Child Outcomes Quality Assurance

1. Child OutcomesQuality Assurance January 8, 2010 Presented by Sherlock Center on Disabilities at RI College and The RI Department of Human Services For more information contact Maureen Whelan: MWhelan@ric.edu

2. Today’s Learning Outcomes • Understand how the Child Outcomes Summary Forms (COSF) gets translated and reported to OSEP (the Office of Special Education Programs) • Learn ways to review your own program data • Discover how to improve the validity and reliability of your data and • Begin to use the data for quality improvement The Sherlock Center on Disabilities at RI College and RI Department of Human Services

3. Outcome Statements Children will demonstrate positive social emotional development (including positive social relationships) Children will acquire and use knowledge and skills, including early literacy skills. Children will use appropriate behavior to meet their needs. The Sherlock Center on Disabilities at RI College and RI Department of Human Services

4. Federal Reporting: Accountability • Moving from Compliance to Performance • Summary Statements • Target Setting • RI’s Current Process: COSF The Sherlock Center on Disabilities at RI College and RI Department of Human Services

5. Next Steps The Sherlock Center on Disabilities at RI College and RI Department of Human Services

6. Outcome Statements Children will demonstrate positive social emotional development (including positive social relationships) Children will acquire and use knowledge and skills, including early literacy skills. Children will use appropriate behavior to meet their needs. The Sherlock Center on Disabilities at RI College and RI Department of Human Services

7. Outcome 1: Children will demonstrate positive social emotional development (including positive social relationships) • Involves: • Relating with Adults • Relating with Children • Following and understanding rules • Regulating emotions and behaviors • Includes areas like: • Attachment/separation/autonomy • Expressing emotions and feelings • Learning rules and expectations • Social interactions and play The Sherlock Center on Disabilities at RI College and RI Department of Human Services

8. Outcome 1: Children will demonstrate positive social emotional development (including positive social relationships) • Regulate emotions • A 3 – 6 month old child can be comforted or soothed by caregiver when over stimulated • A 12 – 18 month old may use a security object to soothe, may have small tantrums but can be easily directed • A 24 – 36 month old begins to verbalize feelings, can wait for short periods of time, can transition between activities and follows directions with little resistance The Sherlock Center on Disabilities at RI College and RI Department of Human Services

9. Outcome 2:Children will acquire and use knowledge and skills, including early literacy skills. • Involves: • Thinking • Reasoning • Remembering • Problem Solving • Using symbols and language • Understanding physical and social worlds • Includes areas like • Early concepts – symbols, pictures, numbers • Imitation • Object permanence • Expressive language and communication • Early literacy The Sherlock Center on Disabilities at RI College and RI Department of Human Services

10. Outcome 2:Children will acquire and use knowledge and skills, including early literacy skills. • Memory • A 3-6 month old will begin to repeat an enjoyable activity (i.e. shaking a rattle) • A 12-18 month old will show object permanence and remember social games or actions • A 24-36 month old can retell stories, remember simple rules, and remembers simple life events The Sherlock Center on Disabilities at RI College and RI Department of Human Services

11. Outcome 3:Children will use appropriate behavior to meet their needs. • Involves: • Taking care of basic needs • Getting from place to place • Using tools (e.g. fork, toothbrush, crayon) • Health and Safety • Includes areas like: • Integrating motor skills to complete tasks • Self-help skills • Using appropriate communication to ask for help when needed • Acting on the world to get what one wants The Sherlock Center on Disabilities at RI College and RI Department of Human Services

12. Outcome 3:Children will use appropriate behavior to meet their needs. • Communicating and satisfying hunger • A 3-6 month old will have a different cry to mean hungry, and will begin to hold bottle • A 12-18 month old may have a few words or signs for familiar foods, can use hands to feed self, and explores with utensils • A 24-36 month old can ask for food using familiar phrases and simple sentences, feeds self independently with utensils The Sherlock Center on Disabilities at RI College and RI Department of Human Services

14. Functional Skills are INTEGRATED Have Positive Social Relationships Acquire & Use Knowledge & Skills Take Appropriate Action to Meet Their Needs NOT domain-specific The Sherlock Center on Disabilities at RI College and RI Department of Human Services

