Infant Toddler Development Training
Module 3, Lesson 4
Establishment of Priorities
Assessment results will yield far more goals and objectives than can possibly be addressed within a designated time frame (Wolery, 2004). Thus the team is going to have to prioritize their goals. In considering which goals and objectives should be selected, the following should be considered:
- Does the outcome have immediate benefit and provide an opportunity for the child to become more independent and function better in natural environments?
- Does the outcome allow the child to learn skills that will result in learning other skills?
- Are the outcomes functional across multiple settings currently and in the future?
- Can the outcomes be carried out in everyday routines, activities and places?
Development of IFSP Outcomes and Intervention Plans
Child outcomes need to be developed based on the information gathered from the family, the evaluation and assessment process, and observations within natural environments. Outcomes are defined as changes that a family wants to see for their child and themselves. Outcomes are written in understandable language for caregivers (Bricker, et al 2002)
In planning intervention services, child outcomes should be embedded into everyday routines, activities and places using logically occurring antecedents and consequences to develop functional and generative skills (Bricker, Pretti-Frontczak, McComas, 1998).
Steps in Developing a Systematic Approach to Monitoring
After the IFSP has been developed, which includes child and family outcomes, an individualized instructional plan for each prioritized outcome needs to be developed. Often the objectives need to be analyzed into smaller steps in order to develop a plan for instruction and a monitoring system. This task analysis may become part of the monitoring system.
For example, an outcome for Mario on his IFSP, is that while holding a railing or hand, Mario will be able to walk up the steps to his room where he can play with his toys. In order to monitor progress of this outcome it is necessary to analyze the task and break it into smaller steps leading to the desired outcome. This could involve practice in various settings where steps exist (e.g. church, child care center).
The analysis might look like this:
- Mario will walk up two steps using same step placement holding adult's hand
- Mario will walk up three steps using same step placement holding adult's hand
- Mario will walk up four steps using same step placement holding adult's hand
- Mario will walk up four steps using same step placement with adult hand over his on railing
- Mario will walk up four steps using same step placement holding railing without assistance
- Mario will walk up two steps using alternate feet holding railing or a hand
- Mario will walk up several steps using alternate feet holding railing or a hand.
- Mario will walk up all the steps to his room using alternate feet holding railing or a hand
In planning for Mario, the team determined the everyday routine, activity and place in natural environments (home) where Mario could best practice the development of this skill. Important questions to consider would be:
- Is there an upstairs railing?
- Are there steps on the bandstand in the park? Or the library? Or at the church?
- Are there steps of appropriate size in the home on the front porch?
- Does Mario attend a center program with a stationary set of steps in the motor area?
- When, during the day, could Mom work on this skill with Mario? How often?
- When could Mario's primary service provider help coach Mom to work on this skill?
- How often?
For an example, look at Figure 1: Monitoring Form used by Ms. Fuentes, a mother who worked on this same outcome for her daughter, Maria. The form is for the particular objective which includes the task analysis into steps for Maria. Using this system, the parent recorded Maria's progress in the accomplishment of the functional outcome.
From the form, it is easy to see that Maria still needs help alternating feet when going up steps. Maybe it could be suggested to Mom that she use colored chalk or foot patterns of different colors and have Maria put her foot on the outline. Maybe Maria is not sure of her balance. She may need to practice standing on just one foot for a short time to become more confident.
Recommended practices and those advocated by Early Steps indicate that children learn best when they are actively engaged in everyday routines, activities and places in natural environments. Infants and toddlers are most actively engaged in an activity when skills are taught using materials and activities to which children are attending and when teaching occurs in the environment where children need those skills (Sandall, McLean, & Smith, 2000). In routine based instruction, objectives should be embedded into the routines.
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