Logan’s annual IFSP review is underway and you are excited to celebrate his progress. You’ve been working with his family for a year so you’ve seen the steady pace at which Logan continues to develop. When he first entered early intervention, he was only two months old and doing most of the things a two-month-old needed to do. Now that he’s 14 months old, his delays appear more significant but you want his parents to remain hopeful so you and your colleagues explain the assessment results, celebrating his gains and acknowledging the next skills to come.

When the team discusses the child outcomes summary process, the service coordinator uses the Decision Tree (PDF, New Window) as a guide. Because of his age and slow but steady progress, Logan is showing very early skills when compared to his same age peers, which sounds very different from the discussion the team had last year. You want to help Logan’s parents understand why this is, but then another team members drops this question:

“So what do we think? Is Logan a 1 or a 2 now?”

“OMG,” you think, “Logan is NOT a number!” Now what do you do?

Children are Not Numbers on the Decision Tree

This is an important point that ALL team members need to understand. The discussion about the child outcomes and the Decision Tree (PDF, New Window) should never include labeling a child with a number. It should be about using the information you have to make an informed decision as a team that describes Logan’s development according to the three global child outcomes (“global” because these are outcomes we’d like to see for all children during their early childhood years).

During the meeting, the team describes the child’s development using summary statements on the Decision Tree, not numbers (see the Child Outcomes Booklet (PDF, New Window) for more info). The numbers on the Decision Tree can be thought of as categories that describe skill development related to the child outcomes – not categories of children. For example, “Category 1” includes a summary statement (or description) that tells us that Logan has “very early skills in this area. This means that [Logan] has the skills we would expect for a much younger child.” This does NOT mean that “Logan is a 1.” While the service coordinator does have to report a number for each outcome in documentation back at the office, and these numbers are referred to as “child ratings” according to the Office of Special Education Programs (OSEP), it’s a really good idea to let go of the idea that the child outcomes discussion results in a number for the child. Let. It. Go.

Here’s why: If you hold this belief, even an underlying belief in linking a child to a number, then you will convey this belief to the family. No parent wants their infant or toddler rated or numbered. It can be hard enough for a parent to hear the age equivalency scores from the assessment tool. Parents must be involved in the child outcomes discussion, and we want them to understand the process – a process that, admittedly, can be hard to explain.

The Words You Use Matter – Tips for Developing Your Script

The words you use to explain this process matter. Yes, some parents may be mentally exhausted by the time you get to this discussion, but that does not mean you should sugarcoat it, skip it, or hurry through it, which can be tempting to do. It can also be tempting to let the professional team members discuss the process without much explanation for the parent. To avoid this, try these tips:

1. Write down a sample script for how you can explain the process to all team members (including and especially the parent) without assigning the child a number, then let a colleague read it and give you feedback.
2. Read it out loud to yourself and see how it sounds.
3. Listen to how others explain the process and “borrow” their words.
4. Ask families who are already enrolled in your program what they understood about the child outcomes discussion from their initial or annual IFSP meeting.

Here’s a big one: Dig in a bit and reflect – Are you the team member who asked about a child’s “number” at an assessment or IFSP meeting? If you are, then it’s a good thing to recognize that now and commit to a change in thinking for your next assessment or IFSP meeting.

There is No Need to Pick a Number at the Meeting

How you explain the process will likely differ from your colleague’s script and that’s okay. The words you use may change a bit with each meeting depending on your style, the team with whom you work, the family’s understanding and learning needs, etc. The important point here is to think about the message you (and your team members) convey with the child outcomes process. There is no need to “pick a number” for a child during the meeting, but there is a need to be accurate, respectful, and sensitive while helping all team members understand, participate in the process, and identify summary statements to describe the child’s development.

Open the door for this discussion with your team members using the questions here, or share your thoughts by adding a comment below:

How do you explain the child outcomes discussion process to families? What are your go-to phrases to help all team members understand?

If a team member tries to pick a number at the meeting, what could you say in response?

For more information, check out these resources:

Virginia’s Child Outcomes Booklet (PDF, New Window)

Virginia’s System for Determining Child Progress (OSEP Child Outcomes)

Decision Tree Tutorial Video

The post Logan is Not a Number! – Explaining the Child Outcomes Process appeared first on Early Intervention Strategies for Success.

