COS Form and Documenting Evidence

Child Identifier:

Enter the child's unique numerical identifier.

Last Name, First Name, and Middle Name:

Enter the child's full name as shown on their IFSP or IEP. If a middle name is not used, leave it blank.

Birthdate:

Enter the date (MM/DD/YYYY) of child's birth.

Date of Ratings:

Enter the date (MM/DD/YYYY) the team met and determined the COS ratings.

Timing of Ratings:

Identify the timing of this rating:

• Entry ratings are the initial ratings when the child enters the program.
• Interim ratings (if applicable in your state) are ratings made between entry and exit (for example, a six-month or annual IFSP/IEP review).
• Exit ratings are made as the child leaves the program.

People contributing information in COS process:

List everyone who provided information about the child's functioning including those who contributed information but did not take part in determining the ratings. Include people who shared information, verbally, in writing, or through an assessment process.

• Name: Enter the first name and last name of each person who contributed information. At least one family member should be listed. In extenuating circumstances, use the Additional Information section to explain why ratings were determined without a family member contributing information.
• Role: Enter each participant's role (for example, discipline/profession). Enter each family member's relationship to the child (for example, father or foster mother).
• Check if participated in rating decisions: Use this field to indicate participation (in person or virtual) in the COS rating discussion. Leave this field blank for anyone who contributed information about the child but did not take part in the ratings discussion.

What types of information were used to understand the child's functioning? (select all that apply)

Use these fields to indicate each type of information the team used. One assessment tool may include multiple types of information. For example, if family report and observation are part of the administration of an assessment tool, check assessment tool, family report, and observation. If Other is selected, describe in the space provided.

Name assessment and screening tools used:

Enter the name of all tools used to understand the child's functioning.

Additional information:

Enter any other pertinent information (for example, details about the timing of the ratings, specifics about team member participation, reference to settings in which the child was observed).

Document the child's current functioning relative to age expectations.

Enter information about the child's level of functioning in the appropriate section(s), starting with age-expected (AE) skills and behaviors. If there are no skills at an AE, IF, or F level, leave its section blank. Information about the child's functioning must be included in at least one of these sections.

• Include descriptions of the child's current functioning across settings and situations. Avoid simply listing discrete skills, making statements about what the child is not yet doing, or making vague references to skills.
• Include functional skills across the breadth of the outcome area.
• Include functional skills that clearly align with the outcome area.
• Include functional skills that are accurately age anchored and organized into categories of AE, IF, or F.
• Include evidence that clearly supports the COS Decision Tree for Summary Rating Discussions responses and the team's rating.

If the overall functioning is age-expected but there are significant concerns, describe the concerns:

Leave this section blank if either the child's functioning is at the AE level and there are no concerns or if some functioning is at the IF or F level.

Questions 1a, 2a, and 3a: To what extent does this child show age-expected functioning, across a variety of settings and situations, on this outcome? (Select one number)

For each outcome, select one of the following ratings to document the team's decision about the child's current functioning:

• Not Yet Age-Expected Functioning
  • 1. Not yet IF (all F)
  • 2. Occasional IF
  • 3. Mostly IF
• Some Age-Expected Functioning
  • 4. More not AE
  • 5. More AE
• Overall Age-Expected Functioning
  • 6. All AE with concerns
  • 7. All AE No concerns

The headings associated with COS rating numbers reinforce key points that differentiate the ratings. They are not stand-alone substitutes for understanding the COS Definitions: 7-Point Rating Scale Criteria.

Questions 1b, 2b, and 3b: (If this is not the entry rating): Has the child shown any new skills or behaviors related to this outcome since the entry COS rating? (Select No or Yes)

For entry ratings, skip these questions. For interim or exit ratings, answer Yes if the child has shown any new skills in this outcome, compared to the child's own functioning at the entry rating. Otherwise, answer No. If Yes, briefly describe evidence of the child's progress.

A child can have learned new skills, even if their COS exit rating is the same or lower than at entry. For all ratings of 2 or higher at entry, if the child's exit rating is the same as the child's entry rating, the answer to these questions is Yes.

• All practitioners participating in the COS process have been trained. While the form includes basic instructions and prompts, meaningful professional development is essential to procedural fidelity and quality (for example, COS Process Professional Development).
• Training on the COS process covered multiple facets, including understanding:
  • COS Definitions: 7-Point Rating Scale Criteria
  • Age Anchoring Information About Child Functioning using the terms age-expected (AE), immediate foundational (IF), and foundational (F).
• For in-depth analyses, the data captured in the form will be linked to other information in the state data system such as child demographics and program information. States that cannot do this will add fields to the form to capture information essential to analyses of the outcomes data.
• All states using the COS form will use the 7-point scale as defined and the scale will not be altered.
  • The scale has been studied extensively and validated.
  • Each point on the scale clearly describes a child's developmental status relative to age expectations.
  • The scale is fundamental to the numerous materials developed to support use of the COS form and process.
  • A single exception applies to states who have expanded the scale to create additional points beyond 7 to describe development that exceeds age expectations without changing the definitions of points 1 through 6. These additional points are rolled together for summary statement calculation and reporting.

The first step for state leaders is to carefully review the COS form, the guidance embedded within the form itself, and the instructions for use at the program and practitioner levels. Identify the items in the form that align with your state practices and procedures and modify those that need to be changed. If you modify the form, you also need to edit the Team Instructions for Completion for completing the form accordingly.

Although these materials are copyrighted, states and programs may use and reproduce COS materials. States should use caution when modifying the COS form. Contact the Child Outcomes Measurement topic specialist for technical assistance on allowable state modifications.

• Review the information collected and add any items that your state or local program needs for analysis that are not captured elsewhere or cannot be linked to other data (for example, date of first or last service, program name, or program ID).
• Remove unnecessary items that duplicate data that are collected or available through other means. If your state doesn't use interim COS ratings (between entry and exit), remove the interim rating option.
• Rename items that don't match usage or labels within your data system.

• The three outcomes are labeled as Outcome 1, Outcome 2 and Outcome 3. Some state refers to them as Outcome A, Outcome B, and Outcome C, respectively.
• If your state uses culminating descriptor statements rather than numerical 1 to 7 ratings, you can replace the numbers in the boxes with the culminating descriptor statements.

If the COS form is submitted for centralized data entry by the local program, determine if you would like summary information to appear first on the form, eliminating the need by data entry personnel to page through the document. You may want to include summary fields like the following, and instruct those completing the form to fill them out after completing the COS rating.

Overall Age-Expected Functioning

Some Age-Expected Functioning

Not Yet Age-Expected Functioning