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Guiding Parents during IFSP Development

Will, the service coordinator, is sensing that Malika, Jeremiah’s mother, is feeling overwhelmed after the assessment. Malika has agreed to proceed8268841926_2c3f9996aa with developing Jeremiah’s IFSP, but when they get to discussing possible outcomes, she becomes quiet and tells the other team members to put whatever they think Jeremiah needs to learn on the plan. Will has two choices here: 1) do what Malika says and let the rest of the team take over, or 2) be responsive to Malika and help her be able to participate in the discussion. 

Option 1

If Will chooses option #1, the IFSP might be filled with outcomes that aren’t based on what is most important to Malika. Skill-based outcomes could pop-up that are based on what Jeremiah missed on the evaluation and assessment. It’s also more likely that the outcomes will be discipline-specific, meaning that the IFSP will have “PT goals” or “speech goals.” Without Malika providing input about how her family works, what motivates Jeremiah, and when he struggles, the outcomes are likely to be less meaningful to Malika and her family and harder to address in their daily lives. This is not the preferred way to write outcomes or the best way to begin the parent-provider partnership.

Option 2

If Will chooses option #2, then he is treading into more sensitive water. He needs to acknowledge what he is sensing with Malika and find ways to support her so that she feels like she has an active and important role to play. If she is overwhelmed, she may need to have her hand held (as Erin suggested in our last blog post). What should Will do?

Here are a few suggestions to help Malika and the rest of the IFSP team move forward with developing outcomes:

Check-in before you jump in – Will should probably check in with Malika to see how she’s feeling and if she wants to take a break or complete the IFSP at a later time. Just offering these options can alleviate some of the pressure parents can feel that they have to complete the plan at that moment.

Go back to previous conversations about the family’s priorities and concerns – Start the outcome discussion by revisiting what Malika previously shared about what’s important to her, her concerns and priorities for Jeremiah’s development. As the discussion continues, keep bringing it back to what you know about the child and family.

Summarize the assessment and ask Malika what she would like to address first – Give a few examples of Jeremiah’s strengths and areas of needs. Relate them to his everyday life to help focus the discussion and let Malika pick what’s most important to her to start with.

Ask: “What would make your life easier? What would you most like Jeremiah to be able to do?” – If you can pinpoint something important like this, it can get the ball rolling. Then you can help link what the team knows about Jeremiah’s development to the activity that Malika identifies. Helping parents understand how their everyday activities provide the context for their children’s learning starts here.

It’s okay if you end the day with only 1 or 2 IFSP outcomes – It really is. The initial IFSP is only a beginning; you can always add to it or make adjustments later when Malika is more comfortable with the process.

Ask for Malika’s input regarding service recommendations – As the team (including the mother) discusses services following outcome development, ask Malika how often she’d like support. Be careful to balance guiding her to be a part of the decision-making process and avoiding overwhelming her further.

The important thing to remember here is to be responsive to parent’s needs, as well as those of the child – we tend to be very aware of what children need but can overlook parents’ needs if we aren’t paying attention. Guiding the parent during this process does not mean developing the plan while the parent passively listens. It means being flexible in how you support the parent as he or she participates in the process. HOW you guide the family, HOW you facilitate the team discussion and HOW you weave together the family’s input with input from other team members are what makes the difference.

What other suggestions do you have for this team? What would you do if you were Will or one of the service providers?

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37 Comments to “Guiding Parents during IFSP Development”

  1. WOW, timely blog! I am going to be teaching a class on families in the next few weeks and this conversation really provides good tips.

  2. I love the notion of “check in before you jump in”! Planning on sharing with a group of 50 Service Coordinators during staff meeting next week. It’s great to have resources like this to spark discussion about practice rather than the usual meeting agenda items – thanks!

  3. Hi Dana,

    This “blog log” was the subject of our lively staff discussion yesterday. Since we began using the Routines-Based Iinterview process with fidelity (about 1 year ago) this scenario is now foreign to us. In the past we would often experience a primary caregiver who would defer to the professionals around the table for outcomes on the IFSP. The RBI process involves families and guides them in such a manner THEY are able identify and prioritize the needs of THEIR child and family. We agree wholeheartedly with your last statement: “HOW you facilitate the team discussion and HOW you weave together the family’s input with input from other team members are what makes the difference.” We wish we would have known that (and had the skills to apply that) years ago! Thanks for your continued support of frontline early interventionists with valuable topics!!

    • Thanks for sharing how you all are using the RBI to guide families, David! It’s great to have a process like that to help parents be so involved in the EI process from the very beginning. How long does it take your staff to do the RBI with a family? Do they typically complete it in one visit, like at an intake? Are they also doing an ecomap?

