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State Performance Plan Indicator 7
 School Year 2009-10 and Onward
(Revised 5/1/09)

Directions for Completing the Child Outcomes Summary Form

The following includes the forms and directions for conducting entry and exit assessments for preschool children with individualized education programs (IEPs) as required by Indicator 7 of the the State Performance Plan (SPP). Additional information regarding the sampling process and data reporting requirements may be found at:  http://www.p12.nysed.gov/specialed/spp/indicators/7.htm. The schedule of the year in which school districts are required to submit this data may be found at:  http://www.p12.nysed.gov/sedcar/sppschedule.html. Please direct your questions to the Special Education Policy Unit (518) at 473-2878 or Strategic Evaluation Data and Collection Analysis and Reporting (SEDCAR) Unit at (518) 486-4678.
 
All preschool children who were initially evaluated on or after March 1, 2006 and found eligible for preschool special education programs and/or services are required to have entry assessment results.

Starting in the 2006-07 school year, exit assessments only need to be conducted for preschool children with disabilities who stop receiving preschool special education services due to program completion or declassification during the school year in which the school district is required to report exit data on this indicator.  The only children in the sample of school districts who require exit assessments are those who received an entry assessment and participated in preschool special education for at least six months prior to exiting.  Even though only a sample of school districts need to conduct exit assessments and report progress data during the school year in which the district is scheduled to report, a school district may choose to conduct exit assessments on all preschool special education students to assist in making student and programmatic decisions.

The sample of school districts assigned to conduct these assessments each year will be reporting data through the Student Information Repository System (SIRS), using the Assessment Fact Template. This will enable the State to determine, for each outcome area, the:

The following information is to assist approved preschool evaluators, school district evaluation staff and Committees on Preschool Special Education (CPSEs) or Committees on Special Education (CSEs) in filling out the Child Outcomes Summary Form and Summary Assessment Results Form (11/06) for entry and exit assessments. The shaded column to the left on the Child Outcomes Summary Form indicates who should fill in the requested information.

ENTRY ASSESSMENTS

Approved preschool evaluators

CPSEs

EXIT ASSESSMENTS

Approved preschool evaluators or school district evaluation staff

If the child is being considered for declassification as a preschooler, approved preschool evaluators will provide the following exit assessment information to the CPSE. If a child is referred to the CSE, school district evaluation staff will provide the following exit assessment information to the CSE:  

CPSE or CSE 

The CPSE or CSE must:

  1. indicate the date of the CPSE or CSE meeting, identify the persons attending the meeting and their role(s) and indicate the methods for collecting family information on the child’s functioning.
  2. review the information provided by the approved preschool evaluator or school district evaluation staff, the Child Outcomes Summary Form at entry and current assessment reports.
  3. determine the child’s continuing eligibility for preschool special education programs and/or services or his/her eligibility for special education as a school-aged student.
  4. determine in each of the three outcome areas identified in questions 1b, 2b and 3b whether the child has shown any new skill or behavior in the area and circle “yes” or “no”.  If answering “yes”, then indicate what progress has been made. (*new data element)
  5. identify on a scale of 1-7 the child’s typical functioning (not his/her capacity to function under ideal circumstances) across typical settings in each of the three outcome areas identified in questions 1c, 2c, and 3c, that relate to the child’s behaviors and skills. Only one rating (number) should be circled for each outcome.  This information must also be transcribed to the summary assessment results page. Children rated as 6 or 7 are considered as having functioning typical of their same-aged nondisabled peers.
  6. retain the Child Outcomes Summary Form in the child's record.

 

Completely

Means:

 

7

Child shows behaviors and skills expected for his or her age in all or almost all everyday situations that are part of the child’s life.

  • Behavior and skills are considered typical for his or her age.

 

6

 

Between Completely and Somewhat

 

 

Somewhat

Means:

 

 

5

Child shows behavior and skills expected for his or her age some of the time across situations.

  • Behavior and skills are a mix of age appropriate and not appropriate.

  • Behavior and skills might be described as more like those of a slightly younger child.
  • Some behaviors or conditions might be interfering with the child’s capability to achieve age-expected behavior and skills.

 

 

4

 

Between Somewhat and Emerging

 

 

Emerging

Means:

 

 

3

Child does not yet show behaviors and skills expected of a child of his or her age in any situation.  Child’s behaviors and skills include immediate foundation skills upon which to build age expected skills.

  • Behaviors and skills might be described as more like those of a younger child.

