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Maryland State Department of Education Division of Special Education/Early Intervention Services

Maryland Infants & Toddlers Program

Individualized Family Service Plan (IFSP)

Process & Document Guide

MarylandStateDepartmentofEducationDivisionofSpecialEducation/EarlyInterventionServices–eff.Oct.1,2018(v6/18) 1

MarylandStateDepartmentofEducationDivisionofSpecialEducation/EarlyInterventionServices

June2018

©2018MarylandStateDepartmentofEducation,DivisionofSpecialEducation/EarlyInterventionServices.


IFSPProcess&DocumentGuideIntroduction 3• GoalofEarlyIntervention• Mission&KeyPrinciples• FederalandStateLegalRequirements• Teaming&Collaboration• IFSPProcess&DocumentVisual

PROCESS IFSPDOCUMENTATION ItAllBeginswithaReferral IFSPCoverPage 8

DeterminingEligibility PartI–InformationAboutMyChild’sDevelopmentSectionA–HealthInformation

10

SectionB–EvaluationforEligibility GettingtoKnowtheChild&Family-AuthenticAssessment

PartII–MyChildandFamily’sStorySectionA–Assessment:NaturalRoutines/Activities&EnvironmentsSectionB–Assessment:OurFamily’sResources,Priorities,andConcernsSectionC–AssessmentSummary:PresentLevelsofFunctionalDevelopment

12

DevelopingFunctional,Routines-BasedIFSPOutcomes

PartIII–MyChildandFamilyOutcomes

18

DeterminingEarlyInterventionSupports&Services

PartIV–OurEarlyInterventionSupports&Services

22

PlanningforTransition(s) PartV–MyChild’sTransitionPlanningSectionA–IdentifyingTransitionsTransitionBeforeAge3TransitionAtAge3TransitionAfterAge3SectionB–TransitionPlanning

23

ObtainingParentalConsent PartVI–ParentConsent 25ObtainingAuthorizations PartVII–Authorization(s)

SectionA–IDEAConsentSectionB–MedicalAssistance(MA)Consent

26

ProvidingPriorWrittenNotice PriorWrittenNotice(PWN) 27ImplementingtheIFSP ServiceLogs 28ReviewingtheIFSP 30

GeneralIFSPRequirements 31

IFSPProcessSupplementalTrainingResources 33


Introduction

TheMarylandStateDepartmentofEducation(MSDE),DivisionofSpecialEducation/EarlyInterventionServices(DSE/EIS)istheleadagencyinadministeringtheMarylandInfantsandToddlersProgram(MITP),aninteragencyprogramprovidingacoordinated,comprehensivesystemoffamily-centeredearlyinterventionservices.ItisMaryland'suniquestate-of-the-artIFSPdocumentthatinformsandsupportstheuseofevidence-based

earlyinterventionpracticesthroughacomprehensive,family-centeredprocesstoenhancechildandfamilyoutcomes.GoalsofEarlyInterventionTheultimategoalsofearlyinterventionareto:

● Enableyoungchildrentobeactiveandsuccessfulparticipantsduringtheearlychildhoodyearsandinthefutureinavarietyofsettings-intheirhomeswiththeirfamilies,inchildcare,preschoolorschoolprograms,andinthecommunity;and

● Enablefamiliestoprovidecarefortheirchildandhavetheresourcestheyneedtoparticipateintheirowndesiredfamilyandcommunityactivities.

Withtheseoverarchinggoalsinmind,theMITPsupportsoutcomesforbothyoungchildrenwithdisabilitiesandtheirfamilies.Participatingineffectiveearlyinterventionservicessupportsachild’sdevelopmentofpositivesocial-emotionalskillsandsocialrelationships,theacquisitionanduseofknowledgeandskillstosuccessfullyparticipateinactivities,andtheuseofappropriatebehaviorstomeetneedsthatleadtoincreasedindependence.Intentionallyengagingfamiliesasequalandinformedpartnerssupportsfamiliestoknowtheirrights,toeffectivelycommunicatetheirchild’sneeds,andtohelptheirchilddevelopandlearn.MissionandKeyPrinciples

Currentresearchinthefieldofearlyinterventionprovidesthefoundation,“theroots,”forourworkwithchildrenandfamilies,asdescribedintheMissionandKeyPrinciplesforProvidingEarlyInterventionServicesintheNaturalEnvironment.Thesesevenkeyprinciplesweredevelopedbyanationalworkgroupincluding

parents,providers,leadresearchersinearlyintervention,nationaltechnicalassistanceproviders,OfficeofSpecialEducationProgramsmembers,andStatePartCstaffandareatthecoreofallthatearlyinterventiondoeswithyoungchildrenandtheirfamilies.

1. Infantsandtoddlerslearnbestthrougheverydayexperiencesandinteractionswithfamiliarpeopleinfamiliarcontexts.

2. Allfamilies,withthenecessarysupportsandresources,canenhancetheirchildren’slearninganddevelopment.

3. The primary role of a service provider in early intervention is toworkwith andsupportfamilymembersandcaregiversinchildren’slives.


4. The early intervention process, from initial contacts through transition, must bedynamicand individualizedtoreflect thechild’sandfamilymembers’preferences,learningstyles,andculturalbeliefs.

5. IFSPoutcomesmustbefunctionalandbasedonchildren’sandfamilies’needsandfamily-identifiedpriorities.

6. Thefamily’spriorities,needs,andinterestsareaddressedmostappropriatelybyaprimaryproviderwhorepresentsandreceivesteamandcommunitysupport.

7. Interventionswithyoungchildrenand familymembersmustbebasedonexplicitprinciples, validated practices, best available research, and relevant laws andregulations.

DECRecommendedPractices

TheDivisionofEarlyChildhood(DEC)RecommendedPractices(RPs)inEarlyIntervention/EarlyChildhoodSpecialEducationareanotherfoundationalcomponentofeffectiveearlyinterventionservicesby

providingguidancetopractitionersandfamiliesaboutthemostimpactfulwaystoimprovelearningoutcomesandpromotethedevelopmentofyoungchildren,birththroughfiveyearsofage.Theysupplementdevelopmentallyappropriatepracticesforallyoungchildrenwithmorespecializedpracticesandsupportchildren’saccessandparticipationininclusivesettingsandnaturalenvironments.TheRPsaddresscultural,linguistic,andabilitydiversity.Theyaresupportedbyresearch,values,andexperienceandconsistof66practicesacrosseighttopics:leadership,assessment,environment,family,instruction,interaction,teamingandcollaboration,andtransition.TheDECRecommendedPracticesbridgetheresource-to-practicegapintheearlychildhoodspecialeducationfieldbyillustratingtheeffectualpracticesforfamiliesandpractitioners.Foradditionalresourcesaroundthefoundationsofearlyinterventionandpreschoolspecialeducation,pleasereferto:http://olms.cte.jhu.edu/mdcos-gateway-foundations.FederalandStateLegalRequirementsTheIndividualizedFamilyServicePlan(IFSP)providesthefoundationorblueprintforfamily-centeredearlyinterventionservices.Itisthewrittendocumentthatdescribesthechild’ssocialrelationships,engagement,andindependenceduringeverydayroutinesandactivities,thefamily’sresources,prioritiesandconcerns,thechild’spresentlevelsoffunctionaldevelopment,theoutcomesthefamilyandtheteamwouldlikethechildtoachieve,andtheservicesthechildandfamilywillreceiveintheearlyinterventionsystem.ThiswrittenagreementbetweenthefamilyandtheLITPdescribesthe“what,when,why,andhow”oftheearlyinterventionservicesandsupportsprovidedtoachildandfamily.TheIFSPisadynamicdocumentthatchangesovertimeandmustbetailoredforeachindividualfamily,recognizingthatfamilieshavetheirownarrayofinterests,needs,abilities,challenges,resources,anddesiredoutcomes.


RelevantFederalandStatePartCRegulations● Foreachinfantortoddlerwithadisability,theleadagencymustensurethe

development,review,andimplementationofanIFSPdevelopedbyamultidisciplinaryteamthatincludestheparent[PartCIDEA303.340].

● AnIndividualizedFamilyServicePlanorIFSPmeansawrittenplanforprovidingearly

interventionservicestoaninfantortoddlerwithadisabilityandtheinfant'sortoddler'sfamilybasedonthemultidisciplinaryevaluationandassessmentofthechild,andtheassessmentofthechild’sfamily[COMAR13A.13.01.03B(28)(a)(i)].

InaccordancewiththefederalandstateregulationsandfullygroundedintheKeyPrinciplesandRecommendedPractices,theMarylandInfants&ToddlersProgramIFSPProcessandDocumentGuideexplainsthepurposeandnecessarydocumentationofeachstepintheIFSPprocess.Pleasenote,theprocessinthisguidedetailsthedevelopmentofinitialIFSPsandreferencesimplementation,review,andthedevelopmentofsubsequentIFSPs.IntherareinstanceswhenaninterimIFSPisneeded,theprocessmaybealteredtomeettheimmediateneedsofthechildandfamily.Teamsshouldthenre-visitmissedcomponentsoftheprocessandcompleteevaluationandassessmentwithin45days.Thisguideandtheresourcesprovidedarebasedonresearchandevidence-basedpracticesinearlyintervention.

