integrating the child outcomes into the ifsp process anne brager, va part c program sherri britt...

Integrating the Child Outcomes into the IFSP

ProcessAnne Brager, VA Part C Program

Sherri Britt Williams, NC Part C Program

Kathi Gillaspy, ECTA Center

May 22, 2014

2014 Inclusion Institute1

Why Integrate Outcomes?

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For children

to enable young children to be active and successful participants during the early childhood years and in the future in a variety of settings – in their homes with their families, in child care, preschool  or school programs, and in the community

For families

to enable families to provide care for their child and have the resources they need to participate in their own desired family and community activities 

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Goal of Early Intervention

The Early Childhood Outcomes Center (2005). Family and Child Outcomes for Early Intervention and Early Childhood Special Education. Retrieved August 2012. From http://www.fpg.unc.edu/~eco/assets/pdfs/ECO_Outcomes_4-13-05.pdf

Part C early intervention builds upon and provides supports and resources to assist family members and caregivers to enhance children’s learning and development through everyday learning opportunities.

•Mission and Key Principles of Early Intervention Services http://www.nectac.org/~pdfs/topics/families/Finalmissionandprinciples3_11_08.pdf

•Seven Key Principles Looks Like/Doesn’t Look Like http://www.nectac.org/~pdfs/topics/families/Principles_LooksLike_DoesntLookLike3_11_08.pdf

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Mission of Early Intervention Services

1) Positive social emotional

skills (including positive

social relationships)

2) Acquisition and use of

knowledge and skills

(including early

language/communication

and for preschool, literacy)

3) Use of appropriate

behaviors to meet their

needs5

3 Global Child Outcomes

• The IFSP Process plans supports and services to address priorities and to support successful participation in daily activities

• Individual outcomes or goals for each child build on his/her interests/skills and reduce barriers to successful participation in daily learning opportunities

• Through participation – all children learn (interest-based learning, practice and independence)

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Integrating Outcome Measurementinto IFSP Process

Functional assessment is the means by which we accomplish an integrated process, including developing individual outcomes/goals as well as determining the rating for each of the three global child outcomes.

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Making the Connection:Using Functional Assessment

• Why not complete the Child Outcome Summary (COS) rating while talking about the child’s functioning and development?

• Providers who are integrating the outcomes work, suggest that the completing the COS rating at the IFSP meeting to summarize the assessment results is a natural and enriching conversation

• Outcomes and goals become more functional – routine and activity based

For more information about integrating outcomes into the IFSP/IEP process, please visit the ECO website at www.the-eco-center.org.

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The Right People, the Right Situation,the Right Time

Integrating Outcomes Measurement:

Focus and Purpose

Integration – Outcomes and IEP Processes

• Not just about creating a more seamless process…not just details and how

BIG• Critical to the picture of what we are all trying to accomplish

Disconnect?

• States accountable for….• Programs working

toward….• Providers focus on….• Children achieve….

Alignment Across Levels

• States accountable for….• Programs working

toward….• Providers focus on….• Children achieve….

Ultimate Goals for EI and ECSE

For children: “To enable young children to be active and

successful participants during the early childhood years and in the future in a variety of settings – in their homes with their families, in child care, preschool or school programs, and in the community.”

Based on the ECO stakeholder process when identifying

3 functional outcomes

What is the Framework Guiding Our Thinking?

• Providers always bring some kind of framework for taking information about the skills a child currently uses and planning where they want to see the child go next

• Are these guiding ideas explicit or unspoken? • Are they using a unified framework or multiple

frameworks?

Examples of Guiding Frameworks

• The items on a specific assessment tool• A milestone checklist or series of skills to

learn based on a provider’s specialty area• A specific curriculum, with assessment

identifying starting point• Whatever the family wants

Early Childhood Outcomes Center

The 3 Outcomes as a Guiding Framework

The 3 functional outcomes can be a framework, a lens, for viewing child functioning and planning

intervention

Global Outcomes =Having positive social relationships

Taking appropriate action to meet needs

Acquiring and using knowledge and skills

Why Use the Outcomes??

