Child Outcomes Summary (COS) Process
Topic Editor: Kellen Reidkellen.firstname.lastname@example.org
The COS process is a team decision-making process involving discussion about the child's functioning across settings and situations by those who know the child best, such as family members and practitioners. The COS process provides a consistent way for teams to rate a child's functioning relative to age-expected behavior at a specific point in time.
- The team discusses information about a child's functioning in three outcome areas, resulting in a rating on a 7-point scale for each of the three child outcomes. Ratings are always provided on all three outcome areas.
- The team synthesizes all the information they have gathered about a child. This includes what they have learned from many types of assessment tools as well as from observations and other sources. The COS Form itself is not an assessment tool. It is a mechanism to document rating decisions and provide evidence that supports the rating.
- At a minimum, teams determine COS ratings at program entry and exit for children who received services for at least six months. States may complete the process more frequently, such as annually or every 6 months, to provide additional data for program improvement.
- Training and use of the decision tree and rating definitions are key for the process to produce consistent ratings. For more information, see COS Process Professional Development, especially the COS Process Online Module, the COS Process Quick Reference Guide, and a list of Topical COS Professional Development Activities.
Frequently Asked Questions about the COS
States use the COS process for many reasons:
- No assessment instrument assesses the three child outcomes directly.
- Recommended assessment practice is to use multiple sources of information.
- Programs use different assessment instruments, and the state needs outcome data that are summarized across programs for reporting and program improvement.
- Through COS Calculators and Ratings Conversion, the COS process provides necessary outcomes data for states to submit annually to meet federal requirements for outcomes reporting.
How does the COS process help programs achieve the goals of early intervention (EI) and early childhood special education (ECSE)?
- Goal of EI and ECSE: The overarching goal of EI and ECSE is to enable young children to be active and successful participants during the early childhood years and in the future in a variety of settings—in their homes with their families, in child care, in preschool or school programs, and in the community.
- IDEA language: This goal is consistent with what is stated in IDEA under Public Law 114-95, the Every Student Succeeds Act (2015): "Improving educational results for children with disabilities is an essential element of our national policy of ensuring equality of opportunity, full participation, independent living, and economic self-sufficiency for individuals with disabilities."
- COS process: The COS process provides information about how each child is functioning relative to age expectations. Gathering child development information at program entry and again at program exit describes changes in the trajectory of the child's development over time.
- Age expectations: Being mindful of a child's functioning relative to age expectations helps support the child's current functioning and development and provides an important foundation for the child's future school success when the child's achievement is measured by grade-level standards.
- COS process data use: COS process data is used in important ways at many levels to support EI and ECSE goals:
- Practitioners can use information from COS process to identify the individual plan that best supports the child's learning and participation.
- Families can build on this information to communicate their child's strengths and needs to support successful participation in settings with same-age peers.
- States and local programs can synthesize COS data across many children to make data-informed decisions that improve the services they provide.
The COS process supports and brings together DEC Recommended Practices, particularly in the areas of assessment and family. As states support effective implementation of the COS process, they also strengthen practitioner skills and reinforce quality practices.
A good COS process involves a team of people who know the child well, and fully involves families in the COS discussion. Authentic assessment information from multiple sources helps identify how the child uses skills to accomplish meaningful tasks in everyday settings. The team references established child development milestones in the discussion of where the child's functioning is relative to age expectations so that all team members understand where the child's skills are in the sequence of common developmental progressions.
Additionally, some states have integrated the COS with IFSP and IEP processes to promote ongoing assessment, a functional view of the whole child, and to link understanding the child's functioning with planning individualized intervention and instruction.
No. States have the option to collect the child outcomes data in any way that produces valid and reliable data. States that choose to use the COS process do so because it allows them to aggregate information from programs that use different assessment tools, and to consolidate information about a child's functioning from multiple sources. States do use other approaches to child outcomes measurement.
No. The COS process is a technique for consolidating information into a single rating from multiple sources including one or more assessment tools. It itself is not an assessment tool. The COS process requires looking at multiple sources of information about a child's functioning (including assessment tools) and then making an informed determination (usually in a team setting) of a rating that best describes the child's functioning compared to age expectations.
