Beruflich Dokumente
Kultur Dokumente
The IFSP and IEP are plans that identify services and supports so that family members and early education
programs are actively engaged in promoting the childs learning and development.
The IFSP/IEP team determines the skills/abilities and appropriate supports and services either in the
natural environment or the least restrictive environment to accomplish the established goals and outcomes.
These decisions are not made by matching the childs areas of delay with a particular Early Intervention
discipline. Rather, supports and strategies are individualized and build on the strengths and skills the child
demonstrates in all areas of development.
The IFSP and IEP are plans that consider: the strengths of the child; concerns of the parent/guardian; most
recent evaluation results; academic, developmental and functional needs of the child; communication
needs of the child; and will incorporate revisions to the plan to address lack of progress.
6/08
Initial IFSP
Child Information
Family Information
Role
Parent/Guardian
Parent/Guardian
Grandparent
SLP
Printed Name
Todd XX
XX XX
XX XX
Stephanie Fowler
Attendance Signature
The following individuals provided information to the IFSP/IEP team but did not attend or were excused from the meeting.
Role
Printed Name
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tip toes when reaching for objects, and jumping up and down and showing good control/range of motion of feet while dancing. He is also capable of walking up and
down stairs with his hand being held, throwing a ball overhand and kicking a ball forward. His strengths of fine motor development include scribbling with crayons,
stacking blocks, grabbing small objects with thumb and finger, grabbing large objects with whole hand, and using utensils while eating. In the area of cognitive
development, XX has many strengths. He is capable of finding objects buried in the sand, pretending to drink from an empty cup, racing Matchbox cars, and dancing
when music is playing. XXs needs in this area include pointing to desired objects, following directions, completing puzzles, responding to his name, pointing to
pictures on request, turning pages of books one at a time and identifying body parts. In the area of communication development, XXs strengths include the ability to
say dada, the use of babbling and unrecognizable words, and the ability to maintain attention to activities he enjoys. XXs needs include controlling frustration, using
the words mama and dada specifically, using recognizable words, naming objects and pictures, imitating words and sounds, following directions, responding to his
name and pointing to indicate what he wants. Another need is to respond to words like no and stop. In the area of social and emotional development, XX exhibits
his strengths through showing a preference for toys and activities, showing affection by giving hugs and kisses and displays a recognition for family members. XX
also shows a variety of emotions, plays next to other children and engages in solitary play. His needs include finding an appropriate way to express his frustration
that is not harmful to himself or others, learning to share toys with his brother, and getting more involved with other children at daycare. In the area of adaptive
development, XX shows his strengths through feeding himself from a spoon, drinking from a sippy cup, finger feeding, putting on his own pants (as long as they do
not have buttons or zippers), undressing himself, wiping his nose, and eating a variety of textures. He also obtains objects within reach, brushes his teeth with some
help, sleeps about 10 hours a night and takes a 1-2 hour nap in the afternoon. One of XXs needs is to increase ability for following instructions, instead of having him
be physically taken to each activity, as well as asking for help instead of trying to get everything down from the cabinets himself. One of the familys needs is to be
able to control his tantrums in order to go out as a family. They would like XX to be able to express what he wants so that they no longer have to continuously guess.
XXs mom would like to be able to interact in joint activities such as puzzles, reading books and talking. The familys needs include finding a way to give equal
attention to all members of the family. XX suffers from frequent ear infections and has had two sets of tubes put in his ears. XXs interests include dancing to music,
going for walks in the stroller, and looking at things in the store. He enjoys looking at picture books with animals, playing with cars and playing in the sand table.
Provide a summary from the Evaluation Report, if current, or update with current information.
XX is the son of XX and XX XX. He has a 5 year old brother, XX, and a sister, XX, who is 11 months old. XXs older brother received early intervention services
through a birth-to-three program for speech and language. XX currently receives services through the XX Area School District. XX XX works at the XX in XX and XX
works variable shifts at XX. XX, XXs maternal grandmother, also lives with the family. She watches the children occasionally, but has just had back surgery so
cannot lift the children or play with them in any activities that require great movement.
With parent consent, list assistance to the family in helping them access community, medical or other non-EI funded services.
