1. Section 5 Child Development and Age Anchoring
Facilitator’s Notes:
Once we have gathered good, thorough information about the family and how the child participates within the day of the family, the next step in informing the global outcomes is to compare the skills that the child is demonstrating with the skills that a child of that age would be expected to have.
Handouts used in Section 5: Child Development and Age Anchoring
Larimer County Age-Anchoring Tool
Bucket List: EDIS-COSF Rating Scale Descriptor Statements
Child Development and Age Anchoring
Comparing Child’s Functioning to Age Expectations

2. Key Principles Addressed
All families, with the necessary supports and resources, can enhance their children’s learning and development
IFSP outcomes must be functional and based on children’s and families’ needs and priorities
The primary role of the service provider in early intervention is to work with and support the family members and caregivers in a child’s life
Facilitator’s Notes:
This section of the training is primarily related to the first three Key Principles for Early Intervention Service Provision.

3. Key Points
Because global outcomes ratings look at the skills and behaviors of the child in relationship to typical peers, age anchoring is an important early step of the rating determination process
Facilitator’s Notes:
We are now going to move into actively determining the Global Outcomes rating for a child, and beginning the completion of the IFSP.

4. Key Points, cont. Functional skills are:
Not domain specific
Emphasize the purpose behind the action
Focus on the child’s ability to apply the behavior in a meaningful way
Thinking about skills as part of a developmental progression is important for understanding where a child is on a trajectory of functional development
Facilitator’s Notes:
Review with participants. Keep in mind that functional skills are framed with the context of the 3 global outcomes not within domains. We will discuss functional skills in terms of a developmental progression of the skill.
Let’s take a look at child development and the developmental progression of functional behaviors and skills. Included in each of the 3 global outcomes are numerous functional skills that can be thought of in terms of developmental progression of ability. Let’s look at a few examples of this together.

5. Developmental Progression of Functional Skills
Global Outcome #1 (Positive social relationships)
Begins with a positive caring relationship between parent and child
As child grows, she develops a sense of self, relationships with family members, other adults, and peers
As relationships expand to making friends, the child learns to get along with others and follow social rules and expectations
Facilitator’s Notes:
This slide illustrates how Global Outcome #1 (Children will have positive social emotional skills, including social relationships) typically develops in children.

6. Developmental Progression of Functional Skills, cont.
Global Outcome #2 (Acquiring and using knowledge and skills)
Remington pretends to drink from a toy cup by putting it in his own mouth
Remington uses the toy cup to give his bear a drink
Remington puts the bear in his high chair, gives it a drink from the toy cup and wipes the bear’s face
Remington says: “ Bear drink”, pretends to pour milk in the cup, gives the bear some “cookies”, serves himself some, pretends to eat, and then goes to give the bear a pretend bath using his blanket for a towel
Facilitator’s Notes:
This slide illustrates how a skill related to Global Outcome #2 (Children will acquire and use knowledge and skills, including communication skills) typically develops.
Another example of the scaffolded development of specific skills is with a child’s development of pretend play behaviors This is an example of the how that skill presents itself in children who are developing typically.

7. Developmental Progression of Functional Skills, cont.
Global Outcome 3# (Use of appropriate behaviors to meet their needs)
Gina picks up a spoon by the handle
Gina eats thick food with a spoon, spilling often
Gina uses spoon successfully most of the time with little spilling
Gina uses a fork one handed
Facilitator’s Notes:
This slide illustrates how a skill related to Global Outcome #3 (Children will use appropriate behavior to meet their needs) would progress in children who are developing typically. Children progress in independence and ability to meet their own needs, such as moving about their environments, eating, drinking, dressing, going to the bathroom, and following health and safety rules.
In general, as each outcome is explored during the Global Outcomes process, keep the complexity of child development in mind and keep the focus on functionality of skills and behaviors not on isolated skills and milestones.

8. Developmental Progression
Children typically follow a predictable developmental pattern
Think about development in terms of the progression of skills: Head control-sitting-crawling-standing-walking
Remember that not all children follow the same pattern and that is ok!!!
Facilitator’s Notes:
Review with participants. Reinforce that MOST children will follow this developmental trajectory, but there are exceptions to every rule!