No. Currently, the COS Form is only available in English.
Yes, a state can adapt some features of the COS form. For example, a state can change the formatting so all three outcomes fit on one page. Some states have elected not to use a numerical scale, and instead use words to describe the seven ratings.
Features of the COS process that cannot be altered include:
- the number of points on the scale (for example, states cannot make it a 5-point scale); and
- the definition for each rating.
For more information about how any adaptations under consideration might influence the ratings, contact ECTA Center's Child Outcomes Measurement topic specialist.
Yes. Previously, this process was called the COSF (Child Outcomes Summary Form), but proved somewhat misleading. The name was changed to Child Outcomes Summary (COS) Process to emphasize that accurately determining the child's status on the three child outcomes requires more than completing the form.
Questions about Using the COS Process
The information family members provide about a child's functioning is essential to developing a complete picture of a child's functioning. This information is used to determine the most accurate description of a child's functioning compared to age expectations. Teams have different ways of obtaining that information, including the option to have family memebrs present for the discussion. States vary in whether or not family members are present when the actual rating is determined.
To determine a COS rating, one or more members of the team must discuss and descibe:
- the child's functioning across settings and situations;
- age-expectations for children's development and functioning in the general population;
- the Breadth of the Three Child Outcomes;
- guidelines for completing the Child Outcomes Summary form; and
- appropriate age expectations for child functioning within the child's culture.
See also: COS Process Professional Development
What sources of information can be used to determine a child's level of functioning on each of the three outcomes?
Multiple sources of information can and should be used. The determination of a child's functioning relative to age expectations can be based on:
- observations in the child's home;
- observations in early care and education settings;
- observations in other settings where that child regularly spends time;
- criterion- or curriculum-based instruments or norm-referenced scales;
- interviews with family members, child-care providers, and caregivers;
- informed clinical opinion; and
- work samples.
Although there are many advantages to in-person meetings, some teams are completing COS ratings when teams can't meet in person using telecommunications. Check with your state and program for specific policies related to remote screening, evaluation, and assessment. Doing so requires careful planning.
Questions about COS Ratings
Making COS ratings requires teams to synthesize information about a child's functioning from multiple sources and across different settings, and then accurately apply the rating criteria in each of the three outcome areas. Teams need training and practice to correctly select the description that describes the child's functioning compared to age expectations.
Professionals who have been trained and who implement the process thoughtfully can reach valid and reliable ratings. 9–12 hours of initial training and ongoing training for individuals and teams completing COS ratings are strongly recommended to produce valid ratings.
Because team members see the child in different settings and situations, people may see differences in the child's functioning across settings. Differing views should be taken into account when determining a rating.
Helping team members describe specific information about the child's functioning in different contexts and sharing how these are related to the kind of functioning expected for a child that age will usually generate enough discussion to reach consensus. Combining these approaches with the decision tree helps teams reach consensus on a rating.
How can a child who is eligible for services under IDEA be rated as having age-appropriate functioning with a rating of "6" or "7" at entry?
COS ratings are independent of eligibility determinations. There are a number of different situations where children receiving services may be functioning at age-appropriate levels. Children receiving services may exhibit age-appropriate functioning in one outcome and have challenges in another outcome area.
Some children with diagnosed conditions, such as a visual impairment, may be functioning at age appropriate levels in all outcomes and the services and supports are intended to prevent the child's condition from negatively impacting functioning.
If the COS rating stays the same from one time to the next or even goes down, can the team still say that progress has been made (that is, answer "yes" to the progress question)?
Yes. The question on progress refers to the child's functioning relative to his or her functioning at the last rating. If the child has acquired new skills in the outcome area, the child has made progress. The answer to the question about progress should not be based on changes in the ratings, but on whether the child has used any new skills.
For example, a child who receives a rating of 4 at entry and 4 at exit will show higher-level functioning at exit (a "yes" on the progress question) because to maintain a rating of 4 over time the child's functioning has to improve relative to what that child could do at the previous rating.
In another example, a child who receives a rating of 4 at entry and 3 at exit could also receive a "yes" on the progress question if he or she has acquired new skills in the outcome area, but the rate of development is slower than for peers of the same age.
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