module 4 guidance for completing the sfp and cos rating within the team process every day, we are...

Module 4Guidance for Completing the

SFP and COS Rating Within the Team Process

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

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 Age-expected Child Development,

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

Levels

The Present Levels of Development (PLODs)The PLODs are intended to:

Be a brief summary of assessment results by domain

Focus on what the child can and cannot yet do

Include the child’s developmental level (e.g., % delay, age-equivalent, standard deviations)

Be used to determine eligibility for Part C services

See the IFSP Resource Guide: http://www.del.wa.gov/publications/esit/docs/IFSP_Resource_Guide.pdf


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

By Comparison: The Summary of Functional Performance and COS

For each outcome, you will:Synthesize all information about the child and provide a brief summary of the child’s functioning across settings and situations in that outcome area

Select a “descriptor statement” that best matches the child’s functioning relative to age expectations


Differences


SFP vs. PLODs

Summary of Functional Performance (SFP)

Present Levels of Development (PLODs)

Emphasis on… Functional use of skills in everyday situations

Performance through the lens of assessment measures

Settings… Emphasizes functioning across settings and situations and with different caregivers

Emphasizes mostly the skills displayed in specific assessment situations

Skills… Describes holistic picture of child’s skills across domains in the service of each outcome

Focuses on skills specific to each domain

For comparison provides…

Information about how child uses skills relative to what is observed in other children the same age

Scores relative to other children in assessment sample (standardized score)

Uses… Provides qualitative information to translate into patterns of progress for accountability reporting. It also may help inform development of specific goals for child and intervention activities.

Provides quantitative information that may be helpful for eligibility determinations or to track extent of changes over time.

SFP vs. PLOD Knowledge Check


1. True or FalseThe SFP is an open space on the IFSP to repeat and re-emphasize statements about a child’s skills that were recorded on the PLOD.

2. True or FalseThe SFP is useful for determining the child’s program eligibility.

SFP vs. PLOD Knowledge Check


1. True or False: The SFP is an open space on the IFSP to repeat and re-emphasize statements about a child’s skills that were recorded on the PLOD.

False

2. True or False: The SFP is useful for determining the child’s program eligibility.

False

Completing a Summary of Functional Performance for Each Outcome

Do not simply repeat PLOD statementsThe summary should paint a picture of how the child uses his/her skills in everyday functioning

Specifics about what the child does and howSpecifics about that the child does not yet do

Example: Alex has three words: Mama, Dada, and NoPLODs: Alex has three wordsSFP: Alex uses three words. He says Mama and Da when he wants help or when he wants to show his parents something. He is only using them at home, not when he’s out in public with his parents.


Summary of Functional Performance… For Each Outcome

Describe how the child uses his/her skills across domains in meaningful ways related to the outcomeInclude examples of things the child does and does not yet do and a sense of the mix of skills observedInclude information from multiple sources and observations across settingsInclude specific examples of the child’s functioning related to the range of content for each outcome


Summary of Functional Performance… For Each Outcome (Continued)

Include information from one or more assessment toolsDescribe functioning with respect to age-expected functioning, immediate foundational skills, and/or foundational skills as appropriate to provide support for the descriptor statementDescribe functioning at the current point in time (that is, do not compare functioning to a previous time point)


ReflectionHow are you gathering information beyond the assessment tools that you use? What types of information do you collect? What else do you need to collect?How do you incorporate that information in the IFSP process?


Why is it important to document the child’s functioning?

Documentation…Provides a record of the rationale for the rating decisionProvides quality assurance information so others can see whether people are using the system consistently and appropriately (i.e., using definitions, rating similar children in the same ways)Helps identify needs for future training and technical assistanceDescribes the child’s functioning for new team members reviewing the file


How much to write?

Write enough to provide a rich (but not overly long) description of how the child is doing in the outcome. The writing should provide evidence to support the descriptor statement that the team selects.


