Despite not being able to meet in person, tele-intervention (telehealth) has brought new opportunities to think about how we are talking about the child outcome summary process. Let’s be completely honest. Tele-intervention forces us to use good teaming practices because there cannot be any side conversations among professionals and everyone is only able to see and hear the same information. This helps us think outside of the box to ensure that all team members have the exact same information so caregivers can make the best decisions for their child.

After completing tele-assessments, I have experienced great success incorporating the caregivers in the Child Outcomes Summary (COS) discussion. The COS process summarizes a child’s functional development in three child outcome areas: positive social-emotional skills (including social relationships), acquire and use knowledge and skills (including early language/communication), and use of appropriate behaviors to meet their needs. The Decision Tree can be a helpful tool to facilitate the COS process.

All caregivers participate in the COS discussion using the Decision Tree. This includes deciding with the team which rating statement represents their child’s functioning compared to other kids of the same age. (Click here for more information about the Decision Tree and Virginia’s COS Process). Before even going through the process, it is most helpful to discuss who will facilitate the discussion with the caregiver and the rest of the team members. This includes sharing the screen to show the Decision Tree.   This can be the service coordinator or a provider. Here are 6 steps you can use throughout the process that I have found beneficial.

6 Steps for Engaging Caregivers during the COS Process

1. Explain the caregiver’s role as a team member.

This is an important step. Caregivers need to understand their role in the process and how they can participate. When they are unsure of what to do, they may be more reluctant to participate. Encourage their voices by involving them throughout process, giving thorough explanations, and asking open-ended questions to receive more in-depth answers.

2. Explain each outcome area and the use of the Decision Tree.

The second page of the Decision Tree shows the Infant & Toddler Connection of Virginia Child Outcomes Summary handout. This handout was specifically designed to support the caregiver’s understanding of the process. It is helpful to send this handout to caregivers prior to the meeting and share the screen with the document pulled up while discussing and highlighting different outcome areas. This will also encourage caregivers’ participation when they fully understand what is being discussed and why.

3. Discuss each outcome area with individualized examples.

During the Assessment for Service Planning, the team discusses functional development within each outcome area based on parent report, observation, clinical opinion, etc. Functional child development focuses on what matters in the family’s daily life, showing how the child is engaging, initiating, and participating throughout their day. It has little meaning to a caregiver if a child can stack blocks, so a functional example would be, “During bath time, Sydney enjoys lining her plastic blocks on the bathtub ledge before knocking them off and laughing. Her mother commented Sydney enjoys playing this game the entire time.” Embedding functional information like this contributes rich examples to the Decision Tree discussion that help all team members understand the child’s abilities and needs. During the discussion, it is also helpful to share the screen to show each outcome area on the IFSP as it is discussed. Screen sharing gives the parent the opportunity to follow along.

4. Review typical functional development.

This is an important step and not to be missed. It truly helps each team member, including the caregiver, understand what is typical for the child’s age within that given child outcome area. This will help each team member understand whether or not the child has “age-expected” functional skills. Utilize your resources for typical development. This can include a combination of resources such as the Act Early Milestones, Functional Development, Age-Expected Snapshots of Development, etc. Again, sharing the screen to show this information and/or sending the info prior to the meeting is beneficial to all team members.

5. Use the Decision Tree discussing each question and prompt.

Again, sharing the screen and/or sending the Decision Tree to the family prior to the meeting can be really helpful. Screen sharing allows each team member (including the caregivers) to look at the same information and follow along accordingly. Ask each question out loud for each decision point. Pause for discussion or examples. When choosing between two items at the decision point, read it and reflect with the caregiver and other team members about specific examples to reach an agreement on the best possible choice. By this point, caregivers should feel empowered to help make the best decision based on the information given to them and understand the importance of their voice.

6. Decide as a team the best statement.

Everyone has a voice. Check in with each person to make sure everyone is in agreement including the caregiver. Discuss specific examples if there is a difference of opinion at any given point in time.

Please note: When I share my screen, I already have these resources pulled up and ready to share as they are discussed: Decision Tree and the Infant & Toddler Connection of Virginia Child Outcomes Summary handout, the child’s IFSP, and information about typical functional development (See #4 above).

What are your top tips to engage families during the Child Outcome Summary Process?

How do you help facilitate the discussion?

Share your tips and ideas by leaving a comment below!

