IFSP Module 3 Trainers' Guide - Johns Hopkins...

Adapted by MCIE and the Maryland State Department of Education – Division of Special Education and Early Intervention Services from materials created by:

Module 3 Developing Effective, Functional, Routines-Based Outcomes and

Strategies Trainers’ Guide

Trainers’ Guide The purpose of these modules is to support local lead agencies in providing professional development to their teams on developing effective, functional, routines-based IFSPs for young children with disabilities and their families. The modules were adapted from materials developed by the Early Childhood Technical Assistance (ECTA) Center and customized to reflect Maryland’s strengths, needs, and practices. Please feel encouraged to further adapt them to meet the needs of your program and staff. You may wish to add additional information on some topics or skip some slides and activities, based on previous trainings you have conducted and the professional development needs of your staff.

Module 3: Developing Effective, Functional, Routines-Based Outcomes and Strategies

This module explores how information from the authentic assessment process is translated into IFSP outcomes that are functional for the child and family and meaningfully embedded in daily routines and activities. Participants will learn the characteristics of effective functional outcomes and goals and strategies for developing them. Multiple effective examples and not effective examples are provided. Participants will engage in the placemat activity developed by ECTA and modified by MSDE/DSE/EIS to reflect on effective, functional, routines-based outcomes. Participants will then utilize a tool developed by MSDE/DSE/EIS to reflect on IFSPs that they or their colleagues developed and determine which effectiveness standards are in place and target areas for improvement and future development. This module will take approximately 11/2 to 2 hours to deliver.

Materials

• Handouts: • Process for Developing Effective, Functional, Routines-Based IFSPs (Handout 3-

1) • Placemat Activity (Handout 3-2a through 3-2f)

• Placemat MD Revision (Handout 3-2a) • Definitions of IFSP Outcome Rating Criteria (Handout 3-2b) • Example IFSP Outcome Card (Handout 3-2c) • IFSP Outcome Cards (Handout 3-2d) • Worksheet for Rating IFSP Outcomes (Handout 3-2e) • Answer Key for Rating IFSP Outcomes (Handout 3-2f)

• IFSP Reflection Tool OUTCOMES, STRATEGIES, and SERVICES sections – (Handout 3-3)

• Web Resources on Routines-Based IFSPs (Handout 3-4) • PowerPoint handouts for participants, if desired

• Sample IFSP for reflection activity, if participants do not bring their own. • Post-it notes (if desired) • Computer and LCD projector • Internet access for playing on-line videos and exploring web-based resources • Evaluation forms for your own planning purposes (if desired)

Adapted by MCIE and the Maryland State Department of Education – Division of Special Education and Early Intervention Services from materials created by:

Developing Effective, Functional, Routines-Based Outcomes and Strategies

Module 3

Welcome to Developing Effective, Functional Routines-Based IFSP Outcomes. My name is (name) and I am the (title) at (organization). Note to Trainers: Please tailor this introduction to meet the needs of your audience. You may want to add your names to the title slide. You may want to include the following in your introduction:

• Housekeeping items, such as the schedule, breaks, food and drink locations, location of the bathrooms

• Who’s in the room (i.e. disciplines represented, agencies represented, etc.) • Orientation to the packet/handouts

Understand the connections among:

• Functional Assessment

• Developing Functional, Routines-Based IFSP Outcomes

• Measuring the 3 Broad Early Childhood Outcomes and the 3 Family Outcomes

2

Functional, Routines-

BasedIFSP

Outcomes

3 Early Childhood Outcomes & 3 Family Outcomes

Functional Assessment

The purpose of Developing Effective, Functional IFSP Outcomes is to support professionals (such as teachers, caregivers, providers, practitioners) and families to understand the practical connection among:

• the functional assessment of young children, • the development of meaningful and functional IFSP outcomes, and • the measurement of the child’s functioning in relation to the three broad early childhood

outcomes.

Module 1: Setting the Context

Module 2: Functional Assessment in the IFSP Process

Module 3: Developing Effective, Functional Routines-Based Outcomes and Strategies

This training on Developing Effective Functional IFSP Outcomes was created to share information and strategies for best practices for developing IFSPs that support children and families and lead to improved outcomes and school readiness. The training is organized in three modules: Module 1 sets the context with regard to the purposes of early intervention and early childhood special education and reviews how research and professional knowledge about how children learn impact the delivery of high quality services. We explore the importance of engagement and routines-based intervention to support children’s growth and development and progression towards the three broad early childhood outcomes. Module 2 explores functional assessment, which includes the what, why, when, how and who of the functional assessment of young children. The module illustrates the connections between the broad early childhood outcomes and individual IFSP outcomes, and shows how the same information can be used for both the development of functional IFSP outcomes and the federally required child outcomes measurement. Module 3 explores the process of developing functional IFSP outcomes, including the requirements of the law, the characteristics of high quality IFSP outcomes, and the process of developing strategies and services to support outcomes.

