Child and Family Outcomes

The Bottom Line

Go-To Tools

The handy tools that help you get the job done efficiently.

Functional Outcomes Tip Sheet

Goal Functionality Scale III

Functional Outcome Rating Tool

rating-ifsp.pdf

Enhancing Recognition of High Quality, Functional IFSP Outcomes

Purpose of Outcomes

Functional outcomes identified with families are the focal point of the IFSP document. They provide direction for future collaboration between the parents and providers of infant and toddler intervention services. The outcomes specify what should happen for families and children as a result of their participation in early intervention services. Outcomes reflect parents’ priorities, build upon identified strengths, build capacity in parents and other caregivers and promote the development of functional skills in children served. 

Creating Outcomes

Don't forget to use the Family Directed Assessment (FDA) as the main source of you outcomes. Remember that the outcomes will inform services and interventions the family receives. It is our job to make sure that a family’s values, beliefs, and priorities are honored and respected.

To learn more about the FDA, go to the Family Directed Assessment page.

Writing Functional Outcomes

IFSP Outcome Formula

6 Parts of Functional Outcomes:

1. Necessary and functional for child’s and family’s life

This means that the outcome focuses on ways to support the child and family’s participation in community life and family activities that are important to them. For the outcome to be necessary and functional, it should benefit the child by focusing on social relationships, acquiring and using knowledge and skills, and/or using appropriate actions to meet needs. It should also help the child and/or family improve participation in chosen activities and/or help them begin new activities that are important to them. The determination of what is necessary and functional is not based upon what the practitioner thinks is meaningful and functional for the family.

4. Jargon-free, clear and simple

This means that the outcome is written so that is understandable by the family and the general public, and does not include professional jargon or practitioner “speak.” For example, the outcome should describe how the child will move, such as reaching up or down for toys, instead of using phrases like “range of motion.” Another example would be wording an outcome so that it describes a child’s ability to speak words clearly to make herself understood, rather than using the term “articulation”. 

2. Reflect real-life contextualized settings

This means that outcome statements reflect the everyday activity settings and routines for the child and family. This includes mealtime, bathing and riding in the car, as well as routines and activities that are specific to the individual family. Specific isolated skills (e.g., test items that were missed during evaluation) are not considered real-life or contextualized.

5. Emphasize the positive, not the negative

This means that the focus of the whole outcome statement is positive. It also means that the outcome states what the child and/or family will do, rather than what they will not do or stop doing. If there are any negative words within the statement, it is not a positively worded outcome. For example, the outcome should state “Johnny will chew and swallow food when eating with his family” rather than “Johnny will not spit out food when eating with his family.”

3. Crosses developmental domains and is discipline-free

This means that the outcome is written to describe the child’s participation in routines and everyday activity settings, promoting skill development across multiple domains, which can be addressed by any member of a child’s IFSP team. It also means that the outcome should be written so that the child and/or family are the “actors” or persons doing something rather than the occupational therapist or early interventionist. For example, an outcome might state, “Annabelle will help her dad with the laundry by pulling up and standing at the dryer on her own and putting clothes into the laundry basket with her dad close by”, as opposed to “Annabelle will pull to a standing position at the couch and maintain her balance.” 

6. Uses active words rather than passive words

This means using words that encourage a child and/or family’s active participation or engagement. Active words include eat, play, talk, walk, etc. and indicate what the child or family will do. Passive words reflect a state of being (e.g., tolerate and receive), or a change or lack of change in performance (e.g., increase, decrease, improve, and maintain).

Examples of Functional Outcomes

The following examples* meet the 6 parts of functional outcomes (listed above):

*outcomes come from ECTA training activity.

Examples of NON-Functional Outcomes

The following examples* DO NOT meet the 6 parts of functional outcomes (listed above):

*outcomes come from ECTA training activity.

Documentation of Outcomes in the IFSP

Measurable result or measurable outcome: 

Outcomes should be worded as observable skills, behaviors, products or events the team wishes to see within 6 months to 1 year. 

Why is this result or outcome being addressed:

This establishes a rationale for the prioritization of this outcome. This statement makes clear to all members of the IFSP why the outcome has been prioritized and is included. 

What is already happening:

This section equates to the “present levels of performance” section of an IEP, describing what the child and family are currently doing specific to this functional outcome.