15. The Ratings: Things to Remember When assessing children for the outcomes: • Involve multiple sources • Involve multiple measures • Ask yourself: • What does the child typically do? • What is the child’s actual performance across settings and situations? • How does the child use skills to • accomplish tasks? The Sherlock Center on Disabilities at RI College and RI Department of Human Services

16. The Ratings: Things to Remember Outcomes are NOT: • The child’s capacity to function under unusual or ideal circumstances • Necessarily the child’s performance in a structured testing situation • MOST IMPORTANTLY!!! • What are the typical functional skills and behaviors for this child across a variety of settings? The Sherlock Center on Disabilities at RI College and RI Department of Human Services

17. What do we need to know when filling out the COSF? • Understand the contents of the three outcomes • Understand age-expected child development • Understand age-expectations for a child functioning within the child’s culture • Know about the child’s functioning across settings and situations • Know how to use the rating scale The Sherlock Center on Disabilities at RI College and RI Department of Human Services

18. COSF Ratings 7 Completely • The child shows behaviors and skills expected in all or almost all everyday situations that are part of the child’s life • The child’s functioning is considered appropriate for age • No one has significant concerns about the child’s functioning in this outcome area The Sherlock Center on Disabilities at RI College and RI Department of Human Services

19. Outcome 3:Children will use appropriate behavior to meet their needs.Example: 28 month old child 7 Completely Child is independently mobile in all settings. Child dresses, brushes teeth, puts away own clothes, and eats independently. Child is able to communicate with a variety of people wants, needs, and asks for help using verbal language. Child remains safe in all settings, and demonstrates an understanding of rules at home and at childcare. The Sherlock Center on Disabilities at RI College and RI Department of Human Services

20. COSF Ratings 6 Between Completely and Somewhat • The child’s functioning is generally considered appropriate for age, but there are significant concerns about the child’s functioning in this outcome area The Sherlock Center on Disabilities at RI College and RI Department of Human Services

21. Outcome 3:Children will use appropriate behavior to meet their needs.Example: 28 month old child • 6 Between Completely and Somewhat Child is independently mobile in all settings. Child dresses, brushes teeth, puts away own clothes, and eats independently. Child is able to communicate with a variety of people wants, needs, and asks for help using verbal language most of the time. Child requires constant supervision at home due to safety concerns (jumps off furniture and throws objects). Child is able to follow rules, but this is more consistent when in a highly structured environment. The Sherlock Center on Disabilities at RI College and RI Department of Human Services

22. COSF Ratings • 5 Somewhat • The child shows functioning expected for age some of the time and/or in some situations • The child’s functioning is a mix of age-appropriate and not-appropriate function • The child’s functioning might be described as like that of a slightly younger child The Sherlock Center on Disabilities at RI College and RI Department of Human Services

23. Outcome 3:Children will use appropriate behavior to meet their needs.Example: 28 month old child • 5 Somewhat Child is independently mobile in all settings. Child is able to take clothes off independently, but needs help to finish dressing. Child can brush teeth with help, and eats independently with utensils. At times, the child needs a reminder to use verbal language to communicate with a variety of people his wants, needs and to ask for help. Child remains safe in all settings, and is more likely to demonstrate an understanding of rules at child care than at home. The Sherlock Center on Disabilities at RI College and RI Department of Human Services

24. COSF Ratings • 4 Between emerging and somewhat • Child shows some age appropriate functioning some of the time or in some situations or settings, but most of the child’s functioning would be described as not yet age appropriate • The child’s functioning might be described as that of a younger child The Sherlock Center on Disabilities at RI College and RI Department of Human Services

25. Outcome 3:Children will use appropriate behavior to meet their needs.Example: 28 month old child • 4 Between Somewhat and Emerging Child is independently mobile in all settings, although child tends to trip a lot when an object is in his way. Child dresses and undresses with adult help, brushes teeth with help, and eats most of a meal using utensils before using his fingers to self-feed. At times, the child needs a reminder to use verbal language to communicate with a variety of people his wants, needs and to ask for help. Child requires much supervision at home and at child care due to safety concerns. Child is beginning to follow some daily routine activities, but requires a lot of assistance and guidance with other rules and non-routine directions within his daily routine both at home and at child care. The Sherlock Center on Disabilities at RI College and RI Department of Human Services

