1. Every day, we are honored to take action that inspires the world to discover, love and nurture the greatness in all children.
Module 4 Guidance for Completing the SFP and COS Rating Within the Team Process
Welcome to Part Four of the Early Support for Infants and Toddlers training in a 6 part series on measuring the child outcomes.

2. Overview of Modules
Module 1: Setting the Stage: Global Child Outcomes and the SFP
Module 2: Learning More About the SFP and COS Rating
Module 3: Essential Knowledge for Completing the SFP and COS Rating
Module 4: Guidance for Completing the SFP and COS Rating Within the Team Process
Module 5: Understanding Age-expected Child Development, Developmental Trajectories, and Progress
Module 6: Using COS Data to Inform Program Improvement at all Levels
This module is part of a larger training series. Earlier modules have provided the foundation for why to measure child outcomes, how effective assessment information is included in the summary of functional process, and information about key definitions associated with descriptor statements or ratings at various levels of child functioning.
In this training (module 4), you’ll learn more about how to complete the Summary of Functional Performance on the Washington IFSP. You will hear information about:
Documenting the rating for each of the three outcomes
The team process for determining a rating
Reaching consensus on the ratings
Within this section you’ll have some opportunities to check your understanding of these essential knowledge areas. Let’s start by looking at how to document the child outcomes ratings on the Summary of Functional Performance.
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3. The Present Levels of Development (PLODs)
The PLODs are intended to:
Be a brief summary of assessment results by domain
Focus on what the child can and cannot yet do
Include the child’s developmental level (e.g., % delay, age-equivalent, standard deviations)
Be used to determine eligibility for Part C services
See the IFSP Resource Guide:
In order to understand the purpose of and use the Summary of Functional Performance, it is important to understand the section of the IFSP that includes the child’s present levels of development, or PLODs. This section precedes the Summary of Functional Performance on the IFSP. The PLODs section includes a very brief summary of the child’s assessment results by the five developmental domains, with a focus primarily on what the child can and cannot yet do. It includes numbers, scores, age equivalents, etc. to show the child’s developmental levels in each of the five domains. It includes all of the required information to show the child’s developmental level on an IFSP. This information is used to determine the child’s eligibility for Part C services, which occurs on the subsequent page of the IFSP.
For more information, please see the IFSP Resource Guide, located at the link on the slide.
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4. By Comparison: The Summary of Functional Performance and COS
For each outcome, you will:
Synthesize all information about the child and provide a brief summary of the child’s functioning across settings and situations in that outcome area
Select a “descriptor statement” that best matches the child’s functioning relative to age expectations
By contrast, the Summary of Functional Performance focuses on the child’s functioning in every day settings and situations.
First, you’ll notice that the format of the information is different from the PLODs. The PLODs page offers boxes to capture the most salient information about the child’s developmental level from the assessments and evaluations. On the Summary of Functional Performance form, you will find larger text sections for each of the three outcomes. In each section, you will also see a space for the descriptor statement that you will select to describe the child’s functioning in each outcome area, related to same-age peers.
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5. Differences SFP vs. PLODs Summary of Functional Performance (SFP)
Present Levels of Development (PLODs)
Emphasis on…
Functional use of skills in everyday situations
Performance through the lens of assessment measures
Settings…
Emphasizes functioning across settings and situations and with different caregivers
Emphasizes mostly the skills displayed in specific assessment situations
Skills…
Describes holistic picture of child’s skills across domains in the service of each outcome
Focuses on skills specific to each domain
For comparison provides…
Information about how child uses skills relative to what is observed in other children the same age
Scores relative to other children in assessment sample (standardized score)
Uses…
Provides qualitative information to translate into patterns of progress for accountability reporting. It also may help inform development of specific goals for child and intervention activities.
Provides quantitative information that may be helpful for eligibility determinations or to track extent of changes over time.
Differences
Although both the PLOD and the Summary of Functional Performance provide information about the skills a child displays and the skills a child does not yet display, there are some important differences that help us understand why both types of information are collected.
The Summary of Functional Performance emphasizes the functioning across a wide range of everyday situations and with different caregivers. It describes a holistic picture that integrates the child’s skills across domains for each of the three global outcomes. In contrast, the PLOD focuses on skills embedded in assessment measures that are observed during the assessments situations. The PLOD provides specific information about skills split out for each domain area.
The description in the Summary of Functional Performance provides an overview of how a child is using skills relative to what is observed in other children of the same age. In contrast, the PLOD compares assessment scores for the child to a standardization sample of children.
Finally, the Summary of Functional Performance is useful as a picture of the child that informs specific goals and intervention activities and descriptor statements can be translated into patterns of progress in the child’s growth trajectory for accountability reporting . The PLOD, on the other hand, provides information for eligibility and a quantitative measure for tracking changes over time. It is important to note that both sections are valuable and needed in the IFSP process and document.
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6. SFP vs. PLOD Knowledge Check
True or False
The SFP is an open space on the IFSP to repeat and re-emphasize statements about a child’s skills that were recorded on the PLOD.
2. True or False
The SFP is useful for determining the child’s program eligibility.