Example 1: Alex, 23 months Summary of Functional Performance

Alex can say 3 words, however, these can be difficult for others outside the family to understand and are rarely heard other than during quiet times with his parents at home and during play with Dad, with the exception of the word, “No.” He does not yet use words other than “no,” “Mama,” and “Da” regularly across settings and situations. He points to items that he wants, and understands familiar, recurring 2-step directions like going to get his shoes and bringing them to his Mom when he is getting ready to leave the house.

Alex uses gestures effectively to communicate when calm, but often gets overwhelmed in social situations with peers or in loud settings and may cry, scream, hit, or kick when he is frustrated rather than using gestures or words. He will listen to a short story, but usually loses interest after about two minutes. He can point to pictures in a book and sometimes jabbers along with the adult reading the book, imitating the adult’s voice and some of the sounds in the words they use. Alex responds to his own name and recognizes lots of objects, showing his understanding of named objects by pointing to them from pictures or picking them out of a group. Alex’s talking includes lots of jabbering that sounds like sentences.


Example 1: Alex, 23 monthsWhat did you notice?


Example 2: Kim, 17 months Summary of Functional Performance

In regards to Outcome 3, using appropriate behavior to get needs met, Kim:holds objects when placed in her hand (toys, spoon) but is still working on picking them up herselfknows what she wants, but often cries and fusses when she is not understood and cannot yet convey those wishes using words or actionshas not yet begun to use toys as tools to get other toys or interact with toys in sequences of exploratory actions like other children the same ageeats mostly baby food, taking between 5-10 spoonfuls of food that is fed to her per meal, seated in an adapted high chaireats small meals every 3-4 hours; is tube fed twice a day and is on a feeding tube at nightnot yet able to assist in dressing or bathing due to her motor challengesable to move short distances forward (twisting her body to inch along) and is motivated to attempt to get her toys, with occasional success at touching a toy, but not yet picking it up


Example 2: Kim, 17 months

What did you notice in this example?


SFP vs. PLODsHow is this description different from information you might find if you just looked at the PLOD?

Child’s skills domain by domainAssessment tools individually


Kim’s abilities by Domain

ReflectionThink about:

What would you do to improve the way teams in your program write the Summary of Functional Performance section ?Can others easily read it and have enough specific information to see how and why you chose the descriptor statement you did?What differences do you see between your Summary of Functional Performance and PLOD sections?


SFP and PLODsIFSP Process and Resource Guide:http://www.del.wa.gov/publications/esit/docs/IFSP_Resource_Guide.pdf



The Collaborative Team Process


Teaming and CollaborationDEC Recommended Practices:

Teaming and collaboration practices promote and sustain collaborative adult partnerships, relationships, and ongoing interactions to ensure that programs and services achieve desired child and outcomes and goals.


Teaming in Early Intervention

Teaming is well-established as a key component of providing high quality early intervention services to young children with disabilities and their families.The word “team” appears 49 times in the Individuals with Disabilities Education Act (IDEA)


Why do we team?

Many young children’s developmental needs are too complex to be addressed by a single discipline.


Why do we team for the Summary of Functional Performance and COS Rating?

Determining the correct rating at entry and exit requires knowledge of the SFP process AND knowledge of the child across settings and situations.Multiple perspectives on the child’s functioning increase the likelihood of selecting a rating that accurately reflects what the child can and cannot do.


WA ExpectationsThe SFP should not be completed by just sending reports to the FRC, or selecting descriptor statements individually and hoping it matches the FRC’s or parents’ inputIt is a part of the IFSP meetingIt is a discussion with the family and all members of the team together It can be face to face or through meeting participation over the phone


Who should be on the child’s team?

Individuals who can contribute knowledge about the child’s functioning across settings and situations in the three outcomes areas.

