DELAWARE BUILDING BLOCKS BETTER LASTING OUTCOMES FOR CHILDREN— KEYS TO SUCCESS Guidelines for Infants and Toddlers Birth to Three Early Intervention System Division of Management Services Delaware Health and Social Services 1901 N Dupont Hwy New Castle Delaware 19720 302-255-9134 fax 302-255-4407 Introduction to Building BLOCKS The State of Delaware is committed to supporting early education for all young children. The Office of Early Care and Education was established in 2002 to support the development of a quality early care and education system. Considerable effort has taken place to bring together the many distinct elements that make a good system. Curriculum and instruction is one important aspect to a quality education system. The Delaware Early Learning Foundations for preschoolers and the Infant Toddler Early Learning Foundations were developed as curriculum guides for programs. The Foundations are meant to provide a structure and guide for planning instructional experiences that are essential to facilitate children’s development. Assessment and ongoing monitoring is also another important aspect to a quality education system. Assessment serves the purposes of monitoring the effectiveness of instruction, making sure developmental growth is being made, and ensuring that the outcomes targeted for instruction are being met. Assessment can and should be a positive component to any educational process. Linking assessment and instruction is a critical component to an effective system. Identifying specific outcomes and using assessment and instruction as a basis for determining effectiveness are essential to current educational practice. Bringing together these elements will further support effective instructional practices. The federal government has established a set of outcomes for programs providing early intervention services to children with IFSPs and IEPs. States are now required to annually collect assessment data and report this information to the Office of Special Education Programs (OSEP). OSEP has established three functionally-stated outcomes upon which states must report. The outcomes are measured according to the extent to which children are making or not making progress as a result of receiving early intervention. The outcomes are: * Children have positive social-emotional skills (including social relationships) * Children acquire knowledge and skills (including early language/ communication and early literacy) * Children use appropriate behavior to meet their needs Delaware has established an early childhood outcomes (accountability) system: Delaware Building BLOCKS. The system is intended to: 1. be a process for the ongoing monitoring of children’s development to support effective instruction; and 2. to serve as the statewide mechanism for reporting the OSEP outcome data. Background Information on the Outcomes Initiative In September 2004, the Delaware Child Outcomes Work Group (COWG) was established to work on the development of Delaware’s early childhood outcomes/accountability system. Participants included representatives from early childhood agencies, child care centers, school district programs, families of children with special needs, and advocacy groups. For over two years, the Work Group proceeded with an extensive research and development process which resulted in the following recommendations: * The Delaware outcome system needs to be linked to the state’s Early Learning Foundations (preschool) and the Infant Toddler Early Learning Foundations. * Assessments must be aligned with the Delaware Early Learning Foundations and the Infant Toddler Early Learning Foundations. The results will provide information about how children are developing in relation to the state’s early learning guidelines and the three OSEP Child Outcomes. * Reporting to OSEP will delineate children’s progress toward the outcomes and will be reported as: * % of children who maintained skills comparable to same-aged peers * % of children who made progress to attain skills to same-aged peers * % of children who made sufficient progress to narrow the gap * % of children who made progress but did not narrow the gap * % of children who do not make progress * Part C data will be entered into ISIS by Child Development Watch and school districts will enter Part B data into E-School Plus. * Confidentiality issues of sharing information between Part C and Part B Programs resulted in a Confidentiality Policy. Therefore, parents will be asked to provide written consent to share information across programs. Special Project Activities Highlights: Validity Analysis In 2005, a team of master early childhood education teachers and interventionists examined the validity of the state’s Child Outcomes Framework using nationally recognized early childhood assessments as the foundation. The analysis confirmed the validity of the state early learning guidelines and highlighted where there were high levels of correlation between specific assessments and the framework. From that data, the state piloted a set of assessments to explore the best instruments to use within the Outcomes system. Pilot Project During the 2005–2006 school year, early childhood programs throughout Delaware participated in a pilot project to implement the Child Outcomes System. The purpose was to determine the appropriateness of the assessment instruments and to explore effective processes to complete the assessment and reporting system. Teachers and early intervention therapists and service providers working with children with varying abilities and disabilities participated by using one of nine different criterion-referenced assessment instruments designed to measure progress. Pilot project information guided decisions for the selection of assessments and procedures for the Child Outcomes System, Delaware Building BLOCKS. Implementation Starting September 1, 2006, Delaware began full implementation of the Child Outcome System. This guidebook is intended to document policies and procedures governing DE Building Blocks for Infants and Toddlers eligible under Part C of IDEA. Guidelines for Infants and Toddlers covers: * Overview of the federal requirements for child outcomes * Infant Toddler Foundations and how they relate to the three child outcomes * Delaware Approved Assessment Tools * Procedures for measuring outcomes and progress * Authentic Assessment and Observing children * Forms and instructions for the Child Outcomes Summary Form * Timelines for submitting outcomes and a one page overview * Frequently Asked Questions OFFICE OF SPECIAL EDUCATION PROGRAMS (OSEP) CHILD OUTCOMES Outcome One Children have positive social–emotional skills (including social relationships) Outcome Two Children acquire and use knowledge and skills (including early language/communication and early literacy) Outcome Three Children use appropriate behaviors to meet their needs Information required by OSEP includes – * % of children who maintain functioning at a level comparable to same-aged peers * % of children who reach functioning at a level comparable to same-aged peers * % of children who made sufficient progress to narrow the gap * % of children who improve functioning but did not narrow the gap * % of children who do not improve functioning DELAWARE CHILD OUTCOMES FRAMEWORK The Child Outcomes Work Group made the recommendation that the Delaware Building Blocks accountability system needs to be aligned with both the Delaware Early Learning Foundations and the Delaware Infant/Toddler Early Learning Foundations. To support this link the Child Indicators Subcommittee, a working group of the Child Outcomes Work Group completed a process aligning each of the respective Learning Foundations to the three OSEP outcome statements. Alignments from the Infant and Toddler Foundations to the three OSEP outcome statements have been provided in the following section. In these alignments, the Foundations are grouped according to outcome and age group. For children 0-9 months, the practitioner will have a listing of all development skills that characterize “Children having