IFSP Quick Guide

Partial funding for this guide provided by Early Intervention Colorado, Colorado Department of Early Childhood.

This tool is intended to be a simple guide for documenting assistive technology (AT) on the Individualized Family Service Plan (IFSP). For more in-depth information, please refer to the most recent version of Early Intervention Rules and Regulations on the Colorado Secretary of State's website.

This guide is not intended to answer every question that may come up when documenting AT on the IFSP, as every child and family has individual needs. It will provide clarification to providers and service coordinators on how AT services are implemented and documented.

All documentation of AT on the IFSP should be determined through collaboration amongst all team members and based on the priorities, needs, and concerns of the child's family and caregivers.

A child may need Assistive Technology (AT) when added tools or services could help them participate more successfully in daily routines or progress toward IFSP outcomes. At this point, your goal is simply to consider whether AT might enhance the child's functional capabilities and whether further evaluation is needed.

Your documentation should:

• Identify what AT the child is using.
• Explain why the AT is important to the child.
• Clarify who is evaluating, selecting, and supporting the AT.
• Describe when and where the child will use the AT in daily routines.
• Show how the AT improves the child's functional participation and supports IFSP outcomes.
• Specify how the AT is being funded.

For example, an infant with motor delays may need an AT device, such as a supportive seating system for feeding; while a toddler beginning to use a communication app may need AT services, such as coaching for the family on integrating the app into routines.

If the IFSP team has determined that AT may be needed for the child, an AT evaluation is required unless the IFSP team determines that the child's existing AT device is appropriate, or a recent AT evaluation was sufficient.

Sometimes the child may already own the AT, and sometimes it is a new solution that is being explored. For low- and mid-tech AT solutions, an AT evaluation can often be done by a member of the early intervention (EI) team. If the needs are more complex, outside expertise for the evaluation may be required. This determination needs to be made by the IFSP team.

You have determined that an AT evaluation is not required.

If a device is being or will be used by the child that does not require a formal AT evaluation, no documentation of the evaluation is needed and you can go straight to documenting any device and/or service being used.

You have determined that an AT evaluation is required.

Document the AT evaluation both within the Strategies section (how the evaluation is a strategy to meet the desired outcome), and on the IFSP Agreement page as an AT Service including location, method, frequency, intensity, projected start and end dates, and the funding source.

Whether or not an evaluation was done, the next step is to document any necessary AT services and/or devices on the IFSP.

Jump to Definition of AT Devices.

The Family Assessment is a place where AT can first be considered, even if specific devices are not identified. This can generate the need for an AT evaluation (see AT services).

To determine if an AT device might be necessary, ask yourself, "If the child did not have an AT device available, would the family be able to implement the strategies to accomplish the outcome(s) listed on the IFSP?" If the answer to this question is "no," the child might benefit from an AT device. Proceed through the decision tree to determine how and where the AT device should be documented. Remember that "explore AT solutions" can be listed in the strategies if you are not yet sure if the child will require a full AT evaluation to determine the need for an AT device.

If an evaluation was completed but no device was recommended, document the results of the evaluation and/or that an AT device is not necessary in the treatment note.

At this point, there are no further documentation needs.

Proceed to Documenting AT Devices on the IFSP Agreement Page.

Once a device is determined to be necessary by the IFSP team, it must be documented on the IFSP.

Just as with documenting AT services, the question of, "If the child was not using this device, would the family be able to implement the strategies to accomplish the outcome(s) listed on the IFSP?" needs to be asked.

AT devices need to be documented on the IFSP when:

• The child requires more than simple temporary adaptations and will need the AT device(s) for longer than 3–6 months. Any simple temporary adaptations - such as using a pool noodle in a highchair - should be included in the strategies for the related outcome, not documented as an AT device. 
• The AT device will be purchased specifically for the child, rather than being a readily available or easily modified item that any child might have.
• Without the AT device(s), the child could not progress toward the functional outcome on the IFSP.
• The AT device is an over-the-counter purchase customized specifically for the child (i.e., not simple or readily available); list the purchase as an AT device and the modification as an AT service on the IFSP.

You have determined that a device is not essential to an IFSP outcome.

Document the device in the family assessment, including information about how, when and where the child is using the device.

At this point, there are no further documentation needs. You can stop here or explore the rest of the guide.

You have determined that the device is essential to an IFSP outcome. You may proceed.

You have determined that the device is not being newly acquired.

Strategies Section: Document the device in the Strategies section related to an outcome. Include a description of the device and how it will be used to achieve the outcome (include trials).

AND/OR

Incorporate into an Outcome: Incorporate the device into an outcome. The outcome should not be about use of the device itself but should include the device in achieving the targeted skill(s). Jump to Help with outcomes.

You have determined that the device is newly purchased or acquired.

Strategies Section: Document use of acquired, purchased, or trialed devices in the Strategies section related to an outcome. Include a description of the device and how it will be used to achieve the outcome.

AND/OR

Incorporate into an Outcome: Incorporate use of devices to be acquired or purchased directly into an outcome. The outcome should not be about use of the device itself; it should address how the device supports achieving the targeted skill(s). Jump to Help with outcomes.

AND

Document on IFSP Agreement Page: Document devices to be acquired or purchased on the IFSP Agreement page. Include a description of the device within the strategies section of the related outcome.

Jump to Definition of AT Services.

Does use of a device or the implementation of AT strategies require assistance with selection, acquisition, training, modification, maintenance, or coordination? If so, AT services may be indicated.

An essential question to ask is, "If the child was not receiving AT services, would the family be able to implement the strategies to accomplish the outcome(s) listed on the IFSP?"

Whether or not to document AT services on an IFSP can be unclear at times. It may not always be necessary, and can feel burdensome to providers and service coordinators if they feel like they are "over-documenting." The following guidelines can help clarify when and when not to document AT services on an IFSP. These guidelines should be combined with sound clinical judgement and input from the entire IFSP team.

AT services need to be documented on the IFSP when any of the following apply:

• There is a need for evaluation, selection, purchase, use, training, modification, or consultation related to an AT device.
• The child transitions between programs or providers and will need clear documentation of the strategies provided through AT services to ensure continuity of care.
• AT strategies necessary to achieve the outcomes on the IFSP are beyond the scope of the current service(s) the child is receiving.

If an evaluation was completed and no service was recommended, document the results of the evaluation in the treatment note if applicable.

Proceed to documenting AT devices.

• Document use of AT on the Plan of Action page within Outcomes and/or Strategies, AND
• Document AT as a service on the IFSP Agreement Page.

Proceed to Documenting AT Services on the IFSP Agreement Page.

AT Services directly assist an infant or toddler with a disability or the family, other caregivers, or other service providers in the selection, acquisition, or use of AT. Services include:

• Functional evaluation of needs in child's usual environment
• The selection, acquisition, modification or customization, and maintenance of AT
• Training or technical assistance for an infant or toddler, a child's family, or professionals providing EI services
• Coordination with other therapies, interventions, and services

An AT device is an item or piece of equipment that is used to increase, maintain, or improve the functional capabilities of an infant or toddler with a disability in their usual environment. It can include numerous technologies from simple low-tech adaptations to complex high-tech devices. AT devices can help with positioning and mobility, communication, play, learning, and self-help.

1. Use of private pay at the discretion of the parent; then,
2. Private health insurance; then,
3. TRICARE, a military health system; then,
4. Medicaid/Title XIX or Home and Community Based Services waivers, and Child Health Plan Plus; then,
5. Child Welfare and Temporary Assistance to Needy Families; then,
6. Other local, state or federal funds, including mill levy funds, as may be made available; then,
7. State General Fund early intervention services; then,
8. Federal Part C of the Individuals with Disabilities Education Act funds

1. Service: Document "AT Device" as the service and that the type is "new" since only newly acquired, purchased, or trialed devices need to be listed.
2. Location: Indicate the location where the device will be kept.
3. Method, Frequency, Visits, and Intensity: Indicate the device is for an Individual. It is purchased once, so the frequency and visits are all 1. The intensity can be 0 since there is not an amount of time attached to the device.
4. Dates: A projection of when the AT device will start being used and when it may no longer be needed. If the device will be used ongoing, note this duration as 6 months or until next IFSP review or annual.
5. Funding Source: Enter the individual or agency, or combination of funding sources, responsible for paying for the device.

1. Service: Document AT as a Service.
2. Location: Select either "Home" or "Community" depending on where the AT service will be provided.
3. Method: Select the method of AT service delivery from the check boxes.
4. Frequency, Intensity, and Visits: How often the services will occur, how long the sessions will be, and how many sessions will occur.
5. Dates: A projection of when the AT service will start and when it may no longer be needed. Important! Services must start within 28 days and may not be written for a duration of more than 6 months.
6. Funding Source: See Funding Hierarchy.

Describe how the AT device will help the child make progress toward the outcome. Note that use of the AT device should not be the outcome, but a means to help the child achieve the outcome. Outcomes should be functional, meaningful, measurable, and reflect the priorities of the family.

EI funding can help support the purchase of AT services and devices by following the funding hierarchy for children who qualify for EI services. All allowable funding sources must be considered for payment of the service or device. Funding sources may include private pay by the family, private insurance, public insurance programs, charitable or private sources of funding, or other community or state funding possibilities. Federal Part C (EI) dollars can only be used if all other possible sources of funding have been explored. However, no eligible child can be denied the timely provision of a necessary service on an IFSP, including AT services or devices, because of a family's inability to pay. If AT devices and services documented on an IFSP cannot be purchased through alternate funding sources (community organizations, insurance, Medicaid, etc.), the EI program is still responsible for the provision of this service. For more information, visit EI Colorado's website.

The EI Colorado State Plan defines personnel qualified to provide early intervention services. For AT services, this includes all disciplines described under other services who meet discipline-specific certification or license requirements and have additional professional development, knowledge or experience in AT, as well as an Assistive Technology Practitioner (ATP) or Rehabilitation Engineer.

Any early intervention provider working with the child and family can provide AT services if it falls within their level of expertise and scope of practice. In some cases, if an early intervention provider does not have the expertise needed, a consult from another provider may be needed. AT can be included within the scope of other EI services (such as OT, PT, SLP, and Developmental Intervention). The IFSP team determines when AT is needed as a separate service. The provision of more sophisticated AT requires a specialized skill set. Many early intervention providers may not have the specialized training to evaluate and implement sophisticated AT systems. In this case an evaluation or a consult by an AT specialist may be required. For more information, please reference the Personnel Standards on the EI Colorado website.

AT services may be provided as part of a regular visit or as a dedicated visit specifically for the provision of AT. Either of these examples could require one or two visits or a prolonged period of intervention.