how to reach a
family’s desired outcomes. Identifying functional outcomes with families is the cornerstone for
developing the IFSP document since the outcomes specify what should happen for families and
children as a result of their participation in early intervention. Too often, IFSPs focus only on
child outcomes and do not address family supports from early intervention providers and other
community resources (Jung & Baird, 2003; Boone et al, 1998; McWilliam et al, 1998).
The following guidelines assist early intervention providers and family members during the
development of a family’s IFSP. Functional outcomes should be:
1. meaningful:
2. family-desired:
3. specific; and
4. do-able. (link to each section below)
1. Functional outcomes should be meaningful to families.
Insert reflection box here: Do outcomes promote a child’s participation in
situations, activities and routines meaningful to each family?
Outcomes that are meaningful promote a child’s functioning in three key foundations of
early development - social interaction, mastery of the environment and engagement in
learning- in ways specific to each family/child (McWilliam, 2002; National Research Council,
2000).
16 Early Childhood Tutorial- Developing and Implementing IFSPs
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Social interaction includes understanding & expressing emotions,
forming friendships, interacting with family members/peers;
Mastery over environment includes caring for one’s self, navigating
spaces and places, using tools, toys and objects purposefully in
specific activity settings;
Engagement in learning includes acquiring and using information
from body/environment in play and relationships, adapting to familiar
and novel people/objects in specific situations, figuring out cause and
effect.
Examples of functional child outcomes
Insert tip box below: Click here for examples of functional outcomes with guidelines for
avoiding wording that is broad, negative and/or domain-specific. (link to Examples of
functional outcomes at end of this session).
The three foundations of early development- social interaction, mastery over environment
and engagement in learning- cover the domain specific skills that have traditionally been
identified as child outcomes on IFSPs. Traditional child outcomes typically focus on isolated
motor, language, social/emotional, cognition, and self-help skills, and often lose sight of the
family/community context in which a specific behavior or skill will be used. Functional
outcomes that are meaningful to families include a real life context i.e., how and/or where
a child or parent will use an identified action or interaction (Rosenketter, & Squires, 2000).
Functional outcomes Traditional outcomes
(what child and/or family will do in a specific (domain specific skills)
context)
Neena will eat and drink by mouth during Neena will improve her
family outings. eating skills.
(For a child whose feeding tube keeps
the family from going out to eat
together)
Tommy will tell Mom what he wants to eat Tommy will improve his
and play with so that both are more relaxed expressive language skills;
with each other. or Tommy will say 25
words.
(For a child who whines and cries,
creating much stress for his mother)
Jermaine will walk on his own during after Jermaine will develop motor
dinner walks with his family. skills at the 12-14 month
17 Early Childhood Tutorial- Developing and Implementing IFSPs
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level; or Jermaine will
(For a child who has increased muscle decrease muscle tone in his
tone which interferes with taking family legs.
walks)
Examples of functional outcomes for families
Paula and Pete will find an appropriate wheelchair for Megan and feel
comfortable using it during family outings.
Megan gets around her home by rolling over and crawling, but has to be carried
on family outings. Pete and Paula are interested in using a wheelchair so they
can all go out together.
Sylvia will take Paolo to the park and shopping, by herself.
Sylvia has a significant visual impairment and wants to “shine” as a parent and
take her son to the library, a park or the mall by herself.
2. Functional outcomes are desired by a family.
Insert reflection box below: Are outcomes, identified by each family, written in language
understood by family members?
IFSP outcomes should be identified by a family, and written in language that reflects a
family's understanding about “where we are going.” Functional outcomes reflect how
family/child knowledge, skills, actions will help a child participate successfully in
family/community life. After prompting family members to talk about how they would like
their child to participate in daily activities, early intervention providers can assist families to
“wordsmith” their desires as IFSP outcomes. Use words that a family might say, rather than
the professional jargon understood by early intervention providers (Nebraska Department of
Education, Early Development Network, 2004; Rosenkoetter & Squires, 2000).
Insert reflection box here: Mayra’s story illustrates how Jana, a service coordinator,
prompts a mother to think about what she wants for her son. (link to Mayra’s story at
end of session 2)
Using words that a family understands, and uses themselves, is not the same as writing
down word-for-word what a parent says as an IFSP outcome without first trying to
understand what parents want for their child. For example, parents often identify a very
broad outcome for their child, e.g., to “walk” and/or “talk.” It is helpful to clarify what walking
or talking would look like in the next four to six months, and how this could help a child
participate to a greater extent in family/community life before crafting an IFSP outcome.
18 Early Childhood Tutorial- Developing and Implementing IFSPs
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3. Functional outcomes are specific.
Insert reflection box here: Do outcomes identify specific knowledge, skills and/or
actions for a child and/or family members that will promote meaningful participation in
daily life?
Functional outcomes identify specific behavior and/or knowledge that support a child’s and
family’s participation in family/community life. Non-specific outcomes are very broad and
often use words such as improve, increase, change, decrease etc. (e.g., Mina will improve
her fine motor skills; Sara will decrease aggressive behavior). Identifying positive and
specific actions and skills is one of the key factors in writing family-centered IFSPs
(McWilliam, Ferguson, Harbin, Porter, Munn & Vandiviere, 1998).
Examples of specific family outcomes:
Charlotte and Bruce will know how well Sonya hears people and sounds.
Darla will be cared for competently in their church nursery while Denise attends
services.
Examples of specific child outcomes:
Mina will play with small toys and feed herself little bites of finger food.
Sara will play with other children on equipment at her local playground.
Chantell will let her family know what she wants and answer simple questions,
using words and short phrases.
4. “Do-able”:
Insert reflection box here: Can each outcome reasonably be achieved within 4-6
months?
The “do-able” guideline for a functional outcome considers whether or not an action,
knowledge or skill can happen within 4-6 months, given the child’s expected rate of
progress, family routines and current responsibilities and commitments (Rosenkoetter &
Squires, 2000). Parents, understandably, often think of things they want for their children
that will be achieved in the distant future. It is important for early intervention providers to
acknowledge that they accept a family’s long-range goal as a guide for their supports and
services over the next 4-6 months. For example, in Mayra’s story, the service coordinator
with Mayra that it was very important for her son to understand language like his brothers
19 Early Childhood Tutorial- Developing and Implementing IFSPs
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did before prompting the mother to be more specific. Link to Mayra’s story at the end of
this session
Sometimes a parent insists on an outcome that will probably be achieved in more than a
year (e.g., Darla will walk by herself). In order to demonstrate support for the family’s
desire, use the parent’s preferred wording in the outcome statement. Then, talk with the
family about an intermediate step that is achievable in 4-6 months, and record that in the
criteria section of the IFSP (e.g., Darla will hold on to furniture or another person to take at
least 5 steps, 3x per day).
h. Assisting families to select functional outcomes
Outcomes identify the aspects of family and community life that parents would like to see their
child participate in. Outcomes are “owned” by a family and “adopted” by early intervention
providers who will provide supports and services to help families achieve their outcomes. This
does not mean, however, that parents have their desired outcomes on the “tips of their tongue.”
Ask parents where and how they want a child to participate in family and community life, rather
than what they want their child to do, or learn next. This helps define a meaningful context for
prompting a child’s desired behavior and interactions. Active exploration within multiple contexts,
supported by key caregivers, is critical to a child’s early development. (link to Appendix B this
session)
Insert tip box below: A Routines-Based Interview (McWilliams) helps focus on functional
outcomes versus developmental delays or deficits. (link to recommended reading)
Exploring a child’s and family’s positive interactions and interests also helps parents think about
outcomes that will be meaningful to them (McWilliams, 2005; Dunst, Hamby, Trivette, Raab, &
Bruder, 2000). Family interests and routines (e.g., gardening, cooking, raising pets/animals,
playing musical instruments, visiting friends and family) provide a context for young children.
Child and family interests also provide direction for selecting individualized IFSP strategies in
support of family-desired outcomes. In Mayra’s story, for example, Pedro’s interest in playing with
other children in his nursery school suggests key strategies for prompting his receptive language,
as identified by his mother, Mayra. (link to Mayra’s story at end of this session)
In addition to exploring family/child interests, prompt family members to talk about the actions,
places and routines they would like to see their child be part of. Prompts that invite families to
think about their interactions and interests include:
Child’s interests Family’s interests
My child likes it when… Our family enjoys…
My child gets excited about…. When we have time we like to…
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My child likes to do… Places we often go….