CompletefederalIFSPlegalrequirementscanbefoundinPartCoftheIndividualswithDisabilitiesEducationAct(IDEA)at:https://sites.ed.gov/idea/regs/cStateIFSPregulationscanbefoundintheCodeofMarylandRegulations(COMAR)at:http://www.marylandpublicschools.org/programs/Documents/Special-Ed/PAB/040913COMAR.pdf


TeamingandCollaborationEarlyinterventionprogramshavelongemphasizedfamily-centered,team-basedapproachestoservicedelivery.TheKeyPrinciplesandDECRecommendedPracticesstronglyindicatethatfamiliesmustbeconsideredandexpectedtobeequalandactivemembersofIFSPteams.However,thereisgreatvariabilityinhowteammembersinteractwitheachother,includingwithfamilies.Themostcommonteamingmodelsrangefrommultidisciplinarytointerdisciplinarytotransdisciplinarytotheprimaryserviceprovider(PSP)approach.Althoughhistoricallyprogramshavenotnecessarilyidentifiedaparticularteamingapproach,understandingtheresearchinearlychildhoodspecialeducation(asidentifiedintheKeyPrinciplesandDECRecommendedPractices)compelsprogramstotakeaprincipledapproachandidentifyteamingmodelsofinteractionbasedontheevidenceofthefield.Earlyinterventionisrelationship-basedworkandthequalityoftherelationshipsandinteractionsbetweentheadultsinvolvedinthechild’slifeimpactsthesuccessofchildandfamilyoutcomes.Regardlessoftheteamingapproach,theservicecoordinatorortheproviderfulfillingthatrole,isresponsibleforensuringtheIFSPprocessiscompletedwithinmandatedtimelinesandinaccordancewithbestandrecommendedpractices.Servicecoordinationistheonlyservicerequiredforallchildrenandfamilies.

TheDECRecommendedPracticesinTeamingandCollaborationincludestrategiesforinteractingandsharingknowledgeandexpertiseinwaysthatarerespectful,supportive,enhancecapacity,andareculturallysensitive.


IFSP

Process

ItAllBeginswithaReferral

DeterminingEligibility

GettingtoKnowtheChild&Family-

AuthenticAssessment

DevelopingFunctional,

Routines-BasedIFSPOutcomes

DeterminingEarlyIntervention

Supports&Services

PlanningforTransition(s)

ObtainingParentalConsent

ObtainingAuthorizations

ProvidingPriorWrittenNotice

ImplementingtheIFSP

ReviewingtheIFSP

Document/OnlineIFSP

IFSPCoverPage

PartI– InformationAboutMyChild’sDevelopment

SectionA – HealthInformationSectionB – EvaluationforEligibility

PartII – MyChildandFamily’sStory:Assessment

NaturalRoutines/ActivitiesOurFamily’sResources,Priorities,and

ConcernsSummary:PresentLevelsofFunctionalDev.

PartIII – MyChildandFamilyOutcomes

PartIV – OurEarlyInterventionSupports&Services

PartV – MyChild’sTransitionPlanningSectionA – IdentifyingTransitionsBefore,

At,AfterAge3SectionB – TransitionPlanning

PartVI – ParentConsent

PartVII – Authorization(s)SectionA – IDEAConsent

SectionB – MedicalAssistance

PriorWrittenNotice(PWN)

ServiceLogs

Updatesatleastevery6months/Annually


ItallBeginswithaReferral…Referral:

GatheringChild&FamilyInformationWhenaninfantortoddlerissuspectedofhavingadevelopmentaldelay,atypicaldevelopment,oraphysicalormentalconditionthatputsthechildathigh-probabilityfordevelopmentaldelay,heorshemaybereferredtothelocalInfantsandToddlersProgram(LITP)byaparent,physician,educator,childcareprovider,socialservicesprovider,familymember,communityserviceprovider,oranyotherpersonwithconcerns.Eachjurisdictionhasadesignatedsinglepointofentryandreferralsmaycomeinviaphone,fax,oronline.Theprocessforreceivingreferralsandmakingfirstcontactswithfamiliesvariesacrossprograms.Regardlessofwhospeakstothefamilyfirst,it’simportanttorecognizethatthenatureoftheinitialcontactandrelationshipbetweenfamiliesandearlyinterventionpersonnelandproviders“setsthetone”andultimatelycontributestothesuccessofchildandfamilyoutcomes.Firstcontactswithafamilyarethebeginningoftheearlyinterventionjourneyandoftenaveryemotionaltimeforfamilies.Thefocusshouldbeonlisteningtothefamily’sstory,discoveringtheirconcerns,andbuildingacollaborativerelationshipthatisrespectfuloffamilycultureandcircumstances.Displayingrespectandvaluingtheperspectivesofothersisparamounttoestablishingatrustingrelationship.It’simportant,too,tosharebasicinformationabouttheearlyinterventionprogramtoensureparents’andotherreferralsources’expectationsmatchthephilosophy.Thisincludessharinginformationabouttheultimategoalsofearlyinterventionandtheapproachtobuildfamilycapacitytosupporttheirchild’sdevelopmentofsocialrelationships,acquisitionanduseoffunctionalknowledgeandskillstoparticipateinactivities,anduseofappropriatebehaviorstomeettheirneedsandgainindependence.Asimplewaytobeginframingtheseconversationsistoaskhowtheparent’sconcerns(e.g.“nottalking”)affectshowtheirchildisinteractingwithothers,isabletoparticipateinactivities,andisabletogettheirneedsmet.Earlyinterventionpersonnelshouldalsoexplainwhatthereferralandevaluationforeligibilityprocesswilllooklikeforfamilies,includingstepsandtimelinesforIFSPdevelopment.

The initial IFSP must be completed within 45 days from date of referral.

TheDECRecommendedFamilyPracticesencompassthreethemes:

1. Family-centeredpractices2. Familycapacity-buildingpractices3. Familyandprofessionalcollaboration


Participationinearlyinterventionservicesisvoluntary,soprovidedparentsareinterestedinproceeding,thenextstepismovingforwardwithascreening,ifthelocalinfantsandtoddlersprogramhaspoliciesandproceduresinplacetoconductdevelopmentalscreening,and/oranevaluationforeligibility.Thelocalleadagencymustensurepriorwrittennoticeandwrittenparentalconsentisobtainedbeforeadministeringscreeningprocedures,conductingevaluationsandassessments,providingearlyinterventionservices,utilizingpublicbenefitsorinsurance,ordisclosingpersonallyidentifiableinformation.Insomeoftheseinstances,thepriorwrittennoticeandparentalconsentmaybedocumentedonlocallydevelopedforms.Familiesmustbegiveninformationabouttheeligibilityprocessandhowachildwillbedeterminedeligiblefortheearlyinterventionprogram.Familiesmusthavetheopportunitytoaskquestionsandtodiscussrelevantconcernsinordertogiveconsenttobegintheevaluationforeligibilityandassessmentprocess.Consentmustbegiveninwritingforbothachild’sevaluationandassessment.Familiesneedtounderstandtheirconsentisvoluntaryandmayberevokedatanytime.Ifwrittenconsentisnotgivenbyparents,reasonableeffortsmustbemadetoensurethattheparentunderstandshowparticipationinearlyinterventionservicesmaybenefittheirchildandfamilyandthatneitherevaluation,assessment,orearlyinterventionservicescanbeprovidedwithoutit.

Atthetimeofreferraland/orintake,basicdemographicinformationistypicallygatheredanddocumentedintheBasic,Child,andFamilyInformationtabsoftheMDOnlineIFSPoronthecoverpageofthepaperIFSPform.Allfieldsshouldbecompletedasappropriate.Note:Ifthereferralcameinviatheonlinereferral,somechildandfamilyinformationwillautomaticallypopulateintotheonlineIFSP.

Documentation


DeterminingEligibilityReferral:

IFSP:HealthInformationInformationaboutachild’shealthanddevelopmentisessentialfortimely,comprehensive,multidisciplinaryevaluation.Childrenreferredtoearlyinterventionservicesmayexperienceawiderangeofphysicaland/ormentalhealthrisksandchallenges.Somehavenothingoutoftheordinaryandothershaveverycomplexneeds.Theamountofhealthinformationgatheredshouldreflectthisrange.Preliminaryhealthinformationistypicallygatheredaspartoftheinitialevaluationforeligibilityprocessandadditionalhealthinformationmaybegatheredaspartofchildandfamilyassessment.Sensitivityisessentialwhengatheringhealthinformationandshouldreflectwhatisrelevanttoappropriatelyassess,develop,andimplementeffectivesupportsandservices.Again,writtenparentalconsentisrequiredforanyandallmedicalrecordsthatmayberequestedandreleasedtotheLITP.

EvaluationforEligibilityEachchildundertheageofthreewhoisreferredforevaluationreceivesatimely,comprehensive,multidisciplinaryevaluation.Proceduresforevaluationofthechildinclude:

1) Administeringanevaluationinstrument;2) Takingthechild’shistory(includinginterviewingtheparent);

CompletetheHealthInformationsectionoftheChild’sDevelopmenttaboftheMDOnlineIFSPoronthepaperIFSPform.Allfieldsshouldbecompletedasappropriate.Note:PertinentmedicalrecordsorreportsmaybeuploadedintotheonlineIFSP.

