The Child Outcome Summary 7 Point Rating Scale

The Child Outcome Summary 7 -Point Rating Scale Kathi Gillaspy, NECTAC Sharon Ringwalt, NECTAC/MSRRC Maryland State Department of Education/Division of Special Education/Early Intervention Services/Early Childhood Intervention and Education Branch

Session Agenda • Overview of the 3 Early Childhood Outcomes • Overview of and practice with the 7 -point scale • Key concepts when choosing a rating • Using the 7 -point scale – Kim’s case study 2

The Who, What, How, When and Where of the COS 3

WHO - The 3 Early Childhood Outcomes Percentage of states using the following for child outcomes measurement: • COS = 75% • Publisher = 5% • One tool for whole state = 13% • Other = 7% 4

WHAT - The 3 Early Childhood Outcomes • Children will develop positive social and emotional skills (including social relationships). • Children will acquire and use knowledge and skills. • Children will use appropriate behaviors to meet their needs. 5

Global Outcomes vs. Domain specific… • Eva communicates by waving when she sees her mother, asking for ‘nilk’ when she wants her milk, and saying “brrmmmm” when she plays with cars. She can make the sounds of a cow and a sheep. She signs help when she has trouble putting on her socks and says “Mama!” when she’s scared or shy. 6

WHAT - The Child Outcomes Summary Key Features of the COS: • It is not an assessment tool. • It uses information from assessments and observations to get a global sense of how the child is functioning across settings and situations at one point in time in each of the 3 outcome areas. • It uses the 7 -point rating scale to rate the child’s functioning at these points in time. • Ratings are based on the child’s functioning compared with what is expected given the child’s age. 7

HOW is information used for the COS? Parent Input Assessment Results Naturalistic Observation RBI Professional Opinion COS Single rating for each of the three outcomes Progress & More 8

WHEN is the COS completed? • @ Initial and Exit • To what extent does the child show behaviors and skills related to each outcome appropriate for his/her age across a variety of settings and situations? (Rating 1 -7) • @ Exit • Has the child shown any new skills or behaviors related to each outcome since the last outcomes summary? (yes or no) • Ratings are based on the child’s functioning: • What the child does across settings and situations • Compared with what is expected given the child’s age 9

WHERE is the COS completed? NEW!! STRENGTHS AND NEEDS SUMMARY

The 7 -Point Scale and Age-Expected Development 11

Comparison to Age-Expected Development • Children can be described with regard to how close they are to age expected behavior for each of the three outcomes. • Most children in the population demonstrate the outcomes in age-expected ways. • By providing services and supports, early intervention is trying to move children closer to age-expected behavior. • Some children will never achieve this.

Age Expected, Immediate Foundational and Foundational Skills • Age-Expected skills are those that we expect to see in children of a certain age. • Immediate Foundational skills are the set of skills and behavior that occur developmentally just prior to age-expected functioning. • Foundational skills are skills and behaviors that occur earlier in development and serve as the foundation for later skill development.

Why do we compare to age-expected functioning? • Part of federal requirement • Stronger evidence of program’s effects • Set high expectations (and many do attain them), but also celebrate different kinds of progress • Want to promote active and successful participation now and in the future (including school readiness) • Families want to know both individual progress and relative to age-expected (avoid being surprised later)

Steps in the process 1. Collect information about the child’s functioning across settings and situations in the 3 outcomes. 2. If needed, assemble resources on age expectations. 3. Meet as a team to review the information (often at IFSP). 4. Write summary of each outcome area reflecting how child uses skills relative to age-expectations. 5. Use resources (including the decision tree to discuss and agree upon a descriptor statement (rating) for Outcome 1. 6. Repeat for Outcomes 2 and 3.

Essential knowledge for Using the 7 -Point Scale Among them, team members must: 1. Know about the child’s functioning across settings and situations 2. Understand age-expected child development 3. Understand age expectations for child functioning within the child’s culture 4. Understand the content of the three child outcomes 5. Know how to use the rating scale

The 7 -Point Scale 17

Thinking about children’s functioning Early Childhood Outcomes Center 18

7 • 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 19

6 • 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 20

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

4 • Child shows occasional age-appropriate functioning across settings and situations • More functioning is not age-appropriate than age-appropriate.

3 • 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 23

2 • Child occasionally uses immediate foundational skills across settings and situations • More functioning reflects skills that are not immediate foundational than are immediate foundational

1 • 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

ECO and MD Descriptor Statements

Rating Scale Jeopardy Age appropriate functioning $100– no concerns Mix of age appropriate and not age $100 appropriate functioning No age appropriate functioning – not yet $100 showing immediate foundational skills Some age appropriate $200 functioning but very little No age appropriate functioning – lots of $200 immediate foundational skills Age appropriate functioning $200– some concerns Rarely shows age appropriate $300 functioning No age appropriate functioning – some $300 immediate foundational skills Age appropriate $300 functioning 27

Using the 7 -Point Scale • Kim’s Case Study

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 ratings involve clinical decision making from the team – much like that used in deciding on goals and intervention strategies 29

Informed Decisions Conditions: 1. 2. 3. 4. 5. Operational definitions of the observed attributes Structured rating format to record informed opinion Gather data from multiple sources Establish consensusdecision making process Provide training to facilitate reliable ratings Research on clinical judgment shows that professionals can reach reliable conclusions under certain conditions The process meets all of these conditions.

Questions?

Contact Information Kathi Gillaspy, NECTAC kathi. gillaspy@unc. edu 919. 843. 5950 Sharon Ringwalt, NECTAC/MSRRC sharon. ringwalt@unc. edu 919. 843. 2275