CMS Early Steps Orientation Training ~ Module 3

Page 10 of 19

version 1.2

Text of Audio

The Early Steps IFSP is comprised of ten forms, lettered from A through J. Each Form contains information required by Early Steps and Part C of the Individuals with Disabilities Education Act (IDEA). This section of the module reviews the content required by Early Steps and Part C and tells you where it is documented on the IFSP. Use the arrows in the upper right to navigate through the required components on each IFSP form.

Form A
Early Steps requires that there is demographic information included in each IFSP. Form A: Your Family's Information provides the important demographic information about the child and family and other important caregivers, and contact information for the service coordinator and the family resource specialist.

Form B
Part C of IDEA requires that a statement of the child's present levels of development in the areas of physical development, including vision, hearing and health status, cognitive development, communication development, social or emotional development, and adaptive development are included on the IFSP. Form B: Planning for Your Child's Evaluation/Assessment captures vision, hearing, health, and screening information.

Form C
Form C is titled "Your Family's Routines/Concerns/Priorities/ Resources" and provides a snapshot of the family's day-to-day routines, activities in which the child lives, learns, and plays, and identifies the family's concerns, priorities, and resources related to enhancing the development of their child. The family voluntarily shares this important information, which in turn, guides the entire IFSP process.
Form D
Form D: Your Child's Eligibility Evaluation Information, is where you will find information about the child's current developmental status. This includes the child's gross and fine motor skills, self-help/adaptive skills, social/emotional development, academic/cognitive development including pre-literacy skills, and receptive and expressive communication skills. This information is gathered from the parents, observations, collateral information, and screening and evaluation tools.

Form E
Form E: Your Child's Assessment Information, captures an integrated summary of the child's current and emerging skills in each of the developmental areas focusing on the child and family's everyday routines and activities and the child's participation in everyday natural learning opportunities.

Form F
Form F: Your Family's Outcomes, documents the outcomes to be achieved for the child and family that address family priorities and concerns. Form G also determines the short-term goals needed to reach each outcome and states the strategies and resources that will be used to address the outcome and that support parents and other caregivers to enhance the child's development through participation in routines and activities that are important to the family.

Form G
Form G: Your Family's Supports and Services provides a summary of the specific early intervention services and supports necessary to meet the unique needs of the child and family. The frequency (number of days or sessions per week or month that a service will be provided), intensity (length of time the service will be provided during each session), and method (how a service is provided, e.g., consultation, family education, direct services, etc.) and the projected dates for initiation of services and the anticipated length of service is also delineated on Form G. Part C of IDEA, also requires that the IFSP identify the natural environments in which services will be provided, including justification of the extent, if any, to which the services will not be provided in a natural environment. This is also documented on Form G. The IFSP must also identify other services and supports that are not part of the Early Steps system in order to provide a comprehensive picture of the child's total service needs. Service coordinators will assist families, as needed, in gaining access not only to early intervention services, but to the other services identified in the IFSP on Form G, and will coordinate the provision of these services. Other services may include access to child care, assistance in applying for Medicaid benefits and food stamps, specialized medical services related to the child's disability, etc. Other services does not apply to routine medical care such as immunizations or well baby check-ups unless the child needs these services and they are not otherwise available or being provided.

Form H
Form H: Your Individualized Family Support Plan Team, lists the IFSP team members who participated in the development of the IFSP and/or who will help to implement it. This Form documents the parent(s) or legal guardian(s) consent to implement the IFSP and that they have received an explanation and written copies of their procedural safeguards. It also identifies those individuals for whom the parents have provided permission to receive a copy of the IFSP.In addition, there is space to document receipt and explanation of Written Notice Regarding Insurance as option to consent form.

Form I

Form I
Form I: Your Family's Transition Plan, documents the steps that will be taken to assure a smooth transition for the child and family from Part C services to the appropriate activities, supports, and /or services that the family chooses and for which the child is eligible.

Form J
Form J: Your Family's Individualized Family Support Plan Periodic Review, documents the degree in which progress toward achieving the outcomes is being made, whether or not additional needs have been identified based on ongoing assessment/observation, and whether or not modification or revision of the outcomes or services is necessary.

