Developing Functional, Prioritized Outcomes

Discussion of Family and Professional Views of Outcomes

This portion of the IFSP meeting should include a discussion of the family's and professional's views about important family/child outcomes that would be possible in the next 6 months.

The family should be provided an opportunity to share the wishes or goals they have for their child/family in this upcoming 6 month period. They should be encouraged to elaborate on

• what they have tried themselves already and
• what specifically they are hoping people on the team could do to help achieve that outcome.

A person designated as a "recorder" should be noting these family-identified wishes/goals on paper.

Next, the professionals at the meeting should engage each other in a conversational discussion highlighting what they believe to be important for the child/family. This might include a quick review of recommended targets by the MDT (not recommended services), child care provider, grandparents, physician, nurse, social worker, etc. Professionals will need to provide justification/rationale for these suggestions, especially if they differ from those proposed by family members.

A recorder should be noting these professional-identified wishes on paper.

Summary/Prioritizing of Family- and Professional-Identified Outcomes

The recorder can now outline/summarize all the nominated wishes/goals. Family and professionals should rank order the outcomes in order of priority. This can be done individually on paper and shared or collectively as a group process. Factors to consider when prioritizing outcomes include:

• Importance to family members
• Likelihood of family and team acting on the outcome within the next 6 months.
• Probability that attention to the outcome will result in change in the next 6 months

Unlike the IEP for older children in the public schools, the IFSP is not an education-only document and should aim to address outcomes targeted at family as well as child needs. Not all families will have or want family concerns or outcomes listed on the IFSP. However, when family concerns related to care and raising of the child with special needs have been identified and discussed (listed on page 2), every effort should be made to identify possible resources to address them and list outcomes desired to resolve the concern.

The team should agree which, if not all, listed outcomes will be a priority and the focus of the IFSP for the next 6 months. Left-over outcomes on the list can be incorporated into other outcomes or simply listed as topics requiring ongoing discussion/evaluation during the next 6 months. For example:

"Team will determine need to pursue communication systems, electric wheel chairs, safety helmets, speech therapy and home-health care in the year ahead."

Outcomes should be worded as observable behaviors or products the team wishes to see or have in place in 6 months. It is not helpful to write outcomes as "improvements" or "increases" in specific behaviors. Outcomes should not be a description or listing of services to be provided. Futhermore, the outcomes for the IFSP, unlike the IEP should be worded to reflect the family's understanding of the the outcome. Federal law does not specify how to phrase the wording of the IFSP outcomes other than to say they should reflect the family's words and wants. This requires that families, services coordinators, and others involved in the IFSP process engage in conversations about realistic and useful outcomes for the family.

Some or all prioritized outcomes may require rewording to satisfy the intentions of all present. Whenever possible, vocabulary and phrasing used by the family should be used to write the outcome on the IFSP form.

For example:

Let's take a look at some comments/suggestions parents and team members have made for possible outcomes. After each is an example of how that goal can be made more specific and possibly more helpful.

Family Outcomes:

Services Coordinator: Family will be empowered.
Specific Outcome: Family will be able to identify needed community resources in addition to those offered by the treatment team.

Educator: Family is open to receiving services.
Specific Outcome: Family will pursue/secure additional respite care available through the local church and community center.

Parent: We want what is best for Thomas.
Specific Outcome: Family will work with Thomas on developing communication skills by learning about appropriate communication milestones and methods to encourage his communication.

Child Outcomes:

Physical Therapist: Jose will improve large motor skills.
Specific Outcome: Jose will successfully crawl, pull himself to sitting position, and reach for objects.

Psychologist: Sasha will learn age appropriate social skills.
Specific Outcome: Sasha will have daily opportunities to play and interact with other childrenn.

Speech Pathologist: Johann will learn language skills.
Specific Outcome: Johann will use gestures and simple words to identify needs and wants.

Click here for other specific and general examples of outcomes; note the wording as well as the type of behavior/event that is targeted in each.