hawai’i january, 2008 progress toward measuring goals in early intervention: what’s new from...
TRANSCRIPT
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Hawai’iHawai’iJanuary, 2008January, 2008
Progress toward Measuring Progress toward Measuring Goals in Early Intervention: Goals in Early Intervention:
What’s New from What What’s New from What CountsCounts
Kathy HebbelerKathy HebbelerECO at SRI InternationalECO at SRI International
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 2
ObjectivesObjectives
Review why data are being collected Describe national trends Identify and address challenges to
good data Discuss some preliminary data from
Hawai’i
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 3
Why are we doing this?
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 4
Keeping our eye on the prize:
High quality services for children and
families that will lead to good outcomes.
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 5
High Quality Data on OutcomesHigh Quality Data on Outcomes
Data are a piece of a system that helps to achieve overarching goals for children and families
Data yield Findings that can be interpreted as
having a particular meaning that should lead to specific actions to improve the system.
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Prof’l Development•Preservice•Inservice
System for Producing Good Child and System for Producing Good Child and Family OutcomesFamily Outcomes
Good Federal policies and programs
Good State policies and programs
High quality services and supports for children 0-5 and their families
Good outcomes for children and families
Good Local policies and programs
Adequate funding
Strong Leadership
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 7
The Vision: Using Data as a Tool for The Vision: Using Data as a Tool for Program ImprovementProgram Improvement
Hawai’i will have quality data available on an ongoing basis about multiple components of the system Goals for children and families Services provided Personnel (types, qualifications, etc.) Etc.
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 8
Driving Force for Data on Child Goals Driving Force for Data on Child Goals Comes from the Federal LevelComes from the Federal Level
Government Performance and Results Government Performance and Results
Act (GPRA)Act (GPRA)
Program Assessment Rating Tool (PART)Program Assessment Rating Tool (PART)
Individuals with Disabilities Education Individuals with Disabilities Education
Act (IDEA)Act (IDEA)
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 9
Requires goals and indicators be
established for IDEA Indicators and data collection further
along for school age population than
for EC Previously, for early childhood data
had been collected on:
• Number of children served (Part C)
• Settings (both Part C and 619)
Government Performance and Results Government Performance and Results Act (GPRA) passed in 1993Act (GPRA) passed in 1993
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 10
130 programs examined in 2002; 50%
programs had no performance data
Programs looking at inputs, not results
Part C and Section 619
No long-term child outcome goals or data
Need to develop a strategy to collect
annual performance data in a timely
manner
OSEP: PART evaluation results (2002)OSEP: PART evaluation results (2002)
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 14
Federal Funding for Early InterventionFederal Funding for Early Intervention
Total U.S. Hawai’i
2004 $444,362,700 $2,177,738
2005 $440,808,096 $2,160,317
2006 $436,399,920 $2,138,714
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 15
SEC. 616. <<NOTE: 20 USC 1416.>> MONITORING, TECHNICAL ASSISTANCE, AND ENFORCEMENT. ``(a) Federal and State Monitoring.-…..…..``(2) Focused monitoring.--The primary focus of Federal and State monitoring activities described in paragraph (1) shall be on-- ``(A) improving educational results and functional outcomes for all children with disabilities;
Individuals with Disabilities Education ActIndividuals with Disabilities Education Act
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 16
Where are we now:
Federal reporting requirements
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 17
OSEP Reporting Requirements: OSEP Reporting Requirements: the Goals the Goals
Positive social emotional skills (including positive social relationships)
Acquisition and use of knowledge and skills (including early language/ communication [and early literacy])
Use of appropriate behaviors to meet their needs
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 18
OSEP Reporting CategoriesOSEP Reporting Categories
Percentage of children who:
a. Did not improve functioning
b. Improved functioning, but not sufficient to move nearer to functioning comparable to same-aged peers
c. Improved functioning to a level nearer to same-aged peers but did not reach it
d. Improved functioning to reach a level comparable to same-aged peers
e. Maintained functioning at a level comparable to same-aged peers
3 outcomes x 5 “measures” = 15 numbers
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 19
Reporting ScheduleReporting Schedule
Reported February 2007 Entry information: Age
expected? Yes, No One time requirement Reported for children
entering between July 1, 2005, and June 30, 2006
Due February 2008 Data in reporting
categories at exit for all children who have been in the program for at least 6 months
Must be reported for the year beginning July 1, 2006
Repeat with next year’s data in 2009, etc.