Progress Monitoring

Early Intervention Services, Supports and Linkages

Strategies, Activities, Learning Opportunities and Measureable Criteria

Functional, Routines-Based Child and Family Outcomes

Family Assessment Concerns, Priorities

and Resources

Functional Assessment

Across Environments

Comprehensive Picture of

Strengths and Needs

This slide, introduced in earlier modules in this series, depicts the process for developing IFSPs that reflect best practice in routines-based, functionally-oriented early intervention. This graphic, vetted by Maryland’s Quality IFSP Workgroup, depicts a process for creating Effective, Functional, Routines-Based IFSPs that aligns with Maryland’s Online IFSP. It is important to note that each of these steps is interrelated, meaning what is gathered and used in each step is used and built upon in subsequent steps. This is critical for putting together the various types of information needed to truly understand the child and family. Following formal evaluation methods to determine eligibility, functional assessment provides meaningful information about the child’s abilities during daily activities and routines and focuses on priorities and concerns a family has for intervention. The process begins by gathering detailed information through family assessment including a family concerns, priorities and resources and then functional assessment across environments. This involves assessing the child’s skills and interests in the real life contexts and routines of family, culture and community, across the three early childhood outcome areas, with consideration of the developmental guidelines/early learning standards and natural learning opportunities for the child’s age. The functional assessment process (steps one through three in the graphic) was the focus of Module 2. Once comprehensive information has been gathered, it can be translated into outcomes that improve the quality of the child’s engagement and participation in daily routines and activities, and strategies and services that support parents and caregivers to help children meet those outcomes. Note to Trainers: A version of this graphic with more detailed information is included in the materials as a handout.

Understand the components of effective functional, routines-based IFSP outcomes

Discuss ways to determine effective IFSP strategies, supports, and services

Review and reflect on IFSP outcomes

5

The goal of this module is to delve into the process for translating the information gathered during functional assessment into routines-based, functional outcomes that support children’s development in the context of ongoing and relevant activities. We will discuss the characteristics of effective outcomes and strategies for writing them. We will also look at the other components of IFSPs–strategies, supports, and services that lead to the attainment of the goals. We will use the MSDE reflection tools to self-assess some IFSP outcomes to determine which best practices are already in place and identity opportunities for improvement.

6

First… develop IFSP outcomes based on functional, authentic assessment information

Next… determine strategies and measurable criteria

Then … determine supports and services to meet these outcomes

As we begin delving into the development of effective, functional, routines-based IFSP outcomes, remember to develop the outcome before determining services and supports – outcomes drive supports and services. The services a child needs to receive should be based on the outcome, not the other way around. In virtually all cases, this will be the natural environment for an infant or toddler or preschooler on extended IFSP – the place(s) the child would be if she did not have a disability.

7

1) Start with the family’s/caregiver’s priorities and concerns about the child’s social relationships, engagement, and independence

2) Consider what’s working and what’s challenging in everyday routines and activities

3) Consider the child’s current knowledge, skills, and behaviors compared to typical development

In developing IFSP outcomes, there are 3 key areas to consider. First, it’s critical to start with the family’s/caregiver’s priorities about what they hope for the child and family and what’s most important or meaningful to them. Special focus should be placed on their desires related to interactions, participation, and independence in family and community activities. Using focused open-ended questions can help parents and other care providers reflect on how they want the child to participate in activities and routines that are meaningful to them and what factors impact their child’s successful participation. It is these family priorities, not the practitioner’s or teacher’s priorities, that should serve as the basis for high quality, participation-based outcomes. Second, it’s also important to consider what’s working and what’s challenging at home, in the community, and in the classroom (if applicable). Be specific about what the child’s participation in the activity looks like. Make note of those situations that are motivating and interesting to the child and family and those that impact participation in family and community life. Asking parents what the child enjoys doing and what they enjoy doing together helps to clarify the context where the child is learning and participating. Similarly, asking parents which parts of their day are not going well provides an understanding of changes that would benefit the child and family. In addition, the team must incorporate what has been learned during the evaluation and functional assessment process about the child’s developmental skills, needs, and disability and their impact on the child’s learning and participation. Understanding of typical development and age-appropriate expectations also helps inform the setting of targets. Maryland Early Learning Standards define the key aspects of development and learning that are the foundation for a child’s school and life-long success. Maryland’s Early Learning Standards come from two different sources:

• Healthy Beginnings: Supporting Development and Learning from Birth through Three Years of Age • Maryland College and Career-Ready Standards for the Pre-K through Grade 2 portion of the Pre-K to 12 Standards

All 3 components are critical for developing quality outcome statements, as well as informing decisions about strategies and activities that will most effectively promote incidental learning and the opportunity to practice new skills to meet outcomes. If the family routines and priorities, and strengths and needs sections of the IFSP have been completed thoroughly with specific examples that illustrate the child’s skills using a functional approach, appropriate outcomes will be readily apparent.

8

The IFSP must include:¡A statement of the measurable results or measurable outcomes expected to be achieved for the child and family¡The criteria, procedures, and timelines used to determine the degree to which progress toward achieving the results or outcomes is being made

The Part C Regulations released in September 2011 state that the IFSP must include: • A statement of the measurable results or measurable outcomes expected to be achieved

for the child and family (including language, pre-literacy and numeracy skills as developmentally appropriate for the child. Remember that students on the extended IFSP MUST have outcomes in these areas);

and • 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.