      • Following intake and eligibility our first visit with the family is an overview of EI, rights/safeguards, and the ecomap. This is a critical moment in setting the stage for EI…explaining how infants and toddlers learn (in everyday routines) and that intervention takes place BETWEEN visits of the specialists. The Routines-Based Interview is generally scheduled for the next visit, or whenever the family can block out two full uninterrupted hours. When we were first trained by Dr McWilliam our entire staff balked at that time-commitment. We have since found the time is well-spent and yields incredible insights. Even the most quiet word-less primary caregivers become engaged and talkative, given the structure of the interview. This visit is followed by the development of the IFSP. Yes, the 45 day timeline pushes us hard but every one of us agrees that the benefits for children and families far outweigh the upfront sacrifice in time.

        • Thanks, David. This is really interesting. It sounds like you have several visits before the IFSP. I like the idea of really getting to know the child and family more before you write the plan. Surely that would result in a better, more meaningful IFSP. Thanks for sharing!

  4. What other suggestions do you have for this team? What would you do if you were Will or one of the service providers?

    If I were a service provider in Will’s shoes, I would try my best to let Malika know how important her input is for making decisions about her son’s IFSP plan. Furthermore, I would try my best to support Malika’s decisions and let her know how important of a member she is on the IFSP team. Moreover, I would try to alleviate any fears that Malika was having in any way that I could while highlighting her family’s strengths to increase her confidence. Finally, in regards to the options, I would take option #2 and try my best to be responsive to Malika’s needs in order to help her effectively participate in the creation of the IFSP plan. I would also try to ask for Malika’s input whenever possible when making important decisions for her family’s IFSP plan.

    • Thanks Ethan. Emphasizing the mother as an equal team member with valuable input and an essential role in writing her child’s IFSP is so important!

  5. If I were one of the service providers I would go with option 2 because this option is more family oriented which is what these services are based on. It should be focused on the dyadic relationship between the parent and child. If the mother feels overwhelmed then her mental state should be balanced before moving on to the IFSP. Simply just choosing the plan without the parents input would not help Malika feel included in her own child’s treatment which is not okay. This also would make it to where the plan does not include any of the goals Malika hopes her child will accomplish.

  6. If I were one of the service providers, I would utilize option #2 as I find it incredibly important for Malika to participate and be a part of the discussion. I believe it is important to acknowledge and understand what Malika wants for her child as she knows her child the best. The mother may feel overwhelmed and scared throughout this process, but I consider it critical for the team to hear and listen to her. With the IFSP plan in place, the team should provide Malika with all the information needed and answer questions she may have. The mother should feel as though she is truly supported and encouraged to take part in the process. This means being patient and takin time off if needed. I believe the service provider is a supportive and responsive team that provides additional encouragement during the process.

  7. If I was a service provider in this situation, I would definitely go with Option 2. It is so important for the IFSP outcomes to be completely individualized to fit the family’s needs and preferences. If it is not, then the mother may feel that she has a backseat position in her child’s intervention when in reality, she should be driving the whole process as an equal team member. The mother knows her child best because she is with him everyday and she should be fully included in creating the IFSP. Option 2 may take more time but it is important to develop a bond with the mother so that the service coordinator can be a person of support for the mother and the child throughout this whole intervention process. Ultimately, this will improve the intervention and create lasting and beneficial impacts for the family.

  8. If I was Will or one of the service providers, my priority would be to make sure the mother feels comfortable and feels like her voice and opinion does matter. Even if that means to take a break or have the family sleep on what they have talked about before establishing the IFSP outcomes, that is fine. I would want the family to be as involved as they are comfortable with, and I would want them to know there is no pressure. All the decisions made should be made according to the family’s priorities.

    • Great point, Urooj! I really like the flexibility you write about. Parents should never feel pressured by us and we have to be careful not to let our busy schedules insert pressure into our interactions.

  9. In order to perform a family-centered practice, I would definitely choose option number two. I believe it is crucial to work together with the primary caregiver to achieve mutually agreed outcomes. If I was the service coordinator, I would ask Malika what her concerns are and what she wishes to be the priorities. I would also try to help Malika gaining her confidence by integrating her inputs while creating the service plan and letting her know she’s the expert of the child. If she feels overwhelmed by the amount or difficulty of the information, I would convey the information in a way the parent can easily understand and follow.

    • Yes, adjusting how you engage the parent, how you provide information, and how you build the parent’s confidence – all to match the parent’s preferences for learning and participating – are important skills to develop, for both service coordinators and service providers!