Wyatt was just referred to early intervention (EI) and his parents are unsure about what to expect. EI is a new system for them, one full of acronyms, paperwork, and professionals. They are eager to get services in place but are feeling overwhelmed by the process and Wyatt’s new diagnosis of cerebral palsy. Their service coordinator, Phoebe, met the family at the intake and is working with them to schedule the assessment. She wants to support them in a way that is respectful and responsive to what they need while helping them feel comfortable and informed.

Using the Family RPs to Guide Our Work

When you read the Family component of the DEC Recommended Practices (2014), you’ll find that they discuss three themes that are important to EI: family-centered practices, family capacity-building practices, and family and professional collaboration. Our work should always be family-centered because infants and toddlers develop within the context of their families. The lens through which we provide support should always focus on family capacity-building. If we are doing our jobs right, parents’ knowledge and skills expand and their abilities to facilitate their children’s development, access resources, and get their needs met are strengthened. How this happens is through a collaborative partnership with the family, where we are equal team members, working together to develop and implement the IFSP to help them achieve their goals for the child.

In our example, Phoebe can use these guiding themes and the specific RPs to reflect on the support she provides. Let’s look at the first five family RPs and see how Phoebe has implemented them.

DEC Recommended Practices: Family

F1. Practitioners build trusting and respectful partnerships with the family through interactions that are sensitive and responsive to cultural, linguistic, and socioeconomic diversity.

This began for Phoebe when she first contacted Wyatt’s family to schedule the intake. She scheduled the intake early in the morning, when both parents could be home, as Wyatt’s mother works the afternoon shift at a local nursing home. She took time to get to know the family and explained the importance of a trusting partnership between the family and other team members.

F2. Practitioners provide the family with up-to-date, comprehensive and unbiased information in a way that the family can understand and use to make informed choices and decisions.

Phoebe explained the EI process, family rights and safeguards, and family cost share so that Wyatt’s parents could make informed decisions about next steps. She took her time and offered the family opportunities to ask questions. She applied this information to their specific situation, encouraging them to help decide who would attend the assessment, when it would be scheduled, and what information they would like to share with the rest of the team.

F3. Practitioners are responsive to the family’s concerns, priorities, and changing life circumstances.

Phoebe asked open-ended questions to determine what the family wanted to see happen as a result of their participation in EI. She asked about their daily routines, their interests, their concerns, and what went well and what was challenging related to Wyatt’s development. She was careful not to make assumptions about what Wyatt or the family would need, based on his diagnosis. After their discussion, Phoebe asked for the family’s permission to include this information in Wyatt’s IFSP and share it with the rest of the team so that they could use it when developing outcomes and goals.  

F4. Practitioners and the family work together to create outcomes or goals, develop individualized plans, and implement practices that address the family’s priorities and concerns and the child’s strengths and needs.

During the assessment and IFSP meeting, Phoebe helped Wyatt’s parents share what they told her during the intake and provide updates. She frequently turned to them first for their input into Wyatt’s outcomes and goals and what types of services they felt they needed. Phoebe helped everyone on the IFSP team keep the family’s priorities, interests, routines, and goals in mind as they developed outcomes and determined services. She used her leadership skills to guide a family-centered process.

F5. Practitioners support family functioning, promote family confidence and competence, and strengthen family-child relationships by acting in ways that recognize and build on family strengths and capacities.

After the IFSP was developed and services were in place, Phoebe regularly checked in with the family and the physical therapist to make sure that intervention focused on building the family’s capacity to facilitate Wyatt’s development. She shared her excitement about Wyatt’s progress, often complimenting his parents on their successes with weaving intervention strategies into Wyatt’s daily routine. She checked in often to find out how the family was feeling about Wyatt’s progress and their services and to see if any new issues has arisen that might affect family functioning. She was attentive and responsive when the family or the physical therapist expressed a concern and pulled the team together to meet whenever needed.