That’s a lot of information to digest….
So, grab a piece of paper and jot down your answer to these two knowledge check questions to check your understanding.
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7. SFP vs. PLOD Knowledge Check
True or False: The SFP is an open space on the IFSP to repeat and re-emphasize statements about a child’s skills that were recorded on the PLOD.
False
2. True or False: The SFP is useful for determining the child’s program eligibility.
False
How did you do? Both of these questions were false. The SFP and the PLOD are different.
First, the SFP is NOT just a space to repeat and re-emphasize statements about a child’s skills that were recorded on the PLOD. Use the SFP to describe how the child integrates functioning across domains and uses skills and any available assistive technology to function effectively across settings and situations.
Second, the SFP should NOT be used to determine the child’s program eligibility. The PLOD includes specific details tied to program eligibility, so information from the PLOD should be used for that purpose.
Let’s take a closer look now at what goes in the Summary of Functional Performance section.
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8. Completing a Summary of Functional Performance for Each Outcome
Do not simply repeat PLOD statements
The summary should paint a picture of how the child uses his/her skills in everyday functioning
Specifics about what the child does and how
Specifics about that the child does not yet do
Example: Alex has three words: Mama, Dada, and No
PLODs: Alex has three words
SFP: Alex uses three words. He says Mama and Da when he wants help or when he wants to show his parents something. He is only using them at home, not when he’s out in public with his parents.
Teams will first complete the narrative that describes that child's level of functioning using all that you know from multiple sources. In this section, you will want to describe the child's functioning in this outcome across settings and situations. This information will differ from the PLODs in that it will offer more detail about the child’s functioning in his or her everyday life with regard to this outcome. This requires synthesizing information from the developmental domains across the three child outcome areas and describing the child functional abilities and skills. The information used on the PLODs may be a part of what is considered, but it should not just be duplicated. There will need to be additional information to show how the child uses his or her skills to function in everyday settings and situations.
Let’s take a look at an example for Alex. In his assessment report, it says that he has three words: Mama, Da and No. On the PLODs, you would simply document that these are the only three words he has. On the Summary of Functional Performance, however, you would include how and when he uses them (with his parents when he wants something or wants to show them something) and where (only at home, not out in public). This information shows how Alex uses his skill functionally across settings and situations.
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9. Summary of Functional Performance… For Each Outcome
Describe how the child uses his/her skills across domains in meaningful ways related to the outcome
Include examples of things the child does and does not yet do and a sense of the mix of skills observed
Include information from multiple sources and observations across settings
Include specific examples of the child’s functioning related to the range of content for each outcome
Let’s look a little deeper into what the narrative should include for each outcome. The summary should include information about how the child uses his/her skills to accomplish meaningful tasks. It needs to include examples of what the child can do as well as specific information about skills that are just emerging or not yet apparent. Information from different sources and settings will need to be combined and represent the full breadth of the outcome area. Even if only one aspect of the outcome area is a challenge for the child, the summary should describe functioning on each of the different aspects of the outcome. A refresher on the range of content for each outcome is included in Module 3 of this training series.
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10. Summary of Functional Performance… For Each Outcome (Continued)
Include information from one or more assessment tools
Describe functioning with respect to age-expected functioning, immediate foundational skills, and/or foundational skills as appropriate to provide support for the descriptor statement
Describe functioning at the current point in time (that is, do not compare functioning to a previous time point)
In addition to the information you include from observations and family reports, you will want to include information from assessment tools that is relevant to the outcome. Information from assessment tools can be very important for gathering specific information about a child’s current skills and for age-anchoring the child’s skills to what we expect at that age. To the extent possible, try to describe the child's functioning using terms like "age-expected," "immediate foundational skills," and "foundational skills" as well as describing what the functioning looks like so that someone else who reads the narrative will be able to understand why a particular descriptor statement was selected. For more information about age-anchoring and the terms used describe children’s development, review Module 3 of this series.
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11. Reflection
How are you gathering information beyond the assessment tools that you use?
What types of information do you collect? What else do you need to collect?
How do you incorporate that information in the IFSP process?
Before moving on to the next section, we’d like you to consider how you will apply the information shared. Using your piece of paper, write out a response to the following questions:
How are you gathering information beyond the assessment tools that you use?
What types of information do you collect? What else do you need to collect?
How do you incorporate that information in the IFSP?
You may want to refer back to information in this module to support your response. If you like, you may share your response with a co-worker or supervisor, and talk about how to include this information in your conversations with families and in your planning with other professionals on the IFSP team.
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12. Why is it important to document the child’s functioning?
Documentation…
Provides a record of the rationale for the rating decision
Provides quality assurance information so others can see whether people are using the system consistently and appropriately (i.e., using definitions, rating similar children in the same ways)
Helps identify needs for future training and technical assistance
Describes the child’s functioning for new team members reviewing the file
Why is it important to accurately document the child’s functioning on the Summary of Functional Performance? First of all, the documentation provides an independent reviewer with the information that the team used to determine which of the descriptor statements were chosen to describe the child. This information, when looked at over programs and regions, can help provide helpful information to supervisors and technical assistance providers about the use of the Summary of Functional Performance. They can see whether teams understand the key components of the process and are using the rating scale and decision tree to come to logical decisions about which summary statement to choose. If needed, the documentation will help supervisors and technical assistance providers know what kinds of training and technical assistance is needed to support better understanding of the process. Finally, the documentation you provide in the Summary of Functional Performance may be a useful picture of the child’s functioning for new team members who review the child’s file.
