Outcomes FAQ

An outcome is a benefit experienced as a result of services and supports provided for a child or family. The fact that a service has been provided does not mean that a positive outcome has been achieved. Likewise, an outcome is not the same as satisfaction with the services received. The impact that services and supports have on the functioning of children and families constitutes the outcome. Consider the example of a child with autism who receives therapy services to increase communication skills. Receiving the services is not an outcome, but, if the child learns words he can use to convey his needs to others, then he has achieved an outcome. Similarly, a family may receive information about their child's disability. Although this information is a service provided to the family, it is not an outcome. However, if the information enables them to assist in their child's learning and development more effectively, then the family has achieved an outcome.

In this age of accountability, policymakers are asking questions about the outcomes achieved through participation in programs supported by public funds. Judging the effectiveness of any program requires looking at results, not simply at the process of providing services. The Office of Special Education Programs (OSEP) in the U.S. Department of Education now requires states to report outcomes data for children and families served through Part C and Part B Preschool of the Individuals with Disabilities Education Act (IDEA) as part of their Annual Performance Report (APR). Many states have begun to use data on child and family outcomes in many different ways to improve their programs.

States must report the percentage of infants and toddlers with Individualized Family Service Plans (IFSPs) or preschool children with Individualized Education Programs (IEPs) who demonstrate improved:

1. Positive social-emotional skills (including social relationships)
2. Acquisition and use of knowledge and skills (including early language/communication [and early literacy*])
3. Use of appropriate behavior to meet needs

* Early literacy only applies to preschool.

The outcomes address three areas of child functioning necessary for each child to be an active and successful participant at home, in early care and education settings, and in the community.

Positive social-emotional skills refer to how children get along with others, how they relate with adults and with other children. The outcome includes the ways the child expresses emotions and feelings and how he or she interacts with and plays with other children. For toddlers and preschoolers, these skills also include how children follow rules related to interacting with others in group situations such as in a child care center.

The acquisition and use of knowledge and skills refers to the child's ability to think, reason, remember, solve problems, and use symbols and language. The outcome also encompasses the child's understanding of physical and social worlds. It includes understanding of early concepts (e.g., symbols, pictures, numbers, classification, spatial relationships), imitation, object permanence, the acquisition of language and communication skills, and of early literacy and numeracy skills. The outcome also addresses the precursors that are needed so that children will experience success later in elementary school when they are taught academic subject areas (e.g., reading, mathematics).

The use of appropriate behavior to meet needs refers to the actions that children employ to take care of their basic needs, including getting from place to place, using tools (e.g., fork, toothbrush), and in older children, contributing to their own health and safety. The outcome includes how children take care of themselves (e.g., dressing, feeding, hair brushing, toileting), carry out household responsibilities, and act on the world to get what they want. This outcome addresses children's increasing capacity to become independent in interacting with the world and taking care of their needs.

A short Video: Child Outcomes Step-by-Step, provides additional information about the three outcomes.

The Office of Special Education Programs (OSEP) funded the Early Childhood Outcomes (ECO) Center to build consensus around a set of child and family outcomes. Between fall 2003 and spring 2005, ECO convened numerous stakeholder groups to gather input on what the outcomes should be and to review and comment on initial drafts of the outcomes. A draft set of outcomes was posted on the ECO website in December 2004 and January 2005. Based on the input received, ECO recommended a set of child and family outcomes to OSEP in February 2005. The child outcomes required by OSEP are similar to those recommended by the stakeholders. However, the OSEP-required family data are somewhat different from the ECO-recommendations.

See also: What are the family outcomes that states are required to report to the Office of Special Education Programs (OSEP)?

Functional outcomes describe children's mastery and appropriate application of behaviors, knowledge, and skills in a meaningful way in their everyday lives. The three child outcomes refer to actions that children need to be able to carry out and knowledge that children need to use in order to function successfully across a variety of settings. To be successful in these settings, it is important for children to be able to, for example, get along with others, follow the rules in a group, continue to learn new things, and take care of their basic needs in an appropriate way. Ultimately, achieving these outcomes will help children thrive at home, in school, and in many settings throughout their communities.