Examples: early interventionists, child care providers, therapists, FRCs, and families


Essential Knowledge for the SFP and COS Ratings

Among them, team members must:1. Know about the child’s functioning across settings and

situations2. Understand age-expected child development3. Understand age expectations for child functioning within

the child’s culture4. Understand the content of the three child outcomes5. Know how to use the rating scale


Quote


None of us is as smart as all of us. - Ken Blanchard

http://www.boardofwisdom.com/default.asp?topic=1010&search=Ken+Blanchard

Reflection

What does your team look like? Are there others that should be involved?

How does your team composition reflect understanding of all five areas of essential knowledge for the Summary of Functional Performance?


The Team Discussion ProcessThe team describes the child’s functioning (not just test scores or ratings)The child’s current functioning is considered relative to what is seen in same-age peersDiscussion includes the child’s full range of functioning (describing skills that are immediate foundational or foundational)The summary of functional performance written by the team on the IFSP describes the child’s functioning and serves as the rationale for the descriptor statementDecide which descriptor statement best describes the child’s current functioning


Descriptor Statements

Kids' Potential, Our Purpose Early Childhood Outcomes Center

In a high-quality team discussion…All team members participateParent input is respectfully elicited and used to inform the selection of the descriptor statement Multiple sources of assessment information are considered (observation, family report, formal ‘testing’)Discussion focuses on the child’s functioning on the outcomes and includes the full range of content of the outcomeGroup reaches consensus on rating


ToolsUsing the decision tree as a guide and language of descriptor statements will:

Help make the process family-centered Produce more valid, consistent ratings Focus examples shared to more efficiently fit discussion into time available/meeting flowFamily outcomes brochure on ESIT website will help introduce the outcomes and summary process to families http://www.del.wa.gov/publications/esit/docs/ChildOutcomes_MeasuresBrochure.pdf


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

Where to focus in deciding the rating

Focus on the child’s overall functioning across settings and situationsFunctioning that is displayed rarely and/or when the child is provided with a lot of unusual support or prompts is of little significance for the rating


Suggestions for reaching consensus on SFP and COS ratings

Whole team participation in the processRe-visit process – describe functioning first, not #Focus on outcome content – considering range of outcome content, does the skill fit, is it functional?Share examples – settings, situations, supports, and describe if view as AE, IF, F (do not correct for prematurity)Include more discussion about skills that would be seen in a child with typical developmental patterns for comparison


See http://www.fpg.unc.edu/~eco/assets/pdfs/Consensus.pdf

http://www.fpg.unc.edu/~eco/assets/pdfs/Consensus.pdf

Example probe in team discussionTell me about the kinds of evidence that suggest to you this child has [AE, IF, F] functioning in this outcome?When have you observed those skills? In what situations? How frequently does that occur? Were the accommodations/supports available in that setting? What were they? Are there other steps in the sequence of development that need to occur between developing this skill and the skills same-aged peers display (AE) in this area? (when an IF skill is identified)Is there other information we need to be better equipped to make this decision?


ReflectionThink about your recent teaming on the summary of functional performance.

What could you do to facilitate higher quality team discussions in the future ?What else would help other teams in your program also have high quality discussions?


Is the rating subjective?

What is subjective?“relating to the mind of the thinking subject and not the nature of the object being considered”

The summary of functional performance ratings involve clinical decision making from the team

much like that used in deciding on outcomes and intervention strategies


Effective Team Decisions


Research on clinical judgment shows that professionals can reach reliable conclusions under certain conditions.

Conditions for Effective Team Decisions The SFP Process

Operational definitions of the observed attributes Specific definitions for each of the 7 points on the rating scale

Structured rating format to record informed opinion The Decision TreeConsistent questions within the SFP section of the IFSP

Gather data from multiple sources Team process used in assessment and the SFPEstablish consensus-decision making process Team process used in assessment and the SFP

Provide training to facilitate reliable ratings ESIT SFP Training Modules

The SFP meets all of these conditions.