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13. How much to write?
Write enough to provide a rich (but not overly long) description of how the child is doing in the outcome. The writing should provide evidence to support the descriptor statement that the team selects.
A question you might be asking is "how much should we be writing for each outcome?". We all know there is a lot we could write about with regard to a child and each of the outcomes. The narrative describing the child's functioning should provide the team including the family with a rich description of how the child is doing in the outcome without being overly long. The narrative also should provide enough information that an independent reviewer could read the narrative and understand the rationale for the rating that has been chosen.
Let’s take a look at an example of a summary for outcome 1, positive social relationships, for a 23 month old child named Alex.
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14. Example 1: Alex, 23 months Summary of Functional Performance
Alex can say 3 words, however, these can be difficult for others outside the family to understand and are rarely heard other than during quiet times with his parents at home and during play with Dad, with the exception of the word, “No.” He does not yet use words other than “no,” “Mama,” and “Da” regularly across settings and situations. He points to items that he wants, and understands familiar, recurring 2-step directions like going to get his shoes and bringing them to his Mom when he is getting ready to leave the house. Alex uses gestures effectively to communicate when calm, but often gets overwhelmed in social situations with peers or in loud settings and may cry, scream, hit, or kick when he is frustrated rather than using gestures or words. He will listen to a short story, but usually loses interest after about two minutes. He can point to pictures in a book and sometimes jabbers along with the adult reading the book, imitating the adult’s voice and some of the sounds in the words they use. Alex responds to his own name and recognizes lots of objects, showing his understanding of named objects by pointing to them from pictures or picking them out of a group. Alex’s talking includes lots of jabbering that sounds like sentences.
Here is how Alex’s team summarized his functioning in the area of Acquiring and Using Knowledge and Skills. Take a few minutes to read this example to get a sense of the kind of information you will be summarizing in the Washington IFSP. Click “Play” when you’re ready to continue with the presentation.
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15. Example 1: Alex, 23 months What did you notice?
What did you notice in the description? (Pause to allow reflection) Do you have a picture of how Alex currently uses and displays his knowledge and skills? Was there description about how Alex uses certain skills to accomplish everyday tasks? And what skills are just emerging or he does not yet use across various settings? How did the description weave in information from assessment tools and information about the extent to which Alex’s skills were at an age-appropriate, immediate foundational or foundational level? Which aspects of the knowledge and skills outcome were described for Alex?
Effective summaries document how the child uses skills in everyday functioning with enough detail to show what skills in the outcome area are age-expected and where in the progression of skills, the child’s functioning currently is. After reading them, there should not be any doubt about what descriptor statement was chosen.
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16. Example 2: Kim, 17 months Summary of Functional Performance
In regards to Outcome 3, using appropriate behavior to get needs met, Kim:
holds objects when placed in her hand (toys, spoon) but is still working on picking them up herself
knows what she wants, but often cries and fusses when she is not understood and cannot yet convey those wishes using words or actions
has not yet begun to use toys as tools to get other toys or interact with toys in sequences of exploratory actions like other children the same age
eats mostly baby food, taking between 5-10 spoonfuls of food that is fed to her per meal, seated in an adapted high chair
eats small meals every 3-4 hours; is tube fed twice a day and is on a feeding tube at night
not yet able to assist in dressing or bathing due to her motor challenges
able to move short distances forward (twisting her body to inch along) and is motivated to attempt to get her toys, with occasional success at touching a toy, but not yet picking it up
Here is a second example for a child, Kim, who is 17 months old for the outcome taking appropriate action to meet needs. When you finish reading this section, please click “play” to continue with the presentation.
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17. Example 2: Kim, 17 months What did you notice in this example?
Now that you have read the summary for Outcome 3 for Kim, consider these questions:
Does this description give you a sense of the child relative to this outcome?
Do you have enough information to predict what rating the team selected?
This second example shows that the Summary of Functional Performance does not just include space to string together bullets from other sources. Information detailed, but is still combined to provide a picture of the child’s functioning.
The next slide, by contrast, will show you how Kim’s PLODs were completed.
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18. SFP vs. PLODs
How is this description different from information you might find if you just looked at the PLOD?
Child’s skills domain by domain
Assessment tools individually
As you are developing your skills in writing the Summary of Functional Performance, it may be helpful to look at Kim’s summary with these questions in mind. How does the information differ from what is in the PLODs? From the domain-specific information? How does it look compared to when you review assessment reports individually?
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19. Kim’s abilities by Domain
In this partial example, you will see by contrast Kim’s abilities by domain area. For the Summary of Functional Performance, information from all three of these areas, as well as those not shown, were combined to highlight Kim’s functional abilities relative to Outcome 3, using appropriate behaviors to meet her needs.