Documentation

Evaluationmeanstheproceduresusedbyqualifiedpersonneltodetermineachild’sinitialandcontinuingeligibilityfor

theprogram[34CFR§303.321a(2)(i)].


3) Identifyingthechild’sleveloffunctioningineachofthefivedevelopmentalareas(cognitive,communication,social/emotional,adaptive,orphysical,includingvisionandhearing);

4) Gatheringinformationfromothersourcessuchasfamilymembers,othercaregivers,medicalproviders,socialworkers,andeducators,ifnecessarytounderstandthefullscopeofthechild'suniquestrengthsandneeds;and

5) Reviewingrelevantmedical,educational,orotherrecords.Awrittenreportmustbeincludedinthechild’searlyinterventionrecordtodocumenttheresultsofevaluationsandassessmentsconductedbyqualifiedpersonnelandtodetermineinitialeligibilityofachildreferredforevaluation[COMAR13A.13.01.05C].InMaryland,achild,birththroughagetwo,iseligibleforearlyinterventionservicesthroughtheMITPinanyoneofthreeways:● Achildhasatleasta25%delay,asmeasuredandverifiedbyappropriatediagnostic

instrumentsandprocedures,inatleastoneormoreoffivedevelopmentalareas(cognitive,communication,socialoremotional,adaptive,orphysical,includingvisionandhearing);

● Achildhasatypicaldevelopmentorbehavior,whichisdemonstratedbyabnormalqualityofperformanceandfunctioninoneormoreoftheabovespecifieddevelopmentalareasorwhichinterfereswithcurrentdevelopmentandislikelytoresultinadevelopmentaldelay(evenwhendiagnosticproceduresdonotcurrentlydocumenta25%delay);or

● Achildhasadiagnosedphysicalormentalconditionthathasahighprobabilityofresultinginadevelopmentaldelay.

Qualifiedpersonnelmustuseinformedclinicalopinionwhenconductinganevaluationandassessmentofthechild.Inaddition,thelocalleadagencymustensurethatinformedclinicalopinionmaybeusedasanindependentbasistoestablishachild’seligibilityforearlyinterventionservicesevenwhenotherinstrumentsdonotestablisheligibility;however,innoeventmayinformedclinicalopinionbeusedtonegatetheresultsofevaluationinstrumentsusedtoestablisheligibility.Achild’smedicalandotherrecordsmaybeusedtoestablisheligibility(withoutconductinganevaluationofthechild)iftherecordsindicatethatthechild’sleveloffunctioninginoneormoreofthedevelopmentalareasconstitutesadevelopmentaldelayorthatthechildotherwisemeetsthecriteriaforaninfantortoddlerwithadisability.

CompletetheEvaluationforEligibilityortheChild’sDevelopmenttaboftheMDOnlineIFSP(underReferralorIFSP,respectively)oronthepaperIFSPform.Indicatewhethertheevaluationisforinitialorcontinuedeligibilityandcompleteallfieldsasappropriate.Note:TheonlineIFSPwillautomaticallycalculatethechild’sadjustedageifapplicable.

Documentation


GettingtoKnowtheChild&Family:AuthenticAssessmentIFSP:

Whenachildisfoundeligibleforservices,furtherdiscussionsneedtooccuraroundconductingauthentic,routines-basedchildandfamilyassessmenttosupportrich,functionalplandevelopment.

Proceduresformultidisciplinaryassessmentoftheuniquestrengthsandneedsofthechildandtheidentificationofsupportsandservicesappropriatetomeetthoseneedsinclude:

1) Areviewoftheresultsoftheevaluation;2) Personalobservationsofthechild;and3) Theidentificationofthechild’sneedsineachofthedevelopmentalareas.

Proceduresforassessmentofthefamilyincludeidentifyingthefamily’sresources,priorities,andconcernsandtheidentificationofsupportsandservicesnecessarytoenhancethefamily'scapacitytomeetthedevelopmentneedsofthechild.Thefamily-directedassessmentmust:

1) Bevoluntaryonthepartofeachfamilymemberparticipatingintheassessment;2) Bebasedoninformationobtainedthroughanassessmenttoolandalsothroughan

interviewwiththosefamilymemberswhoelecttoparticipateintheassessment;and

3) Includethefamily'sdescriptionofitsresources,priorities,andconcernsrelatedtoenhancingthechild’sdevelopment[COMAR13A.13.01.05(F)].

Tounderstandandsupportthechildandfamily’sstory,earlyinterventionserviceprovidersneedto“sitbesideandgettoknow”intheeverydayactivitiesandplaceswherethechildandfamilyspendtheirtime;otherwiseknownasauthenticassessment.

TheRecommendedPracticesinAssessmentprovideguidancearound11assessmentpracticesthroughoutachildandfamily’sparticipationin

earlyinterventionservices,includingforindividualizedplanning,monitoringchildprogress,

andmeasuringchildoutcomes.

Assessmentsareongoingproceduresthroughoutachild’seligibilitytoidentifythechild’suniquestrengthsandneeds,concerns,priorities,andresourcesofthefamily,andthesupportsandservicesnecessarytoenhancethefamily’scapacitytomeetthedevelopmentalneedsofthe

child[COMAR13A.13.01.03(5)].


Assessment:NaturalRoutines/Activities&EnvironmentsThepurposeofearlyinterventionservicesistounderstandthechildandfamily’sstorytobeabletosupportachild’ssuccessfulparticipationineverydayhomeandcommunityactivitiesthataremeaningfultothefamily.

Therefore,understandingchildren’sfunctionalabilitiesrequiresassessmentofthechildinnaturalactivitiesandsettingswithfamiliaradults.Recommendedassessmentpracticesusemultiplemethodstogatherinformationaboutachild’sfunctioningacrosssettingsandsituations,includinginterviewingadultswhospendtimewiththechild,observations,and,asappropriate,theuseofcriterion-referencedassessmenttools.InMaryland,earlyinterventionprovidersmayutilizetheRoutines-BasedInterview™(RBI),theScaleforAssessmentofFamilyEnjoymentwithinRoutines(SAFER),ortheNaturalRoutines/Activities&EnvironmentssectionoftheIFSPastheprimaryassessmenttool.Additionalassessmenttools,suchascriterion-referencedorcurriculum-basedtoolsthatelicitfunctionalskillsandabilities,maybeusedtosupplement.

Routines-BasedInterview(RBI)TheRBIisasemi-structuredinterviewdesignedtoestablishanimmediatelypositiverelationshipbetweenthefamilyandtheprofessional,toprovidearichanddetaileddescriptionofchildandfamilyfunctioning,andtohelpfamiliesdecideonoutcomesfortheirindividualizedplans.TheRBIisanevidence-basedassessmentpracticethatgathersinformationabouthomeandcommunityroutinesandthechild’sengagement,independence,andsocialrelationshipswithinthoseroutinestopromoteroutines-basedintervention.ProvidersmustbetrainedorintraininginaccordancewiththeStateGuidetoRBITrainingandCoachingtoconductanRBIwithafamily.ScaleforAssessmentofFamilyEnjoymentwithinRoutines(SAFER)EarlyinterventionprovidersmayalsoutilizetheSAFERasanassessmenttooltodevelopfunctionalinterventionplans.LiketheRBI,theSAFERgathersinformationabouthomeandcommunityroutinestoidentifytheindependence,engagement,andsocialcompetenceofthechild,aswellastheconcernsandprioritiesofthefamily.Thegeneralquestionsareintendedtoguidepractitionersthroughtheassessmentprocess.Practitionersareencouragedtodeveloptheirownquestionstofollowupwitheachfamily’suniqueexperiences.NaturalRoutines/Activities&Environments(IFSPPartII,SectionA)IfneithertheRBInortheSAFERareused,providersmustinterviewparentsandcaregiverstogainunderstandingofwhatatypicaldaylookslikeforthechildandfamily,usingtheNaturalRoutines/Activities&EnvironmentssectionoftheIFSPtoguidethediscussion.Providersshouldagainremindfamiliesofthegoalofearlyinterventionandtheimportanceofunderstandingwhatthechildisdoing,andwithwhom,throughoutthedayinordertoplanservicesthatsupporthis/heractive

Infantsandtoddlerslearnbestthrougheverydayexperiencesandinteractionswithfamiliarpeopleinfamiliarcontexts(KeyPrinciple#1).


participation.Theintentistogatherinformationspecifictoeachroutineoractivityabouthowthechildis:

• Interactingandrelatingwithothersduringeachactivity,• Learningabouttheactivitytosuccessfullyparticipate,and• Usingappropriatebehaviorstogethis/herneedsmetandgaining

independence.It’salsohelpfultobeginunderstandinghowtheparentand/orcaregiverthinksthechild’sfunctioningcomparestootherchildrenhisorheragewithinthecontextoftheroutineoractivity.Askingthisquestionallowstheprovidertogaugetheparent’sunderstandingoftypicalchilddevelopmentandtoprovideorplanongivingfurtherinformationaboutdevelopment.Finally,byasking“How’sitgoing?”,familieshaveanopportunitytothinkabouteachroutineoractivityandhowtheymightwantittolookorfeeldifferently,whichprovidesafoundationforplanningearlyinterventionsupportsandservices.Providersmustinterviewthefamilyaboutatleasttworoutinesandneedtodoasmanyasisnecessarytogetafullpictureandunderstandingofthechildandfamily’sdayincludinghowthechildisfunctioningthroughout.

