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 rating 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.
- To discuss any changes your state is making, contact ECTA Center's Child Outcomes Measurement topic specialist 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 scale instead of a 7-point rating 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-expected functioning than they would without such services.
- Documenting children's progress toward age-expected 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-expected functioning, with each lower point being a degree of distance from age-expectations.
Definitions for COS Ratings — Online Edition
Overall Age-Expected Functioning
7
Child functions in ways that are age-expected in all or almost all everyday situations that are part of the child's life. No one on the team has concerns about the child's functioning in this outcome area.
6
Child's functioning generally is considered age-expected, but there are some significant concerns about the child's functioning in this outcome area. Although age-expected, the child's functioning may border on not keeping pace with age expectations.
Some Age-Expected Functioning
5
Child functions using a mix of skills, with more skills that are age-expected than not age-expected, across settings and situations in this outcome area. Child's functioning might be described as like that of a slightly younger child.
4
Child occasionally uses age-expected skills across settings and situations in this outcome area. More functioning is not age-expected than is age-expected.
Not Yet Age-Expected Functioning
3
Child uses immediate foundational skills most or all of the time across settings and situations. Child does not yet function in ways that would be considered age-expected in this outcome area. Functioning might be described as like that of a younger child.
2
Child occasionally uses immediate foundational skills across settings and situations. Child does not yet function in ways that would be considered age-expected in this outcome area. More functioning reflects skills that are foundational than are immediate foundational.
1
Child only uses foundational skills across settings and situations. These foundational skills are crucial to build immediate foundational skills. Child does not yet function in ways that would be considered age-expected or immediate foundational in this outcome area. Child's functioning might be described as like that of a much younger child.
Definiciones para las clasificaciones del resumen de resultados del niño — edición en línea
Funcionamiento en General Esperado para la Edad
7
El niño funciona de la manera esperada para su edad en todas o casi todas las situaciones cotidianas que son parte de su vida. Ningún miembro del equipo tiene preocupaciones sobre el funcionamiento del niño en esta área de resultados.
6
En general, se considera que el funcionamiento del niño es el esperado para su edad, pero existen algunas preocupaciones significativas sobre el funcionamiento del niño en esta área de resultados. Aunque es el esperado para su edad, el funcionamiento del niño puede estar al borde de no seguir el paso de las expectativas de su edad.
Algún Funcionamiento Esperado para la Edad
5
En todos los entornos y situaciones de esta área de resultados, el niño funciona utilizando una combinación de habilidades, con más habilidades esperadas para su edad que no esperadas para su edad. El funcionamiento del niño podría describirse como el de un niño un poco menor.
4
El niño utiliza ocasionalmente las habilidades esperadas para su edad en distintos entornos y situaciones en esta área de resultados. Hay más funcionamiento no esperado para su edad.
Funcionamiento No Esperado Para la Edad
3
El niño utiliza las habilidades fundamentales inmediatas la mayoría o todo el tiempo en distintos entornos y situaciones. En esta área de resultados, el niño aún no funciona como se consideraría esperada para su edad. Su funcionamiento podría describirse como el de un niño más menor.
2
El niño utiliza ocasionalmente habilidades básicas inmediatas en distintos entornos y situaciones. El niño aún no funciona como se consideraría esperado para su edad en esta área de resultados. Su funcionamiento refleja más habilidades fundamentales que fundamentales inmediatas.
1
El niño sólo utiliza las habilidades fundamentales en distintos entornos y situaciones. Estas habilidades básicas son cruciales para construir habilidades básicas inmediatas. El niño aún no funciona como se considera esperada para su edad o inmediatamente fundamental en esta área de resultados. El funcionamiento del niño podría describirse como el de un niño mucho menor.
Términos Utilizados con Frecuencia
Las habilidades funcionales son las que un niño de corta edad utiliza para realizar tareas y participar en la vida cotidiana, y el funcionamiento es el uso de estas habilidades de manera significante para servir un propósito.
Habilidades fundamentales son las habilidades que se desarrollan primero y sirven como la fundación o base para las habilidades que un niño desarrollara en el futuro.
Habilidades fundamentales inmediatas son un conjunto de habilidades que se desarrollan justo antes del funcionamiento esperado para la edad. Son las habilidades fundamentales recién desarrolladas que el niño ha dominado y tendrá que superar ya que son la base para demostrar el funcionamiento esperado para su edad.