Many assessment tools examine children's development in domains. Domains describe children's skills and abilities within areas of development such as social, fine motor, gross motor, cognitive, and language. The skills and abilities described by domains are a necessary but not sufficient component of functioning within the routines and activities of early childhood like toileting, feeding, and playing with peers. Functioning within these routines and activities requires the integration of skills across the various domains. For example, playing with peers requires a social desire to play with peers; expressive communication to initiate, maintain, and direct the peers' attention; cognitive skills to sequence actions in play; and fine and gross motor skills to manipulate objects. Functional outcomes look at the integration of behaviors across domains that children need to participate in developmentally appropriate routines and activities. The three child outcomes focus on functioning rather than traditional domains.

It is certainly true that knowledge and skills underlie functioning in each of the three outcome areas. Knowledge and skills, as used in Outcome 2, refer to the specific set of knowledge and skills that lay the foundation for more formal learning later in school settings. The specific skills referred to in this outcome relate to processes such as acquiring general knowledge, thinking, reasoning, problem solving, and learning new vocabulary words. Positive social relationships addressed in the first outcome area encompass the skills required to get along with others. Taking appropriate action to meet needs addressed in the third outcome area includes knowledge and skills to move, act, and/or communicate so that children effectively meet their needs.

States are required to measure and report on the progress children make between the time they enter a program and the time they exit in each of the outcome areas. Data are to be reported for all children who stay in the program at least 6 months. Specifically, for each outcome, states are to report the percentage of children who:

1. Did not improve functioning
2. Improved functioning, but not sufficiently to move nearer to functioning comparable to same-aged peers
3. Improved functioning to a level nearer to same-aged peers, but did not reach it
4. Improved functioning to reach a level comparable to same-aged peers
5. Maintained functioning at a level comparable to same-aged peers

To report data in these five categories, states must have information about children's functioning at two time points (entry and exit) and have a way to examine the level of improvement or progress in functioning between those time points.

From these categories, data on two Summary Statements are computed. For each outcome, states report the following:

• Percentage of children who entered or exited the program below age expectations in each outcome who substantially increased their rate of growth by the time they turned 3 years of age (6 years of age for preschool) or exited the program, and;
• Percentage of children who were functioning within age expectations in each outcome by the time they turned 3 years of age (6 years of age for preschool) or exited the program.

States must set targets for each of the Summary Statements and report on their progress toward their targets.

The data collected are aggregated to create an overall view of the progress made by all children in the state who received Part C or Part B Preschool services. No identifiable data on any particular child are included in these reports. For more information on the OSEP reporting categories, see: Federal Requirements: OSEP Requirements

Note that although only entry and exit data are reported at the federal level, many states are obtaining this information at more frequent intervals to support statewide decisionmaking and program planning and improvement.

States reported data on the status of children at program entry in their February 2007 Annual Performance Reports (APR). States reported their first data on children's progress in the 2008 APR and have continued to report progress data annually.

Yes. The Office of Special Education Programs (OSEP) requires that states provide data on all three outcomes for every child leaving Part C or Part B Preschool services. Data are required for all outcomes even if there are no concerns about a child's development in an outcome, or if the child has delays only in one or two outcome areas. This includes children receiving only a single service such as speech therapy.

For states sampling children from their Part C or Part B Preschool population for outcomes reporting, data on all three outcomes must be provided for every child being sampled.

States are required to compare the functioning of children in Part C and Part B Preschool programs to age expectations because age expectations provide a common standard for all young children. To merely record that children made progress between entry and exit would not provide strong evidence for the effectiveness of the program. Also, one of the goals of early childhood services is to prepare children to succeed in kindergarten and, in kindergarten, children will be expected to meet grade-level standards. The Office of Special Education Programs (OSEP) recognizes that not all children will be able to function comparable to same age peers at the end of early childhood services, but the system is tracking how many have achieved or moved closer to functioning at an age expected level.

Children with severe disabilities may never achieve functioning comparable to their same age peers, but they often do make progress with the assistance of early intervention and preschool special education programs. Children who make progress but have not moved closer to functioning like same aged peers are counted in category "b" for the Office of Special Education Programs (OSEP) reporting purposes. They are counted as children who made progress. Even small steps of individual progress, the very things we strive for and celebrate for children with more severe impairments, count as progress for category "b."

See also: Federal Requirements

The data reported by states indicates that a very small percentage of children (less than 2% in nearly all states) show no progress between program entry and exit on one of the three outcomes. For their own purposes, it will be helpful for states to be able to describe the types of children who are reported in each of the Office of Special Education Programs (OSEP) "a" to "e" categories, especially those in category "a" (i.e., children who do not make progress). Many states are collecting additional information or linking child outcomes data to existing information collected so that they can understand more about how child and family outcomes are related to key child, family, and service characteristics.