Ways my child shows me she/he is People we like to spend time with…
interested in something…
Things we do at home for fun…
My child pays particular attention to…
Things we like to do in our
My child’s favorite place... community…
My child’s favorite people….
i. Measurable criteria: How we know we have achieved outcomes
Maryland’s IFSP document has a section for recording family-selected outcomes and another
section for specifying the criteria for determining when an outcome has been achieved. Criteria
should clearly state expectations for achieving an outcome, using family-friendly language.
Family members should be able to track progress comfortably.
(Insert reflection symbol here) The following guidelines can help family members and early
intervention providers select measurable criteria so that all team members will know when an
outcome has been accomplished:
WHAT: Can specific actions and/or interactions by a child/family be seen and/or heard by
any team member?
WHERE: What is the context/activity setting in which the identified action/interaction will be
seen or heard?
HOW OFTEN: Is a realistic frequency identified for reviewing an action/interaction?
1. Measurable criteria answers WHAT to look for
Measurable criteria track an action or behavior that can be seen or heard reliably by others.
No interpretation (or guessing) is needed to figure out if an outcome has been achieved.
Outcomes Examples of criteria that can be
seen or heard
Hang will communicate with Hang will say “m,” “p,” and “t” at the
family members by imitating beginning/end of simple words, with
sounds and words and speaking family members in and out of her
simple words spontaneously. home, at least 3x/day.
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Paula and Pete will find an Pete and Paula will take Megan out in
appropriate wheelchair for Megan her wheelchair to the park or
and feel comfortable using it shopping, at least 2x/week.
during family outings.
Neena will eat and drink by Neena will drink a minimum of 4 oz
mouth during family outings. of fluids from a cup and eat 3
spoonfuls of food during family
outings, a minimum of 2x/week...
2. Measurable criteria identify a context for WHERE an action/interaction will take place
Criteria should specify where and when to observe a behavior/action, or set a date when an
action will be completed. For example,
Outcomes Examples of criteria that identify a
context for an outcome
Charlotte and Bruce will know Parents will have written results from
how well Sonya hears people and an audiological screening for Sara by
sounds. March 1, 2004
Jermaine will walk on his own Jermaine will keep his hands open for
with his family on their after 20 minutes when walking with his
dinner walks. parents outside their home, 3 times
per week.
Considering why a family selects an outcome can point the way to identifying criteria
that is measurable and simple to track. For example, Jermaine has increased
muscle tone which makes it difficult for him to walk independently with his family on
their daily after dinner walks. His parents felt that one measure of relaxed muscles
that would have great meaning for their family was if Jermaine could begin the family
walk on his own, like his twin brother. If after, 20 minutes, he grew tired, he could
then sit on his father’s shoulders, or in a stroller.
3. Measurable criteria identify HOW OFTEN an action/interaction will occur
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Insert resource box here: Click her for examples of measurable criteria (link to
Measurable criteria at end of this session) with guidelines for avoiding wording that is
unspecified or too broad.
Criteria for functional outcomes should always help parents, other caregivers and early
intervention providers easily see or hear that an outcome has been achieved. Tracking
progress is difficult when criteria are broad, e.g., Jermaine will keep his hands open 75% of
the time. Criteria stated in terms of “percentage of time” a child will demonstrate an
action/interaction is open to misinterpretation because it is not context-based. Will
Jermaine keep his hands open 75% of the time he is awake, at rest, during play or while
walking with his family?
Measurable criteria should be specific and simple so that family members always know what
to look for. Specific criteria to accompany Jermaine’s outcome to walk on his own with his
family could be written as:
Jermaine will keep his hands open for 20 minutes when walking with his parents
in and outside their home, 3 times per week.
j. Effective strategies identify how functional outcomes will be
achieved
Insert tip box below: Keep informed about evidence-based practices in early intervention
when selecting both initial and continuing strategies for achieving family-selected
outcomes. (link to Appendix B in this section )
Strategies indicate how specific child and family outcomes desired by families can be achieved.
The guidelines below can assist family members and early intervention providers in choosing
effective strategies when an IFSP is initially developed, and later, as ongoing progress is
reviewed with a family. Each strategy recorded on an IFSP should address one or more of
the following guidelines:
1. Individualization, based on family/child interests;
2. Context, building on familiar people, places and routines;
3. Mastery, of actions/interactions across settings; and
4. Collaboration, between families, early intervention and community providers.
1. Effective strategies are individualized for each family.
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Insert reflection box below: Do IFSP strategies build on child and family interests?
Children are active participants in their own development, based on their drive to explore
and master their environment. Interest-based learning has positive benefits and is an
important factor contributing to a child’s learning and development (Dunst, Hamby, Trivette,
Raab & Bruder, 2000; Bruder, Trivette, Raab & McLean, 2001; Nelson, 1999). Strategies
should build on family/child interests and activities such as:
routines/special events (e.g., taking a bath, going to a family celebration)
objects/toys/pets (e.g. feeding a family pet,
interactions (e.g., visiting grandma, playing with brother, answering the phone)
hobbies/fun/leisure (e.g., playing/listening to music, squirting hose at one another)
environment (e.g. taking a walk, playing in back yard, planting flowers)
Examples of strategies that build on family/child interests:
Outcome and Criteria Strategies that are individualized for a family
Sylvia will take Paolo to Sylvia will review the mobility training she received at
the park and shopping, the MD School for the Blind
by herself.
I/T provider (or linkage service) will accompany Sylvia
Criteria: and Paola to community activities such as the library
Sylvia will take one trip
with Paola to either the Sylvia will identify available transportation and ask
library, mall or other family and other community supports to accompany
community activity by her on a trial run
herself within the next 4
months
Neena will eat and drink Family and I/T staff will consult with GI doctor about
by mouth during family realistic timetable and plan for Neena to drink and eat
outings.
I/T providers will share information about oral-motor
Criteria: development with parents and suggest enjoyable
Neena will drink a hand/mouth games to play with Neena
minimum of 4 oz of
fluids from a cup and Family and I/T staff work together to introduce Neena
eat 3 spoonfuls of food to new foods and liquids and track her likes and
during family outings, dislikes
2x/week
I/T staff will accompany family on outings to adapt
eating suggestions
24 Early Childhood Tutorial- Developing and Implementing IFSPs
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I/T staff will link family to other families who have a
child with a feeding tube to see how they cope and
get around in the community
2. Effective strategies build on familiar contexts.
Insert reflection box here: Do IFSP strategies build on familiar places, people and
routines?
Strategies build on familiar situations and people for each family. An effective strategy
should become part of a child’s and family’s every day life. Strategies that are used only
during provider-directed sessions isolate a child and miss the numerous opportunities for
meaningful interactions with caregivers in environments that are most likely to promote
mastery (Dunst, Trivette, Humphries, Raab & Roper, 2001). (link to section a this session)
Examples of strategies that focus on a familiar context:
While reading to Sabrina after her bath, emphasize beginning and ending
sounds of words (versus producing specific sounds “on command” from an early
intervention provider).
I/T staff will show Tallie and her parents how to walk on different surfaces in
and out of her home using her walker (versus practicing walking in a therapy
session once per week).
3. Effective strategies emphasize mastery of actions/interactions across settings.
Insert reflection box here: Do IFSP strategies ensure generalization of a child’s
actions/interactions across settings and tasks?
Much evidence has accumulated about how very young children learn. (link to section a in
this session). Children are active participants in their own development, due to their drive to
explore and master their environment. Even infants are aware of the effects of their own
behaviors, and prefer consequences that they can control directly versus those that are
uncontrollable. Expanding motor and communication behaviors depends on repetition and
practice in meaningful situations with generalization across different settings.
Examples of strategies that encourage mastery of actions/interactions:
Mom will show grandparents how to relax Hang before her bottle (for a premature
infant who is cared for by her grandmother while her mother works).