  10. If I was the service provider, I would go with option two. This is option is much more family-centered and I feel that is a big priority when developing the IFSP. Although it is diving into “sensitive water”, I think that is necessary for Jeremiah to get the best services possible. It is critical for the parent to feel they are included in each meeting. By doing so, they will be ore responsive the service provider. Malika knows what is best for her son and by including her in the sessions she is able to express her concerns and priorities. It is also important for the service provider to get rid of any deals that Malika may have. The service provider needs to not only be supportive of Jeremiah, but also be supportive of Malika and help her to feel as comfortable as possible.

    • I really appreciate the last line you wrote, Lindsay. That dual focus – on what is important and comfortable for both the parent and the child – is a key perspective to adopt. It affects everything, even beyond the IFSP. It’s critical for service delivery and transition too!

  11. If I were one of the service providers, I would use option #2 because this makes the mom be apart of the team and apart her child’s plan. I feel like in order to have a successful plan for Jeremiah, his mother showed be involved in the planning because she knows her child best. Another important part that was brought up is being able to support the mother throughout this time and letting her know about her options.

  12. If I were Will, I would even go forward to suggest a third option. I would bring up the possibility of another close family member, like Malika’s mother or sister, help guide and support Malika during the IFSP process. They more than likely would have up to date information regarding Jeremiah’s condition. Malika may be more willing to open up to her closer family members and in turn could exchange ideas back and forth as to what milestones they want to see Jeremiah achieve. Granted, there must be some sort of consent from Malika to allow other close family members to be involved in this; however, I think the presence of the family will help alleviate her anxieties and fears. I would only suggest this idea after trying to understand her family dynamic. Parents in this situation need as much care and support as the child does. Regarding Option 2, it is imperative that Malika stays involved in the IFSP process.

    • Great point, John. If Malika does have family support, encouraging her to reach out to them to prepare for the IFSP is a fantastic idea!

  13. Hello Dana,

    In order for the mom to be more involved and feel like she’s a part of the child’s assessment, I would definitely go with option #2 since Will believes she might be overwhelmed with everything going on. I don’t think any mom would feel comfortable not being a part of the plan for her child. As the saying goes, ” Mother knows best,” and since she sees her child daily, it would only be sensible to involve the mother in the child’s plan as much as possible in order to ensure that the child is getting treated properly and efficiently. I think it’s normal for a mother in a situation such as this one to feel overwhelmed, so knowing that she has support would only be beneficial.

    • Yes, great point Joyce. As much as we try to make the process easy for families, it is almost always new to them as they enter an unfamiliar system. That “newness” combined with finding out that your child as a delay or disability certainly could set the stage for the parent to feel overwhelmed, and rightly so. Our awareness of this and how we support the parent can make a huge difference.

  14. Good afternoon,

    I would definitely have to go with option 2. IFSP is family orientated and option is has a greater focus on the family/parents. If the parents are heavily involved then it is more likely that the child will have successful outcomes. Although it may it be the more time consuming and more involved option it is better for the family and child.

    Thanks!

    • Yes, good point! Option 2 probably is more time-consuming but that time is well spent. Taking the time to be responsive and engage the parent is essential to ensure that IFSP truly is individualized and meaningful!

  15. As a service coordinator, I would choose option 2 because its important to include the parent’s input in the child’s IFSP. A parent knows their child best so if the team members were to put whatever outcomes they felt were best for Jeremiah, it might be the opposite of what Malika might want for her son. IFSPs focus on the child but it also includes so much involvement from family members so it is important to keep their concerns in mind. As a service provider, it’s important to make everyone feel welcome and valued so that you can work together towards the child’s progress.

    • Great point, Helen! We often *think* we know what parents want or what children should do, but without the parent’s direct input, we can’t be sure. When we are wrong, that makes it so much harder for the parent to be successful supporting the child.

  16. If I were a service provider, one of the steps I would take to ease Malika’s concern about the whole process is to emphasize that this is a work in progress and a learning experience for the family as it is for the IFSP team. Furthermore, I would help Malika understand that her participation is a critical determining factor for the IFSP outcomes by explaining how each member of the IFSP team, from the professionals to the family, brings a unique understanding of Jeremiah’s development. Thus, if I was Will, I would go with option two because this best takes into account the family’s environment, their preferences, their needs, their culture, essentially, it allows the IFSP team to understand and implement the family’s natural environment in the IFSP outcomes. In promoting Malika’s active participation, Jeremiah’s developmental needs are better assessed.

    • Great point, Diana! Helping the family (and sometimes the other team members too) see that the initial IFSP is just the beginning is so helpful. The plan can be changed at anytime. I think this perspective takes some of the pressure off of the experience for parents – and other eager team members who might want to be sure their professional priorities are included.

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