1. Understanding the Outcomes and the COSF: A Quick Review

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

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

4. 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

5. 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

6. 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

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

8. 7 – Completely
Child shows functioning expected for his or her age in all or almost all everyday situations that are part of the child’s life. Functioning is considered appropriate for his or her age.
No one has any concerns about the child’s functioning in this outcome area.

9. 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.

10. 5 – Somewhat
Child shows functioning expected for his or her age some of the time and/or in some settings and situations. Child’s functioning is a mix of age-appropriate and not age-appropriate behaviors and skills.
Child’s functioning might be described as like that of a slightly younger child.

11. 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.

12. 3 – Nearly
Child does not yet show functioning expected of a child of his or her age in any situation.
Child uses immediate foundational skills, most or all of the time, across settings and situations. Immediate foundational skills are the skills upon which to build age-appropriate functioning.
Functioning might be described as like that of a younger child

13. 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.

14. 1 – Not yet
Child does not yet show functioning expected of a child his or her age in any situation.
Child’s functioning does not yet include immediate foundational skills upon which to build age-appropriate functioning.
Child functioning reflects skills that developmentally come before immediate foundational skills.
Child’s functioning might be described as like that of a much younger child.
After going through the ratings on these slides, or at the end of this presentation, it is helpful to walk through a child example. This can be a child presented by a participant, going through the assessment data and discussing level of functioning, etc. in order to come up with a rating. See instructions for holding a COSF rating discussion as part of a training activity at this link:

15. What ECO is learning nationally

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

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

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

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

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

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

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

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

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

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

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