module 3 essential knowledge for completing the summary of functional performance every day, we are...

Module 3 Essential Knowledge for

Completing the Summary of Functional Performance

Every day, we are honored to take action that inspires the world to discover, love and nurture the greatness in all children.

Overview of modules

• Module 1: Setting the Stage: Global Child Outcomes and the SFP• Module 2: Learning More About the SFP and COS Rating • Module 3: Essential Knowledge for Completing the SFP and COS

Rating• Module 4: Guidance for Completing the SFP and COS Rating Within

the Team Process• Module 5: Understanding Age-expected Child Development,

Developmental Trajectories, and Progress• Module 6: Using COS Data to Inform Program Improvement at all

Levels

Kids' Potential, Our Purpose

How we learn about the child’s functioning across settings and situations


1. Good Assessment

DEC* recommended practices for assessment

Involve multiple sourcesExamples: family members, professional team members, service providers, caregivers

Involve multiple measuresExamples: observations, criterion- or curriculum-based instruments, interviews, norm-referenced scales, informed clinical opinion, work samples

*Division for Early Childhood of the Council for Exceptional Children


Assessment practices appropriate for outcomes measurement: ASHA*

ASHA recommended practices:

Gather information from families, teachers, other service providers

Collect child-centered, contextualized, descriptive, functional information

*American Speech-Language-Hearing Association


Listening and learning form parents is good assessment

See the discussion prompts on the ESIT website for possible questions to ask familieshttp://www.del.wa.gov/publications/esit/docs/ChildOutcomes_DiscussionPrompts.pdf

The Routines-Based Interview and other family-directed assessment tools offers lots of information

Check in with parents to see how the child is doing and incorporate this information into the SFP rating process


http://www.del.wa.gov/publications/esit/docs/ChildOutcomes_DiscussionPrompts.pdf



A domain score on an assessment tool does not translate into an outcome rating

Ratings require:

Looking at functional behaviors

Collecting and synthesizing input from many sources familiar with how what the child does in across different settings and situations

Thinking about functioning across all aspects of outcome content


Crosswalks


Many of the instruments used to assess young children have been cross walked by the three outcomeshttp://ectacenter.org/eco/pages/crosswalks.asp

Crosswalks are to be used to show what other sources of information may be needed.

http://ectacenter.org/eco/pages/crosswalks.asp

http://ectacenter.org/eco/pages/crosswalks.asp

Title—32 point font


Ratings are based on…

Types of informationCurriculum-based assessments (e.g., AEPS)

Norm-referenced assessments (e.g., BDI-2)

Developmental screenings (e.g., Ages & Stages)

Structured interviews (e.g., Routines Based Interview, Vineland-II)

Observation and reportKids' Potential, Our Purpose

Sources of informationParents and family members

Service providers

Therapists

Physicians

Child care providers

Teachers

People familiar with the child in all of the settings and situations that s/he is in

SFP: Documenting Assessment Instruments and Information Sources


Reflection

What other sources of information could you include in your assessment process in order to get more functional information about children’s development across settings and situations?


Essential knowledge for completing Summary of Functional Performance


2. Understand age-expected child development

Why do we intervene?

Development in young children follows a predictable course

Children who acquire new skills at a slower rate get further and further behind


Hypothetical Language Acquisition Rates for four Groups of Children: Change in Development Trajectory

(Progress toward Closing the Gap)

Child Development Resources can…

Help you identify the time period when skills often emerge in the general population

Remind you about the sequences in which the skills develop

Washington State Early Learning and Development Guidelineshttp://www.del.wa.gov/publications/development/docs/Guidelines.pdf


http://www.del.wa.gov/publications/development/docs/Guidelines.pdf

http://www.del.wa.gov/publications/development/docs/Guidelines.pdf

Resources for understanding age-expected child development

Website list: http://ectacenter.org/eco/assets/pdfs/Age-expected_Resources.pdf

CDC milestone lists by age

MEISR-COSF- routines by outcomes with approximate age levels

ND state compiled milestone lists in each outcome area by age


http://ectacenter.org/eco/assets/pdfs/Age-expected_Resources.pdf

http://ectacenter.org/eco/assets/pdfs/Age-expected_Resources.pdf

What age to use for comparisons?