25 Early Childhood Tutorial- Developing and Implementing IFSPs
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I/T staff and Dad will look at backpacks with enough support for Dad to take Jamie
on family hikes (for a toddler who enjoys the outdoors and is just learning to sit up).
I/T staff will help parents adapt their bedtime/nap routine so Luci can sleep in
places other than her crib (so family can go visiting with Luci who is easily
overstimulated in new situations)
LITP will help Veronique (childcare provider) find toys/activities that encourage Kata
to play quietly beside other children (for a child who is both social and very
distractible).
4. Effective strategies promote collaboration among families and providers
Insert reflection box here: Do IFSP strategies specify “who will do what”? Click here for
examples of effective strategies. (link to Examples of Effective Strategies, end of this
session)
Shared implementation of strategies by family members, child care and early intervention
providers reinforces the evidence-based practice of supporting key adults to promote child
learning and development in family and community settings. (link to section A this session)
Discussing “who will do what” provides another opportunity to talk with families about the
early intervention model of supports and services in natural environments.
Examples of strategies that specify “who will do what”:
I/T staff will model rate of speech for family members when talking to Kyle.
Mother will call Dr. – to ask about lactose intolerant formula
I/T staff and mother will explore community networks for child care close to mother’s
job
Family and child care provider will hold Nooni so she can see what is going on and
who is talking.
k. Identifying early intervention supports and services
Insert resource box here: Click here for examples of early intervention supports/services
for achieving child and family outcomes. (link to “examples of formal and informal
supports/services”, at end of this session)
26 Early Childhood Tutorial- Developing and Implementing IFSPs
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The IFSP is intended to briefly outline which early intervention services will be provided, how a
service coordinator can initiate those services, and what actions will be taken by parents. (link
to mod 2 session 1a (note 4 in sec. 303.344 content of IFSP) After family/child outcomes,
criteria and strategies are identified, the IFSP team can then consider:
1. Who will provide family/child supports and services;
2. When, and for how long, family/child supports and services will be provided; and
3. Where family/child supports and services will be provided.
1. WHO will provide family/child supports and services?
Insert resource box below: Implementing an IFSP with a family focuses on the issues to
consider when providing formal and informal supports/services (link to essential content
mod 2 session 3)
There are a variety of professional services and community resources that can assist families
and children in reaching their desired IFSP outcomes (Trivette, Dunst & Deal, 1997):
Formal supports/services include early intervention services in a local Infants and
Toddlers Program funded by the IDEA, as well as from other departments, organizations
or programs serving children and families such as parent education classes in a public
school or social service agency, health and specialized medical services, or housing
options for homeless families.
Informal supports/resources include child care centers, toddler programs in libraries,
community service clubs, recreation and sports programs, education programs in parks,
nature centers and museums.
If formal supports/services from a local Infants and Toddlers Program are identified by an IFSP
team, the IDEA requires that the specific early intervention services necessary to meet the
unique needs of the child and family be identified on their IFSP. (link to mod 2 session 1c)
The next consideration is for the IFSP team to decide:
Who has the expertise to support a family to reach their desired child/family
outcomes?
“Expertise” refers to the knowledge and experience that any team member, including
family members, can contribute. The IFSP team discusses which early intervention
provider(s) has the specific knowledge and experience to complement the knowledge
and experience of family members so that desired child/family outcomes can be
achieved.
27 Early Childhood Tutorial- Developing and Implementing IFSPs
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It is critical to review all the outcomes and strategies identified by an IFSP team before talking
about if, and how, formal early intervention supports/services are needed. The goal is not to
assign a different discipline to each outcome, but to consider:
What skills/experience are needed to implement the strategies and supports to
reach each outcome; and
Which family members, early intervention provider(s) and/or community
resources will be most effective implementing these supports and strategies to
promote a child’s participation in family and community life?
2. WHEN, and HOW LONG, family/child supports and services will be provided.
Insert tip box below: The IDEA requires that the frequency, intensity and method of delivery
for specific early intervention services be identified on an IFSP, with projected dates for
initiation of services and their anticipated duration. (link to mod 2 session 1c)
In selecting the frequency, intensity and method of delivery of early intervention
supports/services, the primary consideration for an IFSP team is:
How much support/service is needed to assist family members in reaching their
desired outcomes?
To answer this question, the IFSP team should think about:
Prioritizing family/child outcomes, especially if a family feels that focusing on
one or two outcomes more intensively for an agreed upon period of time would
help them manage competing family, personal and work responsibilities. For
example, some families may prefer to prioritize outcomes to focus on a child’s
feeding, sleep or behavior issues since they often affect the daily rhythms of the
entire family.
the team approach they use for providing early intervention
supports/services. Three approaches to teaming- coaching, transdisciplinary
and collaborative consultation- emphasize collaboration among team members
to achieve a family’s IFSP outcomes. For example, one primary service provider
can often support a family in implementing IFSP strategies with ongoing
coaching/consultation from colleagues. Back-up support should come from the
colleague(s) who have specialized knowledge, skills and experiences that will
assist the primary provider and family in reaching desired outcomes. (link to
mod 2 session 3 pg.10 team models)
28 Early Childhood Tutorial- Developing and Implementing IFSPs
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3. WHERE family/child supports and services will be provided
Insert tip box below: The IDEA requires that the natural environments in which early
intervention supports/services will be provided must be identified on an IFSP (link to
mod 2 session 1k)
In deciding where early intervention supports/services will be provided, the primary
consideration is:
What functional outcomes have been selected by a family, and in what context
will they be demonstrated?
Functional outcomes identify the desirable knowledge, skills and/or behavior that a child
or family members will acquire to participate successfully in daily life. (link to section g
functional outcomes in this module) The “context” specifies where the knowledge, skills
or behavior will occur e.g., in selected routines, activity settings, spaces and places that
a child and family spend their time, and/or would like to participate in.
These contexts, identified by families, are the natural environments where early
intervention supports and services enable a child to use and master emerging skills.
Obvious natural environments are a child’s home and/or child care setting; others
include the neighborhood/community spaces and places where families with very young
children spend their time participating in activities and interactions with friends,
neighbors and other families. (mod 2 session 3a natural environments and activity
settings)
Insert tip box below: If an IFSP team decides that early intervention services can only be
provided outside a child’s natural environments, very careful consideration should be
given to how and when mastery of the child’s emerging skills in familiar situations will be
prompted.
The IDEA also requires that an IFSP include justification of the extent, if any, to which early
intervention supports/services will not be provided in a natural environment. (link to mod 2
session 1c) The intent of the natural environment mandate is to focus the efforts of early
intervention providers on ensuring that young children master and use specific skills and
interactions so that they and their family can participate in meaningful situations and activity
settings that typically developing children/families engage in. Locations which are not
considered natural environments for very young children include hospitals, clinics, private
offices and settings/activities in which only children with disabilities attend.
29 Early Childhood Tutorial- Developing and Implementing IFSPs
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Application 2.1 Reviewing program practices:
IFSP outcomes, strategies, criteria and supports/services
Review how you and your colleagues developed IFSPs with two families recently. Use the Self-
Assessment Inventory: Developing IFSPs with Families in this session to guide your
reflection/discussion. (Link to inventory at end of this session) If you are not involved in IFSP
discussions with a family, consider interviewing family members or early intervention providers
who have participated in them.
After completing the Self-Assessment Inventory, reflect (preferably with colleagues and
families) on the following:
1. How do I/we identify IFSP outcomes, criteria, strategies and family/child
supports/services with families?
2. How do I/we use information from our initial planning conversation with families (link to
Mod 1 session 2a) and data from a child’s evaluation and assessment (collected using
multiple methods link to Mod 1 session 3d key components/methods) ) to select
outcomes, criteria, strategies and supports/services?
3. Do I/we describe and implement our process for developing IFSPs with families
consistently throughout all regions of our Infants and Toddlers Program?
4. How do I/we help families engage in developing IFSPs that are meaningful for their
family? How do I/we support families in making decisions related to where and how
they want a child to participate in family and community life, and how to accomplish this?
5. Do key community partners and referral sources understand how I/we develop IFSPs
with families?
6. Do I/we need continuing education about developing IFSPs with families? If so, what
topics would be helpful to focus on?
30 Early Childhood Tutorial- Developing and Implementing IFSPs
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Application 2.2
Sandi: Developing functional outcomes, measurable criteria and
family-specific strategies
Insert reflection box below: Compare your ideas for functional outcomes, measurable
criteria and family-specific strategies with suggestions for Sandi and her family. (link to
examples of … for Sandi and her family on next page)
Discuss this vignette with colleagues and family advocates. Review the examples of traditional
IFSP outcomes, criteria and strategies for Sandi and her family. Consider how your team could
collaborate with Sandi’s family to identify:
functional outcomes; (link to section g this session)
measurable criteria; (link to section i this session)
family-specific strategies; (link to section j this session)
Information about Sandi and her family: Sandi is 19 months old and is just starting to
cruise around holding on to furniture and loves going outside in her stroller for walks. She
is not very interested in playing with small toys or feeding herself but she does like to eat
when someone feeds her. Sandi goes to family child care each day while her parents work.
Her parents would like her to feed herself.
Example Outcomes Criteria Strategies
Traditional Sandi will improve Sandi will eat Teacher will work with
IFSP her fine motor skills independently at child/family to suggest
least 80% of the activities for carryover in
time the home
Suggestions
for functional
outcome,
measurable
criteria and
family-specific
strategies
31 Early Childhood Tutorial- Developing and Implementing IFSPs
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Examples of functional outcomes, measurable criteria and family-specific
strategies for Sandi and her family
Information about Sandi and her family: Sandi is 19 months old and is just starting to
cruise around holding on to furniture and loves going outside in her stroller for walks. She
is not very interested in playing with small toys or feeding herself but she does like to eat
when someone feeds her. Sandi goes to family child care each day while her parents work .
Her parents would like her to feed herself.
IFSP Outcomes Criteria Strategies
Examples
Traditional Sandi will improve Sandi will eat Teacher will work with
IFSP her fine motor independently at child/family to suggest
skills least 80% of the activities for carryover
time in the home
Collaborative Sandi will feed Sandi will feed Mom and EI Provider
IFSP herself, using her herself at least 6 will review Sandi’s
hands to finger mouthfuls at each favorite foods,
feed and hold a meal various baby utensils
spoon and how to make
eating enjoyable for
Sandi
Mom and EI Provider
will explore with child
care provider how to
help Sandi feed
herself
Insert resource box here: Examples of formal and informal supports and services to
guide families in achieving their outcomes are discussed in Implementing an IFSP with a
family (link to essential content of session 3)
32 Early Childhood Tutorial- Developing and Implementing IFSPs
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Application 2.3
Jacob: Developing functional outcomes, measurable criteria and
family-specific strategies
Insert reflection box below: Compare your ideas for functional outcomes, measurable
criteria and family-specific strategies with suggestions for Jacob and his family. (link to
examples of … for Jacob and his family on next page)
Discuss this vignette with colleagues and family advocates. Review the examples of traditional
IFSP outcomes, criteria and strategies for Jacob and his family. Consider how your team could
collaborate with Jacob’s family to identify:
functional outcomes; (link to section g this session)
measurable criteria; (link to section i this session)
family-specific strategies; (link to section j this session)
Information about Jacob and his family: Jacob is 22 months old and spends his day at
home with his mother and 4 year old sister. He likes to play with toy trains and anything
that his older sister is doing (much to her annoyance). Jacob wears a hearing aide and
has global delays due to his prematurity. His family really would like him to say what he
wants rather than grunting and pointing.
IFSP Examples Outcomes Criteria Strategies
Traditional Jacob will talk Therapist checklist Language stimulation
using simple activities
words
Suggestions for
functional
outcome,
measurable
criteria and
family-specific
strategies
33 Early Childhood Tutorial- Developing and Implementing IFSPs
Session 2 - Developing an IFSP with a family
Examples of functional outcomes, measurable criteria and family-specific
strategies for Jacob and his family
Information about Jacob and his family: Jacob is 22 months old and spends his
day at home with his mother and 4 year old sister. He likes to play with toy trains and
anything that his older sister is doing (much to her annoyance). Jacob wears a hearing
aide and has global delays due to his prematurity. His family really would like him to say
what he wants rather than grunting and pointing.
IFSP Outcomes Criteria Strategies
Examples
Traditional Jacob will use Therapist Language stimulation
fluent speech checklist activities
Collaborative Jacob will Jacob will make Family will serve and play
IFSP speak clearly to choices using at with Jacob’s favorite
tell parents least 8 words foods and toys
what he wants clearly during
during meals meals, snacks EI provider will model how
and while and play each to say words slowly and
playing day clearly when talking to
Jacob
Mom and EI provider will
identify a list of simple
words for Jacob to say
during meals/snack/play
Mom and EI provider will
explore play activities with
Jacob and his sister using
food (cooking, loading
food on toy trains etc)
Insert resource box here: Examples of formal and informal supports and services to
guide families in achieving their outcomes are discussed in Implementing an IFSP with a
family (link to essential content of session 3)
34 Early Childhood Tutorial- Developing and Implementing IFSPs
Session 2 - Developing an IFSP with a family
Application 2.4
Manny: Developing functional outcomes, measurable criteria and
family-specific strategies
Insert reflection box below: Compare your ideas for functional outcomes, measurable
criteria and family-specific strategies with suggestions for Manny and his family. (link to
examples of … for Manny and his family on next page)
Discuss this vignette with colleagues and family advocates. Review the examples of traditional
IFSP outcomes, criteria and strategies for Jacob and his family. Consider how your team could
collaborate with Manny’s family to identify:
functional outcomes; (link to section g this session)
measurable criteria; (link to section i this session)
family-specific strategies; (link to section j this session)
Information about Manny and his family: Manny is 12 months old and wants to be
carried everywhere, even though he can stand up by holding on to someone or the
furniture. Manny’s family lives by the Chesapeake Bay and his dad owns his own shrimp
boat. Manny has two older sisters who are devoted to helping to take care of him. His
family looks forward to the time he can stand up and walk by himself.
IFSP Outcomes Criteria Strategies
Examples
Traditional Parent would like Manny will pull to PT once per week
Manny to do more stand using a ½
pull to stand with kneel position, 2x
weight bearing and daily
cruise on furniture
Suggestions
for functional
outcome,
measurable
criteria and
family-specific
strategies
35 Early Childhood Tutorial- Developing and Implementing IFSPs
Session 2 - Developing an IFSP with a family
Examples of functional outcomes, measurable criteria and family-specific
strategies for Manny and his family
Information about Manny and his family: Manny is 12 months old and wants to be
carried everywhere, even though he can stand up by hanging on to someone or the
furniture. Manny’s family lives by the Chesapeake Bay and his dad owns his own shrimp
boat. Manny has two older sisters who are devoted to helping to take care of him. His
family looks forward to the time he can stand up and walk by himself.
IFSP Outcomes Criteria Strategies
Examples
Traditional Parent would Manny will pull to PT once per week
like Manny to do stand using a ½
more pull to kneel position, 2x
stand with daily
weight bearing
and cruise on
furniture
Collaborative Manny will play Manny will use Family will put favorite toys
IFSP with his environmental on sofa/chairs/shelf for
favorite toys supports as Manny to reach for and
while standing needed to stand
and moving and move Manny will dance & sway to
around his around to play music holding his sisters’
home and at home & one hands
community community
setting within EI Provider will model
(give date physical prompts & supports
within 4-6 to encourage Manny to
months) move and explore his
surroundings
Mom and EI provider will
visit community settings
(e.g., park, beach, fishing
pier, family boat) with Manny
to identify ways to motivate
him to stand up safely and
move around
Insert resource box here: Examples of formal and informal supports and services to
guide families in achieving their outcomes are discussed in Implementing an IFSP with a
family (link to essential content of session 3)
36 Early Childhood Tutorial- Developing and Implementing IFSPs
Session 2 - Developing an IFSP with a family
Application 2.5
Lurindell: Developing functional outcomes, measurable criteria and
family-specific strategies
Insert reflection box below: Compare your ideas for functional outcomes, measurable
criteria and family-specific strategies with suggestions for Lurindell and his family. (link
to examples of … for Lurindell and her family on next page)
Discuss this vignette with colleagues and family advocates. Review the examples of traditional
IFSP outcomes, criteria and strategies for Lurindell and her family. Consider how your team
could collaborate with Lurindell’s family to identify:
functional outcomes; (link to section g this session)
measurable criteria; (link to section i this session)
family-specific strategies; (link to section j this session
Information about Lurindell and her family: Lurindell is 2 /12 years old and has been
attending a child care center sponsored by her parent’s employer. Lurindell enjoys the activities
at the child care center, especially the outside play area and the water table. Her parents have
been informed that unless Lurindell can interact with other children appropriately, they will have
to make other child care arrangements. She has a seizure disorder which is fairly well controlled
by her medication. When tired or frustrated, Lurindell resorts to kicking, hitting and biting to get
what she wants.