9. Age Anchoring
Identifies the age at which a typical child would be demonstrating a given behavior or skill
Keeps in mind when a particular behavior or skill emerges
Looks at the child’s development in relation to same-age peers
Facilitator’s Notes:
Beyond considering developmental progressions, knowing when different skills and abilities evolve is an essential aspect of determining where a child is functioning relative to same-age peers, which is needed for measuring the 3 global outcomes. It is necessary to be able to identify the typical age ranges in which we should expect to see developmental skills or abilities emerge. Many professionals may not know this information for every age range and will need resources to support this process such as age anchoring tools that address child development, developmental guidelines and checklists, criterion-referenced instruments, and consultation with colleagues.

10. Age Anchoring Critical piece of determining Global Outcomes rating
Must be done prior to the rating
When age anchoring behaviors using developmental resources, look for skills and behaviors that are similar to what you observed
Information should be gathered from multiple sources including evaluation/assessment, observation, the family assessment, and additional conversation with the family and other caregivers
Facilitator’s Notes:
Review with participants. Note that there are many tools that may aid with age-anchoring and everyone will develop their own “go-to” tool to help with this process. The more you practice age-anchoring, the comparison of where a child is in relationship to their typical peers, the easier it becomes, as the participants in the process become more familiar with typical child development.

11. Child Development and Age Anchoring Resources
Colorado Early Learning and Development Guidelines (Padlet)
Larimer County Age Anchoring tools
Illinois – 3 Global Outcomes Age Anchoring video trainings (Links on next slide)
Facilitator’s Notes:
Handout : Larimer County Age Anchoring Tool
Here are some available resources to expand your knowledge of child development and developmental progression. These are simply resources and you may use these or other sources that you are familiar with to age- anchor. The MEISR-COSF is also a tool that allows you to see at a glance if a child is demonstrating age-expected, immediate foundational or foundational skills. One effective practice is to highlight the age range of the child on developmental milestones or assessment tools.
REMEMBER: for the global outcomes, age is NOT adjusted for prematurity as it is for evaluation and assessment results.

12. Illinois Videos Focus on Social-Emotional Skills
Focus on Children’s Acquisition and Use of Knowledge and Skills
Focus on Children’s Ability to Take Appropriate Action to Meet Needs
Facilitator’s Notes:
These are modules that address age-anchoring in relationship to each of the 3 global outcomes. Each module is about 20 minutes and contains content in a PP format, a video that illustrates the principles, and a self-assessment. These are great resources that providers and service coordinators can complete on their own to advance their learning.

13. Understanding Age Expectations
Activity 5.1
Facilitator’s Notes:
Activity 5.1:
Handouts Needed:
Developmental Tools or checklists, such as:
Larimer County Age Anchoring tools
Colorado Developmental Guidelines
MEISR-COSF
Many other developmental tools are available, such as the Act Early Milestones from the Center for Disease Control :
Individually:
For the skills documented on the following two slides,
Use a developmental tool
Determine when the skill would typically develop
Ask for answers from the group
Using one of the resources provided, let’s take a moment to practice….Read through the following questions and then we will answer them as a group, let’s take about 5 minutes
Understanding Age Expectations

14. At What Age Does a Child…?
When waking from a nap at Grammy’s, Jared raises his arms to be picked up
While the family eats breakfast Chloe holds her own bottle propped
During dressing, Miguel helps by extending his arms/legs for shirt/pants
In play, Tiguan entertains himself with a single toy for 2-3 minutes
Facilitator’s Notes
Ask the group to determine the age range in which the skill would typically develop. Note that there are may be differences based on what tool is being used. The answers will fly in on mouse click.
Answers below based on Larimer County Age Anchoring tool
5-6 months
4-6 months
10-12 months
6-9 months

