Outcomes review and use of the 7-point scale Welcome to a review of the three child outcomes and the 7-point rating scale used on the Child Outcomes Summary Form. This presentation is intended as a refresher for those who have already had some training and experience in using the COSF. First we’ll go over the three child outcomes that programs are measuring for federal reporting purposes. As you know, this requirement applies to all programs that serve children with an Individualized Family Service Plan (IFSP) or an Individualized Education Program (IEP). Then we’ll go over the 7 points on the rating scale being used by programs measuring child outcomes through the Child Outcomes Summary process.

Outcomes Jeopardy Jeopardy score sheet 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 Now we will check your knowledge of the three child outcomes with a little Outcomes Jeopardy! Grab a pen and paper, or if you want to print out the Jeopardy score sheet, use the link right under the title on this slide. Here’s how to play: under each door there will be an answer corresponding to one of the three outcome areas. Your job is to provide the question, such as ‘What is Outcome 1?’ ‘What is Outcome 2?’ or ‘What is Outcome 3?’ Let’s get started. First let’s start with the easy ones for 100 dollars. Pointing to the cabinet for cereal. Jot down which outcome you think this goes with. The correct response is “What is Outcome 3?” Next we have “Reading the letter “S” on the stop sign.” Right. What is outcome 2? “Washes hands before lunch.” Again we have “What is Outcome 3?” Let’s move on to the next level, for 200 dollars. “Biting” this is a tricky one. 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 biting is associated with feeding issues. “Plays by himself in the classroom.” The correct response is “What is Outcome 1?” “Plays with rhyming words.” The correct response is “What is Outcome 2?” Now moving into the harder questions. Building a castle from blocks with a friend. The correct response is: What are outcomes 1 and 2?” Playing with a friend would be related to outcome 1, while representational play with blocks is Outcome 2. Two more to go! “Problems sleeping.” What did you think? You may have answered “what is Outcome 1?” , “what is Outcome 2?” or “what is Outcome 3?”, depending upon how the lack of sleep affects this child’s functioning. It would be 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, and/or Outcome 3 if he or she is too sleepy to get his or her needs met. OK, only one more to go: “Sharing a cookie at lunchtime.” What are Outcomes 1 and 3? Sharing is Outcome 1 and participating in lunch relates to Outcome 3. $300 $300 $300

How did you do?? So… how did you do? In the following slides we’ll review the three outcome areas so that you can refresh your memory on any that you may have missed. At the end of this presentation there will also be a link to the jeopardy answers if you want to print them out.

Outcome 1: 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 Let’s start with Outcome 1- children will have positive social relationships. Note the breadth of Outcome 1 – it covers relationships with both adults and other children. For older children who may be in group settings, Outcome 1 also addresses their ability to follow social rules. Outcome 1 addresses the child’s ability to express feelings and to engage in socially interactive play. Language comes into play for Outcome 1 when a child with speech and language uses those skills to interact with others. Motor skills are also important if the child uses those skills to participate in social play.

Outcome 2: 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 Outcome 2 focuses on the child’s ability to learn -- including thinking, reasoning, and problem solving. Use of symbols is an important component of Outcome 2, as this affects the child’s ability to understand that sounds make up words and words represent objects and actions, thereby leading to the development of speech and language. Outcome 2 also addresses early numeracy and literacy, including what we may think of as ‘pre-academics.’ Fine motor is important to observe as the child develops pre-writing skills. Gross motor affects Outcome 2 terms of the child’s use of movement to explore, and therefore learn about, his or her environment.

Outcome 3: 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 Outcome 3 reflects the child’s ability to get his or her own needs met. This includes basic needs, such as self help, and also safety issues. Language is an important aspect of Outcome 3 in that a child with speech and language can use those skills to make his or her needs known. Motor skills are also important if the child uses those skills to take action to meet his or her own needs.

Need more information about the three outcomes? ECO Professional Development Resources If your score on Outcomes Jeopardy was not what you thought it should have been, or if any of the information on the previous slides came as a surprise, you may wish to consult additional resources about the three child outcomes and the skills associated with them. Check out links on this page for additional resources that may be of interest. Materials include presentations such as “why collect outcomes data?” and “understanding the three child outcomes.”