9

¡ Reflect what the family wants for the child

¡ Two types of outcomes

§ Child Outcomes

§ Family Outcomes

There are two types of IFSP outcomes, child outcomes and family outcomes. For children over three on the extended IFSP, educational outcomes addressing language, pre-literacy and numeracy must be included along with other child outcomes as appropriate. Writing outcomes that are based on family priorities is the recommended practice. As discussed in Pletcher and Younggren’s Early Intervention Workbook, asking the question “What do you want for your child?” will likely result in broad, not measureable responses from the family. To develop appropriate, specific outcomes, providers must have an understanding about what is currently happening, how the child is currently functioning, and precise family concerns and priorities. Interviews, such as the Routines Based Interview, and/or conversations with the family about daily activities and routines help to identify functional and contextually relevant outcomes for the child and family. Pletcher & Younggren (2013). The Early Intervention Workbook. Baltimore, Maryland: Brookes Publishing.

Child Outcomes

• Reflect family priorities• Enhance a child’s learning through

functional, active participation in everyday routines and activities

• Expand settings/activities in which the child can be competent

• Focus on a child’s engagement and interests

10

Both family and child outcomes can be developed to enhance the ability of the child and/or family to engage in desired activities based on the things they enjoy and are interested in (participation-based outcomes), or to make day-to-day life easier and more productive, or for a more meaningful context for engagement and learning (routines-based child outcomes, resource-based family outcomes). All outcomes should reflect family priorities and be grounded in the family’s ongoing and/or desired activities. Child outcomes should:

• Be important and meaningful to the family/caregiver (their priorities) • Enhance the child’s learning through functional participation in everyday activities (child

is learner/actor), • Expand settings/activities in which the child can be competent, and • Focus on the child’s engagement and interests.

Child outcomes are focused primarily on the child with the family/caregiver as one resource to help it happen and the team supporting the family/caregivers in using a variety of strategies. Child outcomes are skill-based only if the skill is tied to a useful behavior the child can improve social relationships, engage in an activity or to become more independent. Child outcomes are participation-based, showing what activities the child will participate in using those functional skills.

11

Maryland Requirement: Extended IFSPs (for children over 3 until the beginning of the

school year following the 4th birthday) must include an educational component that

promotes school readiness and incorporates:

• Language• Pre-Literacy

and • Numeracy Skills

Maryland offers families with children between three and the beginning of the school year following the 4th birthday the option of receiving services on an extended IFSP. These extended IFSPs are required to incorporate an “educational component” that focuses on language, pre-literacy and numeracy. The focus of the education component is on preparing young children to be ready for school and assist the family to support the child in this process. The IFSP must contain AT LEAST two outcomes that address these areas, and all three areas must be addressed by one or more outcome. The three areas may be combined in functional activities that reflect skills in multiple areas. For example, answering questions about illustrations and events in favorite books addresses both language and pre-literacy skills. These outcomes should follow the same high-quality guidelines as the rest of the IFSP and be active, positively stated, and embedded in routines and activities of the child’s and family’s daily life. If the child participates in childcare, preschool or other community programs, the educational outcomes may also be addressed in those settings. The focus of the “educational component” is around school readiness, so it is critical to utilize Maryland Early Learning Standards Birth-8 Years to ensure alignment with age expectations. http://earlychildhood.marylandpublicschools.org/system/files/filedepot/4/msde-pedagogy-report-_appendix_2016.pdf Maryland’s Early Learning Standards come from two different sources: Healthy Beginnings http://www.marylandhealthybeginnings.org/ Maryland College and Career-Ready Standards (Pre-K to Grade 2) http://mdk12.org Educational outcomes must be included in an extended IFSP even if the family does not include these skills among their priorities; the educational component is not optional. Note to Trainers: The Online IFSP has the Healthy Beginnings developmental guidelines available on the Present Levels of Development and the Strengths and Needs Summary Page. A “Review of Typical Development” tool is available as a resource on the Strengths and Needs summary page and on the Outcomes page as part of the IFSP Outcomes Wizard tool. These tools assist the IFSP team to ensure the alignment with age expectations when developing outcomes and in particular, school readiness outcomes.

Family Outcomes

• Reflect family priorities• Enhance family capacity• Support accessing community

resources and supports • Based on family’s interests

12

Family outcomes can also enhance the ability of the child and/or family to engage in desired activities based on enjoyment and/or interest or can make day-to-day life easier and more productive with an increase in a child’s engagement and learning. Family Outcomes should:

• Enhance the capacity of the family to meet the needs of their child (family is learner/actor),

• Support accessing community resources and supports (service coordinator supported),

• Be important and meaningful to the family/caregiver (priorities), and • Be based on the family’s interests.

Family outcomes may be related to one family member in particular or the whole family (e.g., participating in a Sibshops program, finding a place to live, finding respite services). Note to Trainers: The DEC Recommended Practices provides a guideline around family outcomes:

• Practitioners work with the family to identify, access, and use formal and informal resources and supports to achieve family-identified outcomes or goals.