15. At What Age Does a Child…?
In play Nevaeh names familiar objects (car, ball…)
At home Serena walks about on her own to play and explore in the family room
Silas uses related objects in play (spoon with cup, stick with drum)
Christopher says, “dada”, “doggy”,
“ba-ba”
At child care, when Sam interacts with peers, he uses gestures (e.g. pushes pulls, grabs, aggressive with an occasional pat or toy offering)
Facilitator’s Notes:
Note that this is just an exercise. As participants reflect on these skills, they will see how much the already know a lot about child development and realize that it’s good to check with others and check resources.
It is not expected that everyone is able to say exactly when each skill a child demonstrates comes in developmentally; we will all have our own knowledge, especially in our area of focus, but it is important to know the resources available for anchoring children’s skills by ages. It’s important to not guess, but use the resources available, including other members of your team. Remember that the determination of the global outcomes is a team process.
Answers below based on the Larimer County Age anchoring tool.
13-19 months
13-15months
9-12 months
12-15months
18-24 months

16. Age-Expected, Immediate Foundational, and Foundational Skills and Behaviors
Some of the skills and behaviors that develop early serve as the foundation for later skills
Understanding these concepts are key to talking to families about their child’s development and determining a global outcomes rating
Facilitator's Notes:
Review with participants. Generally, later skills build upon earlier skills in predictable ways. For example, children typically roll over, sit, crawl, and stand independently before they walk. Early childhood development proceeds through several levels of foundational skills, with skills and behaviors becoming more complex and more proficient as children get older.

17. Age-Expected, Immediate Foundational, and Foundational Skills and Behaviors
Facilitator’s Notes:
All skills that lead to higher levels of functioning are foundational; however, the set of skills and behavior that occur developmentally just prior to age-expected functioning can be described as the immediate foundational skills in that they are the most recent set of foundational skills that children master and move beyond. You can think of it like a staircase (see below) where foundational (F) skills lead to immediate foundational (IF) skills which then lead to age-expected (AE) functioning. A child with functioning like that of a slightly younger child is probably showing immediate foundational skills, as her functioning does not meet age expectations, but she demonstrates skills and behaviors that occur during typical development just prior to age-expected functioning (and are the basis on which to build age-expected functioning). A child with functioning that might be described as like that of a much younger child does not meet age expectations, nor does she demonstrate skills and behaviors that immediately precede age-expected functioning. She has foundational skills, but is not yet at an immediate foundational level. Immediate foundational skills are those the child is just on the brink of demonstrating. This is very important for the COS rating.
Foundational

18. Defining Age-Expected (AE), Immediate Foundational (IF), and Foundational (F)
Age–Expected: The skills and behaviors demonstrated that one would expect for a child his/her age
Immediate Foundational: The skills and behaviors that come just before the age-expected skills and behaviors
Foundational: The skills that are farther away from age-expected skills and behaviors (can be either much earlier or atypical skills and behaviors)
Wayla - review

19. Examples of Age Expected, Immediate Foundational, and Foundational Skills and Behaviors
Ask yourself: At what age would I first expect to see this functional skill or behavior and how close is it to the child’s current age?
Wayla –
It is also important to note that some foundational skills get replaced by newer skills whereas others continue in children’s (and adults') repertoires throughout life. The nature of interacting with other children changes fundamentally as children get older. On the other hand, skills like making eye contact, turn-taking, and eating with a fork get incorporated into more sophisticated routines, but never really disappear. To identify whether functioning that continues throughout life constitutes a foundational or immediate foundational skill, ask yourself:
At what age would I first expect to see this functioning and how close is it to the child’s current age?
Because we are very strengths-based in Early Intervention, we often give credit for a child having a behavior or skill that should have come in much earler.

20. Examples of Age Expected, Immediate Foundational, and Foundational Skills and Behaviors
Walking –Age Expected skill (12-15 months)
Cruising-Immediate foundational skill
Stand independently-Immediate foundational skill
Crawling-foundational skill
Sitting –foundational skill
Rolling over- foundational skill
Facilitator’s Notes:
These is an examples of how you can think of the stair step concept. The skill that a child of typical development would be demonstrating at the age of the child is the age expected skill. Refer to developmental resources if needed to make this determination.
In this example, you can see that crawling is a foundational skill for walking, which is the age-expected skill for a child months of age, but not an immediate foundational skill.