Whether you are a service coordinator like Phoebe, or a direct service provider, you can use the Family RPs to reflect on the quality of the support you provide. Take a moment and check out these Family Checklists, which are one-page tools you can easily use as you think about what you do everyday:

Family-Centered Practices Checklist (PDF, New Window)

Informed Family Decision-Making Practices Checklist (PDF, New Window)

Family Engagement Practices Checklist (PDF, New Window)

Family Capacity-Building Practices Checklist (PDF, New Window)

Be sure to check out Part 2 of this series to see how Phoebe applies the last five family practices in her work. Now, take a few minutes and think about your day. Click on one of the checklists and take 60 seconds to reflect on what you do and what you could do even better!

How have you applied these practices today? 

Pick one checklist and forward the link to a colleague today. How else could you use these checklists to improve your practices or those of your staff?

To read more about how to implement other DEC Recommended Practices, be sure to check out the rest of this series by searching for “DEC Recommended Practices” using the search feature at the top of the page.

The post DEC Recommended Practices: Family (Part 1) appeared first on Early Intervention Strategies for Success.

As the idea of conducting functional assessment takes root here in Virginia, there have been some worries about what it means. Does it mean that we won’t do our more traditional assessment anymore? How will we determine a child’s age-equivalency? How will we get all of the information we need? Who will do the functional assessment? When will we do it? How will we find the time to do both???

Some level of anxiety is very normal as a new process is introduced and we strive to figure out how it fits into what we already do. An important thing to remember is that functional assessment actually fits beautifully with the principles and best practices of early intervention. Think about it this way…we’ve always known that viewing a child’s development from a functional point of view is best practice. We’ve always known that traditional assessment provides us with just a snapshot of what a child can and cannot do. We’ve also always known that the results of a traditional assessment, while they may help us confirm eligibility, don’t otherwise mean much unless they are translated into what they mean for a child’s interactions and participation in activities that are relevant to everyday life. These are things we can agree on. The difference now is, our state (and many others) is looking to ensure that we always have a functional perspective and use it with each child to ensure that early intervention truly is individualized and appropriate.

Authentic Assessment

Just this morning, I read a great article entitled “Authentic Assessment – What’s It All About?” Sometimes the terms “authentic” is used to describe the type of assessment we are working towards – authentic meaning that we consider development in the context of the child’s experiences in naturally occurring activities and routines. The authors of this article made a powerful point – that we don’t have to use one type of assessment over another, that we don’t have to worry that this is an either/or discussion. Instead, they suggest that this can be a both/and decision. There is a place for traditional assessment, especially in the early intervention context. Learning about a child’s development, as it compares to other children, is useful in helping us confirm eligibility (like when it can’t be determined from medical records). It helps us figure out why an infant or toddler is struggling when we find gaps in skills or atypical developmental patterns. We can then use that information to focus on how these differences impact the child’s everyday experiences and interactions – the functional assessment piece. Knowing about the child’s developmental status in combination with an understanding of how the child participates in daily routines like bath time, meals, playtime with others, and going out in the community will lead to better IFSP outcomes, more individualized EI services, and hopefully intervention that improves child and family quality of life. That’s what EI is really all about. Yes, we still have to figure out the answers to some of the above questions, and I’ll be exploring them in future blog posts, but the good news is that we are going to do that together.

How do you feel about combining traditional and functional assessment? What do you think it’ll look like in your system?

What questions do you have about implementing functional assessment? 

If you are already using it (and many of you are), share what it looks like and how you’ve woven it in to your assessment and intervention processes.

Share your thoughts by leaving a comment below!

Check out a few other great resources from the ECTA Center and DEC to learn more:

Authentic Child Assessment (practice guidelines) (PDF, New Window)

Authentic Child Assessment Practices Checklist

The post Functional AND (not or) Traditional Assessment appeared first on Early Intervention Strategies for Success.

I have a confession…I don’t actually think we should spend so much time talking with families about their concerns. I think we should ask once, so that we have it for Section II of the IFSP, then leave it alone. Instead, I think we should focus much more on the family’s priority for their child’s development. Concerns and priorities are not the same thing, and the difference matters.

Concerns and Priorities – What’s the Difference?