positive social and emotional skills” according to the developmental domains contained within the I/T Foundations. This structure is then repeated for the other two age groups (10-18 months and 19-35 months). Following the Infant Toddler Foundations is a section containing an abbreviated Foundations/Outcomes alignment. The Child Indicators Subcommittee was of the opinion that the full alignment section might be too cumbersome for some practitioners use and also wanted a structure that would be user-friendly for parents. Full copies of the Early Learning Foundations and the Infant/Toddler Early Learning Foundations can be found on both the Birth to Three Early Intervention System’s website and the on the Delaware Department of Education’s website: http://www.dhss.delaware.gov/dhss/dms/epqc/birth3/directry.html http://www.doe.k12.de.us/programs/buildingblocks/ (Look for Building Blocks Guidelines) Infant Toddler Foundations BABY (0–9 months) Outcome One Children have positive social-emotional skills (including social relationships) BABY (0-9 MONTHS) Social Emotional Development * Express a variety of emotions and feelings to communicate basic needs * Cry, smile, coo * Make eye contact while interacting with caregiver in daily routines * Learn to comfort self * Maintain eye contact and mutual gazing with caregiver * Signal for caregiver’s assistance by crying and squealing * Show a preference for interactions with familiar adults * Initiate interactions with caregiver through eye contact and smiling * Take part in a back and forth interactions with caregiver * Be aware of familiar adults as they move around room * Show awareness of unfamiliar adults * Initiate interactions with caregiver * Imitate actions and sounds of caregiver and peers * Respond to own name (smiles, eye contact, turns head) * Be comforted by familiar routines and environment * Recognize and express a range of emotions and show interest in others Language Development * Turn head toward a voice to search for the speaker * Respond with facial and or body movements * Communicate with facial and or body movements * Communicate interest or excitement through facial /body movement to bottle/breast/spoon/diaper changing * Cry to communicate needs * Coo, babble, and laugh to self and others * Demonstrate enjoyment through facial/body movements to the sounds of words in books * Demonstrate enjoyment through facial/body movements to songs and music Cognitive Development * Respond to touch, smells, light and voices, and focus on contrasts, black/white, red/white, faces * Tell the difference between familiar and unfamiliar people * Apply previous knowledge to new situations Motor Development * Begin to reach for and hold own bottle * Clap hands together for play Outcome Two Children acquire and use knowledge and skills (including early language/communication and early literacy) BABY (0-9 MONTHS) Social Emotional Development * Initiate interactions with caregiver through eye contact and smiling * Imitate actions and sounds of caregiver and peers * Entertain self for short periods of time * Recognize and express a range of emotions Language Development * Turn head toward a voice to search for the speaker * Respond with facial and or body movements * Communicate with facial and or body movements * Communicate interest or excitement through facial /body movement to bottle/breast/spoon/diaper changing * Coo, babble, and laugh to self and others * Demonstrate enjoyment through facial/body movements to the sounds of words in books * Demonstrate enjoyment through facial/body movements to songs and music Cognitive Development * Respond to touch, smells, light and voices, and focus on contrasts, black/white, red/white, faces * Gather information through mouthing, grasping and reaching * Follow moving objects with eyes * Tell the difference between familiar and unfamiliar people * Realize ability to make things happen (e.g. hits or kicks mobile and makes it move) * Apply previous knowledge to new situations * Use play to explore and build increased understanding of objects and materials in the environment * Uncover toy that is hidden Motor Development * Follow or find stationary or moving object * Begin to look at own hand(s), toys, or objects while playing with them * Roll back and forth * Begin to scoot, roll, inchworm or crawl * Begin to pull up on sturdy objects Outcome Three Children use appropriate behaviors to meet their needs BABY (0-9 MONTHS) Social Emotional Development * Express a variety of emotions and feelings to communicate basic needs * Learn to comfort self * Signal for caregiver’s assistance by crying and squealing * Show a preference for interactions with familiar adults * Initiate interactions with caregiver through eye contact and smiling * Take part in a back and forth interactions with caregiver * Initiate interactions with caregiver * Entertain self for short periods of time Language Development * Communicate with facial and or body movements * Communicate interest or excitement through facial /body movement to bottle/breast/spoon/diaper changing * Cry to communicate needs Cognitive Development * Realize ability to make things happen (e.g. hits or kicks mobile and makes it move) Motor Development * Control own body beginning with the head and back and progressing to the arms and legs * Begin to reach for and hold own bottle * Transfer object from one hand to another * Roll back and forth Infant Toddler Foundations TODDLER I (10–18 months) Outcome One Children have positive social-emotional skills (including social relationships) TODDLER I (10-18 MONTHS) Social Emotional Development * Show anxiety when around unfamiliar people * Demonstrate separation anxiety * Check in with caregiver while exploring * Anticipate and follow routines * Demonstrate a sense of accomplishment * Understand the connection between own behavior and the reaction of others * Play side by side with others * Initiate social relationships with others Language Development * Demonstrate understanding of familiar words * Follow one step directions in play * Demonstrate understanding of “no” by stopping what he is doing some of the time * Use physical movements and gestures to express wants and needs * Use simple sounds to express thoughts, wants and needs * Use the same “words” consistently to express wants, needs and thoughts Cognitive Development * Use people to make things happen * Show increased short and long-term memory and increased attention * Anticipate familiar routines Motor Development * Climb into adult lap, or on furniture and up and down stairs Outcome Two Children acquire and use knowledge and skills (including early language/communication and early literacy) TODDLER I (10-18 MONTHS) Social Emotional Development * Anticipate and follow routines * Demonstrate a sense of accomplishment Language Development * Demonstrate understanding of familiar words * Follow one step directions in play * Demonstrate understanding of “no” by stopping what he is doing some of the time * Point to body parts * Use simple sounds to express thoughts, wants and needs * Touch or identify pictures in a book when asked * Become an active reading partner by listening to books for a short period of time * Touch or identify familiar items when asked * Find familiar items not in sight * Use the same “words” consistently to express wants, needs and thoughts * Use animal and other familiar sounds in play Cognitive Development * Gain an understanding of basic concepts such as color, size and shape * Show how objects fit in space * Use objects as tools to make things happen * Use people to make things happen * Show increased short and long-term memory and increased attention * Use play to explore things that go together * Anticipate familiar routines * Use readily available materials as a substitute for actual objects Motor Development * Begin to take steps sideways while holding onto something (cruising) * Begin to explore textures with hands * Begin to turn pages in sturdy (board) book * Begin to hold crayon in palm of hand and make dots on paper * Begin to add and empty