Anne Brager, VA Part C Program
Sherri Britt Williams, NC Part C Program
Kathi Gillaspy, ECTA Center
May 22, 2014
2014 Inclusion Institute
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Why Integrate Outcomes?
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Goal of Early Intervention
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
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
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Mission of Early Intervention Services
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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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 needs
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Integrating Outcome Measurement into IFSP Process
• 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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Making the Connection:
Using Functional Assessment
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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The Right People, the Right Situation, the Right Time
• 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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• Not just about creating a more seamless process…not just details and how
• Critical to the picture of what we are all trying to accomplish

“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

• 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

• 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 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

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, domainspecific 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

Global Outcomes =
Intervention
Having positive social relationships
Taking appropriate action to meet needs
Acquiring and using knowledge and skills

Global Outcomes =
IEP Review
Having positive social relationships
Taking appropriate action to meet needs
Acquiring and using knowledge and skills

• 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

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 Indicators in Virginia
Understanding that the 3 child indicators serve as the foundation for the full EI process
Understanding that information related to the 3 child indicators begins at referral and continues throughout the EI process
Introduced new Indicator Statements
Introduced a new IFSP format for writing ASP narratives

• 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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• 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
Infant & Toddler Connection of Virginia 33

Infant & Toddler Connection of Virginia 34

Functional narrative related to the specific indicator
Functional narrative related to the specific indicator
Indicator
Statement
Indicator
Statement

The “Book”
Guiding
Questions
Indicator Statements
Feedback on Narratives

Infant & Toddler Connection of Virginia
• Feedback provided to each system on 2-3
IFSPs per month
• Feedback also provided to each system statewide before full statewide implementation
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• Replaced state principles with national 7
Key Principles
• Child Outcomes Gone Awry: Putting the
Pieces Together trainings http://www.youtube.com/watch?v=BoTuVtijx34
• Statewide Coaching Initiative
• Connection of Key Principals Visuals
Infant & Toddler Connection of Virginia 40

Infant & Toddler Connection of Virginia 41

Infant & Toddler Connection of Virginia 42

• 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
Infant & Toddler Connection of Virginia 43

• 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
44 Infant & Toddler Connection of Virginia

Child Indicator Guiding Questions

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 Services
Early Childhood Intervention and Education Branch
June 2011

Exploration
• Articulate Desired
Changes/Results
• Compare
Approaches
• Explore
Implementation
• Conduct Public
Awareness
• Move On To
Installation
Stages of Implementation
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
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Exploration
Phase
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Exploration
Phase
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 interrater 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

Installation
Phase
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Installation
Phase
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Initial
Implementation
Stage
Staff Team
Meetings
Individual
Supervision
Implementation
Team
State
Leadership/
Support
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Initial
Implementation
Stage
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Dedicated
State Level
TA and
Support
Local
Implementation
Teams
Communication and Feedback
Loops
Practice Time
Evaluation of
Fidelity and
Quality
Reviewing and Revising
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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
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Time to get your feet wet!
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Integrating Outcomes Resources
• 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
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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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