IFSP Examples Outcomes Criteria Strategies
Traditional Lurindell will stop Parent/therapist Behavior
kicking and biting observation management program
Suggestions for
functional
outcome,
measurable
criteria and
family-specific
strategies
37 Early Childhood Tutorial- Developing and Implementing IFSPs
Session 2 - Developing an IFSP with a family
Examples of functional outcomes, measurable criteria and family-specific
strategies for Lurindell and her family
Information about Lurindell and her family: Lurindell is 2 /12 years old and has been
attending a child care center sponsored by her parent’s employer. Lurindell enjoys the activities
at the child care center, especially the outside play area and the water table. Her parents have
been informed that unless Lurindell can interact with other children appropriately, they will have
to make other child care arrangements. She has a seizure disorder which is fairly well controlled
by her medication. When tired or frustrated, Lurindell resorts to kicking, hitting and biting to get
what she wants.
IFSP Outcomes Criteria Strategies
Examples
Traditional Lurindell will Parent/therapist Behavior management program
stop kicking and observation
biting
Collaborative Lurindell will Lurindell will Parents will talk to pediatrician
IFSP play with other participate in about reviewing Lurindell’s
children at her her child care current medication
child care program for 2
center without hours/day, 3 EI provider and Mom will
hitting, biting days a week explore what Lurindell
or pushing understands and responds to
EI Provider, child care teacher
and Mom will identify and
address the “triggers” for
Lurindell’s undesirable
behavior at home and child care
EI provider will demonstrate
strategies to refocus Lurindell’s
behavior in a positive way when
tired or upset
38 Early Childhood Tutorial- Developing and Implementing IFSPs
Session 2 - Developing an IFSP with a family
Application 2.6
Addressing concerns families may have about developing IFSPs
Insert tip box below: Family members, early intervention providers and administrators
should work together to draft responses that are family-friendly and reflect the policies of
local Infants and Toddlers Programs.
Reflect on the following concerns (often unspoken) families may have and consider responses
that families would find helpful. Review any information sheets or “Frequently Asked
Questions” for families that may be available in your Infants and Toddlers program. Use this
opportunity to ask family members, advocates, and family support coordinators about other
concerns families may have, and draft responses to these questions also.
About a child’s development….
Will my child ever be able to …..?
Why isn’t my child developing like other children?
I don’t know what my child can do.
I’m not sure about my child’s diagnosis, so why do all this now?
About participating in early intervention…
Will this help me/my family cope, learn what to do about……?
What if all this doesn’t help my child to ….?
I don’t know if I accept the results of my child’s evaluation/assessment.
What assurance is there that this approach will make a difference?
About schedules, services and supports…
I want more/less time/services for my child.
There are too many /not enough people coming to my home.
I/my partner work and aren’t home during the day.
39 Early Childhood Tutorial- Developing and Implementing IFSPs
Session 2 - Developing an IFSP with a family
Application 2. 7
Evidence-based practices: EI in Natural environments
Review the discussion about providing early intervention supports and services in natural
environments and consider: (link to section a –“Why provide family/child support.. this section)
How do I/we apply evidence-based practices to guide my/our
IFSP discussions with families?
Evidence-based Prompt Example from my
practice practice
1. A child’s relationships Who are a child’s primary
with primary caregivers, and how do they spend
caregivers organize their time together?
all his or her early
development. How do I/we support caregivers to
make IFSP decisions, in ways
meaningful to each family?
2. Children are active How do I/we solicit and build on
participants in their child and family interests for
own development, selecting strategies?
based on their drive
to explore and master How do I/we ensure that children use
their environment. emerging skills across settings?
3. New motor and How do I vary settings, strategies,
communication people and places, so a child really
behaviors are learned “owns” his or her actions and
with repeated interactions, and uses them to
opportunities for participate in family/community
practice in life?
meaningful situations
across different
settings.
4. Knowledge/resources How do I support caregivers to
are shared with a feel competent, rather than direct
child’s key caregivers children in “hands-on” sessions by
through supportive myself?
adult-adult
relationships
40 Early Childhood Tutorial- Developing and Implementing IFSPs
Session 2 - Developing an IFSP with a family
Recommended Reading: Developing IFSPs with Families
Law, M. (2000). Strategies for implementing evidence-based practice in early intervention.
Infants and Young Children, 12(2), 32-40.
This article focuses on specific strategies that can be used to support an evidence-
based early intervention practice. Methods are described to gather information from the
literature, review research studies critically, and summarize research information for
practice.
McWilliam, R. Routines-based interview. Center for Child Development at Vanderbilt Children's
Hospital, Vanderbilt University, Nashville, TN.
A routine-based interview is a semi-structured interview by one or more professionals
with a child’s primary caregivers, including parents and teachers as appropriate. The
interview focuses on everyday activities and events from a family’s perspective. The
interview elicits a family’s priorities regarding the child’s and family’s well-being,
establishes a positive relationship, and helps identify functional IFSP outcomes. A
Routines-Based Interview Form and 45 minute video are available from the Center for
Child Development. http://www.vanderbiltchildrens.com/interior.php?mid=2261)
National Research Council and Institute of Medicine (2000). From neurons to neighborhoods: The
science of early childhood development. Committee on Integrating the Science of Early
Childhood Development. Jack P. Shonkoff and Deborah Phillips, eds. Board on Children, Youth,
and Families, Commission on Behavioral and Social Sciences and Education. D.C.: National
Academy Press. (see www.nap.edu/execsumm/0309069882.html for an executive summary)
(link to this website)
This extraordinary report regarding research and evidence-based practices supporting
early learning and development was produced by a committee of 17 researchers and
clinicians with backgrounds in neuroscience, psychology, child development, economics,
education, pediatrics, psychiatry and public policy. Their charge was to review all research
about the nature of early development and the influence of early experiences on children’s
health and well-being, to separate established knowledge from erroneous popular beliefs,
and to examine the implications of the science base for policy, practice, professional
development, and research.
Rosenkoetter, S. & Squires, S. (2000). Writing outcomes that make a difference for children
and families. Young Exceptional Children, 4(1), 2-8.
This early intervention provider/parent team offers guidelines for developing the “heart of
the IFSP”; the outcome statements which map the path the team members will take
together. The authors pose six questions for evaluating outcomes:
41 Early Childhood Tutorial- Developing and Implementing IFSPs
Session 2 - Developing an IFSP with a family
1. Do we know why we’re writing this?
2. Does this outcome mesh with activities that the family chooses to do?
3. Have we explored informal, natural and community-based supports to
determine whether they might accomplish developmental aims, rather than
automatically listing more restrictive options?
4. Who will pay or provide?
5. Is the outcome written in language the family might use, rather than professional
jargon?
6. Does this outcome really matter to this child and family?
Especially for families:
Nebraska Department of Education, Early Development Network.
www.answers4families.org/ifspweb/outcomes.html .
Nebraska’s online discussion of the IFSP provides a clear summary of information for
families about developing an IFSP for their children as well as other topics of interest to
families.
Squires, S. (2000). Our family’s experience: An important outcome achieved. Young
Exceptional Children, 4(1), 9-11.
This article was written by a parent of four children (one of whom has cerebral palsy).
