Understanding the Outcomes and the COSF: A Quick Review

Essential knowledge for completing the Child Outcomes Summary Form Between them, team members must: Know about the child’s functioning across settings and situations Understand age-expected child development Understand the content of the three child outcomes Know how to use the rating scale Understand age expectations for child functioning within the child’s culture

Outcomes Jeopardy Biting $100 $100 $100 $200 $200 $200 $300 $300 $300 Pointing to the cabinet for cereal Reading the letter “S” on the Stop sign Washes hands before lunch Biting Plays by himself in the classroom Plays with rhyming words Building a castle from blocks with a friend Problems sleeping Sharing a cookie at lunchtime $100 $100 $100 $200 $200 $200 Note: you must be in ‘slide show’ mode for this to work. You should click on each box and the ‘door’ slides away. Answer key: (1) 100—Outcome 3; (2)100—Outcome 2; (3) 100—Outcome 3. (1)200—Outcome 1, 2 or 3, depending upon how biting is affecting this child’s functioning (Outcome 1 if no one will play because he/she bites, Outcome 2 if he or she is always in time out for biting and misses the learning activities, Outcome 3 if it’s associated with feeding issues); (2)200—Outcome 1; (3)200—Outcome 2. (1)300—Outcome 1 and 2 (playing with a friend=Outcome 1 and representational play=Outcome 2); (2)300—Outcome 1, 2 or 3, depending upon how lack of sleep affects this child’s functioning (Outcome 1 if he/she is too sleepy to interact with others, Outcome 2 if he/she is too sleepy to participate in learning activities, Outcome 3 if he or she is too sleepy to get his or her needs met, (3)300—Outcome 1 and 3 (sharing=Outcome 1 and participating in lunch=Outcome 3). $300 $300 $300

Children have positive social relationships Involves: Relating with adults Relating with other children For older children, following rules related to groups or interacting with others Includes areas like: Attachment/separation/autonomy Expressing emotions and feelings Learning rules and expectations Social interactions and play

Children acquire and use knowledge and skills Involves Thinking Reasoning Remembering Problem solving Using symbols and language Understanding physical and social worlds Includes: Early concepts—symbols, pictures, numbers Imitation Object permanence Expressive language and communication Early literacy

Children take appropriate action to meet their needs Involves: Taking care of basic needs Getting from place to place Using tools (e.g., fork, toothbrush, crayon) In older children, contributing to their own health and safety Includes: Integrating motor skills to complete tasks Self-help skills (e.g., dressing, feeding, grooming, toileting, household responsibility) Acting on the world to get what one wants

Rating Scale Jeopardy $100 $100 $100 $200 $200 $200 $300 $300 $300 Age appropriate functioning – no concerns Mix of age appropriate and not age appropriate functioning No age appropriate functioning – not yet showing immediate foundational skills Some age appropriate functioning but very little No age appropriate functioning – lots of immediate foundational skills Age appropriate functioning – some concerns Rarely shows age appropriate functioning No age appropriate functioning – some immediate foundational skills Age appropriate functioning $100 $100 $100 $200 $200 $200 Note: you must be in ‘slide show’ mode for this to work. You should click on each box and the ‘door’ slides away. Answer key: (1) 100—rating=7, (2)100—rating=5, (3) 100—rating=1. (1)200—rating=4, (2)200—rating=3, (3)200—rating=6. (1)300—rating=4, (2)300—rating=2, (3)300—rating= 6-7 $300 $300 $300

7 – Completely Child shows functioning expected for his or her age in all or almost all everyday situations that are part of the child’s life. Functioning is considered appropriate for his or her age. No one has any concerns about the child’s functioning in this outcome area.

6 – Between completely and somewhat Child’s functioning generally is considered appropriate for his or her age but there are some significant concerns about the child’s functioning in this outcome area. These concerns are substantial enough to suggest monitoring or possible additional support. Although age-appropriate, the child’s functioning may border on not keeping pace with age expectations.

5 – Somewhat Child shows functioning expected for his or her age some of the time and/or in some settings and situations. Child’s functioning is a mix of age-appropriate and not age-appropriate behaviors and skills. Child’s functioning might be described as like that of a slightly younger child.

4 – Between a 5 and a 3 Child shows occasional age-appropriate functioning across settings and situations. More functioning is not age-appropriate than age-appropriate.

3 – Nearly Child does not yet show functioning expected of a child of his or her age in any situation. Child uses immediate foundational skills, most or all of the time, across settings and situations. Immediate foundational skills are the skills upon which to build age-appropriate functioning. Functioning might be described as like that of a younger child

2 – Between 3 and 1 Child occasionally uses immediate foundational skills across settings and situations. More functioning reflects skills that are not immediate foundational than are immediate foundational.

1 – Not yet Child does not yet show functioning expected of a child his or her age in any situation. Child’s functioning does not yet include immediate foundational skills upon which to build age-appropriate functioning. Child functioning reflects skills that developmentally come before immediate foundational skills. Child’s functioning might be described as like that of a much younger child. After going through the ratings on these slides, or at the end of this presentation, it is helpful to walk through a child example. This can be a child presented by a participant, going through the assessment data and discussing level of functioning, etc. in order to come up with a rating. See instructions for holding a COSF rating discussion as part of a training activity at this link: http://www.fpg.unc.edu/~eco/assets/pdfs/Guidance_for_COSF_Demonstration.pdf

What ECO is learning nationally

The process of training for child outcomes data collection has uncovered other areas of significant need related to professional development.

Providers need to know more about: Assessment How to gather assessment data to reflect functioning across settings and situations, especially how to gather child functioning information from families Understanding the results of the assessment Sharing assessment results sensitively and honestly with families

Providers need to know more about: Functional outcomes What are they? How do they differ from outcomes organized around domains? What do they mean for how professionals from different disciplines operate as a team?

Providers need to know more about: Typical child development What are the functional expectations for children at different ages with regard to each of the 3 outcomes? How to involve families in the outcomes measurement process Working as a team

What we are learning nationally about COSF implementation Challenges: Limited staff development time Learning age-expected child development Meeting as a team Shift toward thinking functionally

What we are learning nationally about COSF implementation Strategies: Collaboration with other programs – preschool and Part C Focus groups scheduled throughout the year for teachers and providers Training module to include DVD, individual assistance if needed

What we are learning nationally about COSF implementation Strategies: Training modules available on-line COSF training integral part of staff development Incorporating staff feedback into plans for staff development

What we are learning nationally about COSF implementation Strategies: Use of Early Learning Guidelines Input from child care, general education and preschool teachers Phone conferences Scheduling meetings to coincide with IFSP/IEP team meetings Shared folder on program site that is password protected

What we are learning nationally about COSF implementation Strategies: Establishing core competencies Shift training and practice to incorporate functional assessments and writing functional IFSP/IEP goals Topical monthly teleconferences for training and feedback Select a tool that helps develop functional IFSP/IEP goals Practice, practice, practice!

What we are learning nationally about COSF implementation Benefits: Opportunities to collaborate with other staff, other programs Improved IFSP/IEP goals Improved communication with families about child’s functioning

What we are learning nationally about COSF implementation Benefits: Stronger collaboration between Part C and preschool (especially when both programs are using the COSF) IEPs/IFSPs written with more functional goals At the end of this presentation, it may be helpful to hold a discussion of COSF implementation issues local programs are facing. A discussion worksheet can be found at this link http://www.fpg.unc.edu/~eco/assets/pdfs/COSF_implementation_issues.pdf