presented in collaboration with

1. Developing High-Quality, Functional IFSP Outcomes Jennifer Davis, DPTSarah Nicholas, MOTR/LWyoming Department of HealthEarly Intervention and Education, PART C presented in collaboration with

2. Developers Anne Lucas ECTA Center / WRRC KathiGillaspy ECTA Center Mary Peters ECTA Center With contributions from Naomi Younggren, Department of Defense/Army Early Intervention; Debbie Cate, ECTA Center; Megan Vinh, WRRC; Joicey Hurth, ECTA Center/NERRC; Christina Kasprzak, ECTA Center; and Grace Kelley, SERRC

3. ObjectivesIn this session you will: • Discuss How Children Learn • Discuss Mission, Goals and Outcomes of Early Intervention • Link Assessment Information to IFSP Outcomes • Integrate the Global Child Outcomes Measurement into the IFSP • Learn IFSP Outcome Requirements • Develop Functional, High Quality IFSP Outcomes • Develop IFSP Strategies • Determine Services to Meet Outcomes

4. How Children Learn Mission, Goals and Outcomes of Early Intervention SECTION 1___________________________________________________________Setting the Context

5. How Children Learn • Natural learning opportunities • Every day routines and activities of children and families • Within family and community life 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. (Erratum in Young Exceptional Children, 4(4), 25) Shelden, M. L., & Rush, D. D. (2001). The ten myths about providing early intervention services in natural environments. Infants & Young Children, 14(1), 1-13.

6. Context for Learning: Child Interest and Competence Interests Learning Activities Exploration and Mastery Engagement Competence Dunst, C. J., Herter, S., & Shields, H. (2000). Interest-based natural learning opportunities. Young Exceptional Children Monograph Series No. 2: Natural Environments and Inclusion, 37-48.

7. Interest-based Learning Children’s interests influence: • Participation in activities • Level of engagement in activities • Amount of practice of new skills • Development of new competencies • Sense of mastery Raab, M. (2005). Interest-based child participation in everyday learning activities. CASEinPoint, 1(2). Retrieved from http://www.fippcase.org/index.php

8. Defining Engagement “…amount of time children spend interacting appropriately with their environment.” McWilliam, R.A. (April, 2010). Enhancing Services in Natural Environments [webinar]. Retrieved from http://www.ectacenter.org/~pdfs/calls/2004/partcsettings/mcwilliam.pdf

9. Engagement of Children with Disabilities “Children with disabilities spend more time non-engaged (e.g., wandering around, crying or waiting) than do their typically developing peers.” McWilliam, R.A. (n.d.) Engagement. Siskin Children’s Institute. Retrieved August 2012 from http://www.siskin.org/www/docs/112.181

10. Practice for Children with Disabilities Mahoney, G. (2008). The critical role of practice in the early childhood curriculum. Presentation at South Carolina Early Intervention Conference for Families and Providers. Research on young children with disabilities tells us they need even more practice: twice as much for 50% delay, etc. They need opportunities to learn – in context (walking on rugs and yards and gravel); instruction, coaching and most of all. . . practice!

11. Children Learn through Incredible Amounts of Practice! • The amount of a toddler’s experience with walking is the only predictor of improved proficiency • Toddlers practice walking for more than 6 hours daily • Average 500 – 1500 steps per hour • 9000 steps per day (length of 29 football fields!) Adolph, K. E., Vereijken, B., & Shrout, P. E. (2003). What Changes in Infant Walking and Why. Child Development, 74(2), 475-97.

12. Mastery Mastery of functional skills occurs through high-frequency, naturally occurring activities in a variety of settings that are consistent with family and community life. Shelden, M. L., & Rush, D. D. (2001). The ten myths about providing early intervention services in natural environments. Infants & Young Children, 14(1), 1-13. Dunst, C. J., & Bruder, M. B. (1999). Family and community activity settings, natural learning environments, and children’s learning opportunities. Children’s Learning Opportunities Report, 1(2). Dunst, C. J., Bruder, M. B., Trivette, C. M., Hamby, D., Raab, M., & McLean, M. (2001). Characteristics and consequences of everyday natural learning opportunities. Topics in Early Childhood Special Education, 21(2), 68-92. Dunst, C. J., Bruder, M. B., Trivette, C. M., Raab, M., & McLean, M. (2001). Natural learning opportunities forinfants, toddlers, and preschoolers. Young Exceptional Children, 4(3), 18-25. (Erratum in Young Exceptional Children, 4(4), 25) Dunst, C. J., Hamby, D., Trivette, C. M., Raab, M., & Bruder, M. B. (2002). Young children's participation in everyday family and community activity. Psychological Reports, 91, 875-897.