objects from containers * Begin to stack a few large objects Outcome Three Children use appropriate behaviors to meet their needs TODDLER I (10-18 MONTHS) Language Development * Use physical movements and gestures to express wants and needs * Use simple sounds to express thoughts, wants and needs * Use the same “words” consistently to express wants, needs and thoughts Cognitive Development * Use objects as tools to make things happen * Use people to make things happen Motor Development * Begin to take steps sideways while holding onto something (cruising) * Begin to feed finger foods to self * Begin to hold onto a cup with a lid * Begin to pinch thumb and finger * Begin to turn pages in sturdy (board) book * Walk by self * Begin to feed self with spoon * Climb into an adult lap, or on furniture and up and down stairs * Begin to remove loose clothing and shoes * Begin to run awkwardly and has frequent stopping Infant Toddler Foundations TODDLER II (18 – 35 months) Outcome One Children have positive social-emotional skills (including social relationships) TODDLER II (19 – 35 MONTHS) Social Emotional Development * Demonstrate self control and assert independence * Recognize and react to others’ feelings * Seek praise from familiar adults * Form attachments to one or two children in peer group * Explore with others * Enjoy interacting with others * Express awareness of similarities and differences between self and others Language Development * Ask simple questions using words or change in voice * Refer to self by name * Respond to simple questions * Demonstrate understanding of an increasing number of words and phrases * Answer questions with “yes” and “no” * State first and last name * Use words to communicate feelings that describe physical experience * Increasingly use language understood by others Outcome Two Children acquire and use knowledge and skills (including early language/communication and early literacy) TODDLER II (19- 35 MONTHS) Social Emotional Development * Express awareness of similarities and differences between self and others Language Development * Ask simple questions using words or change in voice * Use words beginning with a variety of sounds * Choose familiar objects upon request * Follow a two-step direction * Imitate and use two and three word phrases * Refer to self by name * Use pronouns occasionally * Respond to simple questions * Identify familiar objects and their use * Demonstrate understanding of an increasing number of words and phrases * Use action words * Use more words in phrases/sentences * Use words that describe objects and actions * Answer questions with “yes” and “no” * Use plurals * State first and last name * Use words to communicate feelings that describe physical experience * Increasingly use language understood by others * Recite phrases from familiar stories, rhymes and songs * Recall and talk about familiar characters and events * Recognize that words and symbols have meaning * Ask “why” and other questions Cognitive Development * Use play and daily routines to explore sorting, classifying, and understanding the concept of numbers * Use skills already mastered in new, imaginative ways Motor Development * Begin to throw balls with aim * Begin to use mature finger grasp with thumb and two fingers * Attempt to snip paper with scissors * Begin to complete simple puzzles and blocks Outcome Three Children use appropriate behaviors to meet their needs TODDLER II (19-35 MONTHS) Language Development * Ask simple questions using words or change in voice * Use words to communicate feelings that describe physical experience * Ask “why” and other questions Motor Development * Begin to use mature finger grasp with thumb and two fingers * Hold an object stable with one hand while using the other to perform a task * Use a fork * Use a cup * Begin to put on own shirt, pants, shoes and jacket Infant Toddler Foundations Abbreviated Version Birth through 60 months Outcome 1 Children have positive social-emotional skills (including social relationships) Baby may… 0-9 months * Acknowledge and/or respond to others through eye contact, vocalizations, facial or body movements or assistive technology * Demonstrate a preference for interactions with familiar adults in some observable way * Initiate interactions with caregivers * Respond to own name (smiles, eye contact, turns head) * Express a range of emotions (happy, sad) * Participate in some form of reciprocal play Toddler I may… 10-18 months * Interact and/or communicate wit others through eye contact, vocalizations, facial or body movements or assistive technology * Demonstrate an awareness that their behavior results in behavioral response in others * Play side by side with others Toddler II may… 19-35 months * Acknowledge others through increasing vocalizations, facial or body movements, or assistive technology * Seek praise from familiar adults * Assert independence * Demonstrate self control * Recognize and react to others’ feelings * Form attachments to one or two children * Interact with others through reciprocity Preschool child may… 36-60 months * Successfully enter a play situation wit peers * Express feelings, needs, and opinions without harming themselves, others, or property * Begin to use compromise, negotiation, and discussion in working, playing, and resolving conflicts with peers * Accept guidance and directions from a range of familiar adults * Develop friendships with children * Express empathy and care for others * Begin to demonstrate positive social skills, i.e. please, thank you * Treat others with respect * Demonstrate reasonable caution in unfamiliar and/or potentially dangerous situations * Engage in a variety of pretend play activities * Begin to identify own gender, name, and age Outcome 2 Children acquire and use knowledge and skills (including early language/communication and early literacy) Baby may… 0-9 months * Demonstrate enjoyment through facial/body movements to the sounds of songs, music and/or words in books * Use mouthing, grasping, and reaching to explore objects and materials in the environment * Imitate actions and sounds of caregiver and peers * Begin to look at own hand(s), toys, or objects while playing with them * Transfer object from one hand to another * Begin to scoot, roll, inchworm, or crawl and/or pull up on sturdy objects Toddler I may… 10-18 months * Follow a one-step direction * Demonstrate understanding of “no” by stopping what he is doing some of the time * Touch or identify familiar items when asked (such as body parts) * Use the same “words” consistently to express wants, needs and thoughts * Anticipate and follow familiar routines * Begin to hold crayon in palm of hand and make marks on paper * Begin to dump and fill objects from containers * Begin to stack a few large objects * Participate in stories through identifying pictures, turning pages, or listening for a short period of time Toddler II may… 19-35 months * Follow a two-step direction * Imitate and use two or three word phrases * Refer to self by name * Identify familiar objects by their use * Use action or descriptive words in phrases/sentences of increasing length * Answer questions with “yes” and “no” * Recite phrases from familiar stories, rhymes, or songs * Recall and talk about familiar characters or events * Ask simple questions using words or change in voice * Work through simple problem such as simple puzzles or block designs Outcome 2 Children acquire and use knowledge and skills (including early language/communication and early literacy) continued Preschool child may… 36-60 months * Communicate using multiple word phrases * Take turns in conversations * Begin to identify, recognize, experiment, and discriminate sounds in words * Hold a book upright, turn pages from the front of the book to the back, and scan pages * Uses scribbles, symbols, drawings or dictation to express experiences * Begin to recognize familiar signs and labels * Begin to name or identify some letters of the alphabet * Begin to write the letters of their first name * Begin to answer questions related to a story that