Child Outcomes Summary (COS) Form and Instructions
COS Form Overview
What is the COS process?
The Child Outcomes Summary (COS) Process is a team process for summarizing information related to a child's progress on each of the Three Child Outcomes on a 7-point scale.
The COS process can be used:
- When the state wants to use multiple sources of information to describe a child's functioning on each of the outcomes. The information could include one or more norm-referenced or curriculum-based assessments, parent report on child's skills and behavior, progress notes of therapists working with the child, observations by a teacher or child care provider, or other sources; or
- When different assessments have been given to different children across the state and the results need to be placed on the same scale to be aggregated.
Outcomes reflect these 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.
The COS Form is not an assessment instrument:
- The COS Form is used for summarizing across multiple sources of information about the child. The COS process allows states to address the OSEP reporting requirement as well as look at the child outcomes data in other ways.
- Using the COS process does not require that programs collect more data about children's progress; it is a mechanism that allows them to summarize assessment information for federal reporting as well as for their own purposes, such as for accountability, program planning, and program improvement.
Who completes the COS process, and how often?
The team completing the COS process includes those who know the child best:
- Those who know the child best frequently includes family members, professionals who work with the child, and anyone else familiar with the child's functioning.
- States might also determine who completes the COS process. States frequently report team sizes of 2–7 people.
- Some states complete the form as part of IFSP or IEP meetings.
- To provide data for the OSEP reporting requirements, the COS process must be completed at program entry and again at program exit with at least 6 months between. States that collect outcome data for their own purposes frequently complete the form annually, or every 6 months.
What training materials are available?
Training is essential for effective and reliable use of the COS process:
- ECTA Center provides COS Process Professional Development resources on child outcomes measurement and the three outcome areas, recommended assessment practices. The included information, activities, and case examples clarify critical choices and requirements for determining a rating, for example, using the rating scale, gathering multiple sources of assessment information, and comparing information to age-expectations.
Some states gather feedback from providers using the COS process:
- Feedback allows individual providers to ask questions, share effective strategies for working with local populations.
- Feedback can be used enhance the consistency of approaches used.
Can a state make alterations to the COS process or form?
Some states author their own versions of COS materials:
- While these materials are copyrighted, states and programs can use, reproduce, and alter the COS materials without charge.
- Contact Kellen Reid at firstname.lastname@example.org to discuss any changes your state is making, so that we have an accurate list of states using their own versions of COS materials.
Make your alterations carefully:
- Minor changes to format and not likely to impact the type of data that will result.
- More substantial changes—for example, using a 5-point rating instead of a 7-point scale—would hinder aligning results to OSEP reporting categories.
- Other substantial changes might invalidate certain lessons learned those using something closer to the original form.
Definitions for COS Ratings
Using the Definitions for COS Ratings
Developmental framework assumptions:
- Children develop new skills and behaviors and integrate those skills and behaviors into more complex behaviors as they get older.
- These skills and behaviors emerge in a developmental sequence in most children, allowing for descriptions of "what 2-year-olds generally do", "what 3-year-olds generally do", and so on.
- The development of children with disabilities can be compared to the development of same-age peers. A child's development might be characterized by delays, acquiring skills and behaviors at a substantially slower pace than others their age.
- A child's development might be atypical—with functioning so different from that of others their age that it is considered outside the limits of age-expected behavior.
Skills and behaviors:
- Foundational (F) skills and behaviors develop early, and provide a scaffold for later skills to build upon in predictable ways.
- Immediate foundational (IF) skills and behaviors indicate a higher level of developmental functioning. For example, children play alongside one another before they interact in play.
- Age-expected (AE) skills and behaviors are those expected for the child's chronological age.
Rating scale assumptions:
- Achieving each of the three child outcomes aligns with the goal of programs and services for children: active and successful participation across a variety of settings now and into the future.
- For many young children with disabilities, recieving high-quality services allows them to move toward age-appropriate functioning than they would without such services.
- Documenting children's progress toward age-appropriate functioning is one type of evidence for the effectiveness of early intervention and early childhood special education.