Validation of the Summary of Functional Performance

The Summary of Functional Performance* is currently being studied to validate the conditions under which the process provides the most meaningful information.See the ENHANCE project for more information http://enhance.sri.comSurveys, team decision-making videos, and a longitudinal study are all underway.


* In other states, the summary of functional performance is called the Child Outcomes Summary (COS) process.

Emerging National Validity EvidenceAcross studies using different methods, evidence supports the following validity claims:

Minimal indication of explicit intent to alter ratings or teams selecting ratings intentionally to make the program look good.Trained teams apply accurate knowledge of which skills relate to various outcomes.Trained teams assign ratings consistent with rating criteria. Children with more severe impairments receive lower ratings.Ratings at exit from Part C are consistent with other state-wide information, including the percentage of children subsequently eligible for Part B Preschool services.


When to complete ratingsESIT requires selection of descriptor statement (rating) at entry and exit

Optional at intervening times, such as at the annual IFSP reviewBenefits of interim use:

Consistency in team actions – familiar each time to caregivers/team - Promotes good discussions about child’s functioning with

caregivers - Will have a more recent rating if family exits suddenly


IF completing the 2nd, 3rd, etc., rating

Do NOT look at the previous rating. Each rating is independent and is to be based on where the child functioning is now.

Looking at the previous rating can introduce bias into the rating process.

Complete the progress question.


The SFP in the DMS


The “progress” question

This question is answered “yes” if the child has acquired ANY new skill or shown any improvement related to this outcome since the last summary of functional performance, e.g.,

Using one new wordUsing one new gesture


b. Has the child shown any new skills or behaviors related to [this outcome] since the last outcomes summary?

Team Ratings of Functioning


Knowledge Check


1. True or False.Since every child is unique, I need to write a specific, individualized descriptor statement for each child.

2. The SFP summary should include:a. Specific statements about the child’s

current functioning.b. Specific statements about skills the

child does not yet use or cannot yet do.

c. Functional assessment informationd. Information anchoring the child’s

skills against age-expected functioning

e. All of these

Knowledge Check


1. True or False: Since every child is unique, I need to write a specific, individualized descriptor statement for each child.

False

2. The SFP summary should include:

e: “all of these”

Knowledge Check


1. True or False.The SFP can be completed by a single individual.

2. In order to be of high quality, the SFP summary should include:a. The child’s name and date of birthb. Information from multiple sources

of assessment informationc. A descriptor statement for all three

outcome areasd. At exit, the answer to the yes/no

progress questione. All of these

Knowledge Check


1. True or False: The SFP can be completed by a single individual.

False

2. In order to be of high quality, the SFP summary should include:

E: “all of these”

ReflectionHow do team members share information during a typical meeting to create a complete picture of the child?


Resources

ESIT Part C Online Training Module 3: Developing Initial and Continuing Individualized Family Service Plans: http://ectacenter.org/wamodules/moduleifsp.asp

ESIT IFSP Process Guide: http://www.del.wa.gov/publications/esit/docs/IFSP_Resource_Guide.pdf


http://ectacenter.org/wamodules/moduleifsp.asp



ResourcesIFSP Exemplars, Alex and Kim:

http://www.del.wa.gov/publications/esit/docs/Child_Outcomes_IFSP_Integrated_Example2.pdf http://www.del.wa.gov/publications/esit/docs/Child_Outcomes_IFSP_Integrated_Example1.pdf

Reaching Consensus Handout:http://ectacenter.org/eco/assets/pdfs/Consensus.pdf Maryland Learning Links- Engaging Families in the COS Process:http://marylandlearninglinks.org/11695Kids' Potential, Our Purpose

http://www.del.wa.gov/publications/esit/docs/Child_Outcomes_IFSP_Integrated_Example2.pdf




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

http://marylandlearninglinks.org/11695

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 4 guidance for completing the sfp and cos rating within the team process every day, we are...

Documents

sfp module

purpose sfp

purpose slide

false slide

purpose module

cos rating module

childs functioning

skills specific