Assessment:OurFamily’sResources,Priorities,&ConcernsOneofthegoalsofearlyinterventionistoenablefamiliestoprovidecarefortheirchildandhavetheresourcestheyneedtoparticipateintheirowndesiredfamilyandcommunityactivities,whichincludesbeingabletodescribetheirchild’sabilitiesandchallenges,tounderstandtheirrights,andtohelptheirchilddevelopandlearn.

Gatheringinformationfromfamiliesabouttheirresources,priorities,andconcernsisnecessarytodevelopfunctional,routines-basedIFSPs.Understandingthefamily’sresourcesallowsteamstoutilizethepeopleandopportunitiesalreadyinplaceand

Allfamilies,withthenecessarysupportsandresources,canenhancetheirchildren’slearninganddevelopment(KeyPrinciple#2).

IftheRBIorSAFERwascompleted,uploadtheRBInotesortheSAFERprotocolintotheonlineIFSP.IftheRBIorSAFERwasNOTcompleted,documentthediscussionaboutfamilyroutinesandactivitiesintheChild&FamilyStory(Routines)taboftheMDOnlineIFSPoronthepaperIFSPform.Note:TheonlineIFSPwillallowuserstochooseasingleroutine/activity,asmanytimesasnecessary,tocompleteathoroughfunctionalassessment.

Documentation


potentiallyidentifygapsthatearlyinterventionsupportsandservicescanaddress.Understandingthefamily’sprioritiesforpromotingthechild’sparticipationinwhattheyneedorwanttodoandwithwhomguidestheteaminidentifyingfunctional,routines-basedIFSPoutcomes.Finally,understandingafamily’sconcernsprovidesinsightonhowtosensitivelypartnerwithfamiliesandtoindividualizetheirsupportsandservices.FamilyResourcesareresourcesthatsupportthechildand/orfamily,includingpeople,activities,programs/organizations,etc.Thisdiscussionbeginswithidentifyingwholivesinthehomewiththechildandexpandstoincludeotherfamilialandsocialsupports.Italsoincludesidentifyingmoreformalsupports,suchashealthcare,childcare,parentgroups,homevisitingprograms,etc.TheEcomapthatiscompletedduringtheRBIprocessmeetstherequirementsofthispartofthefamilyassessment.FamilyPrioritiesarethemostimportantthingsforthechildand/orfamilyrightnowandmayincludeafamily’shopesanddreamsfortheirchild.Thefamily’sprioritieslikelywereexpressedintheRBI,SAFER,ortheNaturalRoutines/Activities&EnvironmentssectionoftheIFSPandshouldbesummarizedwhileseekingclarificationtoensuretheteamaccuratelyunderstands.FamilyConcernsareconcernsthefamilyhasabouttheirchild’shealthanddevelopment.Thesemayincludeinformation,resources,andsupportsthefamilyneedsorwantsfortheirchildand/orfamily.Askingaboutwhatafamilyismostconcernedorworriedabout,orevenwhattheywouldchangeiftheycoulddoesnotimplythataprovidermusthaveananswerorsolution.Itallowsanopportunityforthepractitionertoempathizewiththefamilyandfurtherstrengthenthebuildingoftherelationship.ItpotentiallyidentifiesfamilyoutcomesfortheIFSPaswell.ThefamilyassessmentdiscussionmayidentifymissingconnectionstocommunityresourcesthattheIFSPteamcanhelpfacilitatethrougheithersharingofinformation,makingformalreferrals,and/ordevelopingfamilyoutcomestoaddress.

IfanEcomapwascompletedwiththefamily,itcanbeuploadedintotheonlineIFSP.DocumentthefamilyassessmentwithintheChild&FamilyStory(Resource,Priorities,andConcerns)taboftheMDOnlineIFSPoronthepaperIFSPform.Note:MuchoftheinformationinthissectionwaspotentiallygatheredduringanRBI,completionoftheSAFER,orcompletionofthepreviousIFSPsection.Followthepromptquestions,ifneeded,toensureathoroughdiscussionandconfirmunderstanding.

Documentation


AssessmentSummary:PresentLevelsofFunctionalDevelopmentDuringtheevaluationforeligibilityprocess,thechild’sdevelopmentisevaluatedinthefivedomainsofdevelopment.Duringthechildandfamilyassessmentprocess,informationisgatheredaboutthechild’sfunctionalabilitiesineverydayactivitiesandroutines.Children’sfunctionalabilitiesoverlapdomainsofdevelopmentandcanbecombinedinordertosummarizeallfunctionalabilities,strengths,andneedsintothreefunctionaloutcomeareas.Thesummaryofpresentlevelsoffunctionaldevelopmenthighlightswhathasbeendiscoveredsothattheplanbuildsuponthechild'sdevelopmentalstrengthsandinterests.Sourcesofinformationmayincludeconversationswithfamiliesandcaregivers,observationsofthechildindailyroutines,eligibilityevaluations,childandfamilyassessmentactivities,andoutsidereports.Additionally,theteamidentifieshowthechild’sfunctioninginthesethreeareascomparestootherchildrenofthesameage.Thishelpstheteamtohelpfamiliesandothercaregiverssupportachild’sdevelopmentandparticipationindailyactivitiesANDtounderstandhowchildrenbenefitfromparticipationintheMarylandInfantsandToddlersProgram.

OrganizeallpertinentfunctionalassessmentinformationanddocumentwithinthecontextofthethreeearlychildhoodoutcomesintheChild&FamilyStory(AssessmentSummary:PresentLevelsofFunctionalDevelopment)taboftheMDOnlineIFSPoronthepaperIFSPform.Note:Eachoutcomeareashould“paintapicture”ofthechild’sfunctionalstrengthsandneedsacrossdevelopmentaldomains.

Documentation


ChildOutcomeSummary(COS)DiscussionOncetheassessmentinformationhasbeenorganizedintothethreeoutcomeareas,teamswillneedtouseageanchoringtoolstoprepareforthediscussionwithfamilies.Toolsthatareorganizedbythethreeoutcomeareasorcurriculum-basedtoolsareoftenmoreusefulinidentifyingfunctionalskillsandbehaviors.Examplesofage-anchoringtoolscanbefoundontheMDChildOutcomesGatewaywebsiteat:http://olms.cte.jhu.edu/mdcos-gateway.InkeepingwithCOSprocessfidelity,teamsshouldusetheCOSRatingPrepTooltodocumentthediscussionandidentificationofthechild’sskillsandbehaviorscomparedtootherchildrenthesameageaseitherFoundational,ImmediateFoundational,orAge-Expected.Teamswillneedtokeepinmindanythingthey’velearnedaboutthefamily’scultureandhowfamilieshaveansweredquestionsthroughouttheassessmentprocessofhowtheythinktheirchild’sbehaviorcomparestosame-agepeers.Togetherwiththefamily,teamsreviewtheassessmentsummary,shareinformationabouttypicaldevelopmentandage-anchoringwhilereviewingtheCOSRatingPrepTool,elicitadditionalthoughtsorinformationfromthefamily,andthenusetheDecisionTreetoreachconsensusabouttheappropriatedescriptorstatement.TheonlineDecisionTreeProceduralFacilitatorwillguideteamsthroughthe“yes/no”questionsateachlevel,resultinginthedescriptorstatement/rating.


DevelopingFunctional,Routines-BasedIFSPOutcomesIFSP:

Childandfamilyoutcomeshelptosupportachild’sparticipationineverydayactivitiesandroutinesbasedonprioritiesforhis/herlearninganddevelopment.

Bothchildandfamilyoutcomesareidentifiedwithinauthenticassessmentactivities.Anaturalproductofcompleting(withfidelity)anRBI,theSAFER,ortheNaturalRoutines/ActivitiesandEnvironments,andtheFamilyResources,Priorities,andConcernssectionoftheIFSPistheidentificationofwhatspecificfunctionallearningandbehaviorischallenging,inwhatsettingsandsituations,andwhatfamilieswanttolookdifferently.Whenpractitionershaveaclearpictureofwhattypicalinteractions,engagement,andindependencelookslikeforthechildandfamilyANDwhatafamilywouldliketoseedifferentlyorasnextsteps,theoutcomesandinterventionsettings“risetothesurface”.AdultLearningStyleEarlyinterventionprovidersneedtounderstandadultlearningstrategiestoeffectivelybuildandhelpsustainthefamily/caregiver’scapacitytosupportthechild’slearninganddevelopment.

Providershavetheopportunityandresponsibilitytoshareinformationaboutchilddevelopment,interventionstrategies,andcommunityresourcesinavarietyofways,forexamplethroughwrittenmaterials,verbalconversations,accesstowebsites,anddemonstration.Tobegintheworkwithfamilies,itishelpfultoaskwhattheirpreferredlearningstyleisinorderforproviderstomatchtheircoachingstrategies.Thisisalsoagoodtimetotalkmorewithfamiliesaboutcoachinginearlyintervention.