13. Keys to Development Mahoney, G. (2008). The critical role of practice in the early childhood curriculum. Presentation at South Carolina Early Intervention Conference for Families and Providers. Raab, M. (2005). Interest-based child participation in everyday learning activities. CASEinPoint, 1(2). Retrieved from http://www.fippcase.org/index.php • Child’s opportunities to practice are increased when parents/caregivers/teachers: • select everyday activities that are interesting to the child or foster situational learning • are responsive to a child’s play • Without adequate practice to master a fundamental skill, a child cannot move to the next developmental level • It takes the time it takes!

14. Services Focus on Successful Participation Services should strengthen family and caregivers capacity to use multiple routines and activities as learning opportunities Successful participation = learning and practice = mastery of skills Services should also help families and caregivers figure out how to address challenging activities by improving the child’s skills, making adaptations so s/he can be more successful

15. Parents and Caregivers Influence Learning What happens between intervention visits is most critical for learning The consistent adults in a child’s life have the greatest influence on the child’s learning and development – not providers/teachers All families/caregivers have strengths and capabilities that can be used to help their child develop and learn

16. Supporting Parents and Caregivers Hanft, B. (April, 2010). Enhancing Services in Natural Environments [webinar]. Retrieved from http://www.ectacenter.org/~pdfs/calls/2004/partcsettings/hanft.pdf Shares knowledge and resources with a child’s key caregivers through adult-to-adult relationships Family members are supported in their day-to-day responsibilities of caring for their child

17. Goals of Early Intervention and Early Childhood Special Education The Early Childhood Outcomes Center (2005). Family and Child Outcomes for Early Intervention and Early Childhood Special Education. Retrieved from http://www.ectacenter.org/eco/assets/pdfs/ECO_Outcomes_4-13-05.pdf For children to enable young children to be active and successful participants during the early childhood years and in the future in a variety of settings – in their homes with their families, in child care, preschool  or school programs, and in the community For families to enable families to provide care for their child and have the resources they need to participate in their own desired family and community activities 

18. Mission of Early Intervention Services Part C early intervention builds upon and provides supports and resources to assist family members and caregivers to enhance children’s learning and development through everyday learning opportunities. Mission and Key Principles of Early Intervention Services http://www.ectacenter.org/~pdfs/topics/families/Finalmissionandprinciples3_11_08.pdf Seven Key Principles Looks Like/Doesn’t Look Like http://www.ectacenter.org/~pdfs/topics/families/Principles_LooksLike_DoesntLookLike3_11_08.pdf

19. Integrating Outcome Measurementinto IFSP The IFSP process plans supports and services to address priorities and to support successful participation in daily activities Individual outcomes for each child build on his/her interests/skills and reduce barriers to successful participation in daily learning opportunities Through participation – all children learn (interest-based learning, practice and independence)

20. Linking Assessment Information to IFSP Outcomes Integrating the Global Child Outcomes Measurement into the IFSP SECTION 3___________________________________________________________Integrating Functional Assessment and Outcome Measurement with IFSP Outcomes

21. Key Steps: IFSP Must Meet All Timelines

22. Using Informationwithin the IFSP

23. IFSP Outcome Requirements Developing Functional, High Quality IFSP Outcomes SECTION 4___________________________________________________________Functional, High-Quality IFSP Outcomes

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

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

26. Requirements for IFSP Outcomes IFSP must include: • A statement of the measurable results or measurable outcomes expected to be achieved for the child and family (including pre-literacy and language skills as developmentally appropriate for the child) • The criteria, procedures, and timelines used to determine the degree to which progress toward achieving the results or outcomes is being made and whether modifications or revision of the expected results or outcomes or services are necessary 34 CFR §303.344 (c)