Here is the reference and link for the revised DEC recommended practices. Division for Early Childhood. (2014). DEC recommended practices in early intervention/early childhood special education 2014. Retrieved from http://www.dec-sped.org/recommendedpractices

¡ How often do your IFSPs include family outcomes?

¡ What strategies do you/your staff use to engage families in selecting priorities for child and family outcomes?

¡ What gets in the way of fully engaging families in this process?

13

Note to Trainers: Ask participants to discuss these questions with a partner or small group. Then ask for volunteers to share their responses with the whole group. Engage the group in discussion.

14

Necessary and functional for child’s and family’s life

Reflect real-life contextualized settings

Cross developmental domains and are discipline-free

So how do we know if IFSP outcomes are written effectively? NECTAC, ECO and WRRC, in collaboration with Dathan Rush and M’Lisa Shelden at the Family Infant and Preschool Program in Morganton, NC, have identified 6 unique criteria for determining if an IFSP outcome statement is effective. 3 criteria relate primarily to the CONTENT of the outcomes.

• The outcome statement should be necessary and functional for the child’s and family’s life. This means that the outcome focuses on ways to support their participation in community life and family activities that are important to them. For example, for the outcome to be necessary and functional, it should benefit the child by focusing on social relationships, acquiring and using knowledge and skills, and/or using appropriate actions to meet needs. It should also help the child and family improve participation in chosen activities and/or help them begin new activities that are important to them.

• The statement should reflect real-life contextualized settings by describing behaviors that will take place in routine activities. These may be common activities that occur in all families (such as meals, bath time or riding in the car) or routines specific to the individual family (such as favorite recreational activities, religious observances or hobbies). Specific isolated skills, e.g., test items that were missed during evaluation, are not considered real-life or contextualized.

• The third criteria is that the outcome statement integrates developmental domains and is discipline-free. This means that the outcome is written to describe the child’s participation in routines and everyday activities and promote skill development across multiple domains which can be addressed by any member of a child’s IFSP team. Outcomes may involve several different “types” of skills (e.g., “Keyani will sit in the bathtub without falling and ask for toys and other items during bath time,” involves motor and language skills). It also means that the outcome should be written so that the child and/or family are the “actors” or persons doing something, rather than the occupational

therapist or early interventionist. For example, an outcome might state, "Annabelle will help her dad with the laundry by pulling up and standing at the dryer on her own and putting clothes into the laundry basket with her dad close by," as opposed to, "Annabelle will pull to a standing position at the couch and maintain her balance when placed there by the PT."

15

Jargon-free, clear and simple

Emphasize the positive, not the negative

Use active words rather than passive words

HOW the outcomes are written is also important in creating an IFSP that reflects family participation and supports family ownership of the process and outcomes.

• The wording of the statement should be jargon-free, clear and simple. This means that the outcome is written so that is understandable by the family and the general public, and does not include professional jargon or “practitioner speak.” For example, the outcome should describe how the child will move, such as reaching up or down for toys, instead of using phrases like “range of motion.” Another example would be wording an outcome so that it describes a child able to use words clearly to make herself understood, rather than using the term “articulation.”

• In order to be high quality, the wording of outcome statements must emphasize the positive, not the negative. The outcome statement should be positive, stating what the child and/or family will do, rather than what they will not do or stop doing. If there are any negative words within the statement, it is not a positively worded outcome. For example, the outcome should state, “Johnny will chew and swallow food when eating with his family” rather than “Johnny will not spit out food when eating with his family.”

• The last criterion for high quality is that the statement uses active words rather than passive words. This means using words that encourage a child’s and/or family’s active participation or engagement. Active words (such as eat, play, talk, walk) indicate what the child or family will do. Passive words that reflect a state of being (such as tolerate or receive), change, or lack of change in performance (such as increase, decrease, improve or maintain) should not be used in a high quality outcome statement.

16

Step 1:Determine the functional area(s) Eating

Step 2: What routine(s) does this affect? Meal time with the family

Step 3:Child will participate in[routines in question]

“Kim will participate in family mealtime …”

Step 4:“by ________ing”

(address specific behaviors) “by eating the foods

they eat.”

McWilliam, 2006

The 4 step process on this slide reflects the development of the IFSP outcome statement to ensure that the core portion of the statement is written functionally and is participation-based. These steps were adapted from a 7-step process that includes criteria, procedures and timelines developed by Robin McWilliam. Let’s walk through the example we’ve developed using this 4 step sequence.

• First, based upon the parents’/caregivers’ priorities, determine the functional area that the outcome relates to. In this example, the family expressed concern and frustration that their two year old only eats a few foods. So the functional area is “eating.”

