module 3 essential knowledge for completing the summary of functional performance every day, we are...
TRANSCRIPT
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
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How we learn about the child’s functioning across settings and situations
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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
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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
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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
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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
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Crosswalks
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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.
Title—32 point font
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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
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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?
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Essential knowledge for completing Summary of Functional Performance
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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
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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
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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
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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.
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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
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Looking at Development…
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An example…
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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
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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
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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.
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Essential Knowledge for Completing Summary of Functional Performance
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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
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Reflection
How would you explain immediate foundational and foundational skills to a new teammate?
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Essential knowledge for completing the Summary of Functional Performance
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4. Understand the content of the three child
outcomes
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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
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Outcome 2: Children acquire and use knowledge and skills
Thinking
Reasoning
Remembering
Problem solving
Using symbols and language
Understanding physical and social worlds
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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
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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”
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Outcome 3: Children take appropriate action to meet their needs
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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
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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
$200
$100
$300
$200
$300
$200
$100
$300
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
$200
$100
$300
$200
$300
$200
$100
$300
Outcomes Jeopardy
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Pointing to the cabinet for cereal
Can tell you his name
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
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$200$100
$300
$200
$300
$100
$300
$200
Outcomes Jeopardy
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Biting
Plays by himself in child care
Points to pictures in a book
Outcome 1, 2 or 3, depending on how biting is affecting the child’s
functioning
Outcome 1
Outcome 2
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
$200
$100
$200$200
$100
$300$300
$300
Outcomes Jeopardy
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Building a house from blocks with
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
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5. Know how to use the rating scale
Descriptor Statements
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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
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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
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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
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6 Descriptor Statements
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.
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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
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5 Descriptor Statements
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.
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4 Descriptor Statements
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
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3 Descriptor Statements
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
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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
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1 Descriptor Statements
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
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Assistive technology
If the child regularly uses assistive technology, rate the child’s level of functioning with the assistive technology.
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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
$100
$200
$100
$300
$200
$300
$200
$100
$300
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
$100
$200
$100
$300
$200
$300
$200
$100
$300
Rating Scale Jeopardy
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Age appropriate functioning – no
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
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
$100 $100
$300$300
$100
$300
$200$200
$200
Rating Scale Jeopardy
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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
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
$100
$200
$100
$200$200
$100
$300
$300
$300
Rating Scale Jeopardy
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Rarely shows age appropriate functioning
No age appropriate functioning – some
immediate foundational skills
Age appropriate functioning
Rating =4
Rating =2
Rating = 6 or 7
Summary of Functional Performance Ratings
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Essential Knowledge for Completing the Summary of Functional Performance
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Use the Decision Tree!
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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?
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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
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Resources
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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
Coming Next
Kids' Potential, Our Purpose
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