26. COSF Ratings • 3Emerging • The child does not yet show functioning expected of a child his/her age in any situation • The child’s behaviors and skills include immediate foundational skills on which to build age appropriate functioning • The child’s functioning might be described as like that of a younger child The Sherlock Center on Disabilities at RI College and RI Department of Human Services

27. Outcome 3:Children will use appropriate behavior to meet their needs.Example: 28 month old child • 3Emerging Child has recently become stable with walking long distances, but still has times where he does fall especially if an object is in his path. Child needs assistance with dressing and undressing although he likes to try it on his own first. Child finger feeds to eat, is beginning to use utensils, but is very messy at meal times. Child has a limited vocabulary, but is using some single words to request favorite foods. Child will tug on his mother’s clothing to indicate he wants her help, but will usually resort to crying when he needs help at child care. Child can follow basic routine directions, and is beginning to follow other simple directions and commands with some guidance from an adult. The Sherlock Center on Disabilities at RI College and RI Department of Human Services

28. COSF Ratings • 2 Between Emerging and Not Yet • The child does not yet show functioning expected of a child his/her age in any situation • The child’s behaviors and skills have some of the immediate foundational skills on which to build age appropriate functioning, but these are not displayed often. • The child’s functioning might be described as that of a younger or much younger child The Sherlock Center on Disabilities at RI College and RI Department of Human Services

29. Outcome 3:Children will use appropriate behavior to meet their needs.Example: 28 month old child • 2Between Emerging and Not Yet Child is stable most of the time while walking, but will revert to crawling when he is tired. Child needs assistance with dressing and undressing although he likes to try it on his own first. Child finger feeds to eat, is beginning to use utensils, but is very messy at meal times. Child has a limited vocabulary, but is using some single words to request favorite foods. Child will usually cry or fuss when he needs help, but sometimes will tug on an adult’s clothing to gain their attention for help. Child will follow basic routine directions and simple commands if the adult pairs the command with a physical gesture. The Sherlock Center on Disabilities at RI College and RI Department of Human Services

30. COSF Ratings • 1 Not Yet • The child does not yet show functioning expected of a child his/her age in any situation • The child’s skills and behaviors also do not yet include any immediate foundational skills on which to build age-appropriate functioning • The child’s functioning might be described as like that of a much younger child • Child with 1 ratings still have skills, just not yet an immediate foundational skill The Sherlock Center on Disabilities at RI College and RI Department of Human Services

31. Outcome 3:Children will use appropriate behavior to meet their needs.Example: 28 month old child • 1Not Yet Child currently crawls to get from place to place and has pulled to stand on his sofa a few times. Child requires full assistance with dressing. Child finger feeds to eat at times, but is usually fed by an adult. Child drinks from a bottle, and is not able to drink from an open cup. Child will sometimes point to what he wants, but usually will cry, fuss, or tantrum when he is not understood by others. The Sherlock Center on Disabilities at RI College and RI Department of Human Services

33. Decision Tree Child: Julie Age: 30 months Outcome: 3 Summary: Julie is able to walk from place to place, but will fall if there is an object in her way. She will often bump into things and is a bit unbalanced on uneven surfaces (sand, grassy areas). Julie requires assistance to climb up and down stairs, and up an down from chairs that are not toddler height. Due to this, Julie is sometimes either unsafe in areas that are cluttered or at times unwilling to even approach an area that is cluttered or challenging. Julie can drink from an open cup, use utensils, change her clothes, and brush her teeth with adult assistance. Julie seems to be more independent with these skills at home than at her child care center as reported by her mother and child care teacher. Julie uses some intelligible single words to request foods (drink, cookie, more, banana) and to request favorite activities (book, dora, swing-to mean playground, nana-to mean grammas house). When she is not understood by others, or if she becomes frustrated while trying to do something for herself, she will immediately fall to the floor and tantrum. The Sherlock Center on Disabilities at RI College and RI Department of Human Services

34. Progress Y/N • The ECO Center defines progress as “the acquisition of at least one new skill or behavior related to the outcome” • Compares child to her/himself over time (not to same-age peers, as with the 1-7 ratings) • HINT: The answer should almost always be YES, unless the child has a degenerative or extremely disabling condition • “Impossible” – 1-7 ratings indicate growth but ‘no progress’ indicated The Sherlock Center on Disabilities at RI College and RI Department of Human Services