Coachingisanevidence-basedmannerofinteractingwithfamilies,caregivers,andcolleaguesthatisdesignedtopromoteasenseofconfidenceandcompetenceintherecipient.TheEarlyChildhoodCoachingHandbookdefinescoachingas“anadultlearningstrategyinwhichthecoachpromotesthelearner’s(coachee’s)abilitytoreflectonhisorheractionsasameanstodeterminetheeffectivenessofanactionorpracticeanddevelopaplanforrefinementanduseoftheactioninimmediateandfuturesituations”(Rush&Shelden,2013).CoachingpracticesandthefivecharacteristicsofreflectivecoachingarediscussedmoreintheImplementationoftheIFSPsectionofthisdocument.

IFSPoutcomesmustbefunctionalandbasedonchildren’sandfamilies’needsandfamily-identifiedpriorities(KeyPrinciple#5).

Theprimaryroleofaserviceproviderinearlyinterventionistoworkwithandsupportfamilymembersandcaregiversinchildren’slives(KeyPrinciple#3).

Theearlyinterventionprocess,frominitialcontactsthroughtransition,mustbedynamicandindividualizedtoreflectthechild’sandfamilymembers’preferences,learningsystemsandculturalbeliefs(KeyPrinciple#4).


DevelopingChild-FocusedIFSPOutcomesConductingthoroughauthenticassessmentactivitiesiscriticaltodevelopfunctional,routines-basedIFSPoutcomes.Thekeytosupportingthedevelopmentofoutcomesthatfocusonthechild’smeaningfulparticipationindailyroutinesandactivitiesiscreatingaclearanddeliberatelinkbetweeneverystepoftheIFSPprocess,beginningwiththeveryfirstconversationswithfamilies,throughoutassessmentactivitiesandIFSPdevelopment,aswellasthroughimplementationandbeyond.TheEarlyChildhoodTechnicalAssistance(ECTA)Centerreviewedexpert-generatedresourcesandidentifiedsixkeycriteriathatdefineIFSPoutcomesashighqualityandparticipation-based.Theyare:

• Theoutcomeisnecessaryandfunctionalforthechild’sandfamily’slife.• Theoutcomereflectsreal-lifecontextualizedsettings.• Theoutcomeintegratesdevelopmentaldomainsandisdiscipline-free.• Theoutcomeisjargon-free,clearandsimple.• Theoutcomeemphasizesthepositive,notthenegative.• Theoutcomeusesactivewordsratherthanpassiveones.

Criticaltothisprocessisthefundamentalbeliefthatchildrenlearnbestthroughtheirparticipationineverydayactivitiesandroutineswithfamiliarpeople.WhendevelopingIFSPoutcomes,teamsneedtofocusonthefunctionalityoflearninganddevelopmentwithinthecontextofnaturalroutinesandactivitiesandresistthetendencytodevelopoutcomesthatsimplyreflectthedevelopmentofisolatedskillsdrivenbyevaluationresults.RobinMcWilliamsuccinctlyaddressesthisbysaying,“thechild’sacquisitionofaskillisn’tanendinitself,it’sameanstoparticipationinhome,community,andschool.”(McWilliam,2011)IFSPoutcomestatements(“Whatwewouldliketoseehappenwithinourdailyactivity/routine?”And“Howwillweknowwe’veachievedthis?ByWhen?”)specificallyidentifythemeaningful:

• Contextinwhichthechildwillparticipate,• Acquisitiondescription(whatfunctionalimprovementlookslike),and• Timelineforgeneralization.

Todeterminethemeaningfuldescriptionofwhatitlookslikewhenthechildhasachievedtheoutcomeandwhatafunctionaltimeframeis,teamsneedtocontinueengagingthefamilyindiscussionaboutthenaturalopportunitiesfor“practice”withindailyroutinesandactivitiesandwhatitwouldlikeforthemtoconsiderthey’vemadeprogressorhaveachievedtheoutcome.Forexample,theteamhaslearnedthatparentsneedtocarrythechildintothehouseafterreturningfromshoppingwhichrequiresmultipletripstoandfromthecarandthefamilyisworriedabouthowtheywilldothiswhenthenewbabyisborn.Thediscussionabouttheoutcomemightbeaboutthechildbeingabletoparticipateinreturninghomefromgroceryshoppingbywalkingfromthecartothehousewhileholdingsomeone’shand.Furtherdiscussionidentifieshowoftenthisorasimilarsituationexistsforthefamilytopracticestrategiesaswellasproviderssharinginformationaboutthedevelopmentalsequencesnecessarytoreachtheoutcomesothattogether,teamsidentifyexpectationsabouttimelines.Inthisexample,thefamilysharestheygoshoppingatleasttwiceaweekandthereareusuallyoneortwoothertripsduringtheweekthattheywouldlikethechildtobeabletowalkinthehousewhileonlyholdingsomeone’shand.Theyagreethatifthechildisabletodothisatleastthreetimesaweekforamonth,thenitwould


seemhehasachievedtheoutcome,andtheywouldespeciallylikeitifithappenedbythetimethenewbabywasborninfivemonths,whichtheteamagreesisrealistic.Thisthen,isthemeasurablecriteria.TheonlineIFSPprovidesaproceduralfacilitator“template”forparticipation-basedoutcomestatementstosupportwritingfunctional,routines-basedoutcomestatementsthatincludemeaningfultimelinesforgeneralization.DevelopingFamily-FocusedOutcomesIntentionallyengagingfamiliesasequalandinformedpartnerssupportsfamiliestoknowtheirrights,toeffectivelycommunicatetheirchild’sneeds,andtohelptheirchilddevelopandlearn.Family-focusedoutcomestatementsidentifytheparentorcaregiverasthelearnerandrepresentafamily-identifiedareaofinterestorneedto“promotethestabilityand/orgrowthofthefamilyinwaysthatdirectlyorindirectlymeettheneedsofthechild,”(Shelden&Rush,2013).StrategiesDevelopingstrategiestosupportthechild’smeaningfulparticipationindailyroutinesandactivitiesrequirestruepartneringwithfamiliesandcaregivers.Teamsneedtohaveanunderstandingofwhatthefamilymayhavealreadytried,howitworked,andwhatinsighttheyhaveastowhyorwhynottheyconsidereditsuccessful.Thisisthestartingpointfortheteamtobuildonexistingeffortsandinitialstrategiesshouldencouragefamiliestocontinuewiththingsthatareworking.Theteamcanalsoshareinformationabouthowyoungchildrentypicallylearnthingstobeabletojointlyidentifyanyadditionalfirststrategies.Theprocessofjointlydeveloping,implementing,andevaluatingstrategiesisongoingandrecursivethroughoutearlyinterventionservicesandisattheheartoftheworkwithfamiliesduringearlyinterventionvisits.Thisongoingprocessisdocumentedinvisit/progressnotes.Strategiesforfamily-focusedoutcomesmaysimplybesharinginformationand/orresources,assistingfamiliesinidentifyingoutsidesupports,and“checkingin”tomonitorprogressandadjusttheoutcomestatementasappropriatetoreflectthefamily’spriorities.SupportingfamiliesthroughIFSPoutcomesexemplifiestheunderstandingoffamilydynamicsandtheimpactoffamilystabilityonchilddevelopment.LinkingIFSPOutcomestoEarlyChildhoodorFamilyOutcomesGoodauthenticassessmentyieldsrichinformationabouthowthechildinteractswithandrelatestoothers,learnsandparticipatesinactivities,andusesappropriatebehaviorstogettheirneedsmetandincreaseindependence.Organizingthesummaryoftheassessmentinformationinthethreeoutcomeareashelpsteamsidentifythechild’sstrengthsandneedsand,alongwiththefamily’spriorities,leadstotheidentificationofIFSPoutcomes.Participation-based,child-focusedoutcomestatementsreflectintegrateddevelopmentwithinthecontextofnaturalactivitiesandthennaturallyaligntothethreeearlychildhoodoutcomeareas(socialrelationships,knowledgeandskills,independence).Similarly,family-focusedoutcomesarebenchmarkstowardstheoverarchingfamilygoalofprovidingcarefortheirchildandhavingtheresourcestheyneedtoparticipateintheirowndesiredfamilyandcommunityactivities.IntentionallyconnectingthechildandfamilyIFSPoutcomesto


thebroaderearlychildhoodandfamilyoutcomeskeepsIFSPteamsfocusedontheoverarchinggoalsofearlyinterventionforallchildrenandfamilies.

DocumenteverycomponentoftheoutcomessectionforeachoutcomeintheChildandFamilyOutcomestaboftheMDOnlineIFSPoronthepaperIFSPform.Note:Outcomesarefunctional,measurable,andinthecontextofeverydayactivitiesandroutines.

Documentation

EachchildwhoreceivesservicesthroughanExtendedIFSPisrequiredtohaveaneducationalcomponentaddressingallthreeidentifiedareas

(pre-literacy,language,andnumeracy)andstatedasatleasttwoseparateIFSPoutcomes.