For these ratings, use actual chronological age.

Do NOT correct for prematurity.

This way we can show the progress preemies make as their skills become closer to those of full-term children born at the same time.


Thinking about development in sequences

Skills build on each other to allow more complex behavior

Need to understand what skills are expected at a given age

Where is each child in the progression of skills


Looking at Development…


An example…


What are foundational skills?

Foundational skills are…

The skills and behaviors observed before immediate foundational skills

Skills and behaviors that occur earlier in development and serve as the foundation for later skill development

Teachers and interventionists often use foundational skills to help children move to the next level developmentally


Immediate foundational skills

The set of skills and behavior that occur developmentally just prior to age-expected functioning

Are the basis on which to build age-expected functioning


Caution: Interpreting age-expected skills

A child developing typically often demonstrates skills or behaviors that are not age-expected.

In other words…

Children continue to use the skills that developed at younger ages.


Essential Knowledge for Completing Summary of Functional Performance


3. Understand age expectations for child functioning within the

child’s culture

Age appropriateness and culture

The age appropriateness of some behaviors varies across cultures

Especially those related to independence and self care

Important for working with the child and for completing the Summary of Functional Performance to understand expectations within the child’s culture


Reflection

How would you explain immediate foundational and foundational skills to a new teammate?


Essential knowledge for completing the Summary of Functional Performance


4. Understand the content of the three child

outcomes


The 3 Child Outcomes

http://fpg.unc.edu/~eco/assets/media/ChildOutcomesStepByStep-captioned.mov



Outcome 1: 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:Attachment/separation/autonomy

Expressing emotions and feelings

Learning rules and expectations

Social interactions and social play


Outcome 2: Children acquire and use knowledge and skills

Thinking

Reasoning

Remembering

Problem solving

Using symbols and language

Understanding physical and social worlds


Early conceptssymbols

pictures

numbers

Imitation

Acquiring vocabulary

Early literacy

Another slide on literacy

For infants and toddlers, early literacy and communication includes:

Looking at caregivers, objects and pictures

Early social turn-taking games (Peek-A-Boo)

Producing sounds, babbling, and early gestural communication (pointing, reaching, using sign language)

Patting pictures in a book, helping to flip pages


Another slide on numeracy

For infants and toddlers, early numeracy might include:

Concept of “more”

Early rote counting (1, 2, 3)

Concepts of “one” and “all”


Outcome 3: 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

Functional child outcomesFunctional

Refer to things that are meaningful to the child in the context of everyday living

Refer to an integrated series of behaviors or skills that allows the child to achieve the important everyday goals

Meaningful behaviors in meaningful context – what child usually does in situations (crosses domains)

NOT – unusual, isolated circumstances, only in structured, specific standardized, elicited situations

See http://ectacenter.org/eco/assets/pdfs/Functional_outcomesHO.pdf


http://ectacenter.org/eco/assets/pdfs/Functional_outcomesHO.pdf

http://ectacenter.org/eco/assets/pdfs/Functional_outcomesHO.pdf

Functional Assessment

Our Focus Shifts

From ToKnows how to make eye contact, smile, and give a hug

Initiates affection toward caregivers and respond to others’ affection

Knows how to imitate a gesture when prompted by others

Watches what a peer says or does and incorporate it into his/her own play

Uses finger in pointing motion Points to indicate needs or wants

Shows a skill in a specific situation

Uses a skill in actions across settings and situations to accomplish something meaningful to the child