Decision Tree for Summary Rating Discussions
- Download PDF (7-point rating scale)
- Download PDF (without rating scale numbers)
- Download PDF (Spanish)
Using the Decision Tree for Summary Ratings
The Decision Tree for Summary Rating Discussions contains a series of questions about age-expcted skills and behaviors within the Three Child Outcomes. Responses to these questions guide the user to a rating category on the 7-point rating scale. The version with no rating scale 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 — Flowchart Edition
Decision Tree for Summary Ratings — Text-Only Edition
Step 1
Does the child ever function in ways that would be considered age-expected with regard to this outcome?
- If "YES (Consider rating 4–7)", then proceed to Step 4
- If "NO (Consider rating 1–3)", then proceed to Step 2
Step 2
Does the child use any immediate foundational skills related to this outcome upon which to build age-expected functioning across settings and situations?
- If "YES", then proceed to Step 3
- If "NO", then "Uses skills that are not yet immediate foundational", then Rating = 1 (end)
Step 3
To what extent is the child using immediate foundational skills across settings and situations?
- If "Uses immediate foundational skills most or all of the time", then Rating = 3 (end)
- If "Occasional use of immediate foundational skills", then Rating = 2 (end)
Step 4
Does the child function in ways that would be considered age-expected across all or almost all settings and situations?
Step 5
To what extent does the child function in ways that are age-expected across settings and situations?
- If "Uses a mix of skills with more that are age-expected than not age-expected", then Rating = 5 (end)
- If "Occasional use of age-expected skills; more skills are not age-expected", then Rating = 4 (end)
Step 6
Does anyone have concerns about the child's functioning with regard to the outcome area?
- If "YES", then Rating = 7 (end)
- If "NO", then Rating = 6 (end)
Árbol de decisiones para proceso de resumén de resultados de niños — edición de solo texto
El Paso 1
¿El funcionamiento del niño es el esperado para su edad con respecto a este resultado?
- Si a respuesta es "SI (Considere Calificar 4–7)", continúe con el Paso 4
- Si a respuesta es "NO (Considere Calificar 1–3)", continúe con el Paso 2
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 "SI", continúe con el Paso 3
- Si a respuesta es "NO", entonces "Utiliza habilidades y comportamientos básicas muy alejadas para su edad", entonces la Calificación = 1 (fin)
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 a lo esperado para su edad la mayor parte o todo el tiempo.", entonces la Calificación = 3 (fin)
- 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)
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 tanto habilidades y comportamientos esperadas para su edad y los inmediatos a lo esperado para su edad", entonces la Calificación = 5 (fin)
- 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)
El Paso 6
¿Alguien tiene preocupaciones sobre el funcionamiento del niño con respecto al área de resultados?
- Si a respuesta es "SI", entonces la Calificación = 7 (fin)
- Si a respuesta es "NO", entonces la Calificación = 6 (fin)
COS Form
Getting Started
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.
Gathering Information
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.
Documenting Evidence
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.
Example COS Form Supporting Evidence:
Source | Date | 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 |
|
Determining Ratings
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
When reviewing Child Outcomes Summary forms for quality assurance, documentation should include the following kinds of evidence for each rating:
7
- Provide examples of the child's AE functioning.
- Indicate: "No concerns."
- For a rating of 7, evidence presents only AE functioning.
6
- Provide examples of the child's AE functioning.
- Note any concerns.
- For a rating of 6, evidence presents only AE functioning.
5
- Provide examples of the child's AE functioning.
- Provide examples of the child's functioning that is not AE.
- For a rating of 5, evidence presents more AE than IF functioning.
4
- Provide examples of the child's AE functioning.
- Provide examples of the child's functioning that is not AE.
- For a rating of 4, evidence presents more IF than AE functioning.
3
- Provide examples of the child's IF functioning.
- For a rating of 3, evidence presents more IF than F functioning.
2
- Provide examples of the child's IF functioning.
- Provide examples of the child's functioning that is not yet AE or IF.
- For a rating of 2, evidence presents F than IF functioning.
1
- Provide examples of the child's functioning that is not yet AE or IF.
- For a rating of 1, evidence presents only F functioning.