DeterminingEarlyInterventionSupports&ServicesIFSP:

Supportsandservicesaredeterminedfollowingthedevelopmentoffunctionalchildandfamilyoutcomes.Theyaredesignedtoenhancethecapacityoffamiliestosupporttheirchild’slearninganddevelopmentthroughfunctionalparticipationinfamilyandcommunityactivities(KeyPrinciple#1and#3).EachagencyorpersonwhohasadirectroleintheprovisionofearlyinterventionservicesisresponsibleforsupportingthefamilytoachievealloutcomesoftheIFSP.

Thepurposeofgatheringauthenticassessmentinformationwithinnaturallyoccurringroutines,activities,andenvironmentsistoidentifythecontextinwhichearlyinterventionserviceswillbestsupportthechild’smeaningfulparticipation.Determiningwhatservice(s),atwhatfrequencyandforhowlong,mustbelinkedtowhattheteamlearnedaboutthefamily’sresources,priorities,andconcerns,thechild’scurrentfunctionaldevelopmentandthefamily’scapacitytosupportthechild.Servicesshouldthenbeprovidedwithinthosecontexts.

Documentation

Identifyeachservice,theintensity,frequency,duration,andservicesettingintheEarlyInterventionServicestaboftheMDOnlineIFSPoronthepaperIFSPform.Note:Parentsmustbeprovidedinformationaboutservicesspecificallyforchildrenwhoareblind/visuallyimpairedordeaf/hardofhearingthroughMSBorMSD.

Thefamily’spriorities,needs,andinterestsareaddressedmostappropriatelybyaprimaryproviderwhorepresentsandreceivesteamandcommunitysupport(KeyPrinciple6).

Ifanearlyinterventionservicecannotbeprovidedinanaturalenvironment,ajustificationfortheIFSPteam’sdecisionmustbeprovided.Teamsshouldincludeplanningofstepsandresourcesneededtomoveservicestonatural

environmentsthatsupportachild’sparticipation.

Earlyinterventionservicesmustbeinitiatedwithin30daysofparentsignatureontheIFSP,unlesstheteamdeterminesotherwiseandclearly

documentsthediscussionandreasons.


PlanningforTransitionsIFSP:

Formalandinformaltransitionshappenthroughoutafamily’sparticipationinearlyinterventionservices.Teamsshouldacknowledgeandconsidertheimpactofinformaltransitionsonthechild’sdevelopmentofrelationships,engagement,andindependenceaswellassupportsthefamilymayneedtosuccessfullymovethroughtransitions.

Inearlyintervention,themoreformaltransitionsbeforeagethreethatmightoccurare:fromhospitaltohome;intoearlyinterventionprograms,and;outofearlyintervention,possiblytocommunityearlychildhoodprograms.Atagethree,transitionsincludeoutofearlyinterventiontocommunityearlychildhoodprogramsoroutofearlyinterventionintoPartB/619(preschoolspecialeducation).ForchildrenontheExtendedIFSP,transitionafteragethreetransitionwilleitherbeoutofearlyinterventionintocommunityearlychildhoodsettingsorintoPartB/619(preschoolspecialeducation).

TransitionBeforeAge3Planningfortransitionsbeforeagethreemaybearoundtransitionsthatimpactachildandfamilythatdonotincludetransitioninginoroutofenvironmentsorprograms,suchaswhenaparentgetsanewjob,orwhenanewbabyisborn,orwhenaparentisdeployed.Teamscanprepareforthesetransitionsbyexploringanticipatedreactionsandeffectsandplanningresponses.Therearetimes,too,whenachildismovingbetweenenvironmentsorprograms.Whenachildisdischargedfromthehospitalforthefirsttimeorwithnewchallenges,theteamcanplanhowbesttosupportthechildandfamily’ssuccessfuladjustment.IfachildandfamilymeetalltheirIFSPoutcomesand/orthechildisnolongereligibleforearlyinterventionservices,transitionplanningwiththefamilycanhelpthechildandfamilytoaccesscommunityservicesandsupportsbasedonfamilyprioritiesandresources.TransitionAtAge3ArequiredIFSPmeetingspecificallytosupportachildandfamily’stransitionatagethreeiscalledtheTransitionPlanningMeeting.Thismeetingisheldbetween9monthsand90dayspriortothethird

TheTransitionPlanningMeeting(TPM)mustbeheldbetween9monthsand90dayspriortothechild’s3rdbirthday.


TheRecommendedPracticesinTransitionareassociatedwithgreatersatisfaction,betteradjustmentandbetterchildoutcomes.


birthdayandspecifictransitionactivities,timelines,andpersonsresponsiblearedocumentedintheIFSP.AppropriaterepresentativesfrombothPartCandPartBprograms,alongwithanyotherparticipantsthefamilywouldlike,areinvitedtotheTPM.Familiesneedtobeprovidedtheinformationaboutallprogrammingoptionstomakeinformeddecisionsaboutnextsteps.

InMaryland,familieshavetheoptiontocontinueearlyinterventionservicesthroughanIFSPbeyondthechild’sthirdbirthday,untilthebeginningoftheschoolyearfollowingthechild’sfourthbirthday.IfthechildhasacurrentIFSPandisdeterminedeligibleforpreschoolspecialeducationandrelatedservices,thefamilymayelecttocontinuechildandfamilyservicesthroughanExtendedIFSPormovetopreschoolspecialeducationservicesthroughanIEP.Aspartofinitialtransitionplanning,itiscriticalforservicecoordinatorstoshareinformationwithfamiliesabouttheseoptions.

TransitionAfterAge3TransitionplanningisalsorequiredaftertheageofthreeinpreparationformovingtopreschoolspecialeducationservicesthroughanIEP.TheTransitionPlanningMeetingisheldnolaterthan90dayspriortothebeginningoftheschoolyearfollowingthechild’sfourthbirthday.FamiliesmayrequestservicesfromanIEPanytimeafteranextendedIFSPisinplace,inwhichcaseaTransitionPlanningMeetingshouldbescheduledatsuchtime.TransitionplanningactivitiesmayincludemovingtopreschoolspecialeducationservicesthroughanIEPorhelpingthechildandfamilyaccesscommunityservicesandsupports.

TransitionPlanningRegardlessofwhenachildtransitions(before,at,orafteragethee)thediscussionneedstoincludeplanningnotesandnextsteps,includingwhowilldowhattosupportthechildandfamilytothenewsetting.

Documentanycommunityreferralsbeingmade,transitionactivities,timelines,andresponsiblepersonsintheTransitionPlanningtaboftheMDOnlineIFSPoronthepaperIFSPform.Note:TheTransitionPlanningNotesandNextStepsshouldbecompletedforALLtransitiondiscussions(Before,At,orAfterAge3).

IdentifythespecifictransitionintheTransitionPlanningtaboftheMDOnlineIFSPoronthepaperIFSPform.Note:DocumentanyreasonstheTPMdidnothappenasrequiredandresultsofanymeetings.

TransitionPlanningNotesandNextStepsarerequiredoutcomes

oftheTPM.

Documentation

Documentation


ObtainingParentalConsent(AtorBeforeAgeThree)IFSP:

FamiliesHaveaChoiceInMaryland,ifachildandfamilyhaveacurrentIFSPthroughalocalInfantsandToddlersProgramandthelocalschoolsystemhasdeterminedthatthechildiseligibleforpreschoolspecialeducationandrelatedservices,thefamilyhasthechoicetocontinuereceivingearlyinterventionservicesthroughanextendedIFSPortoinitiatespecialeducationpreschoolservicesthroughanIEP.TheIFSPteamisrequiredtoexplaintheFamiliesHaveaChoiceinformationtofamilies.Thisbeginswithprovidingfamilieswithanannualwrittennoticeaboutthischoicebydistributing,“AFamilyGuidetoNextStepsWhenYourChildinEarlyInterventionTurns3–FamiliesHaveaChoice.”ItisessentialthattheparentunderstandsthecontentofthisconsentbeforemakingthechoicetocontinueIFSPservicesortoterminateIFSPservicesafterthechild’sthirdbirthday.TheIFSPteamshouldencourageparent(s)toreadthrougheachoftheeightstatementsandaddressanyquestionsoftheparent(s)regardingtheconsentrequirements.Iftheparent(s)consenttothecontinuationofearlyinterventionservicesafterthechild’sthirdbirthday,theparent(s)mustprovideinformedwrittenconsenttothelocalschoolsystem(PartB)assoonaspossible.Aspartofthetransitionprocess,theIFSPteamshouldassisttheparent;onestrategymaybetoprovideacopyofthePartVIParentConsentforminorderfortheparenttonotifythelocalschoolsystem(PartB)oftheirdecisiontocontinueearlyinterventionservices.


