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Developing and Prioritizing Functional Child and Family Outcomes

girlUsing the list of child and family priorities identified on page 2 of the IFSP, this portion of the meeting is devoted to the identification of specific outcomes the family desires for their child and for their family. In the process of identifying specific outcomes, families should be encouraged to reflect upon

  • The strategies they have already tried to solve the issue (s),
  • what specifically they are hoping the team can do to assist them in achieving their desired outcomes, and
  • other formal/informal supports available in the community that might be helpful.

When writing actual outcomes, it is important that these outcomes be worded as observable behaviors or resources the family wishes to see or have in place during the next 6 months. This is more difficult than it sounds. Oftentimes, outcomes lack specificity or are written in general terms using professional jargon. For example, it is not helpful to write outcomes as "improvements" or "increases" in specific behaviors; nor should outcomes be a description or listing of services to be provided. For example:

This:

Not this:

"Romeo will be able to sit without much support for play and feeding activities." "To improve overall muscle tone."
"Family will be able to safely travel with Romeo in the family car." "Service Coordinator will explore options for financial assistance for travel chairs.

Here are more tips on writing child and family outcomes and some examples of each:

Family Outcomes:

Functional family outcomes provide clear and measurable descriptions of what the family is choosing to work on. The outcome specifies “who” is going to do “what” by “when”. The family decides how the outcome will be measured. In the chart below, the outcomes on the left represent examples that lack specificity and a way to measure. The examples on the right represent those same outcomes using a more functional and descriptive approach.

Not Functional

Functional

Respite care will be arranged for parents so they can work and to give them a break. "To improve overall muscle tone."
  OR Janice and Larry will have at least 2 nights in a month to go out together by January 15, 2014. (Respite care would be a resource needed to meet this outcome).
Parents will put Johnny to bed at a reasonable time. Jennifer and Mike will have information about bedtime routines for young children so they can decide how to set up bedtime for Johnny by January 15, 2014.

Latitia will meet developmental milestones.

Latitia will meet developmental milestones as measured by the GOLD system.

Felicia will have information about early language development so that she feels she knows the next steps for Latitia to be able to talk by January 15 2014.

Child Outcomes:

Functional child outcomes provide clear and measurable descriptions of the change in child behavior or skill as prioritized and expressed by the family - within their family’s naturally occurring daily routines and activities. It is not enough to simply use words like “daily routines” and “participation” without also using information that comes from the family’s descriptions. The outcomes must be written in ways that are measureable and that make sense to the family. This requires a specific knowledge of how often a particular routine/activity takes place in the individual child and family’s life. Examples can be found below. Please note that the outcomes on the left represent examples that lack specificity and a way to measure them. The examples on the right represent those same outcomes using a more functional and descriptive approach.

Not Functional

Functional

Jenny will develop her gross motor skills to allow her to move in her environment for learning. Jenny will demonstrate improvement overall in strength and endurance, balance skills and position 90% of the time. Jenny will crawl or roll into the kitchen every day for 1 week during breakfast so she can be with her sisters before they leave for school.
Ishmael will improve his fine motor development to actively explore toys/environment; further develop transition skills and increase independence to feeding utensils. Ishmael will feed himself with a spoon. We will know he can do this when he feeds himself oatmeal at breakfast 5 days in a row.
Given naturalistic opportunities, Jordie will use a combination of nonverbal and verbal language for a variety of reasons in 4 of 5 opportunities. Given opportunities to match her non-verbal communication skills, Jordie will imitate 4-6 consonant/vowel productions in 3 of 4 opportunities as judged by the SLP. Jordie will spontaneously use words and phrases at meal time and when playing with Barbie with her sister and other children at home and daycare. We will know she can do this when her sister and familiar children understand her words and phrases and she does not have to show them what she wants, at least once per week in both home and daycare.
Law will participate in his daily routine by playing. We will know he has reached this goal when he gets involved in an activity without fighting with his brother Ryan 5 of 7 opportunities. Lawe will participate in hanging out time while his mother fixes supper by playing with things by himself. We will know he can do this when he plays by himself for at least 15 minutes in the kitchen near Mom for 5 consecutive days.
Jace will participate in the family’s routines by becoming more independent. We will know he has reached this goal when he no longer uses his binky and is able to completely dress himself without fighting 4 of 5 opportunities. Jace will participate in bedtime by going to sleep on his own. We will know he can do this when he goes to sleep within 30 minutes after his bedtime routine without his binky at least 3 nights in a week.
 

AND (there are 2 priorities in the left side outcome example which come from different routines)

Jace will participate in dressing by putting on all of his clothes by himself. We will know he can do this when he puts on all of his clothes within 20 minutes of being asked 2 times or less to “get dressed” on both days of the weekend.

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.

Click here to view the sample IFSP you have been following.

 
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