The Summary of Functional Performance offers two key benefits within the IFSP. First , it is a synthesis of information from multiple sources, which makes it easier to get a holistic picture of the child across developmental domains. Second, it records information about how the child uses his or her skills functionally, which provides a solid foundation upon which to determine the child’s outcome ratings, as well as to develop more functional, meaningful IFSP goals.

20. Reflection Think about:
What would you do to improve the way teams in your program write the Summary of Functional Performance section ?
Can others easily read it and have enough specific information to see how and why you chose the descriptor statement you did?
What differences do you see between your Summary of Functional Performance and PLOD sections?
Take a moment to consider how this content might influence your actions on your next IFSP. Write answers to these questions on your sheet.
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21. SFP and PLODs IFSP Process and Resource Guide:
The Washington IFSP Process and Resource Guide has additional instructions and examples for both the Summary of Functional Performance and the PLODs. Check out pages 14 and 15 of the guide for more information.
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22. The Collaborative Team Process
A key part of the Summary of Functional Performance process is teaming. Measuring child outcomes was also designed to be a collaborative team process, pulling in information from multiple sources and people and synthesizing it into a summary to be used by the child’s team to determine the extent to which the child is functioning like same-aged peers. The heart of making this process work the way it is intended is for each member of the team to contribute information, and collaboratively decide which of the descriptor statements best describes the child in each of the three outcome areas.
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23. Teaming and Collaboration
DEC Recommended Practices: Teaming and collaboration practices promote and sustain collaborative adult partnerships, relationships, and ongoing interactions to ensure that programs and services achieve desired child and outcomes and goals.
The newly revised DEC Recommended Practices define teaming and collaboration practices as “those that promote and sustain collaborative adult partnerships, relationships and ongoing interactions to ensure that programs and services achieve desired child and family outcomes and goals.” These practices are respectful, supportive, culturally sensitive and support the capacity development of the members of the team. Teaming and collaboration practices includes ways in which team members share knowledge and expertise throughout the IFSP process, including the completion of the Summary of Functional Performance.
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24. Teaming in Early Intervention
Teaming is well-established as a key component of providing high quality early intervention services to young children with disabilities and their families.
The word “team” appears 49 times in the Individuals with Disabilities Education Act (IDEA)
Teaming has been a critical component since the implementation of early intervention. It’s well established in the research literature and state policies that teaming is a part of providing high quality early intervention services to young children with disabilities and their families. This includes teaming during the eligibility process, evaluation and assessment, service delivery, and ongoing progress monitoring. The word “team” appears 49 times in the Individuals with Disabilities Education Act.
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25. Why do we team?
Many young children’s developmental needs are too complex to be addressed by a single discipline.
The children we serve in early intervention have very complex developmental challenges that are difficult to address with a single discipline. For example, the child in the picture may have motor challenges that affect his ability to support himself, or educational needs that require specialized learning tools. The team for this child will include his family, and might also include a physical therapist who works with the child to develop their postural support; an occupational therapist who helps the child develop motor skills for play, and an early interventionist, who provides specialized instruction. ALL TEAM MEMBERS collaborate to design learning activities tailored to assist the child to participate in the family’s everyday routines and activities. The team also includes a Family Resources Coordinator, or FRC, who helps the family with services and supports. Together, this team is better able to meet the complex needs of this child. For this reason, the role of the FRC and type of teaming required is unique to Part C.
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26. Why do we team for the Summary of Functional Performance and COS Rating?
Determining the correct rating at entry and exit requires knowledge of the SFP process AND knowledge of the child across settings and situations.
Multiple perspectives on the child’s functioning increase the likelihood of selecting a rating that accurately reflects what the child can and cannot do.
Why do we team for the Summary of Functional Performance? We know that selecting the correct descriptor statement at entry and exit requires knowledge across settings and situations, including the family’s observation and input, an occupational therapists experience with fine motor skills and sensory needs, a physical therapist’s experience with the child’s movement, or a speech therapist’s experience with the child’s language and articulation. Input from multiple sources and multiple team members increases the likelihood that the descriptor statement that is selected is an accurate reflection of what the child can and cannot do, and how this is related to age expectations. Information is combined through team discussions where team members can converse about differences in the child’s functioning across settings or situations or with different therapists, caregivers, and people.
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27. WA Expectations
The SFP should not be completed by just sending reports to the FRC, or selecting descriptor statements individually and hoping it matches the FRC’s or parents’ input
It is a part of the IFSP meeting
It is a discussion with the family and all members of the team together
It can be face to face or through meeting participation over the phone
In Washington, there are certain ways in which all teams are expected to function. Teaming is expected to be a collaborative process, involving open sharing of information and knowledge throughout the IFSP process. It’s not enough for a team member to send information or reports to the Family Resources Coordinator, or to select a descriptor statement for the child individually and hope that it’s the same as the family or FRC’s choice. Because the Summary of Functional Performance is a part of the IFSP itself, it is part of the team discussion about the child’s plan, which is to be completed together. Discussions about the selection of the child’s descriptor statement need to occur with all of the IFSP team members present, whether they attend in person, or over the phone, during the IFSP meeting.