Squires illustrates how the IFSP process was used to develop outcomes and strategies
to educate the nursery caregivers in the family’s church to integrate her twin girls in the
nursery group during church services. One of the girls enjoyed a new social
opportunity, her twin was freed from translating her sister’s needs, and the rest of the
family participated in church services knowing that both girls were safe and happy.
42 Early Childhood Tutorial- Developing and Implementing IFSPs
Session 2 - Developing an IFSP with a family
Self-Assessment Inventory:
Developing IFSPs with families
Review your competency in developing functional outcomes, measurable criteria,
family-specific strategies, and informal/formal supports and services with families
by checking the appropriate column for each guideline...
Where are we going with families? I need more I have basic I do this
support skills very well
Functional outcomes are:
Meaningful: address a child’s participation in
particular family/community activities/routines
Specific: Identifies knowledge, skills or actions
to be demonstrated by child or family
Family-identified: identified by parents and
written in language understood by family
Do-able: Can reasonably be accomplished
within 4-6 months
How will a family know they are “there”? I need more I have basic I do this
support skills very well
Measurable criteria specify:
What: Actions/behavior of a child can be seen
or heard
Where: Specifies a context for observing
actions/behavior
How often: States realistic frequency for
demonstrating action/behavior
43 Early Childhood Tutorial- Developing and Implementing IFSPs
Session 2 - Developing an IFSP with a family
Self-Assessment Inventory: Developing IFSPs with families (con’t)
How can we help a family get “there”? I need more I have I do this
support basic very well
skills
Family-specific strategies address:
Individualization: Builds on interests and
learning style of child and family
Context: Focuses on familiar people, activity
settings and routines
Mastery: generalizes a child’s actions &
interactions across family/community settings
Collaboration: Identifies what EI providers,
family, community linkages will do
What services/resources will help a I need more I have I do this
family reach their outcomes? support basic very well
skills
EI supports/services include:
Formal supports/services: PART C (therapy,
counseling, service coordination, special
instruction, nursing etc) and related agencies
(social service, medical/health, mental health
etc)
Informal resources within family/community
networks (child care, libraries, religious events,
Kiwanis, nature centers, YMCA etc.)
44 Early Childhood Tutorial- Developing and Implementing IFSPs
Session 2 - Developing an IFSP with a family
Appendix A. About evidence-based practice
Early intervention providers must critically evaluate the effectiveness of the assessment
procedures and interventions they use in their daily practice with children and families.
Evidence-based practice is guided by research results and,
“in no way advocates throwing the clinical experience of established practitioners out the
window…Evidence-based practice’s central message here is one of flexibility and of
being able to blend the old ways with the fruits of research and new knowledge.” (Law,
2002, p.5).
References: Evidence-based practice across disciplines
Dunst, C., Trivette, C. & Curspec, P. (2002). An evidence-based approach to
documenting the characteristics and consequences of early intervention practices.
Centerscope, 1(2), 1-6. (www.researchtopractice.org)
Gambrill, E. (1999). Evidence-based practice: An alternative to authority based practice.
Families in society: the Journal of Contemporary Human Services, 80, 341-350.
Geddes, J., Reynolds, S., Streiner, D., & Szatmari, P. (1997). Evidence based practice
in mental health. British Medical Journal, 315, 1483-1484.
Greenhalgh, T.(1997). How to read a paper: The basics of evidence-based medicine.
London: BMJ Press.
Law, M. (2000). Strategies for implementing evidence-based practice in early
intervention. Infants and Young Children, 12(2), 32-40.
Law, M. (2002).(Ed). Evidence-based rehabilitation. Thorofare, NJ: Slack Inc.
Melnyk, b., Fineout-Overholt, E., Stone, P., & Ackerman, P. (200). Evidence based
practice: The past, the present, and recommendations for the millennium. Pediatric
Nursing, 26, 77-80.
Occupational therapy: www.fhs.mcmaster.ca/rehab
Physical therapy: http://ptwww.cchs.usyd.edu.au/pedro
Reilly, S., Perry, A., Douglas, J., & Oates, J. (2001). Evidence based practice in speech
pathology. London: Whurr.
Sackett, D., Rosenberg, W., Gray, J., Haynes, R., & Richardson, W. (1996). Evidence-
based medicine: What it is & is not. British Medical Journal, 312, 71-2.
45 Early Childhood Tutorial- Developing and Implementing IFSPs
Session 2 - Developing an IFSP with a family
Appendix B Evidence-based practices supporting early intervention
in natural environments
Evidence from interdisciplinary sources (early childhood, neuroscience, occupational and
physical therapy, speech-language pathology, social sciences, medicine and nursing) provides
critical support for early intervention in natural environments, as follows:
A child’s relationships with primary caregivers organize all his or her early
development.
Atkins-Burnett, S. & Allen-Meares, P. (2000). Infants and toddlers with disabilities:
Relationship-based approaches. Social Work, 45(4), 371-377.
Commission on Children at Risk. (2003). Hardwired to connect: The new scientific case
for authoritative communities. New York, NY: Institute for American Values.
Gunnar, M, Brodersen, L., Krueger, K., & Rigatuso, R. (1996). Dampening of behavioral
and adrenocortical reactivity during early infancy: Normative changes and individual
differences. Child Development, 67: 877:889.
Meisels, S. Dichtelmiller, M. & Liaw, F. (1993). A multidimensional analysis of early
childhood intervention programs. In Handbook of Infant Mental Health. New York, NY:
Guildford Press.
Schore, A. (2003). Quoted in Hardwired to Connect: The new scientific case for
authoritative communities (p. 16). New York, NY: Institute for American Values.
Shore, R. (1997). Rethinking the brain. NY: Families and Work Institute.
Thompson, R. (1999). Early attachment & later development. In Cassidy & Shaver (Eds),
Handbook of Attachment: Theory, Research & Clinical Applications (pp. 265-286). NY:
Guilford Press.
Weston, D. Ivins, B. Heffron, M. & Sweet, N. (1997). Formulating the centrality of
relationships in early intervention: An organizational perspective. Infants and Young
Children, (9)3, 1-12.
Children are active participants in their own development, based on their drive
to explore and master their environment.
Chandler, B. (Ed.) (1997). The essence of play: A child's occupation. Bethesda, MD:
The American Occupational therapy Association, Inc.
Dalgeish, T. & Power, M. (1999) (Eds.) Handbook of cognition and emotion. New York:
NY: John Wiley and Sons.
46 Early Childhood Tutorial- Developing and Implementing IFSPs
Session 2 - Developing an IFSP with a family
Dunst, C. J., Bruder, M. B., Trivette, C. M., Raab, M., & McLean, M. (2001). Natural
learning opportunities for infants, toddlers, and preschoolers. Young Exceptional
Children, 4(3), 18-25.
Hamilton, V., Bower, G., & Fridja, N. (!988). (Eds.) Cognitive perspective on motivation
and emotion. NATO Asi Series, Series D, Behavioral and Social Sciences Vol. 44. New
York,, NY: Kluwer Academic Publications.
Mandler, J. (2000). Perceptual and cognitive processes in infancy. Journal of Cognition
and Development, 1, 3-36.
National Research Council and Institute of Medicine (2000). From neurons to
neighborhoods: The science of early childhood development. Committee on Integrating
the Science of Early Childhood Development. Jack P. Shonkoff and Deborah Phillips, eds.
Board on Children, Youth, and Families, Commission on Behavioral and Social Sciences
and Education. D.C.: National Academy Press. (see
www.nap.edu/execsumm/0309069882.html for an executive summary)
Parritz, R., Mangelsdork, S., & Gunnar, M. (1992). Control, social referencing and the
infant’s appraisal of threat. In S. Feinman (Ed). Social referencing and the social
construction of reality in infants (pp. 209-228).
New motor and communication behaviors are learned and used when a child
has repeated opportunities for practice in meaningful situations with
generalization of skills across different settings.
Dunn, W., Brown, C., McGuigan, A. (1994). The ecology of human performance: A
framework for considering the effect of context. American Journal of Occupational
Therapy, 48, 595-607.
Eiserman, W., McCoun, M. & Escobar, C. (1990). A cost-effective analysis of two
alternative program models for serving speech-disordered preschoolers. Journal of
Early Intervention, 14(4), 297-317.