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 20
AlsoAlso
States are required to Make public data reported to OSEP Analyze state data by program (i.e.,
compute a through e for each program) Make public the data by program
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Concept of Develomental Trajectory
0
10
20
30
40
50
60
70
1 6 11 16 21 26 31 36 41 46 51 56Age in Months
Sco
re
Typical development Atypical or delayed development
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Illustration of 5 Possible Develomental Trajectories
0
10
20
30
40
50
60
70
1 6 11 16 21 26 31 36 41 46 51 56Age in Months
Sco
re
Maintained functioning comparable to age peersAchieved functioning comparable to age peersMoved nearer functioning comparable to age peersMade progress; no change in trajectoryDid not make progress
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Change over 3 time points
0
5
10
15
20
25
30
35
40
45
1 6 11 16 21 26 31 36 41 46 51 56Age in Months
Sco
re
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Goal Ratings and Developmental Trajectories
Age in Months
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 25
Point of clarificationPoint of clarification
“Why are we comparing children with delays and disabilities to typically
developing children?”
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 26
Point of clarificationPoint of clarification
Process is NOT about comparing groups of children – it IS about asking how close children are to being able to do what is expected at their age
Early learning guidelines Kindergarten and access to the
general curriculum
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Source: National Early Intervention Longitudinal Study
Disability and Special Education Status in Kindergarten of Former EI Participants
32%
10%
58%No IEP, No Disability
No IEP, Disability
IEP
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 28
Where are we now:
State decisions and activities
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 29
To respond to federal
reporting requirements
To meet provider/teacher, local and/or state need for outcome
information and
to respond to federal reporting
requirements
Purpose
WHY?
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 30
State approaches State approaches Most states have embraced outcomes
measurement and are collecting outcomes data for their own purposes.
Many states are building bigger systems than needed to produce the federal data.
Go to www.the-eco-center.org for more information about what other states are doing
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 31
How are states collecting child How are states collecting child outcomes/goal data? outcomes/goal data?
Possible state approaches to collection of child data Child Outcomes Summary Form (COSF)
[= Early Intervention Child Goals Summary Form in HI]
Publisher’s online assessment system Single assessment statewide Other approaches
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 32
State approaches to measurement State approaches to measurement for Part C child outcomesfor Part C child outcomes
40 states using the ECO Child Outcomes 40 states using the ECO Child Outcomes Summary Form (COSF)Summary Form (COSF)
8 states using 1 assessment tool 8 states using 1 assessment tool statewidestatewide
3 states using on-line assessment 3 states using on-line assessment systems with the capacity to report OSEP systems with the capacity to report OSEP data reportsdata reports
5 states using other unique approaches5 states using other unique approaches
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 34
Variations across states in CGSF Variations across states in CGSF implementationimplementation
Some states started early (HI); some did not start until mid to late 2007
Some states completing at IFSP; others at a separate meeting
Some states including parents in the discussion; some are not
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 35
Where states are nowWhere states are now
First data on 5 categories due to OSEP February 3
Many states do not have data on many children yet
Many states focusing on improving the process of collecting the data
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 36
What do we know so far:
Positive impacts of the goals rating process
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 37
Positive impacts reported by statesPositive impacts reported by states
Increases focus on functional outcomes on IFSPs
Easier to write functional outcomes on IFSP
Facilitates communication with parents
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 38
Benefits of discussing the 3 goalsBenefits of discussing the 3 goals
“Requires us to talk & think in terms of functional behaviors, not test items
Incorporates the parents as active and knowledgeable participants
Looks at all settings and situations Bridges the gap between assessment
tools and real life.”From presentation by Sandi Harrington, Norfolk, VA Infant Development Program, at the OSEP EC Meeting, December 2007
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 39
BenefitsBenefits
“Is more meaningful to families Prepares the family for setting IFSP
outcomes – thinking about the skills they want their child to have to function in their daily family life
Guides us towards discipline-free contextualized goals.”