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28. Who should be on the child’s team?
Individuals who can contribute knowledge about the child’s functioning across settings and situations in the three outcomes areas.
Examples: early interventionists, child care providers, therapists, FRCs, and families
The first step of teaming for the Summary of Functional Performance is deciding who should be a part of the team. Teams should include any individuals who can contribute knowledge about the child across settings. Consider all the individuals a child interacts with in an average week, including all the different professionals, and reach out to them about participation on the team.
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29. Essential Knowledge for the SFP and COS Ratings
Among them, team members must:
Know about the child’s functioning across settings and situations
Understand age-expected child development
Understand age expectations for child functioning within the child’s culture
Understand the content of the three child outcomes
Know how to use the rating scale
In Modules 2 and 3, we identified the five elements that each team must have in order for the Summary of Functional Performance and COS Rating processes be successful, and for all team members to successfully participate. Among them, the team should have information about how the child functions in various situations and settings. Team members should also have knowledge of age-expected child development, the three outcomes, and the rating scale. Lastly, the team needs an understanding of the cultural differences that may affect expectations for a child’s development.
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30. None of us is as smart as all of us. - Ken Blanchard
Quote
None of us is as smart as all of us.
- Ken Blanchard
When we have all the right people involved in the conversation, we can make a much better judgment about the child’s development.
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31. Reflection
What does your team look like? Are there others that should be involved?
How does your team composition reflect understanding of all five areas of essential knowledge for the Summary of Functional Performance?
Before moving on to the next section, we’d like you to consider how you will apply the information shared. Using your piece of paper, write out a response to the following questions:
What does your team look like? Are there others that should be involved, who are not currently involved? Who are they?
How does your team composition reflect understanding of all five areas of essential knowledge for the Summary of Functional Performance?
You may want to refer back to information in this module to support your response. If you like, you may share your response with a co-worker or supervisor, and talk about how to include this information in your conversations with families.
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32. The Team Discussion Process
The team describes the child’s functioning (not just test scores or ratings)
The child’s current functioning is considered relative to what is seen in same-age peers
Discussion includes the child’s full range of functioning (describing skills that are immediate foundational or foundational)
The summary of functional performance written by the team on the IFSP describes the child’s functioning and serves as the rationale for the descriptor statement
Decide which descriptor statement best describes the child’s current functioning
Teams completing the Summary of Functional Performance should think about the following when discussing the child’s skills and behaviors. Part of this discussion includes information about the child’s day to day functioning, not just the scores the child received on an evaluation or assessment. Looking at the child’s skills and behaviors across settings and situations provides a full picture of what the child usually does, which is important when discussing whether development is age-expected, immediate foundational or foundational in nature. Skills that are seen every once in a while or only under extreme conditions should not be considered as what the child usually does. Based on the discussion, the team will document the child’s functioning on the IFSP and then decide which of the descriptor statements best describes the child’s development.
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33. Descriptor Statements
Here is a screen shot from the DMS, showing you where and how you will select one of the descriptor statements, once your team has come to consensus on which statement best reflects the child’s functioning.
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Early Childhood Outcomes Center

34. In a high-quality team discussion…
All team members participate
Parent input is respectfully elicited and used to inform the selection of the descriptor statement
Multiple sources of assessment information are considered (observation, family report, formal ‘testing’)
Discussion focuses on the child’s functioning on the outcomes and includes the full range of content of the outcome
Group reaches consensus on rating
A quality team process around the Summary of Functional Performance is very similar to a quality team process for IFSP development and providing early intervention services. That is one of the reasons that Washington embedded the summary of functional performance right into the IFSP process. When the team process is high quality, all team members participate in the discussion. The early intervention team members explain the process to families and actively and respectfully ask for the parent’s input during the team discussion. Teams also record all of the information that is shared as part of the selection of the descriptor statement. As has been mentioned throughout this module, the team discussion must include information from multiple sources and multiple people who are involved with the child across settings and situations. The team focuses their conversation on the outcomes themselves at this point in the IFSP process, and includes the full range of the content of the outcome when considering the evidence and the information available. Lastly, a quality team process includes reaching a consensus as a team on the rating. We’ll discuss more about consensus in a moment.
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35. Tools
Using the decision tree as a guide and language of descriptor statements will:
Help make the process family-centered
Produce more valid, consistent ratings
Focus examples shared to more efficiently fit discussion into time available/meeting flow
Family outcomes brochure on ESIT website will help introduce the outcomes and summary process to families
There are tools available to teams to help support their process. The first is the Decision Tree, which will help guide the discussion based on a few simple questions about the evidence presented. Using the Decision Tree will help the team conversation feel more family friendly and produce more valid, consistent ratings.
For providers who are concerned about how to talk with families about the outcomes, the Family Outcomes Brochure on the ESIT website may be useful to help introduce the outcomes and Summary of Functional Performance process to families.