• Second, determine the routines affected. We selected “meal time with the family.” • Third, develop a statement that reflects how the child will participate in the routines,

such as “Kim will participate in family mealtime. . .” • Finally, add to the initial part of the outcome statement developed in Step 3, what the

child will do (defining specific behaviors) “. . . eating the foods they eat.” The complete outcome statement that we developed using this framework is: “Kim will participate in family mealtime by eating the foods they eat.” Achieving this outcome may involve a variety of supports (such as oral-motor therapy, behavioral intervention, parent training) but those things are not the outcome – the outcome is a statement of what the family would like the child to be able to do. 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

17

The Placemat Activity that we will do now provides an opportunity to rate an IFSP Outcome to see if it meets the criteria to be considered effective, functional, and routines-based. This activity was created several years ago by the ECTA Center and is available to download as a complete training package, called Enhancing Recognition of High Quality, Functional IFSP Outcomes. It is available on the ECTA Center website and it is included as a resource link at the end of the presentation. This activity is slightly adapted for Maryland by using outcomes that were taken directly off of Maryland IFSPs. Please take out the handout titled, “Definitions of Rating Criteria for Effective, IFSP Outcomes”, in your packet. (Trainer show the handout to the group). It is helpful to have these definitions of the criteria handy so when it is unclear whether an outcome meets a certain criteria or not, the full definition can be referenced to help make the decision. Note to Trainers: Read/review each of the six criteria boxes and the bottom center box of the placemat with the group. Note that these are slightly abbreviated versions of the Definitions handout but still require all the components as defined in the full handout.

18

YES

NO

NO

NO

YES

YES

Let’s practice one together: Here is the outcome statement. “Holly will participate in gross motor play, exploration and demonstrate independence by crawling from one place to another.” Is the outcome necessary and functional for the child’s and family’s life? Does the outcome reflect contextualized settings and/or routines? Does the outcome integrate developmental domains and is it discipline free? Is the outcome jargon-free, clear and simple? Does the outcome emphasize the positive, not the negative? Does the outcome use active words rather than passive ones? Since we don’t have the IFSP in front of us we cannot do the bottom questions but if you were doing this with an entire IFSP in front of you, these factors of high-quality could also be rated. Note to Trainers: Read each question and have the group answer as a whole, then press a key to bring the answer in. Repeat for each question.

19

YES

YES

YES

YES

YES

YES

Now here is a revision of the first example outcome. Let’s go through it again and see if it is now a high quality outcome statement. “Holly will participate in playtime on the floor by belly-crawling to a family member who has a toy.” Is the outcome necessary and functional for the child’s and family’s life? Does the outcome reflect contextualized settings and/or routines? Does the outcome integrate developmental domains and is it discipline free? Is the outcome jargon-free, clear and simple? Does the outcome emphasize the positive, not the negative? Does the outcome use active words rather than passive ones? Close your eyes and visualize this outcome…could you do the same with the first one we looked at?

20

DevelopingEffective,

Functional, Routines-Based

IFSPs

Placemat Activity

• Divide into 2 small groups at each table.

• Using the provided IFSP Outcome Cards, place a card in the center of the placemat.

• Within your small group, discuss and rate the outcome statement by writing “yes” and “no” in each quadrant, based on whether the statement meets each of the corresponding criteria.

• Complete all five cards and be ready to discuss at your table and with the large group.

Please pull out your Placemat as well as your Definitions of Rating Criteria. At your table, please get into two small groups…each table will be getting five outcomes to review…both small groups will have the same outcomes. When you finish, talk about your results with the other small group at your table. Up on the screen are the directions to follow as you go through the activity. Note to Trainers: The placemat activity is in teams and is scheduled for 10-15 minutes unless more time is available. The debriefing is scheduled for around 10 minutes. Debriefing: Now let’s take a minute to reflect… §Where did you get stuck with an outcome statement? §How might this activity help you in your work and within your team? §What additional supports do you need to help you successfully identify whether or not an IFSP Outcome is of high quality?

21

What the 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.”

Let’s focus on a few additional examples now. Note that for these hypothetical examples, we only have the family’s statement. When actually developing an IFSP or evaluating the quality of outcomes, it is important to consider ALL the information about the child (assessments, observations, etc) and the developmental guidelines/early learning standards (i.e., Healthy Beginnings, Maryland Early Learning Standards Birth – 8 Years, Maryland’s College and Career-Ready Standards, Pre-K to Grade 2) to determine whether an outcome is appropriate for the child and family, and if it is written in a way that reflects the quality guidelines. For a child outcome, Romeo’s parents state:

• “I wish he could sit without as much support when he eats and plays – it is hard work holding him all the time.”

Note to Trainers: Various resources and tools have been built into the Online IFSP to assist IFSP teams to ensure the alignment with age expectations when developing outcomes. The Healthy Beginnings developmental guidelines are available (click the Resources button) on the Present Levels of Development, and the Strengths and Needs Summary Page. A “Review of Typical Development” tool is available on the Strengths and Needs summary page and on the Outcomes page as part of the IFSP Outcomes Wizard tool.

22

“Romeo will improve muscle tone for sitting.”

NOT THIS

“Romeo will participate in mealtimes by sitting in

the high chair by himself.”

THIS

From this priority shared by Romeo’s parents, here is an example of an effective IFSP child outcome statement in comparison to a statement that is not effective: Effective:

• "Romeo will participate in mealtimes by sitting in the high chair by himself.” Not effective:

• “Romeo will improve muscle tone for sitting." Based on the criteria of effective outcomes that were just reviewed, do you have any ideas as to why this is not high quality? (Answer - not jargon-free, uses passive word, not based in a functional activity.)