has been read or told to him/her * Count in sequence 1 to 10 * Recognize numbers 1 to 10 * Begin to make use of one-to-one correspondence when counting objects * Develop the ability to determine quantity or “how many” * Recognize, name, and sort, according to color, positional terms, and directionality * Show the ability to put objects in a series according to one or two attributes such as shape or size * Imitate, recall, and create patterns * Begin to develop the ability to focus and complete a variety of tasks, activities, and projects Outcome 3 Children use appropriate behaviors to meet their needs Baby may… 0-9 months * Make things happen (e.g. hits or kicks mobile and makes it move) * Communicate basic needs * Learn to comfort self * Entertain self for short periods of time * Control body movements * Reach for and hold objects Toddler I may… 10-18 months * Communicate by verbal and/or non-verbal means (physical movements, signs, gestures, or assistive technology) to express thoughts, wants, and/or needs * Use people and/or objects to make things happen * Signal for caregiver’s assistance * Feed self * Demonstrate intentional mobility (gets from here to there) * Remove loose clothing and shoes Toddler II may… 19-35 months * Initiate action to make things happen * Use simple strategies to meet their own wants and needs * Begin to dress self Preschool child may… 36-60 months * Make independent choices * Begin to develop a plan for play * Develop increasing independence in a range of activities, routines, and tasks * Use positive behavior to solve problems * Begin to show awareness and independence in hygiene, nutrition, and personal care * Build awareness and ability to follow basic health and safety rules DELAWARE APPROVED ASSESSMENT TOOLS FOR PART C ELIGIBLE CHILDREN The following tools have been correlated with the Federal Outcomes: * Primary Assessment Tools The following assessments are criterion-referenced, performance/ observation based assessment measures identified as Primary Assessment Tools for all Part C eligible children. Carolina Curriculum Assessment for Infants and Toddlers Creative Curriculum Developmental Continuum for Infants, Toddlers and Twos * Interview/Observational Assessment Measures Tools that use interviews, observations and/or surveys to collect information from parents and caregivers. Vineland II (The Survey Information Form is preferred; however, the parent report is useful when an interview cannot be conducted.) Ounce Scale * Multi Sources of Information Multi sources of information that measure the child’s progress are required. Recommended sources include, but are not limited to, observations, interviews with the child’s family or caregiver, other assessment tools, and IFSP progress notes. * Other Approved Assessment Tools The following tool may be used for those children who are Part C eligible and are receiving ongoing assessments only or one service (not early childhood education) Bayley III (In conjunction with parts of the Vineland II, ELAP, and with observations, interviews with the child’s family/caregiver, and/or IFSP progress notes) * Tools that may be used with children with severe and profound disabilities Developmental Assessment for Individuals with Severe Disabilities (DASH-2) Callier-Azusa Scale DELAWARE POLICY ON USING OTHER ASSESSMENTS Policy on Using Other Assessments The Birth to Three office is open to using other valid assessments. The provider will need to obtain formal approval to use assessments not on the approved list. Four essential procedures are necessary: 1) The provider will need to determine the alignment of the measurement tool to the Delaware Infant Toddler Early Learning Foundations. 2) The assessment tool needs to be linked to the three OSEP Child Outcomes. 3) The assessment tool needs to be designed for repeated use and designed for ongoing monitoring of children’s development. 4) The assessment should have age anchors to allow assessment teams compare children with typical peers. Approval Process for Using Assessments The provider should submit a formal request to use the assessment. Included in the request should be: 1) A letter requesting the use of an assessment tool 2) A copy of the assessment instrument 3) A completed Validity Alignment Document to align the assessment with the Delaware Infant Toddler Early Learning Foundations PROCEDURES FOR MEASURING PROGRESS OF INFANTS AND TODDLERS IN DELAWARE CHILDREN IN THE CHILD OUTCOMES SYSTEM Children birth to age three with IFSPs All Part C eligible children birth to age three with IFSPs will participate in the accountability outcomes process. Children receiving six months of service Children need to have six consecutive months of service to be involved in the accountability process. There needs to be at least six months between the first assessment and the conclusion of the second assessment during the first year. Children who temporarily withdraw from services are included in the system if they return and continue services within 30 days of the date they withdrew. Policy on children who transfer Assessment information from the former provider should be shared with the new provider. If the information is completed within twelve months of the child’s transfer, it can be considered the outcome assessment. While the preference is to have the same tool completed each year, this may not be possible in all cases. WHO IS RESPONSIBLE FOR REPORTING CHILDREN’S PROGRESS? * Service Coordinators Service Coordinators (sc) are responsible for assuring that child outcomes are completed. All results from child outcome assessments should be sent to SC. SC will assure this is given to central data entry for entry into ISIS. The sc will share results for discussion at IFSP meetings. * Early Interventionists Early intervention providers who work with infants and toddlers, (birth to age three) receiving early intervention services are responsible for participating in the accountability process. All children with an IFSP must be included in the Child Outcomes system. * Multidisciplinary Team All members of the team working or interacting with the child should have the opportunity to collect and report information on the progress the child makes on the three outcomes. Teams can include but are not limited to: * Family Members/Caregivers * CDW Assessors * Service Coordinators * Early Intervention Providers RECOMMENDATIONS FOR TEAMING WITH CHILD CARE TEACHERS AND PARENTS * Child Care Teachers/Caregivers Children who are enrolled in child care have caregivers or teachers who should be part of the child’s Multidisciplinary Team for the Child Outcomes System. Many child care providers, including Early Head Start Programs, are beginning to use criterion-referenced assessment tools such as the Creative Curriculum Developmental Continuum or the Carolina Curriculum to document and report children’s ongoing progress. It is recommended that interventionists collaborate with child care staff to collect and compare information on the child’s current level of performance in a variety of settings. Information can be collected informally through discussions or meetings, or formally using tools such as the Carolina Curriculum or Creative Curriculum. * Parents It is required that parents be included in the Child Outcomes System. Parents can provide valuable information on children’s development on skills. Interventionists, assessors and service coordinators are encouraged to involve parents in either informal formats for collecting information or more formal methods such as family interviews, family reporting and family observations of their child. TIMELINE FOR OUTCOME ASSESSMENTS * Assessment Requirements An initial outcome assessment is completed within two months of start of services as indicated on the IFSP. Any information gathered for eligibility and ongoing progress monitoring may be used to inform the outcome assessments. An outcome assessment will be completed annually. * Timeline for Assessments Initial Outcome Assessment The initial outcome assessment is completed and shared with CDW Service