Outcomes Jeopardy

Pointing to the cabinet for cereal

Can tell you his name

Eats with a spoon

Biting Plays by himself in child care

Points to pictures in a book

Building a house from blocks with

a friendProblems sleeping Sharing a cookie

at lunchtime

$100

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Outcomes Jeopardy




Eats with a spoon

Outcome 2 or 3, depending on context

Outcome 1, 2 or 3 depending on the context in which he is telling

you his name

Outcome 3

Outcomes Jeopardy



Eats with a spoon





at lunchtime

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Outcomes Jeopardy


Biting

Plays by himself in child care


Outcome 1, 2 or 3, depending on how biting is affecting the child’s

functioning

Outcome 1

Outcome 2

Outcomes Jeopardy



Eats with a spoon





at lunchtime

$100

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$200$200

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$300

Outcomes Jeopardy



a friend

Problems sleeping

Sharing a cookie at lunchtime

Outcomes 1 and 2

Outcome 1, 2 or 3 depending on how the lack of sleep is affecting

the child’s functioning

Outcome 1 or 3

Essential Knowledge for Completing the Summary of Functional Performance


5. Know how to use the rating scale

Descriptor Statements


There are 7 categories of ratings

Instead of identifying a number, the team selects a descriptor statement which corresponds to a rating

For each of the 7 rating categories, there are several “descriptor statements” that describe and summarize how the child is functioning in the outcome area

Descriptor statements are selected verbatim in the data system. The data system inserts the child’s name in the statement and associates the statement with a rating for later reports

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


7 Descriptor Statements

For a child whose functioning in the outcome is completely age appropriate, choose one of the following descriptor statements:

• Relative to other children [CHILD’S NAME]’s age, he has all of the skills that we would expect of a child his age in the area of (outcome [e.g., taking action to meet needs]). • [CHILD’s NAME] has a good mix of age expected skills in the area of (outcome).

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



For a child whose functioning is currently age-appropriate, but where there are substantial concerns that may interfere with maintaining age-expected functioning:

• Relative to same-age peers, [CHILD] has the skills that we would expect of her age in regard to (outcome); however, there are concerns with how she [insert functional area of concern].• Aside from the concern regarding, [CHILD] is demonstrating skills expected of a child her age in the area of (outcome).

Common confusion

Summary Rating ≠ EligibilityRatings reflect child’s functioning NOW, not anticipating future delays associated with a child’s diagnosis or condition

Ratings do NOT correct for prematurity – use actual chronological age

Ratings ARE based on functioning with whatever assistive technology is typically available in everyday settings

Ratings reflect child’s FUNCTIONAL use of skills across settings now, not discrete skills a child has, but doesn’t use.


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



For a child whose functioning show a mix of age-appropriate and not age-appropriate skills:

• For a # month old child, [CHILD] has many skills expected of his age, but he also demonstrates some skills slightly below that expected at the age in the area of (outcome).• Relative to same age peers, [CHILD] shows many age-expected skills, but continues to show some functioning that might be described like that of a slightly younger child in the area of (outcome).• [CHILD] is somewhat where we would expect him to be at this age. This means that [CHILD] has many skills we would expect at his age in regard to (outcome), but he does not yet have all of the age-expected skills.

4

Child shows occasional age-appropriate functioning across settings and situations

More functioning is not age-appropriate than age-appropriate.



For a child whose functioning show a mix of age-appropriate and not age-appropriate skills where more of the skills are not yet age-appropriate:

• At # months, [CHILD] shows occasional use of some age-expected skills, but more of his skills are not yet age-expected in the area of (outcome).•At # months, [CHILD] shows occasional use of some age-expected skills, but has more skills that are younger than those expected for a child his age in the area of (outcome).• [CHILD] has a few of the skills we would expect in regard to (outcome), but he shows more skills that are not 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



For a child whose functioning is not yet showing age-appropriate skills and most or all of the time includes immediate foundational skills:

• Relative to same age peers, [CHILD’S NAME] is not yet using skills expected of his age. He does however use many important immediate foundational skills to build upon in the area of (outcome).

• In the area of (outcome), [CHILD’S NAME] is nearly displaying age-expected skills. This means that he does not yet have the skills we would expect of a child his age. He has the immediate foundational skills that are the building blocks to achieve age-appropriate skills.