Greenough, W. (1987). Experience and brain development. Child Development, 58, 539-
59.
Heriza, C,. & Sweeney, J. (1994). Pediatric physical therapy: Part I. Practice scope,
scientific basis and theoretical foundation. Infants and Young Children, 7(2), 20-32.
Lewthwaite, R. (1990). Motivational considerations in physical activity involvement.
Physical Therapy, 70, 808-819.
MacLean, P. (1990). The triune brain in education. New York, NY: Plenum Press.
McEwen, I. & Shelden, M. (1995). Pediatric therapy in the 1990s: The demise of the
educational vs. medical dichotomy. Physical & Occupational Therapy in Pediatrics, 15(2),
47 Early Childhood Tutorial- Developing and Implementing IFSPs
Session 2 - Developing an IFSP with a family
33-45.
McLean, L. & Woods Cripe, J. (1997). The effectiveness of early intervention for children
with communication disorders. In M. Guralnick (Ed), The effectiveness of early
intervention (pp 349-428). Baltimore: Paul H. Brookes.
Schmidt, R. & Lee, T. (1999). Motor control and learning: A behavioral emphasis (3rd
edition). Champaign, IL: Human Kinetics.
The knowledge and resources of early childhood specialists are shared with a
child’s key caregivers through adult-adult relationships that support family
members in their day-day responsibilities caring for their children.
Bricker, D, Pretti-Frontczak, K, & McComas, N.(1998). An activity-based approach to
early intervention (2nd edition). Baltimore: Brookes Publishing Co.
Dunst, C. J. (2001). Participation of young children with disabilities in community
learning activities. In M. Guralnick (Ed.), Early childhood inclusion: Focus on change
(pp. 307-333). Baltimore: Brookes
Dunst, C. J., Hamby, D., Trivette, C. M., Raab, M., & Bruder, M. B. (2000). Everyday
family and community life and children’s naturally occurring learning opportunities.
Journal of Early Intervention, 23, 151-164.
Hanft, B., Rush, D., & Shelden, M (2004). Coaching families and colleagues in early
childhood. Baltimore, MD: Brookes Publishing.
Mahoney et al (1999). Parent education in early intervention. Topics in Early Childhood
Special Education, 19(3), 131-140.
Marvel, M. Epstein, R., Flowers, K., Beckman H. (1999). Soliciting the patient’s agenda:
Have we improved? JAMA, 281, 283-287.
National Research Council and Institute of Medicine (2000). From neurons to
neighborhoods: The science of early childhood development. Committee on Integrating
the Science of Early Childhood Development. Jack P. Shonkoff and Deborah Phillips, eds.
Board on Children, Youth, and Families, Commission on Behavioral and Social Sciences
and Education. D.C.: National Academy Press. (see
www.nap.edu/execsumm/0309069882.html for an executive summary)
Odom, S. Favazza, Brown & Horn, E. (2000). Approaches in understanding the ecology
of early childhood environments for children with disabilities. In Behavioral observation:
Technology and application in developmental disabilities (pp. 193-214). Baltimore:
Brookes.
48 Early Childhood Tutorial- Developing and Implementing IFSPs
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References for essential content
Boone, H., McBride, S., Swann, D, Moore, S. & Drew, B. (1998). IFSP practices in two states:
Implications for practice. Infants and Young Children, 10(4), 36-45.
Bruder, M. (2000). The Individual Family Service Plan. ERIC Early Childhood Digest # E605.
Arlington, VA: ERIC Clearinghouse on Disabilities and Gifted Education.
Dunst, C., Trivette, C., & Deal, A. (1997). Resource-based approach to early intervention. In S.
Thurman, J. Cornwell & S. Gottwald (eds), Contexts of early intervention: Systems and settings
(pp.73-92). Baltimore, MD: Paul H. Brookes.
Dunst, C. J., Hamby, D., Trivette, C. M., Raab, M., & Bruder, M. B. (2000). Everyday family and
community life and children’s naturally occurring learning opportunities. Journal of Early
Intervention, 23, 151-164.
Dunst, C., Trivette, C., Humphries, T., Raab, M. & Roper, N. (2001). Contrasting approaches to
natural learning environment interventions. Infants and Young Children, 14(2), 48-63.
Grisham-Brown, J. Hammeter, M.L. (1998). Writing IEP goals and objectives: Reflecting an
activity-based approach to instruction for children with disabilities. Young Exceptional Children,
1(3), 2-10.
Jung, L. & Baird, S. (2003). Effects of service coordinator variables on individualized family
service plans. Journal of Early Intervention, 25(3), 206-218.
McWilliam, R., Ferguson, A., Harbin, G., Porter, P.,Munn, D., & Vandiviere, P. (1998). The
family-centeredness of Individualized family service plans. Topics in Early Childhood Special
Education, 18(2), 69-82.
McWilliam, R. Routines-based therapy: Integration of ancillary services and instruction for early
childhood. Presentation at NECTAS Early Childhood Conference, Washington D.,C. October 23,
2002.
McWilliam, R. A. (2005). Assessing the resource needs of families in the context of early
intervention. In M. J. Guralnick (Ed.), A Developmental systems approach to early intervention:
National and international perspectives (pp.215-233). Baltimore, MD: Paul H. Brookes
Publishing Co.
National Research Council and Institute of Medicine (2000). From neurons to neighborhoods: The
science of early childhood development. Committee on Integrating the Science of Early Childhood
Development. Jack P. Shonkoff and Deborah Phillips, eds. Board on Children, Youth, and
Families, Commission on Behavioral and Social Sciences and Education. D.C.: National Academy
Press.
Nebraska Department of Education, Early Development Network. Downloaded from
www.answers4families.org/ifspweb/outcomes.html March, 15, 2004.
Pretti-Frontczak, K., & Bricker, D. (2000). Enhancing the quality of individualized education
plan (IEP) goals and objectives. Journal of Early Intervention, 23(2), 92-105.
49 Early Childhood Tutorial- Developing and Implementing IFSPs
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Pretti-Frontczak, K, (2003). Developing team-based meaningful IFSPs/IEPs. Presentation at
Great Beginnings, October 24-25, 2003, Marlboro, Massachusetts.
Rosenkoetter, S. & Squires, S. (2000). Writing outcomes that make a difference for children
and families. Young Exceptional Children, 4(1), 2-8.
50 Early Childhood Tutorial- Developing and Implementing IFSPs
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Mayra’s story: Identifying functional outcomes for Pedro
This vignette illustrates how Jana, a service coordinator, prompted a mother, Mayra, to think
about the daily activities she hoped her son, Pedro, could participate in more fully. Their
conversation takes place during Mayra’s initial IFSP meeting with an early intervention team
form a Local Infants and Toddlers Program.
Jana begins by summarizing, “When we first met, Mayra, you told me that you
wanted to help Pedro talk more and understand you better. When we visited you last
time for his evaluation, we talked about how much Pedro understands and listened to
what he said while you and his brothers played with him. Now it’s time to think more
specifically about what you want for Pedro and how we can help you do this.”
Mayra responds, “I want Pedro to understand what others say to him, just like his
brothers did.”
“That’s important, for sure,” agrees Jana. “Can you tell us some more about
when it’s really important for Pedro to understand what people are saying to him?”
“Well, he really likes going to a play group on Mondays and Wednesdays but has
a hard time doing what the teacher says,” explains Mayra. “She plays a song on the
tape recorder for snack and Pedro thinks it’s time to go outside. Then when they do go
out and she says it’s time to come back inside, he runs over to the sandbox. He’s
always doing things different from the other kids.”
Jana (wondering if there are other times this happens) asks, “Does this happen
at home, too?”
“Oh, yes!” Mayra replies emphatically. “ There are some things, like getting
dressed in the morning, or eating dinner, that we do the same way most of the time, so
Pedro knows what’s happening. But when we make a change, or go somewhere only
one or two times a week, like nursery school or my sister’s, then he has a hard time
keeping up.”