35. Where Do We Go From Here? • COSF data needs translation to interpret • Entry (1-7) + Exit (1-7) + Progress = Categories a-e The Sherlock Center on Disabilities at RI College and RI Department of Human Services

36. Category “a” • Child did not improve functioning from entry to exit • Child didn’t gain any new skills while in the program OR • Child regressed during the program • This category should include only those children with degenerative conditions or very significant disabilities The Sherlock Center on Disabilities at RI College and RI Department of Human Services

37. Child “a”: Sally • Sally was enrolled in EI at age 2 due to recent loss of some single words but was pointing to request preferred foods and toys • Sally was diagnosed with Rett Syndrome at age 25 months • At exit, Sally had no spoken language and had lost her ability to point to request things The Sherlock Center on Disabilities at RI College and RI Department of Human Services

38. Developmental Trajectory for “a” 7 Level of Development 6 5 4 3 2 1 Entry Exit Age in Months The Sherlock Center on Disabilities at RI College and RI Department of Human Services

39. Category “b” • Child who improved functioning but not sufficient to move nearer to functioning of same-age peers • Child who acquired new skills but grew at the same rate throughout their time in the program • Child made gains but did not change their rate of growth The Sherlock Center on Disabilities at RI College and RI Department of Human Services

40. Child “b”: Timmy • Timmy entered EI at age 2, and he was using a few single words to request, but his parents often could not understand his speech • By the time Timmy was 3, he was using more words at home but unfamiliar people still found his speech difficult to understand The Sherlock Center on Disabilities at RI College and RI Department of Human Services

41. Developmental Trajectory for “b” 7 Level of Development 6 5 4 3 2 1 Entry Exit Age in Months The Sherlock Center on Disabilities at RI College and RI Department of Human Services

42. Category “c” • Children who improved functioning to a level nearer but not equal to same-age peers • Child who accelerated their rate of growth during their time in the program • Child made progress toward “catching up” to peers but still functioning below age expectations • “Narrowed the gap” The Sherlock Center on Disabilities at RI College and RI Department of Human Services

43. Child “c”: Kareem • Kareem was enrolled in EI at 9 months of age because he was not sitting independently or crawling • By age 3, Kareem was walking skillfully but still required support to manage uneven surfaces when playing with peers in community settings (parks, library) The Sherlock Center on Disabilities at RI College and RI Department of Human Services

44. Developmental Trajectory for “c” 7 Level of Development 6 5 4 3 2 1 Entry Exit Age in Months The Sherlock Center on Disabilities at RI College and RI Department of Human Services

45. Category “d” • Children who improve functioning to reach a level comparable to same-age peers • Child who was functioning below age expectations when they entered program but are age-appropriate when they leave program • Child “caught up” while in the program The Sherlock Center on Disabilities at RI College and RI Department of Human Services

46. Child “d”: Maria • Maria lives in a bilingual home and entered EI at age 2 with a few Spanish single words, but was mostly pointing or getting things for herself • By age 3, Maria was a bit shy with new people until she became comfortable, but was consistently using 2- and 3-word phrases in both Spanish and English The Sherlock Center on Disabilities at RI College and RI Department of Human Services

47. Developmental Trajectory for “d” 7 Level of Development 6 5 4 3 2 1 Entry Exit Age in Months The Sherlock Center on Disabilities at RI College and RI Department of Human Services

48. Category “e” • Children who maintained functioning at a level comparable to same-age peers • Children who were functioning at age expectations when they entered the program and kept up with age expectations throughout their time in the program The Sherlock Center on Disabilities at RI College and RI Department of Human Services

49. Child “e”: Alex • Alex was enrolled in EI at 3 months of age due to a diagnosis of neurofibromatosis and possible risk for vision problems and developmental delays • Alex was discharged from EI at age 15 months of age because he had not developed vision problems and was age-appropriate in all areas of development The Sherlock Center on Disabilities at RI College and RI Department of Human Services

50. Developmental Trajectory for “e” 7 6 Level of Development 5 4 3 2 1 Entry Exit Age in Months The Sherlock Center on Disabilities at RI College and RI Department of Human Services