ObtainingAuthorization(s)IFSP:

IDEAConsentTheIFSPteamisrequiredtofullyexplainthecontentsoftheIFSPandtheauthorizationitemsinthissectiontotheparent/guardian/surrogate(parent)andaddressanyquestionstheparentmayhave.ItisessentialthattheparentunderstandsthecontentoftheIFSPandeachitemincludedinthisauthorizationsection.Writtenconsentmustbeobtainedfromtheparentpriortotheprovisionofearlyinterventionservices.AuthorizationsmustbeobtainedforinitialIFSPMeetings,annualIFSPMeetings,andallotherIFSPMeetingsinwhichservicesarecontinued,added,ormodified. MedicalAssistance(MA)ConsentTheIFSPteamisrequiredtofullyexplainthecontentsoftheMedicalAssistance(MA)Consenttotheparent.ItisrequiredtoobtainparentalconsentbeforetheLocalInfantsandToddlersProgram(LITP)/publicagencydiscloses,forbillingpurposes,achild'spersonallyidentifiableinformationtotheMDDepartmentofHealth.WhenaparentprovidesMAconsenttheyhaveagreedinwritingthattheLITP/publicagencymayaccesstheirchild'sMedicaidtopayforservicesprovidedtotheirchild.Ifthereisamodification(frequency,length,andintensity)oradditionofanearlyinterventionservicethatisbilledtoMedicalAssistance,itisnecessaryfortheparenttocompleteanewauthorizationform,whichincludespermissiontobillMedicalAssistance.


ProvidingPriorWrittenNotice(PWN)IFSP:

Parentsareessentialteammembersinearlyinterventionandhavetherighttobefullyinformedinordertomakechoicesanddecisionsabouttheservicestheirchildreceives.Priorwrittennoticeisthelegalprovisiontosupportparents’informedinvolvementinearlyinterventionservices.TheLITPmustprovidepriorwrittennoticetofamilieswhenevertheIFSPteamisproposing,refusing,abouttostart,orabouttochangeearlyinterventionservices.Insomesituations,thepriorwrittennoticeisprovidedonlocally-developedformsandinothersthroughtheIFSP.Priorwrittennoticeisrequiredinthefollowingcircumstances:

• Identificationo Screeningtodetermineifachildissuspectedofadevelopmentaldelay;

• Evaluationo ProposetoevaluatetodetermineMITPeligibilityo Refusetoevaluateo Proposetoevaluatetore-determineMITPeligibility

• EligibilityDeterminationo Proposeeligibilityaftercompletionofrecordreviewo Proposeeligibilityaftercompletionofevaluationo Refuseeligibilityaftercompletionofevaluationo Proposetochangeeligibilitystatusafterre-evaluation

• ProvisionofEarlyInterventionServiceso Proposetoprovidethetype,intensity,frequency,methodsand/orduration

ofearlyinterventionserviceso Proposetochangethetype,intensity,frequency,methodsand/ordurationof

earlyinterventionserviceso Refusetoprovidethetype,intensity,frequency,methodsand/ordurationof

earlyinterventionserviceso Refusetochangethetype,intensity,frequency,methodsand/ordurationof

earlyinterventionservicesToensureparentsunderstandthenoticebeingprovided,itmustbewrittenintheirnativelanguage,unlessitisnotfeasibletodoso.Inwhichcase,thepriorwrittennoticeneedstobetranslatedorallytotheparentandtheprogrammustensuretheparentunderstandsandthereiswrittenevidencethattheserequirementshavebeenmet.

DocumentanyproposedorrefusedactionsinthePWNtaboftheMDOnlineIFSPoronthepaperIFSPform.Note:IdentifytheappropriateReasonforInactiveStatustoensureaccuratedatacollection.

Documentation


ImplementingtheIFSPIFSP:

Considerabletimeandeffortgoesintoconductingthoroughauthenticassessmenttolearnandunderstandhowthechildisrelatingtoothers,learningandparticipatinginactivities,andusingappropriatebehaviortogettheirneedsmetaswellasthefamily’sresources,priorities,andconcernsrelatedtotheirchild’smeaningfulparticipationineverydayactivitiesandroutines.

Theassessmentprocessfocusesontheseaspectssothatimplementationofearlyinterventionservicescaneffectivelysupportthechild’sparticipationinactivitiesthatarenaturalandimportanttothefamily.Families’livesarefilledwithnaturalopportunitiesforchildren’slearning.Dailyinteractionsandexperiences,includingparticipationinchildandfamilyroutines,communityactivities,andfamilyoutings,presentnumerousdevelopmentenhancingopportunitiesforyoungchildren.Itisimportanttounderstandandthencapitalizeonthesenaturallearningopportunitiestopromotechildren’sdevelopment.Theresearchinearlychildhoodeducationclearlystatesthatyoungchildrenlearnbestwithinthecontextofeverydayroutinesandactivitieswithfamiliaradultsandpeers.Therefore,earlyinterventionsessionsshouldbescheduledatthetimeandplacethatdailyactivitiesarenaturallyoccurringandprovidersshouldcoachparentsandcaregiversaroundtheuseofevidence-basedstrategiesandinstructionalpracticeswithinthoseactivities.Familiesshouldbedoingwhattheywouldnormallybedoingatthetimesearlyinterventionvisitsarescheduledandprovidersthen“joinin”tosupportfullparticipation.Togetherwiththeparentand/orcaregiver,provider(s)develop,implement,andevaluatestrategiesthatsupportthechild’sfullandmeaningfulparticipation.Thisprocessrepeatsandevolvesthroughoutafamily’sengagementinearlyinterventionservicesasteamsmakeadjustmentstostrategiesandoutcomesbasedonchildfunctioningandparentprioritiesandconcerns.Effectiveongoingearlyinterventionservices:

• Promoteandencouragechildren’saccessandmeaningfulparticipationinnaturalandinclusivelearningopportunitiesandaddresscultural,linguistic,andabilitydiversity,

• Usetheeverydayroutineactivitiesandrelationshipsasthecontextsforchildlearninganddevelopment,

• Identifytheparent/family/caregiverasthelearnertosupporttheirincreasedcapacitytoutilizeinterventionstrategies,

Thereare6Environment,13Instruction,and9Interaction

RecommendedPracticesprovidingguidancearound

evidence-basedintervention.



• Interactwithparentsandcolleaguesusingthe5characteristicsofreflectivecoachingasanadultlearningstrategy,and

• Regularlymonitorongoingprogress.

Theprimaryroleofaserviceproviderinearlyinterventionistoworkwithandsupportfamilymembersandcaregiversinchildren’slives(KeyPrinciple#3).

Documentation

Interventionswithyoungchildrenandfamilymembersmustbebasedonexplicitprinciples,validatedpractices,bestavailableresearch,andrelevantlawsandregulations(KeyPrinciple#7).

EarlyinterventionservicenotesmaybedocumentedwithintheServiceLog(ServiceEncounters)taboftheMDOnlineIFSPoronprogram-developedforms.Note:Allservicecoordinationactivitiesandearlyinterventionserviceprovisionmustbedocumentedintheearlyinterventionrecordinaccordancewithfrequency,intensity,anddurationofIFSPservice(s).


ReviewingtheIFSPIFSPteamsarerequiredtoreviewtheIFSPnotlessthaneverysixmonths.Duringthe“six-monthreview,”teamsshouldupdateanynewinformationregardingthechild’shealth,presentlevelsoffunctionaldevelopment,progresstowardsIFSPoutcomes,andearlyinterventionservices.Modificationstooutcomestatementsand/orsupportsandservicesshouldbemadeasnecessary,withpriorwrittennoticeprovidedasrequired.InpreparationforannualIFSPreviews,althoughafullevaluationusingstandardizedtoolsisnotnecessaryunlessthechild’scontinuedeligibilityforearlyinterventionservicesisinquestion,teamsdoneedtoconductathoroughannualchildandfamilyassessment.Familyroutinesandactivitiesandthechild’sparticipationwithinthoserarelylookthesameayearaftertheinitialassessment.Therefore,afullchildandfamilyassessmentisnecessary.Annually,teamsneedtocompleteeithertheRBI,SAFER,orNaturalActivities/RoutinesandEnvironmentssectionoftheIFSPtoupdateinformationaboutthechild’sfunctioning,andtheFamilyResources,Priorities,andConcernspagetounderstandfamilyneeds.Additionalassessmenttoolsmaybeusedtosupplementtheauthenticinformation,forexample,toaidinanyupcomingtransitionactivitiesasdefinedbylocaljurisdictionpoliciesandprocedures.Allassessmentinformationisorganizedandsummarizedwithinthethreeearlychildhoodoutcomeareas.Aswithpreviousreviews,teamsneedtoreviewprogresstowardspreviousoutcomesandeitherchoosetocontinue,modify,ordiscontinue,aswellasconsideranynewoutcomesbasedonrecentlycompletedauthenticassessmentactivities.Earlyinterventionservicesshouldalsobereviewedandmodifiedasappropriatetosupportthefamily’scapacitytomeetthedevelopmentalneedsofthechild.

DocumentallsectionsofthenewannualIFSP(exceptEvaluationforEligibilityunlesseligibilityfortheMITPisre-evaluated)ontheMDOnlineIFSPoronthepaperIFSPform.Note:TheMDOnlineIFSPwillautomaticallypopulatecertainpagesofanewannualIFSPfromthepreviousIFSP.TheAssessmentsectionwillbeblankfornewinformationtobeupdated.

Documentation

IFSPsarerequiredtobereviewednotlessthaneverysixmonths.