• Socially validated – reflect what we are trying to achieve

• Functional• They’re integrated –

emphasize the whole child• Flexible – not wedded to

one particular assessment, curriculum, or level of child functioning

What Might It Look Like? Assessment

What does our assessment tell us about the child’s functioning in each outcome area across settings and situations?

• Organizer for planning breadth and type of assessment approaches needed and who should be involved in it

• Organizer for writing or sharing results• Produces information for outcomes and planning

Assessment

Global Outcomes =Having positive social relationships

Taking appropriate action to meet needs

Acquiring and using knowledge and skills

What Might It Look Like?IEPs

Planning IEP goals:• Has the team considered how to write

individualized outcomes that continue help the child progress in each of the 3 outcome areas?

• Will the individualized goals written support effective participation (overarching goal)?

• With global outcomes as an organizer for where we want the child to go, use of discrete, domain-specific objectives won’t make sense.

IEP Development

Global Outcomes =Having positive social relationships

Taking appropriate action to meet needs

Acquiring and using knowledge and skills

IEP Development

Global Outcomes =Having positive social relationships

Taking appropriate action to meet needs

Acquiring and using knowledge and skills

Intervention

What Might it Look Like?Intervention

Global Outcomes =Having positive social relationships

Taking appropriate action to meet needs

Acquiring and using knowledge and skills

IEP Review

What Might it Look Like? IFSP/IEP Review

Global Outcomes =Having positive social relationships

Taking appropriate action to meet needs

Acquiring and using knowledge and skills

Benefits

• More understandable, measureable individualized IFSP outcomes

• Families can tell when their children are achieving desired outcomes

• Reinforces the assessment and planning cycle• Improves practice• Supports progress in the overarching areas that

are central to early intervention

Early Childhood Outcomes Center

Active and Successful Participation

Army EDIS

Virginia

• Option to integrate narratives from initial training

in Jan/Feb 2007.

• In 2011, identified need to update training

materials.

– Group of LSMs, providers, state TA, state staff– Training wasn’t enough – it was philosophical shift

that was needed

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Integrating the Child Indicatorsin Virginia

Understanding that the 3 child indicators serve as the foundation for the full EI process

Introduced new Indicator Statements

Introduced a new IFSP format for writing ASP narratives

Understanding that information related to the 3 child indicators begins at referral and continues throughout the EI process

Virginia’s Integration of Child Outcomes into IFSP Process

• Quality Practices provided the foundation of VA’s integration

• Focus was on process not changes to the IFSP form

• Consistent framework statewide

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Keys to Successful Implementation

• Early Implementers chosen from regions across the state

• Quality Practices aligned with Virginia’s IFSP process

• Each component rolled out one month at a time

33Infant & Toddler Connection of Virginia

Regular Meetings with Ongoing Assessment

Infant & Toddler Connection of Virginia 34

Indicator Statement

Indicator Statement

Functional narrative related to the

specific indicator

Functional narrative related to the

specific indicator

Getting From Domains to Indicators

The “Book”

Guiding Questions

Feedback on Narratives

Indicator Statements

• Feedback provided to each system on 2-3 IFSPs per month

• Feedback also provided to each system statewide before full statewide implementation

39Infant & Toddler Connection of Virginia

Feedback on Narratives

Connecting the Dots in Virginia

• Replaced state principles with national 7 Key Principles

• Child Outcomes Gone Awry: Putting the Pieces Together trainingshttp://www.youtube.com/watch?v=BoTuVtijx34

• Statewide Coaching Initiative• Connection of Key Principals Visuals

40Infant & Toddler Connection of Virginia

Connecting the Dots- the what, the why and the how

41Infant & Toddler Connection of Virginia

42Infant & Toddler Connection of Virginia

Local Uses of QP in Virginia

• Initial and follow-up self assessment• Electronic Health Record• TA’s use it to orient new local system

managers• LSM’s use it for orientation and training

43Infant & Toddler Connection of Virginia

Local Uses of QP in Virginia

• Single Point of Entry and service coordinators use it to explain EI and introduce child and family outcomes

