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IFSP Tutorial - Developing and Implementing
 

Developing the IFSP:


Essential Content


Page 9 of 13

Functional outcomes: The guide for early intervention supports and services

2. Family-selected:

Are the outcomes, selected by each family, written in language understood by family members?

IFSP outcomes should be written in language that reflects a family's understanding about “where we are going.” The outcomes reflect how family/child knowledge, skills, actions will help a child participate successfully in family/community life. Early intervention providers can help families with IFSP outcomes by using 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).

This does not mean writing down word-for-word what a parent says without trying to understand what they really want to happen. For example, when parents identify a very broad outcome, e.g., they would like their child to “walk” and/or “talk better”, it is helpful to clarify what walking or talking would look like and how a child could participate to a greater extent in family/community life before making it an IFSP outcome.

The following vignette illustrates how Jana, a service coordinator, prompted a mother, Mayra, to think more specifically about the daily activities she hoped her son could participate in more fully during her initial IFSP meeting with the early intervention team.

 
 

Mayra, when we first met, you told us that you wanted to help Pedro understand language like other children his age,” summarizes Jana. “When we visited you at home to do his evaluation, we looked at how much Pedro understands and what he said. Then we all talked about what we observed. Now it’s time to think about how we can help you and your husband take care of Pedro.

Mayra responds, “I want him to understand what others say to him, just like his brothers did at his age.”

“That’s important, for sure,” agrees Jana. “Can you tell us a little more about the times you would really like Pedro to understand what people are saying to him?”

“Well, he really likes going to nursery school on Mondays and Wednesdays but has a hard time keeping up with 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 she says it’s time to go back inside after lunch, he runs over to the sandbox. He’s always doing things different than the other kids.”

Jana (wondering if there are other times this happens) asks, “Do you notice this at home too?”

“Oh, yes! There are some things, like getting up in the morning, eating dinner, that we do the same way most of the time, so Pedro knows what’s happening. But when we change his schedule, 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 nursery school, at home and his aunt’s home 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 really means by “understanding language like other children.” So far, she has told us what she thinks about an outcome being:

  • Meaningful
    (help Pedro “fit in” at his nursery school and at home)
  • Specific
    (Pedro will understand what to do/where to go when given a direction)

Regarding the guideline that a functional outcome be understandable to a family and reflect words that a family might use, an outcome could be worded to reflect Mayra’s desires for Pedro as:

Pedro will join activities with others at home and nursery school by understanding and following directions from his family and teacher.

3. Specific:

Does each outcome identify the positive knowledge, skills and/or actions for a child and/or family members?

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 outcomes:

Family outcome: Charlotte and Bruce will know how well Sonya hears people and sounds

Family outcome: Darla will be cared for competently in their church nursery while Denise and Denny attend services

Child outcome: Mina will play with small toys and feed herself little bites of finger food

Child outcome: Sara will play with other children her age on playground equipment at her local playground

Child outcome: Chantell will let her family know what she wants and answer simple questions, using words and short phrases

4. “Do-able”:

Can the outcomes reasonably be achieved within 4-6 months?

This guideline for a functional outcome considers whether or not an action, knowledge or skill is “do-able” by a child or family member 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 guiding their supports and services over the next 4-6 months. (Remember that Jana in the vignette above agreed with Mayra that it was very important that Pedro understand language like his brothers did before asking her to describe it more specifically).

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 support a family’s desire for this future outcome, 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’s hands and take at least 5 steps, 3x per day).

Table 2.1 provides additional examples of functional outcomes with guidelines for avoiding wording that is broad, negative and/or domain-specific outcomes.

 


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