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

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

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

30. Developing IFSP Outcome Statments McWilliam, R.A. (2006). Steps to build a functional outcome. Retrieved from http://www.siskin.org/downloads/Steps_to_Build_a_Functional_Child_Outcome.pdf

31. Third Word Rule • The third word of IFSP child outcome statement should be a contextualized action that is functional. • Example: “Kim will eatwith her family at mealtime eating the foods they eat.” Shelden, M. L., & Rush, D. D. (2009). Tips and Techniques for Developing Participation-Based IFSP Outcome Statements. Briefcase, 2(1). Retrieved from http://www.fipp.org/Collateral/briefcase/briefcase_vol2_no1.pdf

32. Developing Criteria, Procedures and Timelines • Whatare the ways in which the family and team will work toward achieving this outcome? • Whowill help and what will they do? • Howwill the team know they’ve made progress or if revisions are needed to outcomes or services?

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

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

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

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

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

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

39. Criteria Definitions • Uses active rather passive words • Words encourage the child and family’s active participation • Words indicate what the child or family will do • Passive words reflect a state of being or a change or lack of change in performance

40. High-Quality, Functional IFSP Outcomes If available, the child’s complete record can reveal if an IFSP outcome is based on: Information gathered from the family (e.g., priorities and concerns) Evaluation and functional assessment of child (e.g., skills, degree of participation, behaviors across settings , strengths, and needs)

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

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

43. Developing Family Outcomes • IDEA, Sec.636 (d)(3) “a statement of the measurable results or outcomes expected to be achieved for the infant or toddler and the family and timelines used to determine the degree to which progress toward achieving the results or outcomes is being made and whether modifications or revisions of the results or outcomes or services are necessary”. • The expectation from The Office of Special Education Programs and Wyoming Early Intervention and Education Program is that outcomes should be • family-directed • Functional • measurable.

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

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

46. Instructions and materials for these activities are at: Developing High-Quality, Functional IFSP Outcomes and IEP Goals Enhancing Recognition of High-Quality, FunctionalIFSP Outcomes and IEP Goals http://www.ectacenter.org/~pdfs/pubs/rating-ifsp.pdf http://www.ectacenter.org/~pdfs/pubs/rating-iep.pdf

47. Resources on IFSPs and IEPs IFSP Key Practices Underlying the IEP Process http://www.ectacenter.org/~pdfs/knowledgepath/ifspoutcomes-iepgoals/Key_Practices_IEP_Process.pdf Contents of the IEP http://www2.ed.gov/parents/needs/speced/iepguide/index.html#contents OSEP model IEP forms http://www2.ed.gov/policy/speced/guid/idea/modelform-iep.pdf Special Factors To Considerhttp://www2.ed.gov/parents/needs/speced/iepguide/index.html#contents Wisconsin Guide to Connecting Academic Standards and IEPs http://dpi.state.wi.us/sped/pdf/iepstandardsguide.pdf IEP • Agreed Upon Practices For Providing Early Intervention Services In Natural Environments http://www.ectacenter.org/~pdfs/topics/families/AgreedUponPractices_FinalDraft2_01_08.pdf • Rush and Shelden. Tips and Techniques for Developing Participation-Based IFSP Outcomes Statements, BriefCASE, Vol 2, No. 1 http://www.fippcase.org/briefcase/briefcase_vol2_no1.pdf • ECTA Center website http://www.ectacenter.org/topics/families/famresources.asp

48. IFSP Strategies Services to Meet Outcomes SECTION 5___________________________________________________________IFSP Strategies to Meet Outcomes

49. Strategies to Meet IFSP Outcomes What will we do to accomplish the outcome? Strategies specify whowill do whatin whicheveryday routines, activities and places.

50. Developing Strategiesto Meet IFSP Outcomes Strategies must: • Help achieve the outcome • Be based on how all children learn throughout the course of everyday life, at home, in early care and education settings, and in the community • Be developmentally appropriate for the child • Focus on naturally occurring learning opportunities whenever possible