From presentation by Sandi Harrington, Norfolk, VA Infant Development Program, at the OSEP EC Meeting, December 2007
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 40
Benefits of INCLUDING familiesBenefits of INCLUDING families
“Determining child progress requires we use the family’s expertise and knowledge of their child across setting and situations
Our discussion becomes more inclusive with the family as an equal source of information for assessment purposes.”
From presentation by Sandi Harrington, Norfolk Infant Development Program, at the OSEP EC Meeting, December 2007
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 41
Benefits of INCLUDING familiesBenefits of INCLUDING families
“One of the biggest shifts in practice, for many systems, was the move to compare their children in Part C to their same age peers.
Looking to children in the frame of same age peers allows us to have authentic, honest discussions with families about their child’s strengths and needs.”
From presentation by Sandi Harrington, Norfolk Infant Development Program, at the OSEP EC Meeting, December 2007
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 42
Benefits of INCLUDING familiesBenefits of INCLUDING families
“We need to be comfortable with reporting strengths AND areas of delay, while being family friendly.”
From presentation by Sandi Harrington, Norfolk Infant Development Program, at the OSEP EC Meeting, December 2007
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 43
What do we know so far:
Challenges to getting good information
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 44
Need for good dataNeed for good data
Encompasses all three levels: federal, state, local
Depends on how well local programs are implementing procedures
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 45
What we are learning nationallyWhat we are learning nationally
The process of training for child outcomes data collection has uncovered other areas of significant need related to professional development.
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 46
Essential Knowledge for Completing Essential Knowledge for Completing the Child Goals Summary Form the Child Goals Summary Form
Between them, team members must:
1. Know about the child’s functioning across settings and situations
2. Understand age-expected child development
3. Understand the content of the three child outcomes
4. Know how to use the rating scale
5. Understand age expectations for child functioning within the child’s culture
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 47
Important pointImportant point
It is not necessary that all team members be knowledgeable in all 5 areas
Especially, no expectation that parents understand the rating scale or typical child development
But the professionals have to!
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 48
Providers need to know more about: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
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 49
Providers need to know more about: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? Typical child development
What are the functional expectations for children at different ages with regard to each of the 3 goal statements?
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 50
Is this process too subjective to produce Is this process too subjective to produce good data?good data?
Best practices in assessment requires looking at multiples sources of information
Assessment as a tool vs. assessment as a process
Research on judgment-based assessment indicates it is as good or better than traditional assessment
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 51
What is informed opinion?What is informed opinion?
Clinical judgment (informed opinion) – knowledgeable perceptions of caregivers and professionals about the elusive and subtle capabilities of children in different settings
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 52
Clinical judgment provides good data Clinical judgment provides good data when….when….
Operational definition of child characteristics to be judged
Structured format for quantifying characteristics
Information from multiple setting and individuals
Training in methods that structure and quantify characteristics
Decision making based on consensus From Bagnato, Smith-Jones, Matesa & McKeating-
Esterle, 2006
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 54
Ratings clarificationRatings clarification
Highest category (Completely, 7) = Child functions in an age appropriate manner across settings and situations
Next highest (6) – Child functions in an age appropriate manner but there is a significant concern about some aspect of the child’s functioning
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 55
Ratings clarificationRatings clarification
Somewhat (5) = Child shows a MIX of age appropriate and not age appropriate behaviors across settings and situations
Between emerging and somewhat (4) – Child shows some age appropriate behavior but rarely
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 56
Ratings clarificationRatings clarification
Emerging (3) – No age appropriate behavior yet. Shows immediate foundational skills in some to all settings and situations
Between not yet and emerging (2) – No age appropriate behavior yet. Rarely uses immediate foundational skills (but does show some).
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 57
Ratings clarificationRatings clarification
Not yet (1) – No age appropriate behavior yet. No immediate foundational skills yet.
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 58
Should the rating be whatever parents Should the rating be whatever parents want?want?
No, the rating is a team consensus Need to think about what and how
parents are being involved in this process
Have the assessment results been thoroughly explained?
Like so much in EI, the rating requires a partnership
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 59
Thinking about relating to adults, relating to other children, and (for those older than 18 months) following rules related to groups or interacting with others.