For more information about the COS process and the Decision Tree, check out these resources:

Decision Tree Tutorial

Virginia’s Child Outcomes Booklet: Team Engagement in the Child Outcomes Summary Process

The Decision Tree: A Tool for Teaming and Family Engagement – Parts I and II

ECTA COS Completion: When Teams Can’t Meet in Person

Extra! Extra! Read All About….Integrating the Decision Tree

Logan is Not a Number! – Explaining the Child Outcomes Process

COS Completion – When Teams Can’t Meet in Person

The post Successfully Engaging Caregivers in the Child Outcomes Summary Process Virtually appeared first on Early Intervention Strategies for Success.

Logan’s annual IFSP review is underway and you are excited to celebrate his progress. You’ve been working with his family for a year so you’ve seen the steady pace at which Logan continues to develop. When he first entered early intervention, he was only two months old and doing most of the things a two-month-old needed to do. Now that he’s 14 months old, his delays appear more significant but you want his parents to remain hopeful so you and your colleagues explain the assessment results, celebrating his gains and acknowledging the next skills to come.

When the team discusses the child outcomes summary process, the service coordinator uses the Decision Tree (PDF, New Window) as a guide. Because of his age and slow but steady progress, Logan is showing very early skills when compared to his same age peers, which sounds very different from the discussion the team had last year. You want to help Logan’s parents understand why this is, but then another team members drops this question:

“So what do we think? Is Logan a 1 or a 2 now?”

“OMG,” you think, “Logan is NOT a number!” Now what do you do?

Children are Not Numbers on the Decision Tree

This is an important point that ALL team members need to understand. The discussion about the child outcomes and the Decision Tree (PDF, New Window) should never include labeling a child with a number. It should be about using the information you have to make an informed decision as a team that describes Logan’s development according to the three global child outcomes (“global” because these are outcomes we’d like to see for all children during their early childhood years).

During the meeting, the team describes the child’s development using summary statements on the Decision Tree, not numbers (see the Child Outcomes Booklet (PDF, New Window) for more info). The numbers on the Decision Tree can be thought of as categories that describe skill development related to the child outcomes – not categories of children. For example, “Category 1” includes a summary statement (or description) that tells us that Logan has “very early skills in this area. This means that [Logan] has the skills we would expect for a much younger child.” This does NOT mean that “Logan is a 1.” While the service coordinator does have to report a number for each outcome in documentation back at the office, and these numbers are referred to as “child ratings” according to the Office of Special Education Programs (OSEP), it’s a really good idea to let go of the idea that the child outcomes discussion results in a number for the child. Let. It. Go.

Here’s why: If you hold this belief, even an underlying belief in linking a child to a number, then you will convey this belief to the family. No parent wants their infant or toddler rated or numbered. It can be hard enough for a parent to hear the age equivalency scores from the assessment tool. Parents must be involved in the child outcomes discussion, and we want them to understand the process – a process that, admittedly, can be hard to explain.

The Words You Use Matter – Tips for Developing Your Script

The words you use to explain this process matter. Yes, some parents may be mentally exhausted by the time you get to this discussion, but that does not mean you should sugarcoat it, skip it, or hurry through it, which can be tempting to do. It can also be tempting to let the professional team members discuss the process without much explanation for the parent. To avoid this, try these tips:

1. Write down a sample script for how you can explain the process to all team members (including and especially the parent) without assigning the child a number, then let a colleague read it and give you feedback.
2. Read it out loud to yourself and see how it sounds.
3. Listen to how others explain the process and “borrow” their words.
4. Ask families who are already enrolled in your program what they understood about the child outcomes discussion from their initial or annual IFSP meeting.

Here’s a big one: Dig in a bit and reflect – Are you the team member who asked about a child’s “number” at an assessment or IFSP meeting? If you are, then it’s a good thing to recognize that now and commit to a change in thinking for your next assessment or IFSP meeting.

There is No Need to Pick a Number at the Meeting

How you explain the process will likely differ from your colleague’s script and that’s okay. The words you use may change a bit with each meeting depending on your style, the team with whom you work, the family’s understanding and learning needs, etc. The important point here is to think about the message you (and your team members) convey with the child outcomes process. There is no need to “pick a number” for a child during the meeting, but there is a need to be accurate, respectful, and sensitive while helping all team members understand, participate in the process, and identify summary statements to describe the child’s development.

Open the door for this discussion with your team members using the questions here, or share your thoughts by adding a comment below:

How do you explain the child outcomes discussion process to families? What are your go-to phrases to help all team members understand?

If a team member tries to pick a number at the meeting, what could you say in response?

For more information, check out these resources:

Virginia’s Child Outcomes Booklet (PDF, New Window)

Virginia’s System for Determining Child Progress (OSEP Child Outcomes)

Decision Tree Tutorial Video

The post Logan is Not a Number! – Explaining the Child Outcomes Process appeared first on Early Intervention Strategies for Success.