Manual for the Infant-Toddler and Family Instrument (ITFI)

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9781557664938: Manual for the Infant-Toddler and Family Instrument (ITFI)

This straightforward, easy-to-use, clinically sensitive tool helps you evaluate the strengths and vulnerabilities of children from 6 months to 3 years, and their families, and leads you directly to a plan of action, if one is needed. With the Infant-Toddler and Family Instrument (ITFI), you can organize your impressions about the child, family, and the environment, enabling you to decide whether further referrals and services are needed. Consisting of an Instrument and Manual, the ITFI gives you a clear, step by step way to question caregivers about their child's characteristics, daily activities, health, development, and family life in understandable language that feels natural and comfortable. The ITFI includes an interview component consisting of 35 easily understood questions to ask caregivers in a comfortable and culturally sensitive way; a child development component that helps you make a judgment through observation and tasks about whether the child is functioning at, above, or below age level in specific domains: gross and fine motor, social and emotional, language, and coping and self-help; and checklists to rate your concerns about the family and child

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About the Author:


Nancy H. Apfel, Ed.M., a graduate of Tufts University and the Harvard Graduate School of Education, is Research Associate in the Child Study Center and Psychology Department of Yale University. At Harvard University, before coming to Yale, Nancy studied children's early home environments, collaboratively developing with Jean Carew and others a measure of parent and child interaction. At Yale University, Nancy joined William Kessen, Greta Fein, and Alison Clarke-Stewart in an evaluation of different models of early intervention with families of young children. Nancy was also involved in a national study called the Infant Health and Development Program. For this Stanford University-based project, which examined the effects of intervention on the development of prematurely born infants, Nancy served as evaluation coordinator for the Yale University Medical Center site. Continuing to evaluate program effects, Nancy has been collaborating with Victoria Seitz in longitudinal studies of various educational and family support programs, including Head Start, Follow Through, the Yale Child Welfare Program, and a school-based program for pregnant and parenting teens in New Haven, Connecticut. Nancy and Vicki have been continuing an 18-year longitudinal study of school-age mothers and their children. Nancy has studied and written about the various ways families support their individual members through life transitions, with a particular interest in teen motherhood.

Sally Provence, M.D. (1916-1993), was Distinguished Professor of Pediatrics at the Yale Child Study Center and the Yale School of Medicine and was a national leader in the fields of pediatrics and child development. A graduate of Mary Hardin-Baylor College in 1937 (now the University of Mary Hardin-Baylor) and Baylor University College of Medicine in 1941, Sally trained in pediatrics at Children's Medical Center in Dallas. Before coming to Yale, Sally had a fellowship at Cornell New York Hospital with Dr. Milton J.E. Senn, one of her earliest mentors. In this fellowship she began to integrate information from child psychiatry and social science into her view of pediatrics. At the Yale Child Study Center, Sally founded and served as Director of the world-renowned Child Development Unit from 1951 until her retirement in 1986.

Sally wrote eloquently about the development of young children and their need for nurturing environments, about creating quality child care for them, and about providing support and guidance to their families in her many books and articles, which include Infants in Institutions: A Comparison of Their Development with Family-Reared Infants in the First Year of Life (co-authored with Rose C. Lipton, International Universities Press, 1962), The Challenge of Daycare (co-authored with Audrey Naylor and June Patterson, Yale University Press, 1977), and Working with Disadvantaged Parents and Their Children: Science and Practice Issues (co-authored with Audrey Naylor, Yale University Press, 1983).

A forceful child advocate dedicated to improving the lives of children and parents, Sally was a founding member and past president of ZERO TO THREE: National Center for Infants, Toddlers, and Families. This center has become a well-respected national network of support and technical services for professionals who work with young children and families. Sally's many achievements were recognized by the American Academy of Pediatrics when it awarded her with its C. Anderson Aldrich Award for her influence on the fields of pediatrics and child development in 1975. Her profound influence in these fields continues to be recognized. Hillary Rodham Clinton presented ZERO TO THREE's Dolley Madison Award for Outstanding Lifelong Contribution to the Development and Well-being of Very Young Children and Their Families to Sally in 1993, posthumously. In 2000, Sally's memory was honored when ZERO TO THREE presented its first Sally Provence Award for Excellence in Infant Family Practice.