The Early Steps IFSP is comprised of ten forms, lettered from A through J. Each Form contains information required by Early Steps and Part C of the Individuals with Disabilities Education Act (IDEA). This section of the module reviews the content required by Early Steps and Part C and tells you where it is documented on the IFSP. Use the arrows in the upper right to navigate through the required components on each IFSP form.

Form A
Early Steps requires that there is demographic information included in each IFSP. Form A: Your Family's Information provides the important demographic information about the child and family and other important caregivers, and contact information for the service coordinator and the family resource specialist.

Form B
Part C of IDEA requires that a statement of the child's present levels of development in the areas of physical development, including vision, hearing and health status, cognitive development, communication development, social or emotional development, and adaptive development are included on the IFSP. Form B: Planning for Your Child's Evaluation/Assessment captures vision, hearing, health, and screening information.

Form C
Form C is titled "Your Family's Routines/Concerns/Priorities/ Resources" and provides a snapshot of the family's day-to-day routines, activities in which the child lives, learns, and plays, and identifies the family's concerns, priorities, and resources related to enhancing the development of their child. The family voluntarily shares this important information, which in turn, guides the entire IFSP process.
Form D
Form D: Your Child's Eligibility Evaluation Information, is where you will find information about the child's current developmental status. This includes the child's gross and fine motor skills, self-help/adaptive skills, social/emotional development, academic/cognitive development including pre-literacy skills, and receptive and expressive communication skills. This information is gathered from the parents, observations, collateral information, and screening and evaluation tools.

Form E
Form E: Your Child's Assessment Information, captures an integrated summary of the child's current and emerging skills in each of the developmental areas focusing on the child and family's everyday routines and activities and the child's participation in everyday natural learning opportunities.

Form F
Form F: Your Family's Outcomes, documents the outcomes to be achieved for the child and family that address family priorities and concerns. Form G also determines the short-term goals needed to reach each outcome and states the strategies and resources that will be used to address the outcome and that support parents and other caregivers to enhance the child's development through participation in routines and activities that are important to the family.

Form G
Form G: Your Family's Supports and Services provides a summary of the specific early intervention services and supports necessary to meet the unique needs of the child and family. The frequency (number of days or sessions per week or month that a service will be provided), intensity (length of time the service will be provided during each session), and method (how a service is provided, e.g., consultation, family education, direct services, etc.) and the projected dates for initiation of services and the anticipated length of service is also delineated on Form G. Part C of IDEA, also requires that the IFSP identify the natural environments in which services will be provided, including justification of the extent, if any, to which the services will not be provided in a natural environment. This is also documented on Form G. The IFSP must also identify other services and supports that are not part of the Early Steps system in order to provide a comprehensive picture of the child's total service needs. Service coordinators will assist families, as needed, in gaining access not only to early intervention services, but to the other services identified in the IFSP on Form G, and will coordinate the provision of these services. Other services may include access to child care, assistance in applying for Medicaid benefits and food stamps, specialized medical services related to the child's disability, etc. Other services does not apply to routine medical care such as immunizations or well baby check-ups unless the child needs these services and they are not otherwise available or being provided.

Form H
Form H: Your Individualized Family Support Plan Team, lists the IFSP team members who participated in the development of the IFSP and/or who will help to implement it. This Form documents the parent(s) or legal guardian(s) consent to implement the IFSP and that they have received an explanation and written copies of their procedural safeguards. It also identifies those individuals for whom the parents have provided permission to receive a copy of the IFSP. In addition, there is space to document receipt and explanation of Written Notice Regarding Insurance as option to consent form.

Form I
Form I: Your Family's Transition Plan, documents the steps that will be taken to assure a smooth transition for the child and family from Part C services to the appropriate activities, supports, and /or services that the family chooses and for which the child is eligible.

Form J
Form J: Your Family's Individualized Family Support Plan Periodic Review, documents the degree in which progress toward achieving the outcomes is being made, whether or not additional needs have been identified based on ongoing assessment/observation, and whether or not modification or revision of the outcomes or services is necessary.