• Some LSMs use it as an observation and feedback tool for staff and contractors

• Focused trainings based on outcomes results

44Infant & Toddler Connection of Virginia

Child Indicator Guiding Questions

Essential Components/Next Steps

Essential Components:• Feedback• Not a one time training

Next Steps:• Continue to connect the dots• Explore formal integration of family outcomes• Coordinate this work with the SSIP

Integrating Child Outcomes With the IFSP Process

North Carolina’s Journey

Graphic developed by:Maryland State Department of Education Division of Special Education/Early Intervention ServicesEarly Childhood Intervention and Education BranchJune 2011

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Exploration

• Articulate Desired Changes/Results

• Compare Approaches

• Explore Implementation

• Conduct Public Awareness

• Move On To Installation

Installation

• Secure Leadership Support

• Develop a Communication Plan/Message Materials

• Build Implementation Team

• Determine System Supports

• Build Training & Technical Assistance Capacity

• Develop an Implementation Plan

• Move on to Initial Implementation

Initial Implementation

• Implement Training & TA

• Implement an Integrated IFSP and COM Process

• Support Reflection & Use of Feedback Loops

• Adapt and Adjust Infrastructure to Support Practices

• Evaluate Fidelity and Quality of Initial Efforts

• Make Changes to Support Sustainability

Full Implementation

• Maintain & Improve Skills and Practice

• Maintain Infrastructure for Data Collection and Monitoring

• Assess Implementation of Integrated Process

• Create Organizational Structures to Support Integrated Process

• Take Action to Ensure Sustainability

Stages of Implementation

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ExplorationPhase

Benefits of Integrating Child Outcomes With IFSP Process

Understanding how child is functioning compared to age

expectations

Gaining confidence in ability to observe

child & share observations with

others

Learning to track and celebrate

progress

Being active in IFSP discussions and

development of IFSP outcomes

Relating evaluation and assessment results to child outcomes and

discussing as a team, including the

parent/caregiver

Keeping focus on how child functions

during everyday situations and

routines

Improving inter-rater reliability

Planning interventions to

impact child outcomes

Discussing with family how

observations and interventions relate

to child outcomes

Discussing progress within the context of child outcomes and

how child is functioning

compared to age expectations

Helping local programs use child

outcome data to inform local

decisions about practice, including

improvement planning

Providing families and other

stakeholders information about

statewide child outcomes data and

how it is used to inform statewide

planning

Families Local Program Staff

Intervention Providers

Statewide Program

ExplorationPhase

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InstallationPhase

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InstallationPhase

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Initial Implementation

Stage

ImplementationTeam

Staff Team Meetings

Individual Supervision

State Leadership/

Support

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Initial Implementation

Stage

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Essential Components

Dedicated State Level

TA and Support

Local Implementation

Teams

Communication and Feedback

LoopsPractice Time

Evaluation of Fidelity and

Quality

Reviewing and Revising

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Key Resources

Virginia’s Child

Indicators Booklet

Maryland’s Family

Worksheet

Decision Tree (adapted)

Guide to Documenting

Global Outcomes

Ratings (adapted)

PACER Center’s

Family Guide to

Participating in the Child Outcomes

Rating Process

Time to get your feet wet!

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Integrating Outcomes Resources

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• ECTA Website - Outcomes Measurement – Integrating Outcomes into the IFSP

http://ectacenter.org/eco/pages/integration.asp Considerations for Implementation Flow charts and activities Training resources State resources and sample IFSPs

• Integrating Outcomes Learning Community:http://ectacenter.org/eco/pages/learning_comm.asp

Monthly calls Secure website Face to face meeting at conferences

Integrating the Child Outcomes into the IFSP Process

Contact Information

Anne Brager, VA Part C Program

anne.brager@dbhds.virginia.gov

Sherri Britt Williams, NC Part C Program

sherri.britt@dhhs.nc.gov

Kathi Gillaspy, ECTA Center

kathi.gillaspy@unc.edu

May 22, 2014

2014 Inclusion Institute

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