See also: Federal Requirements

Using data already reported by states, we can calculate the percentage of children who left Part C programs because they reached their goals. We don't, however, have any data on children exiting from Part B Preschool, nor do we know anything about the progress of those who transitioned into special education programs. A more complete picture of the effectiveness of the programs can be obtained by looking at the extent of progress made by all children who received services.

See also: IDEA Child Outcomes Highlights: How is Progress Measured?, Child Outcomes Calculators and Graphing Templates, and the online calculator in the Converting COS Data to OSEP Progress Categories/Summary Statements?

States are using a variety of approaches to determine the percentage of children making five different kinds of progress in each of the three child outcomes areas.

See also: State Approaches to Measurement and What information is being reported to the Office of Special Education Programs (OSEP) about the three child outcome statements?

No.The Office of Special Education Programs (OSEP) requires that Part C programs report on the percentage of families who report that early intervention services helped the family in three areas. Part B Preschool programs report similar information for all students in special education preschool through secondary school: the percentage of families who report that the school facilitated parent involvement. Neither of these requirements address family outcomes because they ask for information about services provided rather than whether an outcome was actually achieved.

See also: What are the family outcomes that states are required to report to the Office of Special Education Programs (OSEP)?

For Part C, states are required to report the percentage of families participating in Part C who report that early intervention services have helped the family:

1. Know their rights
2. Effectively communicate their children's needs
3. Help their children develop and learn

For Part B Preschool, states are required to report the percent of parents with a child receiving special education services who report that schools facilitated parent involvement as a means of improving services and results for children with disabilities. States also may choose to collect additional information about family outcomes that resulted from the services and supports received in Early Intervention (EI) and Early Childhood Special Education services (ECSE).

See also: Family Outcomes

State Part C programs are using a variety of different surveys completed by families to identify the percentage of families involved with early intervention who indicate that the services have helped them.

Many of these states also gather information about the outcomes families experience as a result of services, such as those recommended by the Early Childhood Outcomes (ECO) Center.

Part B Preschool programs use a variety of approaches to meet the requirement to gather information on parent involvement. In some states, surveys completed by families are used to capture information about how much services have helped families and the outcomes families experience as a result of services. Having accurate information about family outcomes and experiences allows programs to improve their services.

See also: Child Outcomes: State Approaches to Measurement, What are the family outcomes that states are required to report to the Office of Special Education Programs (OSEP)?, What additional family outcome data does the Early Childhood Outcomes (ECO) Center recommend that states measure?

In addition to the required family data, the ECO Center recommends that states measure family outcomes. As a result of the ECO stakeholder process, the following five outcomes were identified as desired outcomes for all families participating in early intervention:

1. Families understand their child's strengths, abilities, and special needs
2. Families know their rights and advocate effectively for their children
3. Families help their children develop and learn
4. Families have support systems
5. Families access desired services, programs, activities in their community

Consensus was achieved for all five of these outcomes as relevant for families participating in Part C early intervention services. For families with children receiving preschool special education services, there was consensus that outcomes 1, 2, and possibly 3 apply. Consensus was not reached as to whether outcomes 4 and 5 apply to families receiving services through preschool programs.

The COS is a process developed by the Early Childhood Outcomes (ECO) Center that provides a common metric for describing children's functioning compared to age expectations in each of the three outcome areas. The COS provides a rubric for a team to summarize the child's level of functioning using information from many sources including assessment tools and parent and provider reports.

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 (including that from assessment tools) about a child's functioning and then making an informed decision (usually in a team setting) of which description in a rubric best describes how the child's functioning compares to that for age expectations. The process generates a single rating, even when knowledge about children's functioning comes from multiple different sources.

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 numbers and are using only words to describe the seven points on the scale. Features of the COS process that cannot be changed include the number of points on the scale (i.e., states cannot make it a 5-point scale) and the definition for each point. For more information about how any adaptations under consideration might influence the ratings, please contact us.

The COS form is currently only available in English.

See also: COS Form and Instructions

No. States have the option to collect the child outcomes data in any way that produces valid and reliable data. Many states have chosen to use the COS process because it allows them to aggregate information from programs that use different assessment tools or from teams who want to consolidate information about a child's functioning from multiple sources. However, the COS process is not the only way that states can gather progress information to address the Office of Special Education Programs (OSEP) child outcome reporting requirements.