What the parent states:“I want her to be ready for kindergarten and know

what other kids know.”What the child care provider states:“Her peers know their numbers and are participating

in math activities.”What Maryland Early Learning Standards states:“Shows beginning interest in numerals and counting” (3 years of age)

Domain: MathematicsStrand: Counting and CardinalityStandard: Count to tell the number of objects 23

As we learned earlier, for children receiving services through an extended IFSP, outcomes related to language, pre-literacy, and numeracy must be included in the IFSP. Information about the child’s developing skills in all environments should be incorporated in the discussion. Since the focus is around school readiness, in addition to observations and the priorities of the family and other caregivers, it is critical to utilize the Maryland Early Learning Standards Birth-8 Years to ensure alignment with age expectations. http://earlychildhood.marylandpublicschools.org/system/files/filedepot/4/msde-pedagogy-report-_appendix_2016.pdf Maryland’s Early Learning Standards come from two different sources:

• Healthy Beginnings http://www.marylandhealthybeginnings.org/ • Maryland’s College and Career-Ready Standards (Pre-K) https://msde.blackboard.com or

http://mdk12.org If a child is 4, it may also be helpful to consult the Maryland College and Career Ready Standards for Pre-Kindergarten Mathematics utilizing the curriculum resources on the blackboard learn site (https://msde.blackboard.com ). In this example, the domain is counting and cardinality and the cluster is know number names and the count sequence. Note to Trainers: The Online IFSP has the Healthy Beginnings developmental guidelines available on the Present Levels of Development and the Strengths and Needs Summary Page. A “Review of Typical Development” tool is available on the Strengths and Needs summary page and on the Outcomes page as part of the IFSP Outcomes Wizard tool. These tools assist the IFSP team to ensure the alignment with age expectations when developing outcomes and in particular, school readiness outcomes.

24

“Taisha will form sets of real objects up to 5 on

request.”

NOT THIS

“Taisha will participate in game time at home and at preschool with friends

by counting out the number of spaces to

move on a game board.”

THIS

Functional Outcomes and School Readiness Videos

Outcomes related to school readiness should have the same characteristics as other types of outcomes – descriptions of meaningful behaviors in contexts that are relevant to the child and incorporating things that she is interested in. Effective outcomes are NOT items from a developmental assessment or school-readiness checklist and they are not written in “educationese.” When creating Extended IFSP Outcomes, it is important to take a broad and holistic view of the whole child and the three early childhood outcomes. These two short video segments (Part 1 and Part 2) provide an illustration of how a team evaluated a young child’s school readiness through a functional lens and developed appropriate outcomes that reflected the educational component as well as the child’s areas of greatest need. Note to Trainers: The Functional Outcomes and School Readiness Video is in two segments on the Maryland Learning Links site (Part 1 – 3:06 and Part 2 – 4:29). It was also previously provided to each lead agency in CD form; if you have access to the CD, you may prefer to play it from there. After watching both segments, invite the participants to share their observations and their experiences writing outcomes to address the educational component of the extended IFSP. Here is the link to these videos on Maryland Learning Links. http://marylandlearninglinks.org/resource/functional-outcomesgoals/

25

What the parents state:“We want to be able

to take Romeo with us in the car;we need a travel car seat.”

Let’s look now at a family outcome. In discussing priorities with Romeo’s parents, they state: “We want to be able to take Romeo with us in the car; we need a travel car seat.” He isn’t able to sit securely in the car seat they used for their older daughter because of his low muscle tone, and lack of trunk and head control.

26

“Staff will explore options for financial assistance for travel

chairs.”

NOT THIS“The family will explore

options for financial assistance for car seats

and secure one with assistance from staff.”

THIS

From this priority shared by Romeo’s parents, here is an example of an effective IFSP family outcome statement in comparison to a statement that is not effective. Effective:

• “The family will explore options for financial assistance for car seats and secure one.” Not effective:

• “Staff will explore options for financial assistance for travel chairs.” Based on the information discussed about family outcomes, why is this not an effective outcome? (Answer - parents are not taking the action – the staff are.)

1) Lily will go fishing with her family and hold her own fishing pole.

2) Marcus will stack 4 blocks.

3) Phu will eat enough food so he can gain weight and not have to have surgery.4) Robin will stop having tantrums at separation from primary caregiver at child care.5) Kimmie will play with toys so Grandma can make breakfast and get the older kids off to school.6) Kamika will respond to a familiar song or story with movements and or sounds.

27

Note to Trainers– Reveal each outcome and have participants give a thumbs up or thumbs down to indicate whether or not it meets the criteria for effective, routines-based functional outcomes. For each - ask someone who said “no” to explain why. Answer key: • Yes (assuming it is based on a family’s stated desire to go fishing) • No – this in not a necessary and functional skill to participate in daily activities and is not

taking place in a meaningful real-life context. It is also a fairly narrow and discipline-specific skill. To create a more functional outcome, you need would need to understand what functional activities his family/team want him to be able to do that he can’t currently do, such as play with toys in creative and age-appropriate ways or use objects to accomplish tasks.