Understanding that Mayra really would like Pedro to fit in with the flow of activities at his play
group, at home and at his aunt’s house provides a context for a functional outcome that
early intervention providers and family can address together. Without this information, it
would be easy to misinterpret what Mayra means by “helping Pedro talk more and
understand better.”
Mayra has told us what she thinks about an outcome being:
Meaningful: Pedro will fit in with other children at his play group and with family
at home.
Family- desired: Mayra said that she wants her son to talk and understand
better to help him fit in with what others are doing.
Specific: Pedro will understand what to do/where to go when given a direction.
51 Early Childhood Tutorial- Developing and Implementing IFSPs
Session 2 - Developing an IFSP with a family
While discussing this outcome, the team decides that they can expect Pedro to take part in
more of the routines and activities that occur at home and nursery school. A functional
IFSP outcome, reflecting Mayra’s desires, can be identified that is “do-able” in 4-6 months:
Functional outcome: Pedro will understand and follow directions so that he can
play with friends and family at home and in his play group.
52 Early Childhood Tutorial- Developing and Implementing IFSPs
Session 2 - Developing an IFSP with a family
Examples of functional outcomes
Functional outcomes How to modify: Examples of functional
avoid: outcomes
Broad developmental
goals such as:
Specify a parent/child Brian will sit quietly and look at
Brian’s behavior will improve action, skill, or a book during bedtime stories
knowledge and how it
Katya will develop age will enhance a child’s Katya will watch her brother’s
appropriate gross motor participation in soccer games by standing up
skills family/community life and holding on to bleachers
and/or people
Separate goals for each
developmental domain:
Babacar will: Select outcomes that Babacar will:
roll over (motor domain) address family
selected routines & Play next to his sister by rolling
use sounds to express activities that promote across the room to reach her
himself (language domain) social interaction,
mastery of the Choose what he wants to
make choices when environment, and do/eat/wear by using specific
presented with two items engagement in sounds for “yes” and “no”
(cognitive domain) learning
play with brothers (social-
emotional domain)
Listing skills only:
Shawna will hold her head Show how Shawna will watch videos and
up 90° and maintain her action/interaction will play with her sister by holding
position for awhile help a child participate her head up
in family/community life
Dante will walk up and down Dante will go outside to play or
stairs get in the car by walking up
and down the stairs
Negative outcomes:
Lars will stop throwing toys Emphasize the positive Lars will help clean up after
and other items on the floor actions/skills a family play by picking up his
wants to replace the toys/objects
negative ones with
Lily will decrease her Lily will enjoy washing her
sensitivity to light touch hands, hair and face
53 Early Childhood Tutorial- Developing and Implementing IFSPs
Session 2 - Developing an IFSP with a family
Examples of measurable criteria
Measurable criteria avoid: How to modify: Examples of measurable
criteria
Unspecified
action/behavior
Jacob will use the same
Jacob will make sounds Actions/behavior of a sound to name each family
child can be seen member, 2 days in a row
and/or heard within a
Jacob will respond to sounds given context Jacob will smile and turn when
in environment called by name by family
members during play periods,
2 days in a row
Broad criteria
Sandi will eat independently Specify a context for Sandi will use a spoon to feed
at least 80% of the time observing a herself for at least 10 minutes
skill/behavior during each evening meal
Family and therapist State frequency for Sandi will use a spoon to feed
observation; therapist demonstrating herself for at least 10 minutes
checklist action/behavior within a during each evening meal
specific time period
54 Early Childhood Tutorial- Developing and Implementing IFSPs
Session 2 - Developing an IFSP with a family
Examples of family-specific strategies
Functional outcome:
Babacar will choose what he wants to do by using specific sounds for “yes” and “no”
Family-specific How to modify: Examples of family-specific
strategies avoid: strategies
Vague/broad
suggestions about what Family will pair sounds with
to do: Identify how to help: words “yes/no” when talking to
Babacar and one another.
Language stimulation a) a child generalize
actions/interactions EI provider will explore with
across settings; and parents/childcare provider
Family and service what prompts, activities and
provider will continue to b) caregivers build interactions help Babacar use
work on strategies and competency, appropriate his sounds.
activities to increase skills to their role.
in the home Mom will show
grandparents/babysitter how to
prompt sounds from Babacar
when feeding him.
Listing formal EI
services as strategies:
Strategies are not formal EI provider will go to the store
Enroll in speech-language services- but could with mom and Babacar to
therapy identify how an EI show how to help him
provider will support a use his sounds.
Physical therapy 1x/week family.
Strategies indicate how Examples above illustrate how
the entire IFSP team will parents, siblings, grandparents
work on achieving and EI providers can
outcomes. collaborate on goals.
Unclear who will do
what: Completing the IFSP See examples above, and:
“Strategy” section is
Teacher will work with another opportunity to talk EI provider will share info
child/family to increase about the benefits of about parent-parent support
skills and provide formal and informal networks
activities for 9the home services/supports that can
help a child participate in Dad/brothers will play with
Ideas for encouraging family & community life Babacar at the pool and in
language at home (the intent of the natural bathtub (child loves water)
activities environment mandate)
55 Early Childhood Tutorial- Developing and Implementing IFSPs
Session 2 - Developing an IFSP with a family
Examples of formal and informal supports/services
For achieving a family outcome:
Outcome and Family-Specific Strategies Examples of
Criteria supports/services
Sylvia will review the Formal EI services:
Outcome: Sylvia mobility training she Depending on their
will take Paolo to received at the MD knowledge/experience any of
the park and School for the Blind the following EI providers could
shopping, by support Sylvia in achieving this
herself I/T provider will outcome:
accompany Sylvia and
Paola to community Family support coordinator
Criteria: Sylvia will activities such as the Occupational therapist
take one trip with library Social worker
Paola to either the Special educator
library, mall or Sylvia will identify Physical therapist
other community available
activity by herself transportation options Other formal service:
within the next 4-6 and ask family and MD School for the Blind
months other community
supports to Informal networks/resources:
accompany her on a Extended family/friends
trial run Library program for children
The frequency and intensity of services should be chosen after discussion with Sylvia
about how much support she desires to navigate the transportation system and reach
her destination while attending to her son’s needs. Will Paolo need a stroller? Is he
walking on his own? How far and how long? How easy will it be to address his toileting
and eating needs while Sylvia and Paola are outside their home?
The natural environments in which supports/services would be provided to meet this
outcome are the public library or shopping mall and the selected transportation method
identified by Sylvia (bus, taxi, walking).
56 Early Childhood Tutorial- Developing and Implementing IFSPs
Session 2 - Developing an IFSP with a family
For achieving a child outcome:
Child Outcome Strategies Examples of
and Criteria supports/services
Family and I/T staff consult Formal EI service:
with GI doctor about Depending on their
Outcome: realistic timetable and plan knowledge/experience any
Neena will eat for Neena to drink and eat one of the following EI
and drink by providers could support
mouth like other I/T providers will share Neena’s family in achieving
kids during information about oral- this outcome:
family outings motor development with
parents and suggest OTR
enjoyable hand/mouth Nurse
Criteria: Neena games to play with Neena Special educator
will drink a SPL
minimum of 4 oz Family and I/T staff work
of fluids from a together to introduce Neena
cup and eat 3 to new foods and liquids Other formal services:
spoonfuls of and track her likes and
food during dislikes Pediatrician
family outings Gastroenterologist
I/T staff will accompany
family on outings to adapt Informal resource:
eating suggestions
Parent-parent support
I/T staff will link family to
other families who have a
child with a feeding tube to
see how they cope and get
around in the community
The frequency and intensity of services should be chosen after discussion with
Neena’s parents about how much support/services would be needed to implement the
strategies identified above. It may be that the early intervention provider (suggested
above with the most experience/knowledge in helping children learn to eat by mouth)
could work out a flexible schedule for Neena and her parents (e.g., 2x/week for 6 weeks,
and then visit once per week for another 8 weeks) until the parents are ready to try a
family outing.
The natural environments in which supports/services would be provided to meet this
outcome are the family home (to begin weaning Neena off tube feedings) and the
community destinations chosen by Nina’s family, when they are ready to go out with her.
57 Early Childhood Tutorial- Developing and Implementing IFSPs
Session 2 - Developing an IFSP with a family
