Child Outcomes Summary (COS) Process Training Module

Child Outcomes Summary (COS) Process Training Module

Child Outcomes Summary (COS) Process Training Module Session 8: The Exit COS Rating What Happens at the Exit COS? At the exit COS, there are two parts to the discussion: 1 2 Determining the rating The process is just like the entry rating. Discussing progress since the entry COS rating was assigned This part is new. 2 Thinking about Progress Development follows a

predictable course. Development can be measured and plotted. Example: Growth charts used by pediatricians Skill Acquisition Over Time Skill Acquisition Over Time Developmental Trajectory Skill acquisition over time 25 Number of Skills 20 15 10

5 0 0 6 12 18 24 30 Age in Months 36 42

48 54 60 Comparing Developmental Trajectories Skill acquisition over time 25 typical development Number of Skills 20 15 children with slower

development 10 5 0 0 6 12 18 24 30 36

42 48 54 60 Age in Months Both lines show the children are acquiring new skills Acquiring new skills and changing rate of growth Skill acquisition over time 25 Typical development Number of Skills

20 Increased rate of developmentskill levels are moving closer to typical development 15 10 Children with slower development 5 0 0 6 12

18 24 30 36 42 48 54 60 Age in Months Children in the yellow line group have narrowed the gap. All three groups acquired new skills.

A flat trajectory indicates no new skills Skill acquisition over time 25 Typical development Number of Skills 20 15 10 5 0 Children who stopped acquiring skills 0

6 12 18 24 30 36 42 48 54 60 Age in Months

Very few children show no growth (or lose skills) over time. Two Questions Addressed at Exit Rating Question: To what extent does the child show ageappropriate functioning, across settings and situations, on this outcome? Progress Question: Has the child shown any new skills or behaviors related to this outcome since the last outcomes summary? How to Answer the Progress Question

! Answer yes if the child has acquired ANY new skill related to any aspect of the outcome since the entry rating. Example: Using one new word or gesture to get his needs met ! Answer no if the child has not acquired ANY new skill related to any aspect of the outcome since the entry rating. Answer to Progress Question is

Answer to Progress Question is YES NO Number of Skills Number of Skills Skill Acquisition Skill Acquisition Over Over Time Time 10 9 8 7 6

10 9 8 7 6 exit 5 5 4 4 3 3 entry

2 1 0 entry 2 exit 1 1 2 3 4 Age in Months

5 6 7 0 1 2 3 4 Age in Months 5 6

7 Points to Consider Answer yes if the child has acquired any new skill, even if the child has... Not made progress across all the skills in an outcome area Not moved closer to ageexpected development What Happens During the Exit COS Process? For each outcome, the team will: Gather information about the childs functioning Discuss the information and determine the rating

Document the rationale for the rating Answer the progress question Should the team look at the entry COS ratings when determining exit ratings? No! This may bias the teams determination of the exit ratings. When to Complete the Exit COS Complete the exit COS process as close to the childs discharge from the program as possible. What if the team members who participated at the exit are different from those who participated at entry? What if...the team

members who participated at the exit COS are different from those who participated at entry? 17 What if a family has left the program without notice? What if... a family has left the program without notice? 18 One Last Point on the Relationship between the Ratings and the Progress Question A rating of 4 at entry is not the

same as a rating of 4 at exit. Entry Exit Closing Click the back arrow to return to the module.

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