21. Examples of Age Expected, Immediate Foundational, and Foundational Skills and Behaviors
“Milk, please”–Age Expected skill (19-24 months)
Have words (or approximations) –Immediate
foundational skill
Babbling –foundational skill
Cooing-foundational skill
Facilitator’s Notes:
Here is a another example of what would be an age-expected communication skill, immediate foundational skill, and foundational skills for a child who is months old.

22. Resource: Bucket List Facilitator’s Notes:
Handout: Bucket List: EDIS-COSF Rating Scale Descriptor Statements
This resource (screen shot on following slide) can help determine the Global Outcomes rating based on strengths/needs statements.

23. Facilitator’s Notes:
Review this resource. The COS rating scale ranges from 1 to 7, with a 6 or 7 indicating age-expected functioning. Lower numbers indicate further distance from age-expected functional behaviors and skills. Remember, you can think about the ratings in relation to the distribution of age-expected (AE), immediate foundational (IF), and foundational (F) skills a child demonstrates relative to each outcome area. The bucket list shows how the IFSP team can sort a child’s skills into these three categories, and then use the definitions of each of the seven points on the scale to assist with determining the applicable rating.
For example, a child that shows:
Only “F” skills for Outcome #1 would have all skills sorted into the “F” bucket and would have a rating of "1" for that outcome area.
For Outcome #2, the same child may have some “F” skills and a couple of “IF” skills, and would receive a rating of "2."
For Outcome #3, he may have mostly “IF” skills and a couple of “AE” skills, and would therefore receive a rating of "4."

24. Activity 5.2
Look at the following statements and determine a rating using the bucket list
Facilitator’s Notes:
Activity 5.2
Handouts: Bucket List
Individually:
On the following slides:
Review the wording describing how the child is functioning
Using the bucket list, determine the COS rating for the child

25. Activity 5.2 Question 1
Luke is somewhat where we would expect him to be this age. In this outcome area he shows functioning expected for his age some of the time and/or in some settings and situations, and has a mix of age-expected and not age-expected behaviors and skills.
Facilitator’s Notes:
Review this slide and give the participants time to review the Bucket list and determine the rating for Luke. Ask for responses from the group.

26. Activity 5.2 Question 1 Relative to same age peers:
This child has all of the skills we would expect in this area -7
This child has the skills we would expect in this area. There are some concerns with(area lacking skill)-6
This child shows many age expected skills. Also continues to show some skills that might describe a younger child in this area-5
This child shows occasional use of some age expected skills. Has more skills of a younger child in this area-4
This child uses many important early skills that are necessary for development of advanced skills, not yet showing skills used by other children this age in this area-3
This child is beginning to show some of the early skills that are necessary for development of more advanced skills in this area-2
This child has the very early skills in this area. This means that this child has the skills we would expect of a much younger child-1
Facilitator’s Notes:
Correct answer will turn red on mouse click.
Luke would have a rating of 5.

27. Activity 5.3 Question 2
Callie shows inconsistent age-expected functioning across settings and situations. In general though, more of her functioning is not age-expected than age-expected.
Facilitator’s Notes:
Review this slide and give the participants time to review the Bucket list and determine the rating for Callie. Ask for responses from the group.

28. Activity 5.3 Question 2 Relative to same age peers:
This child has all of the skills we would expect in this area -7
This child has the skills we would expect in this area. There are some concerns with(area lacking skill)-6
This child shows many age expected skills. Also continues to show some skills that might describe a younger child in this area-5
This child shows occasional use of some age expected skills. Has more skills of a younger child in this area-4
This child uses many important early skills that are necessary for development of advanced skills, not yet showing skills used by other children this age in this area-3
This child is beginning to show some of the early skills that are necessary for development of more advanced skills in this area-2
This child has the very early skills in this area. This means that this child has the skills we would expect of a much younger child-1
Facilitator’s Notes:
Correct answer will turn red on mouse click.
Callie would have a rating of 4.

29. LUNCH Facilitator’s Notes:
If presenting the full-day training, break here for lunch.