Coordinators within two months of start of services. Exceptions to this timeline (initial outcome assessment could under exceptional circumstances take up to four months to complete) are documented on the IFSP. Any information gathered for eligibility may be used to inform the initial outcome assessment. The initial outcome assessment is a part of the IFSP process and discussion. Based on the initial outcome assessment and other information gathered by the team, a Child Outcome Summary Form (COSF) developed by the National Early Childhood Outcomes Center for use in assigning ratings in each of the outcome areas is completed. Results from the outcome assessment tool are entered into ISIS into the Outcome module by central data entry at CDW. ISIS Outcome module produces a COSF on the three Federal outcomes. Additionally, after team discussion using multiple sources of information, the COSF is reviewed, and changes entered into ISIS. The COSF and instructions developed by the National Early Childhood Outcome Center are included in this Guideline. Annual Outcome Assessment On an annual basis the team will: 1. Complete an assessment, based on the list of recommended tools, using information already gathered from ongoing progress monitoring (observation, other tools, family report). 2. Complete a Child Outcome Summary Form (COSF) to document the child’s progress on each childhood outcome. The COSF question about whether the child has made progress is completed for each outcome annually and for the exit outcome. 3. Collect and save all related information in the child’s file. 4. Enter assessment and COSF information into ISIS. Final Outcome Assessment The last annual assessment closest to child’s exit from Part C will be considered the final outcome assessment. The timeline is expected to be close to three months before the child exits from Part C. The Team will follow the same procedures as above. The protocols from the last assessment will be shared as part of transition to the local school district. The OSEP Outcome reporting will be completed in ISIS using both the initial and the final COSF. This will be reviewed by the team prior to child exiting. AUTHENTIC ASSESSMENT Authentic assessment provides information on children’s developing skills. * Occurs in the context that is familiar and comfortable to the child. * Provides an accurate picture of the child as a learner. * Provides repeated opportunities to witness children practicing skills, demonstrating knowledge and exhibiting behaviors in real learning activities. * Occurs when teachers, parents and support staff observe children “in” and “out” of the action * In the action refers to teachers observing while interacting with children * Out of the action refers to observing children without interactions * Includes multi sources of information including: * Interviews with parents * Interviews with child care staff * Work Samples * Other assessments OBSERVING CHILDREN Definition of Observation: Observation in defined as watching or regarding with attention or purpose in order to see or learn something. The following are ways that you can observe as you interact with children to determine their current level of performance on particular skills: * Ask questions that encourage them to talk about what they are doing. * Watch them as they play and work with materials and other children. * Listen to them as they describe how they made decisions and solved problems. * Listen as they talk with others both informally in play and formally in Circle Time discussions * Study their work GUIDELINES FOR INCLUDING AN ONGOING ASSESSMENT PROCESS IN EARLY CHILDHOOD PROGRAMS To prepare for the ongoing assessment process, teachers and therapists should: * Plan for observations * Watch/listen objectively in and out of the action * Observe children in a variety of settings * Record observations in a brief, factual manner * Document observations on paper such as sticky notes or mailing labels * Organize documentations in notebook or file * Reflect on observations * Analyze information from multiple sources * Observations * Interviews with families * Conversations with other teachers and therapists * Work Samples * Use multi sources of information as a part of the ongoing assessment process * Use information for planning interventions for child and/or curriculum for class Child Outcome Summary Form Outcome Determination Date: Child’s Name: ISIS#: Date of Birth: Persons involved in deciding the summary ratings: Name Role Family information on child functioning (Check all that apply): ___ Received in team meeting ___ Collected separately ___ Incorporated into assessment(s) ___ Not included For each outcome, indicate if the child has made progress since the initial outcomes rating. Progress is defined as the acquisition of at least one new skill or behavior related to the outcome. Describe the general nature of the progress in the space provided. Outcome 1: Has the child shown any new skills or behaviors related to positive social-emotional skills (including positive social relationships) since the initial outcomes summary? (Check ONLY one of the following) ___ Yes ___ No ___ Initial Assement Comments: Outcome 2: Has the child shown any new skills or behaviors related to acquiring and using knowledge and skills since the initial outcomes summary? (Check ONLY one of the following) ___ Yes ___ No ___ Initial Assement Comments: Outcome 3: Has the child shown any new skills or behaviors related to taking appropriate action to meet needs since the initial outcomes summary? (Check ONLY one of the following) ___ Yes ___ No ___ Initial Assement Comments: Child’s Name: ISIS#: 1. POSITIVE SOCIAL-EMOTIONAL SKILLS (INCLUDING SOCIAL RELATIONSHIPS) To answer the questions below, think about the child’s functioning in these and closely related areas (as indicated by assessments and based on observations from individuals in close contact with the child): * Relating with adults * Relating with other children * Following rules related to groups or interacting with others (if older than 18 months) To what extent does this child show age-appropriate functioning, across a variety of settings and situations, on this outcome? (Circle one number) Not Yet Emerging Somewhat Completely 1 2 3 4 5 6 7 Supporting evidence for answer to Outcome 1: Source of information Date Summary of Relevant Results © 2005 SRI International. Version: 4-20-06 Permission is granted to reproduce this form for state and local program use. Identify as “Developed by the Early Childhood Outcomes Center with support from the Office of Special Education Programs, U.S. Department of Education.” Adapted for use by Delaware Birth to Three Early Intervention System. Child’s Name: ISIS#: 2. ACQUIRING AND USING KNOWLEDGE AND SKILLS To answer the questions below, think about the child’s functioning in these and closely related areas (as indicated by assessments and based on observations from individuals in close contact with the child): * Thinking, reasoning, remembering, and problem solving * Understanding symbols * Understanding the physical and social worlds To what extent does this child show age-appropriate functioning, across a variety of settings and situations, on this outcome? (Circle one number) Not Yet Emerging Somewhat Completely 1 2 3 4 5 6 7 Supporting evidence for answer to Outcome 2: Source of information Date Summary of Relevant Results © 2005 SRI International. Version: 4-20-06 Permission is granted to reproduce this form for state and local program use. Identify as “Developed by the Early Childhood Outcomes Center with support from the Office of Special Education Programs, U.S. Department of Education.” Adapted for use by Delaware Birth to Three Early Intervention System. Child’s Name: ISIS#: 3. TAKING APPROPRIATE ACTION TO MEET NEEDS To answer the questions below, think about the child’s functioning in these and closely related areas (as indicated by assessments and based on observations from individuals in close contact with the child): * Taking care of basic needs (e.g., showing hunger, dressing, feeding, toileting, etc.) * Contributing