Δ How does the child relate to his/her parent(s)?
Δ How does the child relate to other relatives or extended family and close family friends (e.g., grandparents, aunts, extended kin, etc.)? Do these interactions with people differ depending on the setting the child is in with these people? Δ How does the child interact with familiar caregivers (e.g., child care providers, babysitters)?
Δ How does the child relate to strangers? At first? After a while? In different settings and using different approaches?
Δ How does the child interact with/respond to people in community settings (e.g., park, library, church, grocery store, with neighbors on walks, at the bus stop, in restaurants, at playgroups or outings, etc.)?
….
ECO Discussion Prompts: Child has positive social relationships (see ECO Tools)
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 60
Obtaining good dataObtaining good data
Threats to good data Local providers do not understand the
procedures Local providers do not follow the procedures And others…..
Process requires good training procedures Initial Ongoing
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 61
Many steps to ensuring quality dataMany steps to ensuring quality data
Before
Information sharing
Good data collection/Training
Good data system
During
Ongoing supervision
Feedback
Refresher training
AfterMonitoring
Validity analyses
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 62
Initial Data from Hawai’i
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 63
These data are very, very preliminary.
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EIS First IFSP Ratings (n=1774)
0%
20%
40%
60%
80%
1 2 3 4 5 6 7
Child Goals Ratings
Pe
rce
nta
ge
of
Ch
ildre
n
SE Skills
Acq Use
Appr Action
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 65
EIS Average Ratings at Initial IFSPEIS Average Ratings at Initial IFSP
Social-Emotional
Skills
Acquire and Use
Knowledge and Skills
Appropriate Action
EIS
(N=1774)5.9 5.3 5.1
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Healthy Start First IFSP Ratings (n =1311)
0%
20%
40%
60%
80%
1 2 3 4 5 6 7
Child Goals Ratings
Pe
rce
nta
ge
of
Ch
ildre
n
SE Skills
Acq Use
Appr Action
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 67
HS Average Ratings at Initial IFSPHS Average Ratings at Initial IFSP
Social-Emotional
Skills
Acquire and Use
Appropriate Action
HS
(N=1311) 6.4 6.4 6.4
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Goal 1: SE Skills for HS and EIS at First IFSP
0%
20%
40%
60%
80%
1 2 3 4 5 6 7
Child Goals Rating at First IFSP
Pe
rce
nta
ge
of
Ch
ildre
n
Healthy Start (n=1311)
EIS (n=1774)
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Goal 2: Acquire and Use Knowledge and Skills for HS and EIS at First IFSP
0%
20%
40%
60%
80%
1 2 3 4 5 6 7
Child Goals Rating at First IFSP
Pe
rce
nta
ge
of
Ch
ildre
n
Healthy Start (n=1311)
EIS (n=1777)
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Goal 3: Appropriate Action to Meet Needs for HS and EIS at First IFSP
0%
20%
40%
60%
80%
1 2 3 4 5 6 7
Child Goals Rating at First IFSP
Pe
rce
nta
ge
of
Ch
ildre
n
Healthy Start (n=1311)
EIS (n=1774)
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HS Rating for Social Skills at Initial IFSP by Island
0.00
0.20
0.40
0.60
0.80
1.00
1 2 3 4 5 6 7
Rating
%
Hawaii (n=344) Kauai (n=78) Maui (n=151) Oahu (n=736)
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EIS Knowledge and Skills at Entry and Exit (N=115)
0
10
20
30
40
50
60
1 2 3 4 5 6 7
# o
f C
hil
dre
n
Entry Exit
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HS S oc ial S kills at E ntry and E x it (N=60)
0
20
40
60
80
1 2 3 4 5 6 7
R a ting
# o
f C
hil
dre
n
Initial
E x it
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EIS Entry and Exit Rating for Knowledge and Skills (N=115)
0
2
4
6
8
10
12
14
16
18
20
1 2 3 4 5 6 7
Entry rating
# o
f ch
ild
ren
3 4 5 6 7
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Healthy S tart E ntry and E xit R ating for Appropriate Ac tion (N=81)
0102030405060
1 2 3 4 5 6 7E ntry R a ting s
# of
chi
ldre
n
1 2 3 4 5 6 7
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EIS: 6 Month Review Ratings by Entry Rating for Appropriate Action (N=691)
0
20
40
60
80
100
1 2 3 4 5 6 7
Entry
# o
f ch
ild
ren
1 2 3 4 5 6 7
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Appropriate Action
Review Rating
Initial_3B 1 2 3 4 5 6 7 total
1 1 4 2 7
2 1 1 5 6 9 3 1 26
3 2 15 14 27 19 6 83
4 4 4 21 39 28 12 108
5 1 12 14 71 86 48 232