Edward Zigler, Ph.D., is Sterling Professor of Psychology, Emeritus, at Yale University and Director Emeritus of the Yale Center in Child Development and Social Policy. He was one of the planners of Project Head Start and was the federal official responsible for administering the program when he served as the first director of the U.S. Office of Child Development (now the Administration on Children, Youth, and Families). He was also Chief of the U.S. Children's Bureau. he regularly testifies as an expert witness before congressional committees and has served as a consultant to every presidential administration since that of Lyndon Johnson. Dr. Zigler has conducted extensive research on topics related to child development, psychopathology, and mental retardation and has authored hundreds of scholarly publications.

Excerpt. Reprinted by permission. All rights reserved.:

Excerpted from Chapter 1 of the Manual of the Infant-Toddler and Family Instrument (ITFI)
By Nancy H. Apfel, Ed.M., & Sally Provence, M.D.
©2001. Brookes Publishing. All Rights Reserved.

The ITFI is a relatively short survey of family and child functioning that can be used by family services, child care, and health care providers. It was designed with home visitors in mind but can be used by other individuals in different environments, such as by a child care worker in a child care center or by a nurse, a doctor, a psychologist, or another professional in a medical, community service, or mental health center. Such family services providers can use the ITFI in developing a collaborative plan with caregivers on how to serve the children and their families. In addition, when service providers are called on to determine whether a family or a child needs further in-depth evaluation by a doctor, psychologist, or other professional, this instrument can be helpful in making such a decision.

It is expected that this instrument will supplement other services provided by the agency or individual, increasing the scope of services. To clarify, once the ITFI is completed, the practitioner has a summary of the family's strengths and vulnerabilities, specific child symptoms and stressors, and how well the caregivers are meeting their child's basic needs. With information organized in such a way, the types of services that the family and child may need are clearer. The agency is then better able to collaborate with the family to construct a plan to meet its needs.

It would be unusual for one agency or individual to be able to provide all the services that a typical family at risk might require. For example, a family may need help connecting with a women and children's crisis center, a child psychologist, a pediatrician, a city housing authority, and a community legal aid office. In working with families to develop support plans, an agency could help families look for services already in existence in the community to supplement the agency's own services. Building such connections could enhance the services of a particular agency while also avoiding duplication of services. The ITFI could also inspire the development of new services in an agency, such as support groups or workshops for individuals with specific needs, such as teenage mothers or grandparents raising grandchildren.

The ITFI is not intended to be a definitive measure of whether a child or family should receive services or further evaluation but rather to be a tool to organize the service provider's impressions of family and child needs.

There are four sections to the ITFI:

  1. The Caregiver Interview, divided into three parts—Home and Family Life, Child Health and Safety, and Family Issues and Concerns—to be given in one or more sessions with the parent(s) or primary caregiver(s)
  2. The Developmental Map, a series of observations of spontaneous and elicited behavior of the infant-toddler in four domains—Gross and Fine Motor Development, Social and Emotional Development, Language Development, and Coping and Self-Help Development—plus a Summary Sheet Manual for the Infant-Toddler and Family Instrument (ITFI)
  3. The Checklist for Evaluating Concern, divided into three parts—Home and Family Environment; Child Health, Development, and Safety; and Stressors in the Child's Life—that permit the interviewer to organize his or her impressions and concerns about the family and the child, plus a Summary Sheet
  4. The Plan for the Child and Family, next steps to be taken, if necessary
Several preparation sessions are strongly recommended as orientation and instruction for the appropriate use of the ITFI.

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