GeneralIFSPRequirementsTeamsarerequiredtoidentifythetypeandpurposeofIFSPmeetings:InterimIFSP:FederalregulationsstipulatethefollowingtwosituationsinwhichaninterimIFSPmaybedeveloped:● Thefirstiswhenexceptionalcircumstances(e.g.,theillnessofthechild)preclude

completionoftheevaluationandassessmentwithin45days.TheentireIFSPisnotcompleted.Whenthehealthofthechildisstabilized,theevaluationandassessmentofthechildiscompleted.TheareasoftheIFSP,thatwerenotcompletedattheinterimIFSPmeeting,arecompletedataninitialIFSPmeeting.TheservicecoordinatorinformsdataentrystaffthatthereasonforthecompletionoftheinitialIFSPmeetingmorethan45daysafterthereferraldateis“child/familyunavailable.”

● Thesecondiswhenthechildhasobviousimmediateneedsthatareidentifiedatthetimeofreferral(e.g.,childisreferredwithadiagnosedconditionsuchasfailuretothriveandaphysicianrecommendsimmediateinterventioninaparticularareasuchasoccupationaltherapyforafeedingproblem).OnlytheareasoftheIFSPrelatedtotheimmediateneedarecompletedattheinterimIFSPmeeting.Inthiscase,theevaluationandassessmentmustbecompletedwithin45daysand,theareasoftheIFSPthatwerenotcompletedattheinterimIFSPmeeting,arecompletedataninitialIFSPmeeting.The45-daytimelineforIFSPcompletionappliesinthissituation.

Bothtypesofsituationspresumethatthechild’seligibilityisnotinquestion.InitialIFSP:TheinitialIFSPisthefirstIFSPdevelopedbytheteam,includingthefamily,uponreferralandeligibilitydetermination.6-MonthReview:TheIFSPmustbereviewedatleastonceeverysixmonths.OtherReview:TheIFSPisafluid,flexibledocumentthatcanbeupdatedasthechild’sandfamily’sneedschange.OtherReviewcanbecheckedtorecordthetransitionplanningmeeting,ifnotcompletedatanannualor6-monthreview.AnnualIFSP:Annually,itistheresponsibilityoftheIFSPTeamtoevaluatetheIFSPanddetermineifprogressisbeingmadeasexpectedonthefunctionalIFSPoutcomes,ifservicesareappropriate,andifrevisionstooutcomesorservicesisneeded.AttheannualIFSPreview,allsectionsofPartII-MyChildandFamily’sStorymustberewritten.Regardlessofwhethertheteamisdevelopinganinterim,initial,orannualIFSPorreviewingacurrentactiveIFSP,thefollowinggeneralrequirementsmustbeensured:● EachinitialIFSPmeetingandeachannualmeetingtoevaluatetheIFSPofaninfant

ortoddlerswithadisabilityshallbemultidisciplinaryandincludethefollowingparticipants:1. Theparentorparentsofthechild;2. Theservicecoordinatorthathasbeenworkingwiththefamilysincetheinitial

referralofthechildforevaluation,orthathasbeendesignatedbythepublicagencytoberesponsibleforimplementationoftheIFSP;


3. Individualsdirectlyinvolvedinconductingtheevaluationsandassessments;4. Individualswhowillbeprovidingservicestothechildorthefamily,as

determineappropriate.5. Otherfamilymembers,asrequestedbytheparent,iffeasibletodoso;and6. Anadvocateorindividualoutsidethefamily,iftheparentrequeststhatthe

individualparticipate.● AtaminimumtheIFSPteamshallinclude:

1.Theparent;and2.Twoormoreindividualsfromseparateprofessionswithoneoftheindividuals

beingthechild’sservicecoordinator.● Ifanindividuallistedaboveisunabletoattendameeting,arrangementsshallbe

madefortheindividual’sinvolvementthroughothermeans,including:1. Participatinginatelephoneconferencecall;2. Havingaknowledgeableauthorizedrepresentativeattendthemeeting;or3. Makingpertinentrecordsavailableatthemeeting.

● Thelocalleadagencyshallensuretheprovisionofservicecoordinationtoaneligiblechildandthechild’sfamily,thatincludesthedesignationofaservicecoordinatorfromtheprofessionmostimmediatelyrelevanttothechild’sorfamily’sneeds,orwhoisotherwisequalifiedtocarryoutallapplicableresponsibilitiesandwhoisresponsiblefortheimplementationoftheIFSPandcoordinationwithotheragenciesandpersons.

● Parentsmayrequesttheirchild’scompleteIFSPbetranslatedintothenativelanguagespokenbytheparentsifthelanguageisspokenbymorethanonepercent(1%)ofthestudentpopulationinthelocalschoolsystem.FormoreinformationpleaseconsulttheNativeLanguageTechnicalAssistanceBulletin-November7,2016.

ForadditionalinformationaroundthegeneralfunctionsoftheservicecoordinatorandofservicecoordinationthroughouttheIFSPprocess,pleaserefertotheMITPServiceCoordinationHandbook.IfadditionalsupportsareneededtobuildcapacityaroundanyoftheconceptsthroughouttheIFSPprocess,pleaseseethelistofSupplementalTrainingResourcesonthenextpage.


IFSPProcessSupplementalTrainingResources

Foundations WebsitesKeyPrinciples UniversalOnlinePartCE.I.Curriculum

• http://universalonlinepartceicurriculum.pbworks.com/w/page/79643462/MissionandKeyPrinciples

• http://universalonlinepartceicurriculum.pbworks.com/w/page/100926430/FoundationalPillarsofEarlyIntervention

DECRecommendedPractices

EarlyChildhoodTechnicalAssistanceCenter(ECTA)–DECRecommendedPractices(RPs)• http://ectacenter.org/decrp/

Teaming&Collaboration DECRPs–Teaming&CollaborationandFamilies• http://ectacenter.org/decrp/topic-teaming.asp• http://ectacenter.org/decrp/topic-family.aspMakingAccessHappen–Coaching• https://medium.com/mah-coaching-supportFamilyInfantandPreschoolProgram(FIPP)• http://fipp.org/publications/casecollections/MarylandLearningLinks–ECPLO–TeamingandCoachingWebinars(ECPLO2017)• https://marylandlearninglinks.org/evidence-based-teaming/

Process GettingtoKnowtheChild&Family-AuthenticAssessment

UniversalOnlinePartCE.I.Curriculum• http://universalonlinepartceicurriculum.pbworks.com/w/page/123

567288/AuthenticAssessmentinEarlyInterventionDECRPs–Assessment• http://ectacenter.org/decrp/topic-assessment.aspMarylandLearningLinks–ECPLO–AuthenticAssessmentWebinar• https://marylandlearninglinks.org/authentic-assessment/

ChildOutcomesSummary(COS)

MarylandBirthtoKindergartenChildOutcomesGateway• http://olms.cte.jhu.edu/mdcos-gatewayMarylandLearningLinks–ECPLO–AuthenticAssessment/ChildOutcomesWebinar• https://marylandlearninglinks.org/authentic-assessment-child-

outcomes-connection-webinars/

DevelopingFunctional,Routines-BasedIFSPOutcomes

EarlyChildhoodTechnicalAssistanceCenter(ECTA)• http://ectacenter.org/~pdfs/pubs/rating-ifsp.pdfDevelopingEffectiveIFSPs(MD)• http://olms.cte.jhu.edu/olms2/developing-effective-ifsps

PlanningforTransition(s) DECRPs–Transition• http://ectacenter.org/decrp/topic-transition.asp

ImplementingtheIFSP DECRPs–Environments,Instruction,Interaction• http://ectacenter.org/decrp/topic-environment.asp• http://ectacenter.org/decrp/topic-instruction.asp• http://ectacenter.org/decrp/topic-interaction.asp


Works Cited DivisionforEarlyChildhood.(2014).DECrecommendedpracticesinearlyintervention/earlychildhoodspecialeducation2014.Retrievedfromhttp://www.dec-sped.org/recommendedpracticesLucas,A.,Gillaspy,K.,Peters,M.L.,&Hurth,J.(2014).Enhancingrecognitionofhighquality,functionalIFSPoutcomes.Retrievedfromhttp://www.ectacenter.org/~pdfs/pubs/rating-ifsp.pdfR.A.McWilliam©2009ProtocolfortheRoutines-BasedInterview.SiskinChildren’sInstitute.Chattanooga,TN,USA.R.A.McWilliam,S.Scott(2003)Scaleforassessmentoffamilyenjoymentwithinroutines.FrankPorterGrahamChildDevelopmentCenter.UniversityofNorthCarolinaatChapelHill.Shelden,M.L.&Rush,D.(2013).Theearlyinterventionteaminghandbook.PaulH.BrookesPublishingCo.,Inc.Baltimore,MD.WorkgrouponPrinciplesandPracticesinNaturalEnvironments,OSEPTACommunityofPractice:PartCSettings.(2008,February)Agreeduponpracticesforprovidingearlyinterventionservicesinnaturalenvironments.Retrievedfromhttp://www.ectacenter.org/~pdfs/topics/families/AgreedUponPractices_FinalDraft2_01_08.pdf


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