Concerns are often similar from family to family. Think about the many, many toddlers who are referred to early intervention who are not talking. In fact, most of the children we see are not talking as an age-appropriate level. When you ask their parents what they are concerned about, they are likely to say something like, “He’s not talking like other kids his age.” This is a very common, very real concern. Same with children who are late walkers. These concerns are very important because they are what drive a parent to EI, and they are what keep a parent up at night, worrying about her child. We must acknowledge these concerns, and record them on the IFSP, then dig deeper to find out about priorities.

Turning to priorities reframes the discussion to become more individualized, more positive, and more functional. Priorities are the answers to questions like “What would it look like to you if she was able to talk more?” or “How would your day or your child’s day be easier if she could say more words?” Priorities are descriptions of what life would be like for a child and family if things got better. Priorities reflect the family’s vision for the child’s development. Priorities are the foundation for individualized, functional IFSP outcomes.

Why It Matters

It’s really, really hard to write a good IFSP outcome based on concerns alone. When we focus on concerns, we get outcomes that are “cookie-cutter.” You can substitute any child’s name in the body of an outcome like this: Noah will use words to express his wants and needs. All toddlers need to be able to do that – it’s not an individualized outcome. If you focus on priorities for Noah and his family, you’ll find out that life would be grand if Noah could say words to label toys and activities he likes to do when he plays with his siblings after school. Noah loves to play with his blue ball in the back yard, play in the toy kitchen with his sisters, and look at books with his dad. By digging into priorities for Noah and hus family, we learn about how the family works and what’s important to them. This rich information is where you glean what you need to know to write a good outcome. Here’s an example:

Noah will use 50 words to label his favorite toys (ball, cup, book, doggie) and activities (play, outside, kitchen, dinner, books) when playing with his siblings each afternoon after school for two weeks.

This outcome is individualized to what Noah likes to say and do, includes a context that happens frequently in his home, and includes a measurable criteria that the family can keep track of. If the professionals on Noah’s IFSP team had only focused on his family’s concerns, then they would have missed out on what they really needed to know to ensure that the IFSP was meaningful to Noah’s family. This is important because the IFSP outcomes guide service delivery, and meaningful services are based on what’s important to the family – their priorities for their child.

What do your teams typically focus on – concerns or priorities?

What challenges do you face with finding out about family priorities?

How do you guide the conversation to dig deeper into what’s important to families when writing IFSP outcomes?

Share your comments below!

The post A Priority or a Concern – What’s the Difference and Why it Matters appeared first on Early Intervention Strategies for Success.

As you get to know Jackie, Teddy’s mother, you learn that she has very high expectations for her son. She expects him to feed himself without getting messy, sit during children’s church on Wednesday and Sunday, and begin potty training – but Teddy is only 19 months old. He’s just learned to walk a few months ago and is eager to move. She tells you that Teddy is just being stubborn when he won’t do these things and she’s feeling really frustrated. Other than mild motor delays, Teddy’s development is typical for his age. He may not qualify for EI services much longer, and you are concerned that Jackie’s expectations are too high to be healthy for Teddy.

What do you do?

High Expectations…or Unrealistic Expectations?

Many parents have high expectations for their children. In fact, having high expectations is generally regarded as a good thing for encouraging children to reach their greatest potential. However, there is a line that can be crossed between having realistic, developmentally appropriate expectations and unrealistic expectations that either push the child too hard or demand that the child behave in ways that just aren’t possible for him yet. Having unrealistic expectations is stressful for the child and the parent – and the early interventionist as well. If you find yourself working with Teddy and Jackie, here are three strategies to try:

Ask about what the parent knows about development– Taking the time to ask the parent what she knows about when children typically achieve these milestones is a great place to start.

Discuss the smaller steps that lead to the milestone – Once you know what the parent knows, you can talk about the smaller steps the child needs to learn to get there, emphasizing what is developmentally appropriate for her child. Individualizing this discussion in important so that the parent feels “heard.”