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36. Where to focus in deciding the rating
Focus on the child’s overall functioning across settings and situations
Functioning that is displayed rarely and/or when the child is provided with a lot of unusual support or prompts is of little significance for the rating
Quality team discussions will also focus on the child’s overall functioning across settings and situations, rather than discrete, isolated skills, or those that are rarely seen or used or only appear when given unusual amounts of support.
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37. Suggestions for reaching consensus on SFP and COS ratings
Whole team participation in the process
Re-visit process – describe functioning first, not #
Focus on outcome content – considering range of outcome content, does the skill fit, is it functional?
Share examples – settings, situations, supports, and describe if view as AE, IF, F (do not correct for prematurity)
Include more discussion about skills that would be seen in a child with typical developmental patterns for comparison
At times, teams may have difficulty agreeing on one rating or summary statement for a child. When that happens, these tips may be helpful for bringing the team together.
First, revisit the process – start with describing the child’s functioning and then selecting a rating, rather than having a discussion about a particular rating.
Make sure that the team is considering every aspect of the outcome. Check in to see if there is agreement that a certain skill fits within an outcome area, and ensure that it is a functional skill.
Share examples from multiple perspectives, and openly share with each other perspectives on whether skills are age-expected, immediate foundational or foundational skills. Be sure to have age-anchoring resources, such as developmental checklists or criterion-referenced tools, available to reference. Also ensure that team members are not correcting for prematurity when considering what is age-expected.
Lastly, talk more about what would be typical development, to ensure that no one is creating “slip” in their view of typical development.
See
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38. Example probe in team discussion
Tell me about the kinds of evidence that suggest to you this child has [AE, IF, F] functioning in this outcome?
When have you observed those skills? In what situations?
How frequently does that occur?
Were the accommodations/supports available in that setting? What were they?
Are there other steps in the sequence of development that need to occur between developing this skill and the skills same-aged peers display (AE) in this area? (when an IF skill is identified)
Is there other information we need to be better equipped to make this decision?
During team discussions, it may be helpful to ask each other questions to clarify the information being shared. This slide shows some examples. Remember that the goal is to understand each other’s perspectives, not gather information to prove another team member wrong. These prompts create the opportunity to support the process through increased understanding of multiple perspectives and the child’s development across settings and situations.
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39. Reflection
Think about your recent teaming on the summary of functional performance.
What could you do to facilitate higher quality team discussions in the future ?
What else would help other teams in your program also have high quality discussions?
Before moving on to the next section, we’d like you to consider how you will apply the information shared. Using your piece of paper, write out a response to the following questions:
What could you do to facilitate higher quality team discussions in the future?
What else would help other teams in your program also have high quality discussions?
You may want to refer back to information in this module to support your response. If you like, you may share your response with a co-worker or supervisor, and talk about how to include this information in your work in teams.
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40. Is the rating subjective?
What is subjective?
“relating to the mind of the thinking subject and not the nature of the object being considered”
The summary of functional performance ratings involve clinical decision making from the team
much like that used in deciding on outcomes and intervention strategies
A question that sometimes arises in the context of the Summary of Functional Performance process is whether or not rating a child’s functioning on the 7-point scale is ‘subjective.’ Subjectivity can be defined as related to the ‘mind’ of the rater, rather than the nature of the subject being rated. If your team determines a rating based on what is in their minds, rather on the what the child demonstrates, what age-anchoring tools identify as typical development and the rating criteria, the rating may be subjective. If the rating is based on the child’s demonstrated functioning, as compared to age-expected functioning and the criteria for each of the 7 points, it is a data based decision – not unlike the decisions the team makes when designing an appropriate program for a child.
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41. Effective Team Decisions
Research on clinical judgment shows that professionals can reach reliable conclusions under certain conditions.
Conditions for Effective Team Decisions
The SFP Process
Operational definitions of the observed attributes
Specific definitions for each of the 7 points on the rating scale
Structured rating format to record informed opinion
The Decision Tree
Consistent questions within the SFP section of the IFSP
Gather data from multiple sources
Team process used in assessment and the SFP
Establish consensus-decision making process
Provide training to facilitate reliable ratings
ESIT SFP Training Modules
Rating a child’s functioning based on assessment data draws upon the expertise about children’s functioning and child development that professionals acquire through their experience and training. Research has examined professional rating decisions and identified that teams can make high quality decisions, often more effective decisions that individuals alone, when certain conditions are in place. Let’s explore each of the conditions, and how the Summary of Functional Performance meets each one:
The first condition for effective team decisions is the existence of operational definitions of the observed attributes. Put simply, this means that providers are clear what they are looking at and how it compares to a certain definition. In the Summary of Functional Performance process, the specific definitions of each of the 7 points on the rating scale provide the definitions needed by each team.
The next condition is the existence of a structured rating format to record the team’s informed opinion. The Summary of Functional Performance process has two ways to support this condition – first, the Decision Tree provides a consistent set of questions that each team asks in the process of selecting the descriptor statement for each outcome for each child. Secondly, the Summary of Functional Performance form on the IFSP also has a consistent set of questions that are asked by every team and a consistent format for recording the team’s observations.
Over many modules in this series, it has been recommended that information from multiple sources be used in order to complete the Summary of Functional Performance. One of the conditions of effective team decisions includes the same criteria; so if the team process is used in the assessment as well as in the completion of the Summary of Functional Performance, this condition will be met.