  • Some behaviors or conditions might be interfering with the child’s capability to achieve age-expected behavior and skills.

 

 

2

 

Between Emerging and Not Yet

 

 

Not yet

Means:

 

 

1

Child does not yet show behaviors and skills expected of a child his or her age in any situation.  Child’s skills and behaviors also do not yet include any immediate foundation skills upon which to build age-expected skills.

  • Child’s ways of forming and maintaining social relationships might be described as more like those of a much younger child.

  • Some behaviors or conditions might be seriously interfering with the child’s capability to achieve age-expected behaviors and skills.

.

Approved Preschool Evaluators and CPSEs/CSEs when making their decisions should consider evidence of the following behaviors[1]:

  1. Positive social-emotional skills (including social relationships): Children who achieve this outcome at a level that is comparable to same-aged nondisabled children show a variety of behaviors related to having social relationships. For example, they:
  1. Acquisition and Use of Knowledge and Skills: Children who achieve this outcome at a level that is comparable to same-aged nondisabled children show a variety of behaviors related to having knowledge and skills. For example, they:
  2. Use of Appropriate Behaviors to meet his/her needs: Children who achieve this outcome at a level that is comparable to same-aged nondisabled children show a variety of appropriate behaviors to meet their needs. For example, they:

.


Revised 11/06                                                                                                  

 

CHILD OUTCOMES SUMMARY FORM

This column indicates who should complete each section

 

 

 

Entry Information

CPSE
completes for Entry

 

Date of Meeting:         /         /         

                  Mo. / Day/ Yr.

 

 

 

Approved Preschool Evaluator

completes for Entry

 

Child Information

 

Name:  _______________________                                

 

Date of birth:          /         /       

                        Mo. / Day/ Yr.

       

.

 

 

ID:  ____________________________________________

CPSE
completes for Entry

Persons involved in deciding the summary ratings for Entry:

Name

Role

_________________________

____________________________

_________________________

____________________________     

_________________________

____________________________

_________________________

____________________________

_________________________

____________________________

     

     

     

     

Family information on child functioning (Check all that apply):

      Received in team meeting

      Collected separately

      Incorporated into assessment(s)

      Not included


CPSE
(Declassification)

Exit Information

Date of meeting:          /         /       

                      Mo. / Day/ Yr.

  District Name: _________________________________________

 

or

 

CSE

(Referral)

completes for

Exit

Persons involved in deciding the summary ratings for Exit:

Name

Role

      _________________________

_________________________

____________________________

_________________________

____________________________

_________________________

____________________________

_________________________

____________________________

_________________________

     

     

     

     

Family information on child functioning (Check all that apply):

      Received in team meeting

      Collected separately

      Incorporated into assessment(s)

      Not included

           

.

 

1.   POSITIVE SOCIAL-EMOTIONAL SKILLS (INCLUDING SOCIAL RELATIONSHIPS)

 

To answer the questions below, think about the child’s functioning in these and closely related areas (as indicated by assessments and based on observations from individuals in close contact with the child):

 

·       Relating with adults

·       Relating with other children

·       Following rules related to groups or interacting with others (if older than 18 months)

Entry Information

CPSE completes for Entry

 

 

1a.  To what extent does this child show behaviors and skills related to this outcome appropriate for his or her age across a variety of settings and situations? (Circle one number)

Completely

Somewhat

Emerging

Not Yet

7

6

5

4

3

2

1

.

 

 

Approved Preschool Evaluator

completes for Entry

 

 

Supporting evidence for answer to Question 1a (entry)

Source of information

Date

Summary of Relevant Results

     

     

     

     

     

     

     

     

     

     

     

     

     

     


 

 

.

 

CPSE

(Declassification)

 

or

 

CSE

(Referral)
completes for Exit

Exit Information

1b. Has the child shown any new skills or behaviors related to positive social-emotional skills (including positive social relationships) since the last outcomes summary?  (Circle one number)

YES

1

Describe progress:

 

NO

2

1c. To what extent does this child show behaviors and skills related to this outcome appropriate for his or her age across a variety of settings and situations? (Circle one number)

Completely

Somewhat

Emerging

Not Yet

7

6

5

4

3

2

1

 

Approved

Preschool Evaluator

(Declassification)

 

or

 

CSE

(Referral) completes for Exit

Supporting evidence for answer to Question 1b (Exit)

Source of information

 

Date

 

Summary of Relevant Results

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

 

2.               ACQUIRING AND USING KNOWLEDGE AND SKILLS

 