• Yes • No – this outcome includes excessive jargon (e.g., “primary caregiver”) and is also worded

negatively, describing what she won’t do instead of what she will do. “Robin will enter daycare calmly and chose an activity” or “Robin will say ‘goodbye mom or dad’ and put away her things at daycare independently” would meet the criteria.

• Yes • Yes – note that this could be a language and/or pre-literacy outcome for a child on an

extended IFSP.

28

What will we do to accomplish the outcome?

Strategies specify who will do what in which everyday routines, activities and places.

The next step, after creating effective IFSP outcomes, is to determine strategies for meeting those outcomes. In other words, what will we do to accomplish the outcome? Strategies determine who will do what in which everyday routines, activities, and places.

29

Strategies must:§ Be developed in partnership with the family

§ Be based on how all children learn

§ Be developmentally appropriate for the child

§ Focus on naturally occurring learning opportunities

Specifically, strategies for effective IFSP outcomes must: • Be developed in partnership with the family, • 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, • Build on familiar activities and routines, and • Describe who will do what.

30

Strategies must:§ Support learning through things that the

child and family are already doing and/or interested in

§ Support primary caregivers to identify learning opportunities throughout the day

Strategies for effective IFSP outcomes must also: • Support primary caregivers to provide children with everyday learning experiences and

opportunities that strengthen and promote a child’s competence and development, and • Support learning that occurs in context of things that have high levels of interest and

engagement for child and family. Once strategies have been developed, it may be helpful for the team to consider:

• Do these strategies build on child and family interests? • Do these strategies build on familiar activities and routines? • Do these strategies describe who will do what?

Functional Outcome: Justin will participate in nursery sing-alongs by singing and making

the finger play movements• Parents and child care provider will sing and make movements to “Wheels on

the Bus” during every circle time and after bath (when family normally does this activity)

• Face Justin towards the adult when signing or telling a story so he can watch and respond

• Parents/child care provider to provide hand-over-hand assistance as needed• Parents/child care provider to use props/movements with other songs and

stories as well• Begin singing a song or fingerplay and wait for Justin to smile or move a

body part to continue• Early intervention provider, parents, and child care provider will continue

brainstorming ways to increase Justin’s participation in these activities

31

This outcome, which addresses the broad early childhood outcomes of having positive social relationships and taking appropriate actions to meet needs, as well as language and pre-literacy skills, may be addressed through numerous strategies over the course of the day both at home and at childcare. The strategies emphasize techniques and learning opportunities that Justin’s parents and other caregivers can readily integrate into their day-to-day activities with him. Notice that the parents and the child care provider are the active members implementing the strategies. The role of the service provider is not to “teach” Justin to react appropriately to stories or even to just give the family a list of suggestions; instead, her role is to help the family determine strategies to try, based on what they know about their child and his interests, what they’ve tried in the past and have found works or doesn’t, and then coach and support the family and other caregivers in integrating it into existing activities. She will do this through use of adult learning techniques, such as modeling, direct teaching, indirect teaching, highlighting, etc.

What: Describes behaviors that can be seen or heard

Frequency: Tells how often the behavior will occur (e.g., 2 times a day, or 3 out 4 opportunities)

Consistency: Specifies over what period of time (e.g., 5 consecutive days)

Justin will make sounds and hand movements to a

familiar song 1x/day 4

days/week, for one month.

32

Effective IFSP outcomes need to include observable, measurable criteria that describe the desired performance. The criteria should answer the question: “What does the family want to see that indicates the child has accomplished this outcome?” What would this look like for them? Appropriate criteria are critical for progress monitoring, which allows the team to move on to additional skills as outcomes are mastered or to change intervention strategies if progress is not occurring. The criteria should describe clearly what the child (or the family, in the case of family outcomes for an IFSP) will do – what specific, observable behavior will occur. Limit each outcome to one specific observable behavior so it is clear what will be measured. “Improve communication” or “Be less stressed” are not specific and observable behaviors that would be appropriate for outcome criteria, but “request the food he wants to eat using single signs” and “go to the gym with a friend” are specific and observable. The criteria also need to specify how often, and over what time period, the behavior will occur. Ask the family how often/regularly the behavior would occur for them to say that the child has met the outcome, such as the number of times per day over the course of a specific time frame that would indicate mastery. A generic percentage (80% of the time) is not a useful criterion, because it does not describe the period of time in question. The criteria should be developmentally and contextually appropriate to the skill and to the child’s current skill level. Most children will not go from using no words to complex sentences in the time frame of one IFSP outcome, and few if any two year olds follow directions every time. Like the outcomes and strategies, the criteria should be based on functional contexts. Outcomes should be measured by how the child uses the skill in meaningful daily activities. Skills measured by a professional, on a checklist or assessment, are not appropriate criteria.

1) Lily will go fishing with her family and hold her own fishing pole.

2) Phu will eat enough food so he can gain weight and not have to have surgery.

3) Kimmie will play with toys so Grandma can make breakfast and get the older kids off to school.