- The highest end of the scale represents age-expected or age-appropriate functioning, with each lower point being a degree of distance from age-expectations.
Definitions for COS Ratings — Online Edition
Overall Not Age-Expected
Definiciones para las calificaciones del resumen de resultados del niño — edición en línea
Apropiado para la edad
No apropiado para la edad
Decision Tree for Summary Rating Discussions
Using the Decision Tree for Summary Ratings
The Decision Tree for Summary Rating Discussions contains a series of questions about age-appropriate skills and behaviors within the Three Child Outcomes. Responses to these questions guide the user to a rating category on the 7-point scale. The version with no numbers can be especially useful when families are directly involved in team discussions that describe a child's level of functioning.
Decision Tree for Summary Ratings — Online Edition
Does the child ever function in ways that would be considered age-expected with regard to this outcome?
- If "NO (Consider rating 1–3)", then proceed to Step 2
- If "YES (Consider rating 4–7)", then proceed to Step 4
Does the child use any immediate foundational skills related to this outcome upon which to build age-expected functioning across settings and situations?
- If "NO", then "Uses skills that are not yet immediate foundational", then Rating = 1 (end)
- If "YES", then proceed to Step 3
To what extent is the child using immediate foundational skills across settings and situations?
- If "Occasional use of immediate foundational skills", then Rating = 2 (end)
- If "Uses immediate foundational skills most or all of the time", then Rating = 3 (end)
Does the child function in ways that would be considered age-expected across all or almost all settings and situations?
To what extent does the child function in ways that are age-expected across settings and situations?
- If "Occasional use of age-expected skills; more skills are not age-expected", then Rating = 4 (end)
- If "Uses a mix of skills with more that are age-expected than not age-expected", then Rating = 5 (end)
Does anyone have concerns about the child's functioning with regard to the outcome area?
- If "NO", then Rating = 6 (end)
- If "YES", then Rating = 7 (end)
Árbol de decisiones para proceso de resumén de resultados de niños — edición en línea
El Paso 1
¿El funcionamiento del niño es el esperado para su edad con respecto a este resultado?
- Si a respuesta es "NO (Considere calificar 1–3)", continúe con el Paso 2
- Si a respuesta es "SI (Considere calificar 4–7)", continúe con el Paso 4
El Paso 2
¿El funcionamiento del niño utiliza las habilidades y comportamientos inmediatas, relacionados a este resultado, antes de las esperadas para su edad sobre las cuales puede desarrollar el funcionamiento esperado para su edad en distintos entornos y situaciones?
- Si a respuesta es "NO", entonces "Utiliza habilidades y comportamientos básicas muy alejadas para su edad", entonces la Calificación = 1 (fin)
- Si a respuesta es "SI", continúe con el Paso 3
El Paso 3
¿Hasta qué punto el niño utiliza un funcionamiento inmediato antes de lo esperado para su edad en distintos entornos y situaciones?
- Si a respuesta es "Utiliza habilidades y comportamientos inmediatos de vez en cuando pero en la mayoría de ocasiones utiliza habilidades básicas muy alejadas para su edad", entonces la Calificación = 2 (fin)
- Si a respuesta es "Utiliza habilidades y comportamientos inmediatos a lo esperado para su edad la mayor parte o todo el tiempo.", entonces la Calificación = 3 (fin)
El Paso 4
¿El funcionamiento del niño, relacionados a este resultado, es el esperado para su edad en todos o casi todos los entornos y situaciones?
El Paso 5
¿Hasta qué punto el funcionamiento del niño es el esperado para su edad en distintos entornos y situaciones?
- Si a respuesta es "Utiliza ocasionalmente habilidades y comportamientos esperados para su edad; mayoritariamente utiliza habilidades y comportamientos inmediatos a lo esperado para su edad.", entonces la Calificación = 4 (fin)
- Si a respuesta es "Utiliza tanto habilidades y comportamientos esperadas para su edad y los inmediatos a lo esperado para su edad", entonces la Calificación = 5 (fin)
El Paso 6
¿Alguien tiene preocupaciones sobre el funcionamiento del niño con respecto al área de resultados?
