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A Priority or a Concern – What’s the Difference and Why it Matters

I have a confession…I don’t actually think we should spend so much time talking with families about their 11263316893concerns. I think we should ask once, so that we have it for Section II of the IFSP, then leave it alone. Instead, I think we should focus much more on the family’s priority for their child’s development. Concerns and priorities are not the same thing, and the difference matters.

Concerns and Priorities – What’s the Difference?

Concerns are often similar from family to family. Think about the many, many toddlers who are referred to early intervention who are not talking. In fact, most of the children we see are not talking as an age-appropriate level. When you ask their parents what they are concerned about, they are likely to say something like, “He’s not talking like other kids his age.” This is a very common, very real concern. Same with children who are late walkers. These concerns are very important because they are what drive a parent to EI, and they are what keep a parent up at night, worrying about her child. We must acknowledge these concerns, and record them on the IFSP, then dig deeper to find out about priorities.

Turning to priorities reframes the discussion to become more individualized, more positive, and more functional. Priorities are the answers to questions like “What would it look like to you if she was able to talk more?” or “How would your day or your child’s day be easier if she could say more words?” Priorities are descriptions of what life would be like for a child and family if things got better. Priorities reflect the family’s vision for the child’s development. Priorities are the foundation for individualized, functional IFSP outcomes.

Why It Matters

It’s really, really hard to write a good IFSP outcome based on concerns alone. When we focus on concerns, we get outcomes that are “cookie-cutter.” You can substitute any child’s name in the body of an outcome like this: Noah will use words to express his wants and needs. All toddlers need to be able to do that – it’s not an individualized outcome. If you focus on priorities for Noah and his family, you’ll find out that life would be grand if Noah could say words to label toys and activities he likes to do when he plays with his siblings after school. Noah loves to play with his blue ball in the back yard, play in the toy kitchen with his sisters, and look at books with his dad. By digging into priorities for Noah and hus family, we learn about how the family works and what’s important to them. This rich information is where you glean what you need to know to write a good outcome. Here’s an example:

Noah will use 50 words to label his favorite toys (ball, cup, book, doggie) and activities (play, outside, kitchen, dinner, books) when playing with his siblings each afternoon after school for two weeks.

This outcome is individualized to what Noah likes to say and do, includes a context that happens frequently in his home, and includes a measurable criteria that the family can keep track of. If the professionals on Noah’s IFSP team had only focused on his family’s concerns, then they would have missed out on what they really needed to know to ensure that the IFSP was meaningful to Noah’s family. This is important because the IFSP outcomes guide service delivery, and meaningful services are based on what’s important to the family – their priorities for their child.

What do your teams typically focus on – concerns or priorities? What challenges do you face with finding out about family priorities?

How do you guide the conversation to dig deeper into what’s important to families when writing IFSP outcomes?

Share your comments below!

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12 Comments to “A Priority or a Concern – What’s the Difference and Why it Matters”

  1. Dana: You did it again! Great blog with useful, practical strategies.

  2. Great article! We have our monthly staff training with a group of about 60 Service Coordinators today and I can’t wait to share/discuss. These statements stayed with me – “Turning to priorities reframes the discussion to become more individualized, more positive, and more functional. Priorities are descriptions of what life would be like for a child and family if things got better. Priorities reflect the family’s vision for the child’s development. Priorities are the foundation for individualized, functional IFSP outcomes.” Thanks, Dana!

    • Great to hear from you, Amy! I always love to hear the insights your SCs share with you so keep me posted! So glad you found the post useful!

  3. Brilliant! Simple but profound! Dana, I think you’ve identified another key to making early intervention outcomes (and consequently services) more relevant and meaningful! Thank you!

  4. I really appreciate this wonderful reminder. You painted two concise pictures of the differences between a family’s concern and a family’s priority for the future of their child, that made this thought very simple to adopt and to share. Thank you.

    • Thanks Ryan! What’s been your experience with this? Are you able to learn about the family’s priority during the intake or does it typically emerge later, like during the assessment or IFSP meeting?

  5. I also think that helping to differentiate a priority vs. a concern can guide service recommendations and improve the family’s overall outcomes. There may be concerns in multiple areas of development, but identifying which is their priority will allow for better selection of a primary service provider, and hopefully better support for that specific family and child.

    • Fantastic point, Lauren! Yes, really understanding the priority leads to better outcomes and more appropriate service decisions. It’s not just word smithing…it matters!

  6. Thank you for this! I liked how it was very clear and to the point. I am working of learning the right questions to ask to switch to priorities. Like you mentioned, the concerns are what drive the families to get EI. To then narrow it to priorities is a challenge. I will for sure use some of the example questions you have to help when working with families to make new goals.

    • I hope this helps you, Vanessa! I think moving the discussion from concerns to priorities should be pretty seamless so that the families don’t really know that it’s happening. Keep me posted on how it goes when using these questions with your families!

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