to own health and safety (e.g., follows rules, assists with hand washing, avoids inedible objects) (if older than 24 months) * Getting from place to place (mobility) and using tools (e.g., forks, strings attached to objects) To what extent does this child show age-appropriate functioning, across a variety of settings and situations, on this outcome? (Circle one number) Not Yet Emerging Somewhat Completely 1 2 3 4 5 6 7 Supporting evidence for answer to Outcome 3: Source of information Date Summary of Relevant Results © 2005 SRI International. Version: 4-20-06 Permission is granted to reproduce this form for state and local program use. Identify as “Developed by the Early Childhood Outcomes Center with support from the Office of Special Education Programs, U.S. Department of Education.” Adapted for use by Delaware Birth to Three Early Intervention System. Instructions for Completing the Child Outcomes Summary Form Directions for Completing the Form 1. Page 1: Provide all the requested information. It is strongly recommended that the family be asked to provide information about the child’s functioning, but if the family’s information was not included, check “not included.” Indicate, for each outcome, if the assessment was the Initial Assessment or if the child had made progress since the initial assessment. Progress is defined as the acquisition of at least one new skill or behavior related to the outcome since the initial assessment. Describe the general nature of the progress in the space provided. 2. Pages 2, 3 and 4: Circle only one number for each outcome. Definitions for the scale points are provided at the end of the instructions. 3. Supporting evidence: Provide the evidence that supports the rating. Indicate the source of the evidence (e.g., parent, speech therapist, teacher, XYZ assessment) and the nature of the evidence from the source. For example, if a child’s functioning receives a rating of ‘5’, relevant results should provide evidence of a mix of age appropriate and not age appropriate skills and behaviors. A sample completed evidence table is provided below. Source of information Date Summary of Relevant Results Candace’s mom 4/12/06 Mom reports that when Candace eats by herself she makes a big mess. She eats finger foods but does not use a fork or spoon. She uses a “sippy” cup with two hands. Mom reports that she has not begun to toilet train Candace. Candace does not let mom know when she has a wet or soiled diaper. She pulls off her socks when getting ready for bed. Candace’s child care provider 4/5/06 Child care provider said that Candace is learning to use a spoon, but usually uses her fingers to feed herself. Candace uses diapers and tugs on diaper after it is wet or soiled. Carolina Curriculum for Infants and Toddlers with Special Needs Administered 3/13/06 Self-Help: Eating – 12-15 months Self-Help: Dressing – 15-18 months Self-Help: Grooming – 18-21 months Self-Help: Toileting -- <15-18 months Developmental specialist Observed over a 4 week period in March 2006 Observed in her child care environment during structured activities and unstructured play time. She clapped and jumped during a group song. During free play Candace tended to sit quietly unless engaged in a play activity by her caregiver. Candace did not object to having hands washed by caregiver, but needed assistance. To Help You Decide on the Summary Ratings: This form asks you to consider and report on what is known about how this child behaves across a variety of settings and situations. Children are with different people (for example, mother, big brother, child care provider) and in different settings (for example, home, grocery store, playground). The summary rating provides an overall picture of how the child behaves across the variety of people and settings in his or her life at this particular time in his or her life. In addition to summarizing across settings and situations, the rating process asks you to compare a child’s skills and behaviors to those of his or her same-age peers. For each of the three summary questions, you need to decide the extent to which the child displays behaviors and skills expected for his or her age related to each outcome area. The summary scale is based on a developmental framework that assumes: 1. Children develop new skills and behaviors and integrate those skills and behaviors into more complex behaviors as they get older; 2. These skills and behaviors emerge in a somewhat predictable developmental sequence in most children, thus allowing for descriptions of what 2 year olds generally do, what 3 year olds generally do, etc.; 3. The development of children with disabilities can be compared to the development of their same-age peers. 4. Some of the skills and behaviors that develop early serve as the foundation for later skills and behavior, or expressed another way, later skills build on earlier skills in predictable ways. Teachers and therapists can use the earlier skills to help children move to the next higher level of functioning developmentally. We refer to these earlier skills that serve as the base and are conceptually linked to the later skills, as “immediate foundational skills.” For example, children play along side one another before they interact in play. 5. Some children’s development is characterized by delays, meaning they acquire skills and behaviors at a substantially slower pace than other children. 6. Some children’s development is atypical in that their functioning is so different from that of other children their age that it is considered outside the limits of age expected behavior for children of that age. Use the following information to help you answer each question: • Ratings are expected to take into account the child’s functioning across a full range of situations and settings. Therefore, information from many individuals in contact with the child could be considered in deciding on a rating. These may include (but are not limited to): parents and family members, caregivers or child care providers, therapists, service providers, case managers, teachers, and physicians. If there is not enough information available about a child’s functioning across settings and situations, you will need to gather more information before you can decide on a rating. • Many types of information could be considered in selecting a rating. These may include (but are not limited to): parent and clinical observation, curriculum-based assessments, norm-referenced assessments, service provider notes about performance in different situations, and progress and issues identified in the IFSP/IEP or individualized planning process. • Depending on the assessment tool, assessment tools can be a useful source of information for reaching a summary decision but resulting information should be placed in context with other information available about a child. Many assessment tools are domain-based and were not designed to provide information about functional behaviors and functioning across a variety of situations. Knowing that a child has or has not mastered assessment items that are related to the outcome provides helpful information but the information should be used in conjunction with what else is known about the child. A high score on a set of items in a domain related to the outcome might not mean the child has achieved the outcome and, conversely, a low score might not mean the child has not achieved it. • Ratings should reflect the child’s current functioning across settings and in situations that make up his/her day. Ratings should convey the child’s functioning across multiple settings and in everyday situations, not his/her capacity to function under unusual or ideal circumstances. • A standardized testing situation is an unusual setting for a young child. If the child’s functioning in a testing situation differs from the child’s everyday functioning, the rating should reflect the child’s everyday functioning. • If the child is from a culture that has expectations that differ from published developmental milestones for when young children