See also: Child Outcomes: State Approaches to Measurement

To determine a COS rating, one or more members of the team must be able to describe/discuss each of the following: the child's functioning across settings and situations, age-expectations for children's development and functioning in the general population, the content 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

Yes. Previously, the process was referred to as the COSF (Child Outcomes Summary Form), but that acronym was somewhat misleading. The acronym was changed to COS for Child Outcomes Summary process to emphasize that accurately determining the child's status on the three outcomes is a process requiring more than completing a form. Materials that states can use to train on and improve their COS process have been updated and revised over time as states have learned more about using the COS process.

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, in early care and education settings, or in other settings where that child usually spends time; on criterion- or curriculum-based instruments, or norm-referenced scales; on interviews with family members, child-care providers, and caregivers; on informed clinical opinion; and on work samples.

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.

Initial and ongoing training for individuals and teams completing COS ratings are strongly recommended to produce valid ratings.

Yes. The Early Childhood Outcomes (ECO) Center recommends 9 to 12 hours of training for professionals involved in the COS process.

Teams can receive training and support to build these skills in a variety of ways:

See also: COS Process Professional Development, Outcomes: Self-Directed Learning, and What does a team need to know to complete the COS form?

Check with your state and program for specific policies related to completing COS ratings when in-person meetings are not possible. Although there are many advantages to in-person meetings, some teams are conducting COS rating determination meetings using telecommunication devices such as phone and/or computers with or without video or having discussions with team members in different locations through teleconferencing when there are extenuating circumstances. Using distance approaches successfully requires careful planning.

See: COS Completion When Teams Can't Meet In Person, Remote Screening, Evaluation, and Assessment

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.

The information that parents or family members provide about the child's functioning at home and in their care is essential to developing a complete picture of the child's functioning and must be considered to select the most accurate description of the child's functioning compared to age expectations. Teams have different ways of obtaining that information, including the option to have the parent present for the discussion. States vary in whether or not the parent is present when the actual rating is determined.

Child Outcome Summary (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.

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. 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.

The Early Childhood Outcomes (ECO) Center "crosswalked" some of the most commonly used assessment tools in Part C and Part B Preschool to the three Office of Special Education Programs (OSEP) child outcomes. The crosswalks show which items or areas on assessments tools address each of the three outcomes. The crosswalks were developed because most currently available assessment tools are organized around domains. As noted above, domains are not the same as functional outcomes (see question: How do functional outcomes differ from domains?). In developing crosswalks, we have applied a consistent set of rules to map assessment tool content to the outcome content. The crosswalks are not meant to be used as a checklist to determine level of functioning in an outcome area.

See also: Outcomes Measurement Resources: Instrument Crosswalks

The Family Outcomes Survey-Revised (FOS-R) was developed by the Early Childhood Outcomes (ECO) Center for states and Part C programs to use to determine the extent to which the five family outcomes were attained and also to provide the required information for the Office of Special Education Programs (OSEP) reporting on Indicator C4. The tool consists of 24 items that address the five family outcomes, and 17 items which can be used by Part C programs to report on the three Annual Performance Report (C4). See questions: What additional family outcome data does the Early Childhood Outcomes (ECO) Center recommend that states measure, and What are the family outcomes that states are required to report to the Office of Special Education Programs (OSEP)?

The FOS-R is a revision of an earlier survey (the FOS). The earlier survey is still available on the website and has separate versions for children birth to 3 years, 3 through 5 years, and parallel versions of the FOS for those participating in general early childhood services who may not have children enrolled in Part C or Part B Preschool services. All versions of the survey are available on the ECO website (see link below) in multiple languages and can be downloaded and reproduced free of charge.

States and programs can adapt the Family Outcome Survey to meet their needs; however, they are encouraged to consider the nature of the changes carefully. Research has been conducted on both versions of the Family Outcomes Survey items as written, so any change to the item wording or scaling means that current research on the surveys will not apply. Formatting changes that do not change the content, such as putting the state's program name or logo on the survey, are of no consequence to the research on the items and are encouraged. For further questions about types of adaptations a state is considering, please contact your ECTA State Contact.

Translations of both versions of the Family Outcome Surveys are available in several languages. If you have developed, or are interested in developing translations of these tools in additional languages, contact Thomas McGee.

See also: Family Outcomes Surveys: Survey Versions