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If the parent does not want to address this item, document in the childs record.
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IV. Outcome/Goal #
Activity/behavior/skill in everyday life, identified by the family and the IFSP/IEP team, that they would like to see happen. Includes information on the routine/activity of the family,
community, or early childhood setting where the behavior/skills will be incorporated. Should address the childs needs identified in the evaluation and the priorities of the family.
Be
functional and measurable to provide a framework for ongoing progress monitoring. Goal should be developed in accord with the PA Early Learning Standards and enable the
child to be involved in and make progress in the general curriculum.
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How will we as a team measure progress and collect data for this outcome/goal? Include what is going to be
measured, how it will be measure, when it will be measured and by whom. Describe when periodic reports on progress will be
We still need to work toward this outcome/goal.
provided to the parent.
Lets continue with what we have been doing.
We still need to work toward this outcome/goal.
Outcome Goal #1- The family will keep data of how XX did throughout the day with pointing and using the PECS system to
Lets discuss new ways to get there.
express his wants and needs. This will be done through a family log/journal. At the end of every day, the caregivers who interacted
Our situation has changed; we no longer need
and worked with XX that day will keep a family journal/log. This will include an overall opinion of how the day went, any specific
to work on this outcome/goal.
instances in which XX was very successful, or any situations in which the system did not work as intended. This will be looked
We are satisfied that we have finished this
over each week at the beginning of the session with the SLP and the caregivers can give an overall impression of how things are
outcome/goal.
going and what they feel needs to be modified. This will also be a running log for the family to see the progress XX is making.
Other:
The family will use this same log and have a separate entry for XXs overall temperament throughout the day. This section will
include any tantrums they saw, what strategies were used to combat it and whether they were successful or not. Triggers to the
tantrum may also be included in order to see what specific things are causing increased frustration in XX. Again, this journal will be
gone over at the start of the session and talked through with the caregivers to see if any changes are suggested.
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Location (1)
Start
Date (2)
Actual
Anticipated
Delivered
Service
Date
End Date
Contact Person:
Contact Person:
Contact Person:
Contact Person:
Contact Person:
Contact Person:
Actual
Service
End
Date
Frequency
up to a
maximum
Session
Duration
Funding
Source
(3)
Unit
Cost
(3)
Estimated
Total Cost
(3)
(Early care and education programs include, but are not limited to: Early Head Start, Head Start, preschools, or child care; including reverse mainstreaming. Attendance at an
early childhood program need not be funded by Early Intervention funds.)
If yes, how many hours per week does the child spend in the regular early childhood program? hrs/wk
(Record the total time in hours that the child typically spends in the early childhood program each week, even if Early Intervention services are provided in a different location.)
For
Preschool
Only
Using form titled Educational Environment Worksheet, please determine the percentage of time this child is educated within a regular early
childhood program, and check the corresponding box below:
The child attends a regular early childhood program (checked yes for the first question above):
The percentage of time inside a regular early childhood program for this student is 80% or more of the week.
The percentage of time inside a regular early childhood program for this student is no more than 79% of the week and no less than 40% of
the week.
The percentage of time inside a regular early childhood program for this student is less than 40% of the week.
The child DOES NOT attend an Early Childhood Program but DOES attend a Special Education Program/Class (checked no for the first question above)
Separate Class: Child attends a special education program in a class with less than 50% nondisabled children
Separate School: Child receives education programs in public or private day school designed specifically for children with disabilities
Residential: Child receives special education and related services in a residential facility
Service Provider Location: Child receives all special education and related services from a service provider (clinicians,
office, hospital facility etc)
Home: Child receives special education and related services in the principle residence of the childs family or caregiver.
EI Preschool
Location of
(List location as described in Preschool PennData EI Reference Sheet)
Intervention
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X. Transition Plan
A transition plan should be completed for children as identified in the Special Considerations section.
Transition Outcome/Goal:
At three years of age, XX will be enrolled in a preschool setting.
What is happening now? What information and child and family considerations should be shared with the team in order to better prepare for
transition?
Date To be
Completed
Actual
Completion
Date
Gather child progress measurement information, review with family, and complete Child Outcome Summary Form.
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