The next condition is that there is an established consensus-decision making process for teams. Again, if teams are using the established teaming expectations and procedures in assessment and in the completion of the Summary of Functional Performance, this condition will be met.
Finally, in order for teams to have effective decisions, members must have training to ensure their understanding of the criteria, processes and procedures related to their decisions. For that reason, the ESIT team has created these six training modules, to facilitate better understanding and application of the Summary of Functional Performance process.
When these practices are in place, as they are with the Summary of Functional Performance, teams are guided by a process and clear criteria to inform decisions rather than inconsistent, subjective approaches.
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The SFP meets all of these conditions.

42. Validation of the Summary of Functional Performance
The Summary of Functional Performance* is currently being studied to validate the conditions under which the process provides the most meaningful information.
See the ENHANCE project for more information
Surveys, team decision-making videos, and a longitudinal study are all underway.
Nationally, a series of studies are underway to validate the summary of functional performance process.
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* In other states, the summary of functional performance is called the Child Outcomes Summary (COS) process.

43. Emerging National Validity Evidence
Across studies using different methods, evidence supports the following validity claims:
Minimal indication of explicit intent to alter ratings or teams selecting ratings intentionally to make the program look good.
Trained teams apply accurate knowledge of which skills relate to various outcomes.
Trained teams assign ratings consistent with rating criteria.
Children with more severe impairments receive lower ratings.
Ratings at exit from Part C are consistent with other state-wide information, including the percentage of children subsequently eligible for Part B Preschool services.
Although final study findings have not yet been released, emerging evidence shows support for a number of key claims that are central to the validity of the summary of functional performance. For instance, evidence from videos of team decisions and provider surveys indicates no widespread manipulation of ratings explicitly to make the program look good. Results also show that COS teams who are trained can effectively apply this knowledge. Trained teams apply knowledge about which skills map on to specific outcomes and identify ratings that are consistent with the specific rating criteria provided. Ratings by independent coders have consistency with team rating scores. Finally, ratings derived from the summary of functional performance follow expected patterns. For example, when the whole distribution of ratings is used, children with more severe impairments receive lower ratings than their age mates. National findings also show that in states where fewer children exiting Part C are eligible for Part B Preschool services, the ratings of children at exit from Part C also show that more children are exiting at age-expected levels. Taken together, trained teams who implement the process using resources and ideas from training are able to implement the Summary of Functional Performance in ways that produce valid, meaningful data.
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44. When to complete ratings
ESIT requires selection of descriptor statement (rating) at entry and exit
Optional at intervening times, such as at the annual IFSP review
Benefits of interim use:
Consistency in team actions – familiar each time to caregivers/team
- Promotes good discussions about child’s functioning with caregivers
- Will have a more recent rating if family exits suddenly
The completion of the Summary of Functional Performance is required at the child’s entry into the ESIT program, and again when the child exits the ESIT program. If your program opts to complete the Summary of Functional Performance more frequently than at entry and exit, such as at an annual IFSP meeting, you will have a richer record of how the child has changed in each outcome area. You also will have more recent information available to complete the exit rating, if some families leave unexpectedly.
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45. IF completing the 2nd, 3rd, etc., rating
Do NOT look at the previous rating. Each rating is independent and is to be based on where the child functioning is now.
Looking at the previous rating can introduce bias into the rating process.
Complete the progress question.
Children must be in services for at least 6 months in order to receive an entry or an exit rating. When completing the exit rating (or annual ratings, if your program opts to complete these), it is important that the new ratings are determined independently of the previous ratings. At the second and subsequent ratings, you will also answer a question about the child’s progress. We complete each Summary of Functional Performance independently so that one rating does not influence the other. In other words, if you know a child has made progress since the last rating, the team should not simply look at the last rating and bump it up. The rating should be based on the child’s current status relative to the criteria for each of the 7 points. The yes/no progress question will compare and capture the child’s development over time.
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46. The SFP in the DMS Kids' Potential, Our Purpose
When you are ready to complete the Summary of Functional Performance within the Data Management System, the DMS will automatically bring up the appropriate information for the selection of the appropriate summary statement and the progress question.
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47. The “progress” question
b. Has the child shown any new skills or behaviors related to [this outcome] since the last outcomes summary?
This question is answered “yes” if the child has acquired ANY new skill or shown any improvement related to this outcome since the last summary of functional performance, e.g.,
Using one new word
Using one new gesture
Unlike the determination of the rating on the 7-point scale which is a comparison of the child’s functioning with age-expected development, the yes/no progress documents the child’s acquisition of any new skill since the last rating. Some of our children may not move up the scale when compared to their same-age peers, however, they are still making progress compared to their own previous level of functioning. Just one new word or one new gesture warrants a ‘yes’ to the question, ‘has this child shown any new skills in this outcome since the last outcomes summary?’ If the child has not acquired any new skills or has regressed in the outcome area, the answer to the question should be “no.”