6 1 3 21 48 63 136
7 2 18 23 56 99
Review Total 2 13 38 60 185 207 186 691
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Another State: OSEP Categories for Another State: OSEP Categories for Goal 1 by Exit StatusGoal 1 by Exit Status
OSEP Categ
ALL Exite
d
a 1%
b 5%
c 39%
d 44%
e 12%
N= 893
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Another State: OSEP Categories for Another State: OSEP Categories for Outcome 1 by Exit StatusOutcome 1 by Exit Status
OSEP Cate
gExited
Before 3Exited at 3
ALL Exite
d
a 1% 1% 1%
b 2% 6% 5%
c 19% 45% 39%
d 57% 39% 44%
e 22% 9% 12%
N= 231 662 893
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Another State: OSEP Categories for Another State: OSEP Categories for Outcome 1 by Exit StatusOutcome 1 by Exit Status
OSEP Cate
gComplete
d IFSPExited
Before 3Exited at 3
ALL Exite
d
a 0% 1% 1% 1%
b 1% 2% 6% 5%
c 12% 19% 45% 39%
d 65% 57% 39% 44%
e 22% 22% 9% 12%
N= 156 231 662 893
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 81
Questions to askQuestions to ask
Do the data make sense? Am I surprised? Do I believe the data?
Believe some of the data? All of the data?
If the data are reasonable (or when they become reasonable), what might they tell us?
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 82
ValidityValidity
Validity refers to the use of the information Does evidence and theory support the
interpretation of the data for the proposed use?
Or Are you justified in reaching the conclusion
you are reaching based on the data? Standards for Educational and Psychological Testing (1999) by
American Educational Research Association, American Psychological Association, National Council on Measurement in Education
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 83
How will/might these data be used?How will/might these data be used?
Federal level Overall funding decisions (accountability) Resource allocation (e.g., what kind of TA to fund?) Decisions about effectiveness of program in individual
states State level
Program effectiveness?? Program improvement??
Local level Program improvement??
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 84
What has ECO learned after 4+
years?
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 85
ECO Message: Strong commitmentECO Message: Strong commitment
States are committed to building good systems to collect data on how children are progressing Variations in how data are being collected Variations in how states plan to use the
information
Common thread: Widespread recogniton of the importance of the data
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 86
ECO Message: Need to build state ECO Message: Need to build state capacitycapacity
Implement oversight procedures around data quality
Examine data for validity Analyze and interpret data for program
improvement Develop messages for policy-makers,
public, media, families from the data
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 87
ECO Message: Need to build ECO Message: Need to build provider capacityprovider capacity
Assessment Functional outcomes Typical child development
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 88
ECO Message: Need for better ECO Message: Need for better early childhood assessment toolsearly childhood assessment tools
Designed around the 3 functional outcomes for all children
Designed to capture child functioning in a variety of setting and situations
Designed to be used in accountability and program evaluation
Current tools are antiquated: Need to incorporate latest research,
recommended practices, psychometrics
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 89
ECO Message: Need for more ECO Message: Need for more resources to ensure quality dataresources to ensure quality data
National resources to support and coordinate across states: Training needs Analysis and use of data
Support for states to continue to develop and validate their systems
Investment in research to examine how outcomes data collection being carried out (impact on quality, local practice, etc.)
Investment in new assessment tools
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 90
Change can be difficult….
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 91
For more information….
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 93
http://hawaii.gov/health/family-child-health/eis/whatcounts.html
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Early Childhood Outcomes CenterEarly Childhood Outcomes Center 95
www.the-eco-center.org