To answer the questions below, think about the child’s functioning in these and closely related areas (as indicated by assessments and based on observations from individuals in close contact with the child):

 

·         Thinking, reasoning, remembering, and problem solving

·         Understanding symbols

·         Understanding the physical and social worlds

 

 

CPSE
completes for Entry

 

Entry Information

2a. To what extent does this child show behaviors and skills related to this outcome appropriate for his or her age across a variety of settings and situations? (Circle one number)

Completely

Somewhat

Emerging

Not Yet

7

6

5

4

3

2

1

Approved Preschool Evaluator completes for Entry

 

Supporting evidence for answer to Question 2a (Entry)

Source of information

 

Date

 

Summary of Relevant Results

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

.

CPSE

(Declassification)

 or

2b. Has the child shown any new skills or behaviors related to acquiring and using knowledge and skills since the last outcomes summary?(Circle one number)

YES

1

 

Describe progress:

 

NO

2

2c. To what extent does this child show behaviors and skills related to this outcome appropriate for his or her age across a variety of settings and situations? (Circle one number)

CSE
 (Referral)
completes for Exit

Completely

  Somewhat   Emerging   Not Yet
7 6 5 4 3 2 1

 

Approved Preschool Evaluator

(Declassification)

 

or

 

CSE

(Referral) completes for Exit

 

Supporting evidence for answer to Question 2b (Exit)

Source of information

 

Date

 

Summary of Relevant Results

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

 

3.         USE OF APPROPRIATE BEHAVIORS TO MEET THEIR NEEDS

 

            To answer the questions below, think about the child’s functioning in these and closely related areas (as indicated by assessments and based on observations from individuals in close contact with the child):

 

·       Taking care of basic needs (e.g., showing hunger, dressing, feeding, toileting, etc.)

·       Contributing to own health and safety (e.g., follows rules, assists with hand washing, avoids inedible objects) (if older than 24 months)

·       Getting from place to place (mobility) and using tools (e.g., forks, pencils, strings attached to objects)

CPSE
completes for Entry

 

 

Entry Information

3a.    To what extent does this child show behaviors and skills related to this outcome appropriate for his or her age across a variety of settings and situations? (Circle one number)

Completely

Somewhat

Emerging

Not Yet

7

6

5

4

3

2

1

Approved Preschool

Evaluator

completes for Entry

 

Supporting evidence for answer to Question 3a (Entry)

Source of information

 

Date

 

Summary of Relevant Results

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

.

 

 

CPSE
(Declassification)
 
or

 

Exit Information

 

3b. Has the child shown any new skills or behaviors related to taking appropriate action to meet needs since the last outcomes summary?
(Circle one number)

YES

1

Describe progress:

NO

2

 

3c. To what extent does this child show behaviors and skills related to this outcome appropriate for his or her age across a variety of settings and situations? (Circle one number)

CSE

 

Completely

 

Somewhat

 

Emerging

 

Not Yet

(Referral)
completes for
Exit

 

7

6

5

4

3

2

1

Supporting evidence for answer to Question 3b (Exit)

 

Approved Preschool Evaluator (Declassification)

 

or

 

CSE

(Referral)

completes for Exit

 

Source of information

Date

Summary of Relevant Results

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     


SUMMARY ASSESSMENT RESULTS

 

Child’s Name:     __________________________________________________

Date of Birth:     __________________________________________________

Transfer information from the Child Outcomes Summary Form for each outcome area to this summary sheet.  This will assist the district in gathering information needed to complete the Assessment Fact Template submitted through the Student Information Repository System (SIRS). For further information see http://www.p12.nysed.gov/specialed/spp/7data.htm .

I. Record Entry and Exit Scores (scale of 1-7).

 

Positive social emotional skills

Acquisition of knowledge and skills

Use of appropriate behaviors to meet his or her needs

Entry Rating (CPSE)

 

 

 

Exit Rating
(CSE or CPSE – for declassification or
CSE – for referral for school-age services)

 

 

 

.

II. The Child’s Progress at Exit: Record “yes” or “no” for any new skills or behaviors.

 

Positive social emotional skills

Acquisition of knowledge and skills

Use of appropriate behaviors to meet his or her needs

Exit Rating
(CPSE – for declassification or
CSE – for referral for school-age services)

 

 

 

 

1 - Greenwood, Charles Ph.D and Carta, Judith Ph.D Issues Related to Implementation of Accountability Systems for Children 0-5 with Disabilities, DEC Roundtable Presentation, December 6, 2004, Chicago, Illinois