33

Now let’s practice determining observable, measurable criteria for the effective functional, routines-based outcomes that we have already identified. Note to Trainer: Elicit possible observable, measurable criteria from participants using the following examples as needed: • When Lily is able to hold her own pole for 10 minutes at a time, three times per fishing trip, 5

consecutive fishing trips. • When Phu eats five bites of food, every two hours during the day, each day for one month. • When Kimmie is able to play independently with her toys for 20 minutes, 3 of 5 school days

a week, for three weeks.

Learning happens between early intervention visits§Throughout the child’s day§In everyday routines and activities§Through multiple repetitions

and lots of practice

34*Jung, L. (2003). More is better: Maximizing natural learning opportunities. Young Exceptional Children, 6(3), 21-26.

More is better*

*More learning opportunities

Services should be INDIVIDUALLY selected to enable the child to meet the outcomes. They are based on the needs of the child and the family/caregivers, not on a set program model. They should also be designed to support learning and growth across the child’s day, not when interacting with professionals. The notion that more is better is true, especially when the family is actively engaged in providing learning opportunities. These natural routines-based activities can provide the repetitions and risk free practice that can move a child forward to success. All services listed on an IFSP should be purposeful and necessary to help children achieve their functional outcomes. Services from educators, related service providers, and other professionals should be designed to support the people who interact with the child on a daily basis (family members, caregivers, and classroom teachers for children who are in school settings) to ensure successful participation in everyday routines and activities. *Jung, L. (2003). More is better: Maximizing natural learning opportunities. Young Exceptional Children, 6(3), 21-26.

35



IFSPs IFSP Outcomes:

For each standard of effectiveness, reflect on whether your document meets the standard, and if not, how could it be improved?

Let’s review some IFSP outcomes, strategies, and services for their effectiveness and functionality. The Components of Effective, Functional, Routines-Based IFSPs Reflection Tool was developed by MSDE and stakeholders to assist lead agencies and service providers in refining their practice in developing IFSPs that use authentic and appropriate information to develop functional outcomes and routines-based supports and services for young children and their families. This tool is a self-assessments that may be used for professional learning and program improvement. Use the provided sections to review one or more of the IFSPs. For each standard of effectiveness, reflect on whether your document meets the standard, why it meets the standard, and if not, how could it be improved? Note to Trainers: The reflection activity is in teams and is scheduled for 20-30 minutes unless more time is available. The debriefing is scheduled for around 10 minutes.

36



IFSPs

Reflecting on Effective

IFSP Outcomes

Note to Trainers: The reflection activity is in teams and is scheduled for 20-30 minutes unless more time is available. The debriefing is scheduled for around 10 minutes. Debrief with the group, asking questions such as:

• “What areas were your documents strong in? Where can you make improvements?” • “How might this activity help you in your work and within your team?” • “What additional supports do you need to help you successfully identify whether or not

an IFSP Outcome is effective?” Other questions may be added to the debriefing by those using the activity to fit the context of the participants and their learning needs.

37

• Tips and Techniques for Developing Participation-Based IFSP Outcomes Statements, BriefCASE, Vol 2, No. 1 http://www.fippcase.org/briefcase/briefcase_vol2_no1.pdf

• Enhancing Recognition of High Quality, Functional IFSP Outcomes http://www.ectacenter.org/~pdfs/pubs/rating-ifsp.pdf

• ECTA Center website http://www.ectacenter.org/topics/ifsp/ifspprocess.asphttp://www.ectacenter.org/decrp/

• Early Intervention: A Routines-Based Approach - Part 1: Traditional vs. Routines; Part 2: What Intervention Can – and Should – Look Like; Part 3: Changing the Mindset http://veipd.org/earlyintervention/three-new-ei-videos-your-must-watch-for-the-day/

• Video Illustrations of Family Guided Routines Based Intervention http://dmm.cci.fsu.edu/IADMM/examples.html

For more information related to IFSPs, including writing IFSP outcomes and implementing routines-based early intervention services and supports, please explore this list of resources. Your packet contains a handout with these links.

Developing Effective, Functional, Routines-Based IFSPs

Thank You for Participating inDeveloping Effective,

Functional, Routines-Based Outcomes and Strategies

Note to Trainers: Wrap-up final activity and ask participants if they have any questions or if they have next steps to consider based on the reflection tool activity or other information included in the training. Thank participants for coming!

Firstname Lastname

TitleOrganization

[email protected]

Firstname Lastname

TitleOrganization

[email protected]

39

This product was adapted by the MCIE and the MSDE from materials created by the ECTA Center and WRRC in response to the need expressed from state and local providers to have specific information and resources about developing IFSP outcomes. The full training package, including a full reference list, is freely available online:http://www.ectacenter.org/knowledgepath/ifspoutcomes-iepgoals/ifspoutcomes-iepgoals.asp

Note to Trainers: Add the contact information for the presenters on this slide. Consider including name, email address and/or phone number.

IFSP Module 3 Trainers' Guide - Johns Hopkins...

Documents

Transcript of IFSP Module 3 Trainers' Guide - Johns Hopkins...