- Si a respuesta es "NO", entonces la Calificación = 6 (fin)
- Si a respuesta es "SI", entonces la Calificación = 7 (fin)
- Building the COS Team: COS ratings are more consistent and accurate when family members provide information about the child's functioning. If family information on child functioning was not included, mark "Not included" on the first page. Additional state-specific information also may be requested.
- Completing the COS Form: Completing the form requires gathering information, documenting supporting evidence, and determining a rating for each of the three outcomes. For a rating to accurately reflect the child's current functioning, the COS Form—including all information-gathering—should be completed within a six-week period.
- Revisiting the COS Form: Questions 1b, 2b, and 3b are to be completed after some time has passed since the initial completion of the COS Form. Indicate if the child has made progress since the previous outcomes rating. Progress is defined as the acquisition of at least one new skill or behavior related to the outcome. Describe the nature of any progress made.
- People Who Know the Child: Gather information from a range of people in the child's life, including their parents, family members, caregivers, child care providers, therapists, service providers, case managers, teachers, physicians, and others who can provide information about the child.
- Settings and Situations: Find out what is known about how the child behaves across a variety of settings and situations (for example, at home, the grocery store, or a playground).
- Assembling Evidence: The information gathered by the Team might include firsthand accounts of child functioning, clinical observation, curriculum-based assessments, norm-referenced assessments, service provider notes about performance in different situations, and progress or issues identified in an IFSP or IEP process you have collected.
- Omitting Sources: Don't include sources that do not know the child, for example, information available in a child's records.
- Cite the Source: Indicate the source of the evidence (a parent, speech therapist, teacher, or specific assessment) and the nature of the evidence from the source.
- Functional Skills: Identify the specific functional skills the child uses in everyday settings and situations, and the consistency with which they are observed.
- Age-Anchoring: Describe the presence and absence of age-anchored skills—Foundational (F), immediate foundational (IF), and age-expected (AE)—that are consistent with the selected rating.
- Function, not Progress: Focus on the child's current level of functioning rather than how much progress the child has made.
- Compare to Same-Age Peers: Compare the child's skills and behaviors to those of same-age peers. For each of the three child outcomes, determine the extent to which the child's skills and behaviors are age-expected.
Example COS Form Supporting Evidence:
|Candace's mom||April 12, 2023||
|Candace's child care provider||April 5, 2023||
|Carolina Curriculum for Infants and Toddlers with Special Needs||Administered March 13, 2023||
|Developmental specialist||Observed over a 4-week period, March 2023||
- Summary Ratings: A summary rating provides an overall picture of how the child behaves across the variety of people and settings in their life at this particular time in their life. It is a number on the 7-point rating scale.
- Provide Guidance: Before determining a rating, ensure all team members have been provided guidance and instruction for using the rating scale.
- Assessment Tool Results: Assessment tools can be a useful source of information for reaching a summary decision. However, many assessment tools are "domain-based", and don't provide information about functional behaviors across a variety of situations. Knowing wether or not a child has mastered assessment items related to an outcome provides helpful information, but this information must be placed in context with what else is known about the child. A high score in a domain related to an outcome doesn't mean a child has achieved that outcome. Conversely, a low score does't mean a child hasn't achieved it.
- Standardized Test Results: A standardized test environment 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.
- Adaptations and Assistive Technology: A rating should describe the child's functioning using any 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 should reflect the child's observed functioning across a range of settings, not their capacity to function under ideal circumstances.
- Cultural Expectations: Some cultures have expectations that differ from published developmental milestones, for example, feeding and dressing oneself. In these instances, use the expectations for the child's culture to determine if child's functioning is age-expected.
- Prematurity: Use expectations for the child's chronological age, not a corrected age. The COS form is intended to describe the child's current functioning relevant to expectations for their age. Over time and with support, many children born prematurely will eventually perform like same age peers.
- Findings of Insufficient Information: It is common for a team to need to gather more information before determining a rating.
Review Rating Criteria
Overall Not Age-Expected