Explore why these milestones are important to the parent – Sometimes unreasonably high expectations are rooted in a lack of information about development, or a deeper concern about the child’s developmental differences. Rather than judging Teddy’s mother, step back and explore why she wants him to do these things. Maybe his behavior at church embarrasses her and she’s not sure what to do. Maybe she doesn’t like getting messy herself so doesn’t want him messy either. Maybe diapers are so expensive that she is eager for him to potty train. Explore the roots of the expectation and help her find a way to manage them. This could lessen the stress on her, and Teddy too.

High Expectations…or Hopes for the Child’s Future?

Another issue with expectations can crop up when we perceive a parent’s expectations as too high because we aren’t sure if a child will ever achieve a particular developmental ability. For instance, I was part of an IFSP team once where the father’s IFSP outcome for his 10-month old son was to play tee-ball one day. The child had a new diagnosis of cerebral palsy, and quite honestly, we didn’t know when he would be able to run the bases or swing a bat. I participated on another team once where the family adamantly wanted the child to walk independently. The child has multiple, significant developmental delays. In both situations, the professional team members wrestled with what to write on the IFSP. We didn’t want to feel like we were setting the parent up for disappointment by putting something on the IFSP that we didn’t think could happen before the child turned 3 years old, but we also wanted to respect the family’s hopes for their child.

So what did we do? In both cases:

• We talked with the parents about the developmental steps that needed to come before the children would play tee-ball or walk, and we wove those into the outcomes.
• We concluded the outcomes with phrases like “…to prepare Jamie to play tee-ball when he’s older.” or “…to help Brooklyn learn to move on his own.” so that the family knew that we “heard” them and valued what was important to them.
• We tried to balance educating with family about the developmental steps that preceded these major accomplishments while honoring what they wanted for their children.

Expectations are all about working toward a child’s future. Honor a family’s expectations when you can, and educate when the expectations are causing stress, like for Teddy’s family. When you think about it, how do we ever know, as the professional team members, if a child will or won’t meet those expectations eventually? We can’t know, so why not honor the family’s expectations and do what we can during our short time together to work toward outcomes that are important to them?

What do you do when working with a caregiver who has expectations that seem really high for the child?

What strategies do you use to educate while honoring the family’s hopes? 

The post The Parent’s Expectations are So High…What Do You Do? appeared first on Early Intervention Strategies for Success.

Imagine you are the parent who’s child is newly referred to early intervention (EI). Someone calls you and asks to come by your home. “Why,” you wonder, “do they want to come here?” Then, when the service coordinator arrives for the intake, she asks you personal questions about your child’s medical history and your family finances. “Why do you need to know about my income?” you ask. The assessment is held and they say your child can’t stand on one foot or dump pegs from a bottle. You think, “So what? He’s never had a reason to before.” You’re exhausted but the group plows on and asks you about your goals for your child and what services you’re interested in. “I’m not sure, what do you think?” you ask, while wondering why they are asking you when they are supposed to be the experts. So many questions…it’s all overwhelming and puzzling. And then the therapist comes out for the first visit, and asks you more questions about your daily routines. Maybe if you understood why all these questions were important, you would know how to answer them…

Sure, this might be an exaggeration and some families might not feel this way at all. However, really try to put yourself in this parent’s shoes. If he or she has no previous experience with EI, all of these questions could seem like an intrusion. It’s easy for us (as early interventionists) to plow through these first visits because we know why we need the information and this is our world. Imagine for a moment what it must be like for a new parent, probably in a vulnerable position, to walk into this world and get asked so many questions.

Now consider – what can you do to make this easier for the parent?

ALWAYS Explain Why

Adults naturally need to understand why something is happening, why it’s important, why it matters. Not knowing can be a barrier to developing the relationship with the family so start off on the right track with building understanding. Remember that most parents have never been a part of a system like EI and you are there as a guide. Take a few extra moments before you ask questions or share information to explain why it is important and how the information is relevant to each step in the EI process. For example, rather than starting the conversation with “What are your goals for your child?” (which can really put some parents on the spot), start with an explanation such as “One of the things we do when we are writing the Individualized Family Service Plan, or IFSP, is talk about what you would like to see your child learn to do. We call these goals because they will help us understand what you’d like to get out of early intervention. The goals also help us figure out how to help you and which service provider might be best to come work with you. When you think about  your child’s development, what would you like to see him be able to do in the next few months?” Sure, it takes longer but it helps the parent understand why the question and answers are important. It also encourages her active participation and decision making , which is key for a successful EI partnership.

