Individualized Family Service Plan (IFSP)
An Individualized Family Service Plan (IFSP) is a strengths-based plan of care for the infant/toddler with a developmental delay or disability. The plan is based on a child and family assessment of strengths and needs as well as the results of multidisciplinary evaluations administered by qualified professionals meeting their state's certification guidelines. The IFSP is similar to an IEP in that it addresses specific services, who will provide them and when/where, how often, etc. and the plan is monitored and updated frequently. Unlike an IEP, however, the IFSP addresses not only the needs of the child but also the needs of the family to meet their family goals and specified outcomes as related to assisting in their child's development. All infants and toddlers receiving early intervention services under Part C of IDEA are required to have an IFSP in order to receive services. Part C of IDEA is the program that awards grants to every state in the United States to provide early intervention services to children from birth to age 3 who have disabilities and to their families. Part C of IDEA also allows states to define "developmental delay" (either as a standard deviation or a percent delay in chronological months) for eligibility. States provide early intervention services to the children who have medically diagnosed disabilities as well as children who exhibit developmental delays. In order to receive funding, participating states must provide early intervention to every eligible child and the respective family, regardless of pay source. Lastly, services from Part C are not necessarily free - early intervention programs, as the payor of last resort, make use of public and private insurance, community resources, and some states implement a "sliding scale" of fees for services not covered by public or private insurance.
Goals for an IFSP
The goal of an IFSP is to assist the family in meeting their child's developmental needs in order to the infant or toddler (birth to age three) to increase functional abilities, gain independence and mobility, and be an active participant in his/her family and community. Another goal of early intervention in general is to improve a child's functional abilities, particularly in the domains of communication, cognitive ability, and social/emotional well-being in preparation for preschool and later kindergarten so that extensive special education services will not be necessary for the child's academic success. Once an infant/toddler is determined eligible (each state sets its own eligibility requirements), the family identifies whom they would like to participate as part of the IFSP team. The Individuals with Disabilities Education Act (IDEA) Part C requires that the IFSP team consist of the family and at least two early intervention professionals from different disciplines (one being the service coordinator) - consistent with CFR §303.343(a)(1)(iv). However, the family may choose to include other members on the team such as the child's pediatrician, an early intervention service provider who may be working with the child, a parent advocate or trusted friend/family member.
The IFSP team works with the family to create a "service plan" to address the deficits of the infant or toddler and to assist the family in meeting their goals for their child's (and family's) development. The team uses information that the family provides as well as the results of at least two evaluations, all available medical records, and the informed clinical opinion of the professionals serving on the IFSP team. An initial IFSP is then created with the family.
An IFSP will outline the following:
-The child's current levels of physical, cognitive, communication, social or emotional, and adaptive development.
-The family's resources, priorities, and concerns to help in their child's development.
-The desired end result for the child and for the family (goals/outcomes), as well as the steps needed to achieve said end result (objectives). The plan will be monitored and evaluated quarterly to gauge progress. If the family chooses to revise the goals or the plan, they include updates as revised additions to the plan.
-The early intervention services for the child and the family. This includes how often and the method of how the child and the family will receive the services.
-The different environments that the services will be provided in and justification for services not provided in the "natural environment" as defined by IDEA (the location that a child without a disability would spend most of his/her time). For example, the family might have requested to receive services for the child at a day care center or in their home.
-The date the services will begin and their anticipated duration.
-The identification of the service coordinator, from the profession most immediately relevant to the infant's or toddler's family's needs, who will be responsible for the coordination and implementation of the plan with the other agencies and persons.
- For toddlers approaching the third birthday, the IFSP will include a transition plan outlining the steps, activities, and services needed to support the transition of the toddler with a disability to preschool or other appropriate services.
In summary, a key to an effective IFSP is to include outcomes that "address the entire family's well-being and not only outcomes designed to benefit the child's development." For this reason, the IFSP will inherently have goals that are designed for the family as well as for the child. The service coordinator helps the early intervention team of service providers write objectives that meet the family's priorities and concerns.
Differences between IFSP and IEP
When writing the IFSP for a child, the IFSP can (but not always) outline services that are not one of the seventeen mandated early intervention services under Part C of the IDEA. For example, a parent may need counseling services to overcome debilitating depression in order to better care for the infant or toddler, and these services will be written into the family's plan. The IEP (Individualized Education Plan) cannot include services to meet "family goals" but must focus solely on what the child needs to achieve academic success in an educational setting (whether the class or activity is academic or extra-curricular in nature).
The Individualized Family Service Plan is different compared to an Individual Education Plan in other key ways:
-Eligibility for early intervention (birth to three) under Part C of IDEA is set by each state individually and is often different from eligibility for special education (3-21) under Part B of IDEA.
- The IFSP will have goals and outcomes for the family and for the infant's/toddler's development.
- Goals on the IFSP may be in non-academic areas of development such as mobility, self-care, and social/emotional well-being. The IEP has goals and outcomes for the child only and related entirely to his/her ability to adapt to and progress in an educational setting.
- The IFSP includes services to help a family in natural environment settings (not just in daycare/preschool) but at home, in the community, etc. Services and activities on the IFSP could be tailored to "nap time," "infant swimming lessons at the YMCA," "church outings," etc. The IEP provides services solely on what happens in a pre-school or K-5 school environment or school-sponsored field trip/activity
- The IFSP team involves a service coordinator who assists the family in developing and implementing the IFSP. The IEP team also involves the family, but the school district generally does not provide a professional who represents them and provides case-management/service coordination. The family will have to communicate with the special education department's designee.
Child Abuse Prevention and Treatment Act
The Keeping Children and Families Safe Act of 2003 (P.L. 108-36) amended CAPTA by requiring that cases of abused and neglected children, or those pre- or post-natally exposed to illegal substances, are referred to early intervention services using IDEA Part C funds. This provision is also reflected in the 2004 revision of IDEA. Specifically, states can apply for grant money from IDEA for specific identification and referral programs.
Abused and neglected children are included under IDEA part C due to the growing body of evidence showing increased risk of developmental delay among children in the child welfare system. In 2013, there were an estimated 679,000 victims of child abuse and neglect. Nearly half (47%) were five years or younger. The results of the 2008 National Survey of Child and Adolescent Well-Being (NSCAW) reported that children in Child Welfare had below average cognitive, behavioral, daily living, language, social-emotional and social skills than their peers. Slightly less than half of children five and under showed developmental delay. A social and emotional assessment given to caretakers of these children showed 34.1% had a possible problem, and 27.0% had a possible social/emotional deficit or delay compared to 25% and 15%, respectively, in a standardized population. Neurodevelopmentally, children in the child welfare system have similar risks to premature and low birth weight infants. Children in this population scored nearly one standard deviation below the mean of the early cognitive development tool used for assessment. Language skills fell almost one standard deviation below the norm as well. Overall, 42.6% of children aged one to five years showed a need for developmental support, making them potentially eligible for early intervention services.
In order to track the adherence to the law, the Child Abuse Prevention and Treatment Act Reauthorization Act of 2010 (P.L. 111-320) required that eligible children, and those actually referred to EI be reported by each state beginning in 2014. A 2008 survey of 30 participating states by the IDEA Infant and Toddler Coordinators Association showed that 65% of children under three that are abused or neglected are being routinely screened for developmental delays. Fifty percent of respondents did not know whether their referrals for Part C had increased or decreased in the prior year. As noted by many respondents to this survey, the referral system needs more funding and better communication among child welfare personnel.