Thursday, February 4, 2010

Implementation I: Writing Outcomes for Family-Level Needs

The next few blog entries will be about implementation issues that have arisen in one state I've been helping.

Question: Instead of writing 10 IFSP outcomes, some teachers [home visitors] are using [the daily contact log] to document concerns such as needing help finding day care, putting plastic on the windows, looking for a toddler bed, etc. The need/concern is documented, and the teacher follows up with the concern on the next visit.

Answer: These kinds of concerns are family needs, which are supposed to be part of early intervention and on the IFSP. What makes the askers of this question think that these needs shouldn't be outcomes? Do the have some child needs they also don't write outcomes for? Our accountability is at the level of outcomes, so we need important activities to be listed as outcomes, not hidden away in the child's record for which there is no accountability.

If the need came up during the Routines-Based Interview and the family selected it as an outcome, obviously it is written as an outcome. If a need comes up in the course of home visiting, it does not necessarily need to be added as an outcome. If much time and energy is going to be put on resolving the issue or if it becomes a big deal for the family, it should be added as an outcome, if the family chooses. Professionals should encourage not discourage this. Home visitors should be working on outcomes, so if something is not an outcome and they're spending much time on it, they are not doing what they should be doing. Similarly, if it's important to the family, we need to see that there is truly a goal to be accomplished, so an outcome gets written.


claudia said...

i am not clear what an outcome should be based on. i have been told they should be written according to the parents/caregivers priorities. Can you tell me what is the foundation we should use when writting outcomes?

MED43 said...

I was under the impression that the outcome(S) should be based on the needs of the child and the requests of the family. So how do we go about writing outcomes that the child truly will benefit from?

victoria said...

Can you please write some examples of well written outcomes?

Robin McWilliam said...

Claudia, they should be written according to the family's priorities. The problem is that often there is no effective way of helping families, especially when they're new to early intervention, figure out what priorities they might want addressed. So the Routines-Based Interview is a good method for providing that support.

MED43, the outcomes do not have to be based on the needs of the child. Family systems theory holds that what is good for the parents is good for the child, so the benefit to the child might be indirect.

victoria, see for a list of well-written (mostly!) outcomes.