Have a Conversation – not an Interview

Parents in EI should never feel like they are being interviewed. Everything we need to know can be gathered from a rich, engaging conversation. No matter how much paperwork you have to complete or how many questions are on your intake form, take the time to have a conversation and I bet you’ll learn all about the family’s priorities, concerns, resources, outcomes, and interests. Use open-ended questions, and follow them with feedback that lets the family know you’re listening. Dig deeper and listen for key information…then maybe you won’t have to ask so many questions.

Read the Situation and Adapt

Some parents will be ready to go – sharing information and freely asking and answering questions. For others, they might need to go a little slower and absorb what is happening at their own pace. Be mindful of where the parent is in the moment. You might have to make more than one visit to complete the intake. You might have to schedule the IFSP meeting at a different time because the parent has had enough with the assessment. Yes, we have our timelines, but our family-centered practices are important too. If the parent needs more time, or opts out of sharing something, that’s okay. Be sure to let the parent know that too and then document their decision. Afterall, we do this job to support them. It’s their IFSP and their EI experience. Let’s make it a great one.

What strategies would you add to this list?

How do you avoid overwhelming parents with too much information and too many questions at the intake, assessment, IFSP meeting, or the first service visit?

Share you great ideas in the comments below!

The post Explaining WHY We Ask So Many Questions appeared first on Early Intervention Strategies for Success.

Have you been sitting in an IFSP meeting and heard another team member say “Wait…isn’t that outcome too specific?” or “If we put one specific routine in there, does that mean that’s the only way we work on this outcome?”

If these questions sound familiar, then read on (or watch the video blog on this topic) because by the end of this post, I hope you’ll have an ah-ha moment and gain a tip you can share with your reluctant colleagues!

The Answer: No! Being Specific is Important!

When early interventionists are learning to write more specific, measurable, individualized IFSP outcomes, this is a common worry – that making the outcome TOO specific and individualized limits the scope of service delivery. This is not true and here’s why: Including a specific routine in the body of an outcome only provides you with the context in which that outcome will be measured.  Read that again. 🙂

Consider the following outcome:

Elise will use ten two-word phrases to request or label her favorite things to do (e.g., down slide, my ball, sand box) while playing in the backyard with her cousin  three afternoons a week for two weeks.

This outcome is very specific. It is individualized to include a favorite and frequent activity that Elise enjoys. It is measurable in that, when Elise is consistently using two-word phrases during backyard play (“consistently” is defined as using 10 phrases during three afternoons a week for two weeks), we can assume that she is using two-word phrases during other activities as well. Inserting the context of having Elise use phrases during backyard play only provides the IFSP team, including the family, with a meaningful way to measure progress. It does not mean that early intervention services should only be provided in the backyard, nor that intervention strategies should only be practiced in the backyard. Rather, services should be provided to support Elise’s caregiver in using intervention strategies across a variety of routines. When Elise is talking with her cousin in this one familiar routine, though, we can feel confident that she has accomplished the “big picture” outcome of expanding her vocabulary and combining words to get her wants and needs met. This last phrase, “get her wants and needs met” might look familiar…

Let’s compare Elise’s outcome with one that is quite common on IFSPs:

Elise will use two word phrases to get her wants and needs met during daily routines.

Sure, I suppose you could say that these outcomes are very similar. They both sort of reflect the big picture. What this outcome is missing, though, is important. This outcome is not measurable. How it will be measured is so nebulous that each IFSP team member could assume something different. Will Elise meet the outcome when she can use two phrases? What will she talk about? If she’s using a phrase or two once or twice a day, is that good enough to say that she’s achieved the outcome? Based on how this outcome is written, we have no idea.

Which Outcome Looks Familiar to You?

Take a moment and reflect on the outcomes your team wrote during your most recent IFSP meeting. Which outcome is closer? How might you help your team understand the importance of writing outcomes that are truly individualized, routines-based, and measurable? Sharing this post might be a first step!

Are you wrestling with the dilemma mentioned in the title of this post?