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48. Team Ratings of Functioning
When teams have discussions that are grounded in a clear set of questions and defined criteria, the group benefits. Everyone builds on the understanding of the child across settings and in all of his/her complexities and produces the most representative snapshot of the child’s functioning.
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49. Knowledge Check
1. True or False. Since every child is unique, I need to write a specific, individualized descriptor statement for each child.
2. The SFP summary should include:
Specific statements about the child’s current functioning.
Specific statements about skills the child does not yet use or cannot yet do.
Functional assessment information
Information anchoring the child’s skills against age-expected functioning
All of these
On your paper, take a moment to consider the answers to each of these knowledge check questions.
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50. Knowledge Check
1. True or False: Since every child is unique, I need to write a specific, individualized descriptor statement for each child. False
2. The SFP summary should include:
e: “all of these”
On question 1 – The answer is False. Teams are not expected to write their own descriptor statements summarizing each child’s functioning. The narrative portion is individualized, but teams must select from the group of descriptor statements, the one that best matches the functioning of the child. These descriptor statements are linked to rating numerals . So, it is important that teams only use the set of descriptor statements provided.
On question 2 – The answer is e “all of these”. The list of skills represents some key kinds of information that are expected to be included in the narrative portion of the summary of functional performance.
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51. Knowledge Check
1. True or False. The SFP can be completed by a single individual.
2. In order to be of high quality, the SFP summary should include:
The child’s name and date of birth
Information from multiple sources of assessment information
A descriptor statement for all three outcome areas
At exit, the answer to the yes/no progress question
All of these
Let’s continue to check your knowledge. On your paper, take a moment to consider the answers to each of these knowledge check questions.
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52. Knowledge Check
1. True or False: The SFP can be completed by a single individual. False
2. In order to be of high quality, the SFP summary should include:
E: “all of these”
On question 1 – The answer is False. The Summary of Functional Performance is a part of a child’s IFSP, and therefore is a team decision making process. This includes deciding what to document to support the selection of the descriptor statement, as well as the selection of the descriptor statement itself. IFSP teams may take many forms, but it is important that the decision making is supported with input from all team members and include the family. There should not be a situation in which one person is completing the SFP, including the selection of the descriptor statement.
On question 2 – The answer is e “all of these”. A quality Summary of Functional Performance section on the IFSP will include basic information such as the child’s name and date of birth, as well as evidence for each descriptor statement, a descriptor statement for each outcome area (even if the child does not have a delay in one of the three outcome areas), and an answer to the yes/no progress question at exit. Check your summaries carefully to make sure all of this information is complete and accurate!
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53. Reflection
How do team members share information during a typical meeting to create a complete picture of the child?
Before moving on to the next section, we’d like you to consider how you will apply the information shared. Using your piece of paper, write out a response to the following questions:
How do team members share information during a typical meeting to create a complete picture of the child?
You may want to refer back to information in this module to support your response. If you like, you may share your response with a co-worker or supervisor, and talk about how to include this information in your conversations with families.
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54. Resources
ESIT Part C Online Training Module 3: Developing Initial and Continuing Individualized Family Service Plans:
ESIT IFSP Process Guide:
There are several resources that are available to help you learn more about the concepts in this module. The first is Module 3 of the Introduction to IDEA Part C: Three Interactive Modules. This module provides additional information on developing initial and continuing IFSPs, including the Summary of Functional Performance.
The ESIT IFSP Process Guide, which can be found on the ESIT website, provides instructions, best practices and examples for the completion of the IFSP, including the Summary of Functional Performance.
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55. Resources IFSP Exemplars, Alex and Kim:
Reaching Consensus Handout:
Maryland Learning Links- Engaging Families in the COS Process:
The ESIT website also contains examples of completed IFSPs for 2 children, Alex and Kim. Both were used in the development of this module, and may provide valuable information about the difference between the PLODs and the Summary of Functional Performance, as well as the flow of information from referral through transition.
There are two resources that may support team process. The Reaching Consensus document provides details on the ways in which teams can work toward consensus when selecting a descriptor statement. The videos produced by Maryland’s Part C program show actual conversations during an IFSP meeting, with a family, where the team comes to a joint decision on the descriptor statement for outcomes measurement. It is a good example of how the conversation can be a natural part of the IFSP meeting.
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56. Coming Next
Module 1: Setting the Stage: Global Child Outcomes and the SFP
Module 2: Learning More about the SFP and COS Rating
Module 3: Essential Knowledge for Completing the SFP and COS Rating
Module 4: Guidance for Completing the SFP and COS Rating Within the Team Process
Module 5: Understanding the Age-Expected Child Development, Developmental Trajectories and Progress
Module 6: Using COS Data to Inform Program Improvement at All Levels
The next module in the series is about understanding children’s progress as it relates to the Summary of Functional Performance, as well as how the ratings that are derived from the SFP are converted for federal reporting. It covers:
An explanation of how individual child ratings are converted into the federal progress categories, using developmental trajectories to understand how children make different kinds of progress in the program;
An explanation of the two summary statements that are used for federal reporting; and
The link between the progress categories and summary statements to program improvement cycles.
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57. Kids' Potential, Our Purpose