2

Child occasionally uses immediate foundational skills across settings and situations

More functioning reflects skills that are not immediate foundational than are immediate foundational


2 Descriptor StatementsFor a child whose functioning is not yet showing age-appropriate skills and occasionally uses immediate foundational skills:

• At # months, [CHILD] shows occasional use of some immediate foundational skills that will help him move toward age-appropriate skills. More of his functioning displays earlier skills in the area of (outcome).• Relative to same age peers, [CHILD] is showing some immediate foundational skills, but has more skills that developmentally come in earlier in the area of (outcome).• For a # month old, [CHILD] occasionally uses immediate foundational skills, but has a greater mix of earlier skills that he uses in the area of (outcome).• Overall in the outcome area, [CHILD] is just beginning to show some immediate foundational skills which will help him work toward age appropriate skills.

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



For a child whose functioning includes foundational, but not yet age-appropriate or immediate foundational skills:

• Relative to same age peers, [CHILD] has very early skills in the area of (outcome). This means that [CHILD] has the skills we should expect of a much younger child in this outcome area.• For a # month old, [CHILD] shows early skills in the outcome area. She does not yet show age-expected skills or the skills that come right before those.

Common confusion

Children with descriptor statements equivalent to 1 still display many skills

Skills are just at a foundational level


Assistive technology

If the child regularly uses assistive technology, rate the child’s level of functioning with the assistive technology.


Rating Scale Jeopardy

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

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concerns

Mix of age appropriate and not age

appropriate functioning

No age appropriate functioning – not yet showing immediate foundational skills

Rating = 7

Rating = 4 or 5

Rating = 1



concerns





foundational skills



No age appropriate


foundational skills


some concerns





$100 $100

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Some age appropriate functioning but very

little

No age appropriate functioning – lots of

immediate foundational skills

Age appropriate functioning – some

concerns

Rating = 4

Rating = 3

Rating = 6



concerns





foundational skills



No age appropriate


foundational skills


some concerns





$100

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$200$200

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$300




No age appropriate functioning – some

immediate foundational skills


Rating =4

Rating =2

Rating = 6 or 7

Summary of Functional Performance Ratings


Essential Knowledge for Completing the Summary of Functional Performance


Use the Decision Tree!


http://www.ectacenter.org/eco/assets/pdfs/Decision_Treenonumbers.pdf

Reflection

How could you incorporate the decision tree into your team Summary of Functional Performance process?


Resources

ESIT Early Intervention Training Modules- Module 2: Functional Assessmenthttp://www.del.wa.gov/development/esit/training.aspx

At A Glance: Summary of Functional Performance Decisionshttp://www.del.wa.gov/publications/esit/docs/child_outcomes_Decision_Tree_glance.pdf


http://www.del.wa.gov/development/esit/training.aspx

http://www.del.wa.gov/development/esit/training.aspx

http://www.del.wa.gov/publications/esit/docs/child_outcomes_Decision_Tree_glance.pdf



Resources


Changes to the Child Outcomes Summary Process in ESIT’s Re-designed IFSPhttp://www.del.wa.gov/publications/esit/docs/Child_Outcomes_Summary_IFSP_integrated_120111.pdf

Who Wants to Be A Millionaire? Outcomes Rating Scale Activityhttp://ectacenter.org/eco/pages/training_activities.asp#millionaire

http://www.del.wa.gov/publications/esit/docs/Child_Outcomes_Summary_IFSP_integrated_120111.pdf



http://ectacenter.org/eco/pages/training_activities.asp#millionaire



Coming Next


Module 1: Setting the Stage: Global Child Outcomes and the SFP

Module 2: Learning More about the SFP and COS Rating

Module 3: Essential Knowledge for Completing the SFP and COS Rating

Module 4: Guidance for Completing the SFP and COS Rating Within the Team Process

Module 5: Understanding the Age-Expected Child Development, Developmental Trajectories and Progress

Module 6: Using COS Data to Inform Program Improvement at All Levels

module 3 essential knowledge for completing the summary of functional performance every day, we are...

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