What have you done to help your team members write better outcomes?

Share your insights in the comments below! And don’t forget to check out our new Video Blogs page too and let us know what you think!

The post Wait…Isn’t that Outcome TOO Specific? appeared first on Early Intervention Strategies for Success.

There are many “rules to live by” when developing IFSP outcomes, and some of these rules vary from state to state. In Virginia, our IFSP includes both long-term outcomes and short-term goals; in other states, only long-term outcomes are included. When you have to write both, it can be tricky to make sure that outcomes and goals are meaningful, measurable, and, of course, individualized. This really is a tall order!

Whenever we do training related to the IFSP or outcome development, we’re always asked for examples of good outcomes and goals. I’m going to try to provide a few examples and I’d love to get your feedback! These examples will be framed in the context of 3 “rules to live by” when developing outcomes and goals. Here goes:

Rule to Live By #1 – BOTH outcomes and goals should be individualized and measurable.

Bad example: Jason will use words to express his wants and needs.

Here we could plug most of the children who receive EI in where we see Jason’s name – the outcome is not individualized. We also don’t know what Jason needs to say or when we’ll know when the outcome is met.

Good example: Jason will use 15 words to ask for people and things he needs, such as his mom, dad, blankie, ball, juice, at least 5x/day  across one week.

This example helps us understand some of the family’s priorities for Jason’s communication (assuming that we asked the parents what they wanted him to say). We also know that Jason has achieved this when he has around 15 words that he uses regularly, as measured by looking across a week.

Rule to Live By #2 – Outcomes and goals should be specific to a meaningful routine or activity.

Bad example:  Jason will use and understand words, follow directions, walk, and play like other children his age.

Wow, Jason will be busy! This long-term outcome is much too full and not the least bit individualized. Too many areas of development are crammed in here.

Good example: Jason will walk across the room independently (5 ft) to get to the dog when he hears the dog’s name everyday for one week.

This outcome combines Jason’s developing motor, cognitive, and receptive language abilities. This could be a long-term outcome or a short-term goal. Being this specific does not mean that this is the ONLY thing that the parent and interventionist address. When Jason can do this specific task, we hope that it will be evidence that he is independently mobile, able to understand some words, and can follow simple directions. This activity would have also been chosen based on info from Jason’s family – perhaps they play a game with Jason, asking him “where’s Barky?” By using this meaningful activity, you help the family understand how development is interrelated and you have a great way to measure progress.

Rule to Live By #3 – Outcomes and goals should relate to each other.

Bad example: LT Outcome – Jason will walk across the room…(same as above)

ST Goal – Jason will eat three bites of textured food without choking at each meal for 2 weeks.

This short-term goal has absolutely nothing to do with the long-term outcome. If Jason needs support with feeding, then in this case, a separate long-term outcome is needed.

Good example: LT Outcome – Jason will chew a variety of textures at his meals, including chicken and other meats, without choking or gagging by feeding himself small bites at each meal for 2 weeks.

ST Goals – Jason will feed himself 3 bites of food using his finger tips or his spoon at each meal for one week. Jason will chew bits of meat without gagging or choking at two meals/day for one week. Jason will sit in his highchair to play for 10 minutes 2x/day for one week.

We can assume that Jason is struggling to eat meat (we would have asked about this before writing the outcome), that he gags a lot, and that his parents want him to start feeding himself. Jason has never been in a high chair but the family has one. The “playing in the high chair” goal might seem unrelated but it is part of getting him acclimated to the chair which will provide the support he needs to reduce his gagging and to learn to self-feed. This outcome is specific to Jason and his family’s priorities and the goals represent small steps that will help Jason achieve the intended outcome.

This is a great time to reflect on the outcomes and goals you and your team write. Do they meet these 3 rules?

What are your “rules to live by” for developing individualized and measurable outcomes and goals?

For more information, visit the VA Early Intervention Professional Development Center’s IFSP and Outcome Development page. For ideas to support your staff as they learn how to develop quality IFSP outcomes and goals, visit our Outcome Development Mini-Lesson and our Quik Reference Guide: Want to Write A Good IFSP Outcome? (PDF, New Window)

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