Rating Scale Jeopardy – Jeopardy score sheet 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 Now let’s check your knowledge of the seven points on the Child Outcomes Summary rating scale with another game of Jeopardy! Get your pen and paper ready, or you can use your score sheet if you already printed it. For this version, the answers under each door correspond to a number on the seven-point rating scale. Your task is to provide the number of the rating, in the form of a question, such as ‘What is a rating of 1?’ ‘What is a rating of 2?’ and so on. Let’s get started. The first row are going to be the easier ones- for 100 dollars: Let’s try the first one: “Age-appropriate functioning with no concerns.” The correct response is: ‘What is a rating of 7?’ Let’s move on to the next one: “A mix of age-appropriate and not age-appropriate functioning” ‘What is a rating of 5?’ “No age-appropriate functioning and not yet showing include immediate foundational skills” Right: ‘What is a rating of 1?’ Now lets move to the next row: “Some age-appropriate functioning but very little” The correct response is: ‘What is a rating of 4?’ “No age-appropriate functioning and lots of immediate foundational skills” If you wrote ‘What is a rating of 3?’ you are correct. And the last $200 answer: “Age appropriate functioning, with some concerns.” What is a rating of 6? And now for the final three: The child “Rarely shows age appropriate functioning”. What is a rating of 4? Next we have “No age-appropriate functioning and some immediate foundational skills” What is a rating of 2? And now for the last one: “Age-appropriate functioning.” This one could be a rating of either a 6 or 7, depending on whether there are any concerns. $300 $300 $300

How did you do?? Outcomes and Rating Scale Jeopardy Answer Key How did you do with the rating scale? If you want to print the Jeopardy answers that we just went over, you can find it at the link above. This link has answers for both the Outcomes and Rating Scale Jeopardy games. In the following slides we’ll review the seven points on the scale.

7 – Completely age-expected 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. A rating of 7 means that the child is ‘completely age appropriate’’ or at age level for the outcome you are measuring and that there are no concerns about the child’s development in this 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. A rating of 6 means that even though the child is overall at age level in the outcome you’re measuring, there ARE some concerns about the child’s development in this area. You might use a rating of 6, for example, if the child is currently keeping up with other children his age, but you are worried that he or she may be starting to fall behind. You would use a rating of 6 if this is an area that you are monitoring for this particular child.

5 – Somewhat age-expected 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. A rating of 5 means that the child is ‘somewhat’ age appropriate in the outcome you are measuring. ‘Somewhat’ means that the child uses age-level skills some of the time, and in some situations or settings, but not others. There is a ‘mix.’ You might also use the rating of 5 if the child has developed skills in one aspect of the outcome, but not others. For example, you may consider a rating of 5 for a child who shows age-level social skills with adults, but NOT with other children in Outcome 1.

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. A rating of 4 should be used when a child has a few age-level skills, but most of the time shows skills that are NOT age appropriate. A child with a rating of 4 may behave more like a slightly younger child in the outcome area you are measuring.

3 – Nearly age-expected 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 A rating of 3 means that the child is ‘nearly’ age appropriate. You would consider a rating of 3 when the child is NOT at age level in the outcome you are measuring, but does have ‘immediate foundational skills.’ Immediate foundational skills are those skills that, developmentally, emerge just prior to the skills that are expected for the child’s age. For example, a 2½ year old child would be expected to initiate and play with his or her peers. For this age, immediate foundational skills might include responding to peer social behaviors but not initiating them, or playing close by but not with his/her peers.

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. A rating of 2 means that the child has a few immediate foundational skills, but, most of the time, the child’s skills and behaviors look more like those of a much younger child

1 – Not yet age-expected 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. A rating of 1 means that the child does not yet have age-level functioning or immediate foundation skills. A rating of 1 does NOT mean that the child has NO skills, it’s just that the child’s behaviors are more like those of a much younger child.

Need more information about the points on the rating scale? Age-expected Child Development Child Outcomes Summary Process If your score on Rating Scale Jeopardy was not what you thought it should have been, or if any of the information on the previous slides came as a surprise, you may wish to consult additional resources about the rating scale and the skill levels associated with each point on the scale. The links on this slide will take you to additional resources that may be of interest.