accomplish common developmental tasks, such as feeding themselves or dressing themselves, use the expectations for the child’s culture to decide if child’s functioning is at the level expected for his or her age. • If the child was born prematurely, use the expectations for the child’s chronological age, not the corrected age. The intent of the form is to describe the child’s current functioning relevant to expectations for his or her age. Presumably over time and with support, many children born prematurely eventually will perform like same age peers. • If assistive technology or special accommodations are available in the child’s everyday environments, then the rating should describe the child’s functioning using those adaptations. However, if technology is only available in some environments or is not available for the child, rate the child’s functioning with whatever assistance is commonly present. Ratings are to reflect the child’s actual functioning across a range of settings, not his/her capacity to function under ideal circumstances if he or she had the technology. Additional Information The outcomes reflect several beliefs about young children: * It is important that all children be successful participants in a variety of settings both now and in the future. Achieving the three outcomes is key to being successful participants in life. * Programs for young children and their families are working to ensure that all children will have the best possible chance of succeeding in kindergarten and later in school – even though school might be several years off for some children. Children who have achieved the outcomes at a level comparable to their same aged peers prior to kindergarten entry have a high probability of being successful in kindergarten. * Learning and development occur continuously in the years preceding kindergarten. There is much variation in how children develop but children whose development is consistently below what is expected for their age are at risk of not being successful in kindergarten and later school years. Definitions for Outcome Ratings Overall Age Appropriate Completely means: 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. 6 Between Completely and Somewhat. Child’s functioning generally is considered appropriate for his or her age but there are some concerns about the child’s functioning in this outcome area. Overall Not Age Appropriate Somewhat means: 5 Child shows functioning expected for his or her age some of the time and/or in some situations. Child’s functioning is a mix of age appropriate and not appropriate functioning. Functioning might be described as like that of a slightly younger child. 4 Between Somewhat and Emerging Emerging means: 3 Child does not yet show functioning expected of a child of his or her age in any situation. Child’s behaviors and skills include immediate foundational skills upon which to build age appropriate functioning. Functioning might be described as like that of a younger child. 2 Between Emerging and Not Yet Not yet means: 1 Child does not yet show functioning expected of a child his or her age in any situation. Child’s skills and behaviors also do not yet include any immediate foundational skills upon which to build age appropriate functioning. Child’s functioning might be described as like that of a much younger child. Frequently Asked Questions 1. The Bayley III is currently used for initial eligibility. After initial eligibility, what outcome assessments will be used? * For children with established condition only, and no other early intervention service is provided, CDW assessors will continue to use the Bayley III or a combination of the Bayley III/Vineland II annually and this will be used as part of the outcome assessment. * For children receiving a single service (not by an Early Childhood Educator (ECE)), CDW assessors may complete the Bayley III or a combination of a Bayley III/Vineland II or other assessment tools that correlates with the three outcomes. * For children receiving services by an ECE only, the ECE will complete and score the Carolina Curriculum. * For children receiving multiple early intervention services including by an ECE, all early interventionists will document their observations, even those outside their discipline, and the ECE will make sure the Carolina Curriculum is completed and scored. If an ECE is not involved, all early interventionists will complete as much of the Carolina Curriculum as possible based on their observations during their interventions, even those outside their discipline. The early interventionist who is the lead for that provider agency will indicate what part of the Carolina Curriculum could not be completed based on observations of the child and send this to the service coordinator. The CDW assessors, with input from Service Coordinators, will attend an intervention session to observe, interact with the family, and complete any remaining parts of the Carolina Curriculum. * In each of these cases, assessments and the Child Outcome Summary Form (COSF) will be reviewed in order to track child’s progress and maintain Part C eligibility. 2. Do children in WATCH and who are not Part C eligible participate in Delaware Building Blocks? No, only children who are Part C Eligible participate in Delaware Building Blocks and receive initial, annual, and exit outcome assessments. 3. When is the Child Outcome Summary Form (COSF) completed and how is it received and revised? The COSF is completed for each of the three outcomes during the initial outcome assessment, annually, and at the exit assessment. If the outcome assessment is a Bayley III or a Carolina Curriculum, the score sheets for these tools are completed, entered into ISIS, and a COSF is generated from ISIS. The COSF is reviewed by the assessor who completed the assessment, the Service Coordinator, and the parents, and is revised based on multiple sources of information, including clinical judgment. For the annual and exit COSFs, the team also determines whether progress has been made for each outcome and documents this on the COSF. If the DASH-2, Callier-Azusa Scale, or a combination of outcome tools is used, the Assessor also completes the COSF for each outcome. The COSF is completed based on multiple sources of information as described above. The team also determines whether progress has been made for each outcome and documents this on the COSF. CDW assessors and service coordinators are a part of the Multidisciplinary Team. All members of the Team will have the opportunity to collect and report information on the progress the child makes on the three outcomes. CDW assessors review this information to help determine the rating on the COSF, to monitor the child’s progress, and to maintain Part C eligibility. CDW assessors and service coordinators use this information to guide outcomes and steps on the IFSP. 4. How do the outcome assessments align with assessments already being conducted by providers? Will there be additional compensation? Providers continue to conduct and bill for assessments on an annual basis based on the child’s need. For example, a speech-language-pathologist may continue to conduct an annual Preschool Language Scale (PLS). The results of the assessment will be shared to inform the outcome assessment. When an early childhood educator is a part of the intervention Team or is the single service provider, it is recommended that they use the Carolina Curriculum, with input from the entire Team, as their assessment to monitor progress and to complete the outcome assessment. The early childhood educator will complete the Carolina Curriculum as their annual assessment tool. When the child has multiple interventionists from the Team, it is expected that the Team will use whatever assessment they are conducting along with ongoing observations to complete the Carolina Curriculum. While no additional reimbursement for the Carolina will be provided, Part C will reimburse for the primary Team member to attend the IFSP meeting in order to incorporate the results into the IFSP. When the child is enrolled in a program such as Children’s Secret Garden or the Early Learning Center, the teacher will complete the Carolina Curriculum with input from the interventionists and the Service Coordinator . 