We will know we are successful when (include criteria and procedures):

This section is a description of how you will measure this achievement of the functional outcome; the acquisition criterion. Measurable criteria track an action or behavior that can be seen or heard reliably by others, and do not require interpretation or guessing to determine when an outcome has been achieved. Specific criteria establish a realistic reference point for parents, other caregivers, and early intervention providers to easily see or hear that an outcome has been achieved. Criteria should specify where and when to observe a behavior or action. Tracking progress is difficult when criteria are too broad, are ambiguous or are stated in terms of percentages. It is important to remember the purpose of an outcome as you identify an ending criterion. For example, if the purpose of the outcome was to promote the acquisition of a new skill or behavior, an ending criterion of “three times within one week” may be appropriate. If the purpose of the outcome was to increase a child’s rate or fluency with which he or she performs an existing skill, an ending criterion of “within two minutes” is logical. If, instead, the purpose of the outcome is to promote a child’s use of an acquired skill or behavior across environments, an ending criteria such as “three times a week at child care and at home” makes sense. Reports of progress by parents and other primary caregivers are acceptable and encouraged. 

Timeline that will be used to determine the extent to which progress is being made:

Describe the timeline, entering the month and year, that will be used to determine the extent to which progress is being made towards achieving the outcomes and the timelines that will be used to determine whether modifications or revisions of the expected outcomes or early intervention services identified in the IFSP are necessary. The timeline should reflect the anticipated date by which an outcome is expected to be achieved, and the points at which, and by whom, the progress will be monitored. For example, a family may choose to emphasize the skill of walking as a measurable result. The IFSP may note the timeline for the outcome of pulling to stand by 3 months from date of the IFSP, for the outcome of cruising around furniture by 6 months from date of the IFSP, for the outcome of walking short distances without support by 12 months from date of IFSP as measured by parent report. 

What will happen within the child and family's everyday routines, activities and places:

Describe how the selected intervention methodologies will be implemented throughout the natural learning opportunities that are part of the family’s daily routines. This section should clearly describe how members of the IFSP team or other caregivers of the child are embedding intervention into activities such as meals, play, bath, bed and other important daily routines. 


Example:

Outcome Documentation Example #1

Measurable result or measurable outcome: 

Tyler will participate in bedtime by lying down, relaxing and falling asleep in his crib without jumping or rocking.

Why is this result or outcome being addressed: 

Dick and Jane and his child care provider are concerned about Tyler's safety and they would him to fall asleep without jumping.

What is already happening: 

Tyler jumps in his crib and rocks the crib so hard the legs of the crib lift off the ground. There has been a few times at child care where Tyler almost tipped his Pack 'n Play crib over.

We will know we are successful when (include criteria and procedures): 

Tyler lies down, relaxes, and falls asleep without jumping and rocking in his crib within 30 minutes during nap time at child care/home and every night at home for two consecutive weeks, as measured through parent observation and report.

Timeline that will be used to determine the extent to which progress is being made: 

We expect this to happen by the time the family goes for a vacation during Spring break. Progress will be monitored every other week by members of the IFSP team.

What will happen within the child and family’s everyday routines, activities and places:

Outcome Documentation Example #2

Measurable result or measurable outcome: Dena (mom) will find resources to help her during the days she has off to drop off and pick up John for work and bring the girls to medical appointments at Minneapolis Children's Hospital.

Why is this result or outcome being addressed: 

Brianna (child), Hannah (sister), and Dena need to find ways to get their basic needs taken care of when they are on the run all day.

What is already happening: 

Dena packs for a full day of being on the run: food, diapers, extra clothes, blankets, etc. When it is time for a nap she has resorted to having the girls rest in the car, feedings might be in waiting areas at the children's clinic or at a fast food stop, diaper changes are in public restrooms or the front seat of the car.

We will know we are successful when (include criteria and procedures): 

Dena and Jon have found three resources/options to make  make the girls medical appointment days go more smoothly.

Timeline that will be used to determine the extent to which progress is being made: 

We expect this to happen by their next month's appointment

What will happen within the child and family’s everyday routines, activities and places:

✋ Frequently Asked Questions

Many parents are concerned about movement and communication milestones (ie., "I just want my child to walk", "I just want my child to talk", etc.), how can I get a parent to be more specific in order to write a functional outcome?

Acknowledging and validating what the parents want (I understand that walking or talking is important to you) but also educating them on how children learn and grow during daily routines.

Here are some questions to ask the parent if they say their priority is the have their child walk or talk: