7. ROUTINE: INTERACTING WITH OTHERS (FAMILY, FRIENDS, PEERS) Family Satisfaction with this Routine Priority Question: 1 2 3 4 How does your child’s delay impact this routine? Concern Possible Concern Ok Works Well Possible Questions to Ask: N/A (Explain in Notes) How does s/he interact with others during play? (e.g., initiating, handling conflict, enjoyment) Possible IFSP Outcome Can s/he self soothe if s/he gets upset? In your perfect/ideal world, would this routine be different? How? Notes: 8. ROUTINE: CHILD CARE (FORMAL/INFORMAL) Family Satisfaction with this Routine Priority Question: 1 2 3 4 How does your child’s delay impact this routine? Concern Possible Concern Ok Works Well Possible Questions to Ask: Child is not being cared for by others at this time. Explain in What type of childcare do you use? notes. How often/hours is s/he cared for by someone else? How does the transition between caregivers go? Possible IFSP Outcome Has childcare provider voiced any concerns? In your perfect/ideal world, would this routine be different? How? If Applicable, Child Care Name/Phone: Release on File Notes: Other Comments/Information about routines:
7. ROUTINE: INTERACTING WITH OTHERS (FAMILY, FRIENDS, PEERS) Family Satisfaction with this Routine Priority Question: How does your child’s delay impact this routine? Possible Questions to Ask: How does s/he interact with others during play? (e.g., initiating, handling conflict, enjoyment) Can s/he self soothe if s/he gets upset? In your perfect/ideal world, would this routine be different? How? 1 2 3 4 Concern Possible Concern Ok Works Well N/A (Explain in Notes) Possible IFSP Outcome Notes: 8. ROUTINE: CHILD CARE (FORMAL/INFORMAL) Family Satisfaction with this Routine Priority Question: How does your child’s delay impact this routine? Possible Questions to Ask: What type of childcare do you use? How often/hours is s/he cared for by someone else? How does the transition between caregivers go? Has childcare provider voiced any concerns? In your perfect/ideal world, would this routine be different? How? If Applicable, Child Care Name/Phone: Release on File 1 2 3 4 Concern Possible Concern Ok Works Well Child is not being cared for by others at this time. Explain in notes. Possible IFSP Outcome Notes: Other Comments/Information about routines:
Family%20Assessment%20Tool.docx