5. How are CDW Assessors participating in the ongoing assessment process and how are they involved in reviewing annual eligibility? CDW Assessors will have the role to review all assessment information annually and to give input and documentation regarding maintaining eligibility and ongoing progress monitoring. This will be done in several ways: The CDW Assessor may review the results of the Carolina Curriculum conducted by the early intervention provider. They will review this with the Service Coordinator, share their input, and determine if any other information is needed to confirm that the child continues to be Part C eligible and/or additional assessments that may be needed to address partial delays that are of concern. CDW Assessors do not have to attend the IFSP meeting unless the Service Coordinator feels that they need some help with any questions that may arise regarding whether the child is making sufficient progress.CDW Assessors will also review the COSF with the Service Coordinator so they are prepared to discuss this at the next IFSP meeting, and, based on this discussion, document on the COSF other sources of information used and whether the child has made progress on the three federal outcomes. The CDW Assessor may conduct the Bayley III/Vineland II annually if the child is eligible based on established condition and is not receiving services by an early intervention provider. A formal report is shared with the family and service coordinator by the CDW Assessor and the COSF is completed and reviewed. As part of the review of the COSF, the CDW Assessor may indicate whether the child has made progress on the three federal outcomes. In all cases the CDW Assessor, Service Coordinator, family and Early Intervention Provider work closely together to monitor the child’s progress and participate in the annual child outcomes assessment. 6. How does CDW’s role support family participation and input? It is the role of both the assessor and the service coordinator to ensure family input into the process by: * gathering additional family input to determine the ratings of the three Federal outcomes; * reviewing all assessments with the family * assuring all information informs IFSP outcomes and steps; and * assure families participate in an annual outcome assessments. 7. How will assessors communicate information important to the IFSP process and how will this change the workload? If the assessor is also the service coordinator, then that individual routinely participates in the IFSP meeting. If the assessor is not the service coordinator, the assessor will need to work closely with the service coordinator to share this information prior to or during the IFSP meeting. It would be ideal to have the assessor, service coordinator; provider and family participate in the annual IFSP meeting. 8. What about children who became eligible before September 1, 2006? What annual assessments will be completed and will their outcome data be reported to OSEP? Only children who started services and/or became Part C eligible after September 1, 2006 will be included in the report to OSEP. Children who started services prior to September 1, 2006 may receive the same annual assessments as indicated above or they could receive an annual Bayley III, depending on the decision of the IFSP Team. 9. Do we complete the Carolina Curriculum for any children who started services before September 1, 2006? Yes. If a child was * eligible for Part C prior to September 1, 2006 * under two years of age as of September 1, 2006 * and receiving ECE services and/or two or more services from an early intervention provider then the expectation is that the ECE and other disciplines from the early intervention provider agency complete the Carolina Curriculum. The Carolina Curriculum is more useful to the local school districts for transition because it is criterion-referenced, reflects the acquisition of functional skills, and many preschool programs for children with disabilities will be using the Carolina Curriculum for their outcomes assessment. 10. When do we assess premature infants when clinical judgment indicates that the child is too premature for the Bayley III to reflect skill levels? If it is determined that the infant is Part C eligible based on an established condition, but the infant is too premature to have the Bayley III accurately reflect skill levels, then CDW should wait to conduct the Bayley III until the child is old enough, usually around five or six months of age. Meanwhile, an Interim IFSP should be signed and in place, and any services necessary should be initiated. If the infant requires no services beyond assessments, the first Bayley III or Bayley III/Vineland II combination will be used as the baseline assessment for outcomes. If the child is receiving a single service, such as feeding therapy, CDW may also need to use the Bayley III as the baseline assessment to ensure that all domains have been assessed for initial eligibility. If the child is receiving two or more services under the Interim IFSP, the Carolina Curriculum should be completed and used as the baseline assessment. The Bayley III would be administered by CDW to determine the five-domain evaluation for eligibility as the child reaches five or six months old. 11. If a child is receiving one service and the Vineland II is being completed, does CDW also have to assess the cognitive domain for child outcomes? No. The Vineland II is sufficient to address the three child outcomes; however, the cognitive section of the Bayley III would need to be completed if there are concerns about a partial cognitive delay. 12. A child is receiving a single early intervention service and the Bayley III/Vineland II was completed as the baseline assessment for outcomes. After six months, it is determined that child requires additional services, and now the agency is providing two or more services. Would the annual outcome assessment be the Carolina Curriculum or should the agency repeat the same assessment as was initially used? While it is more desirable to have the same assessment used over time to monitor progress, we are recommending that second and subsequent assessments follow the assessment guidelines provided in FAQ #1. In this instance, the agency would use the Carolina Curriculum. 13. What about those children who are older than 30 months old who are referred to CDW? Aside from a Bayley III to determine eligibility, are any other assessments required for federal outcomes? Once a child is determined eligible, those who will not be receiving ongoing early intervention services for at least six months would only receive the Bayley III or a combination for initial eligibility and then begin transition planning to the school districts, Head Start, etc. 14. Who is responsible for completing and obtaining the outcome results for the Part C eligible children who also participate in the Birth Mandate programs? The school district teacher and other staff in the Birth Mandate programs are responsible for completing the outcome assessment with input from those agencies providing early intervention services. The Service Coordinator is responsible for informing the school district that an outcome assessment needs to be completed and to request that the assessment scoring results and the COSF rating be sent to the Service Coordinator. The Service Coordinator will give this to data entry for input into ISIS. Additional information can be found at: http://www.dhss.delaware.gov/dhss/dms/epqc/birth3/directry.html http://www.doe.k12.de.us/programs/buildingblocks/ http://www.the-eco-center.org or by contacting: Birth to Three Early Intervention System 1901 North Dupont Highway Main Administration Building, 2nd Floor New Castle, DE 19720 302-255-9134 fax 302-255-4407 Rosanne Griff-Cabelli rosanne.griff-cabelli@state.de.us Susan Campbell susan.campbell@state.de.us 8/24/2007 2