Individualized Family Service Plan (IFSP) is intended
to be developed and implemented by a team of people,
including the family and community service providers
from various agencies. The IFSP process is most effective
when all members appreciate the team model that is being
used by the majority of the team members. During the
IFSP planning process, the team members should engage
in an explicit discussion of how the team should "best"
operate in order to be most effective.
can exist for purposes of assessment, treatment/intervention
or evaluation. One team may address all three functions,
or new members may be appointed/invited to constitute
new teams for different functions or different points
in time. Teams appear to operate in predominately one
of the following three models.
Team:* a group of people who perform tasks
(e.g., educational, medical, familial) independent
of one another, with individual expertise, and
provide services directly to client/family/child
with little coordination or consultation with
than one person is providing input. Expertise
can be tapped.
communication between players can result in
duplication or gaps in services.
The Federal requirement for Multidisciplinary
Team (MDT) evaluation implies at least this
model of team functioning. However, interdisciplinary
or transdisciplinary models may be employed for
Team: a group of people who perform tasks
independent of one another, with individual
expertise, but who coordinate their efforts
with one another to maximize the benefits for
the client/family/child and minimize the duplication
of procedures/services. Coordination usually
takes the form of "staffings" and/or meetings
generally that include the family
and synthesized reports reduce likelihood
of duplication and overlap in services. Members
stay aware of other service provider's goals/priorities.
Problem-solving can be pursued with expertise
from a variety of players.
families with high needs, the number of team
members can become overwhelming. Schedules for
individual sessions/meetings, the individual
goals/expectations and different treatment philosophies
can burden family and child. Coordination of
staffings/meetings are difficult given the number
of people and need for larger meeting spaces.
Communication between members typically relies
on the infrequent staffing/meeting/report or
family member as messenger.
A decision to use an interdisciplinary team
model might be based on:
need for multiple direct providers from an
array of disciplines
needs are limited to 1-2 unrelated areas (i.e.:
needs are limited to 1-2 areas where professional
expertise and agency boundaries make role-release
less than effective/efficient service (i.e.:
speech, child protective services)
needs are limited to few domains and staffing
and scheduling are not a challenge for agencies
employing the needed providers.
Team: a group of people who perform tasks
collaboratively by sharing not only information,
but roles. Mutually agreed upon priority goals
are developed and information, knowledge, and
skills are transferred across disciplinary boundaries.
Periodic staffings/meetings and frequent consultations
(monthly at least) provide opportunities for
exchange of information and training as various
members assume a primary facilitator role for
addressing the goals.
All team members are considered 'active' and
must be available to meet with others on the
team at least monthly and to deliver service
directly as needed.
Direct service by other members can continue
but less frequently, if the primary facilitator(s)
is/are capable of addressing those discipline-related
families/children with many needs, the number
of people providing direct service to family
and child is limited and manageable for family.
For families/children with needs in only 1-2
areas, the primary need could be addressed more
Family members are viewed as capable team members
and supported in their efforts to address goals.
Encourages focus on priority goals only at any
one time. Attention to child as whole is achieved
by integrating services into functional activities
and provision by fewer providers.
"primary" provider for a family/child
with more needs can be challenging.
For larger teams, establishing frequent communications
for exchange of information can be challenging
and require a shift away from exclusive use
of face-to-face dialogue. Members must have
expertise to share and know how to coach others
to do as they would do. Since members may not
always trust others to address what they believe
is their area of expertise, gaps in service
Primary providers with limited experiences or
training may feel overwhelmed and provide ineffective
Family needs may be a challenge for one provider
who has more child expertise.
Decisions to use a transdisciplinary team model
might be based on:
request/need for fewer providers or more integrated
access to specialized providers in region
(i.e.: SLP, PT, OT, Nurse) due to distance
progress due to health status or family stressors
goal(s) for period of time necessitates intensive
attention by one discipline (i.e.: PT following
delays are limited to primarily 1-2 integrated
domains (i.e.: speech-cognition or movement-adaptive)
members ability to meet regularly (electronic
or face-to-face) to share expertise and consult
For more information about the Primary Service Provider model there are two documents developed by The Family, Infant and Preschool Program (FIPP) Center for the Advanced Study of Excellence (CASE) in Early Childhood and Family Support Practices.
knowledge and skill in own discipline
of each other's expertise/past experiences
together to develop at least adequate work relationships
based on trust and respect
(known, routine, flexible) communication
upon goals/agenda for every contact/interaction
of all members to focus on the family/child's needs
and not their own agenda
in each member for what they can offer to the team
in asking for help and offering help
to ask for clarification
of occasionally filling in for absent team member
on some tasks
communication skills for listening, interviewing,
and skill to engage in mutual problem-solving
Member's Experience is:
Member's Attitude or Confidence is:
A Helping Style to use:
help; show them how to do the task. Follow-up
and encourage them.
when invited and provide observation and feedback.
Sell your ideas by giving rationale for your suggestion.
to yours or more than yours
Support/encourage them. Educate them on the why
or how of the new task.
Collaborate. Problem-solve together.