JOHNSTON COUNTY SCHOOLS CHILD OUTCOMES DATA COLLECTION TOOL EC

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Child Outcome Summary Form

Johnston County Schools Child Outcomes Data Collection Tool

EC Preschool Program

Child Outcome Summary Form

Entry and Exit Data

Child’s Name DOB:

CECAS UID:

Initial Placement Date:

Entry Data Date: Exit Data Date:

Persons who contributed to date:

ENTRY EXIT

Name	Role	Name	Role

Family Information on child functioning (check all that apply):

Entry Exit

Received in team meeting Received in team meeting

Collected separately Collected separately

Incorporated into assessments(s) Incorporated into assessments

Other Other

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)

1a.To what extent does this child show behaviors and skills related to this outcome appropriate for his/her age across a variety of settings and situations?

Entry

Not Yet		Emerging		Somewhat		Completely
1	2	3	4	5	6	7

Supporting evidence for answer to Question 1a

Source of information	Date	Summary of Relevant Results

Exit

Not Yet		Emerging		Somewhat		Completely
1	2	3	4	5	6	7

Supporting evidence for answer to Question 1a

Source of information	Date	Summary of Relevant Results

1b. (If question 1a has been answered previously): Has the child shown new skills or behaviors related to positive social-emotional skills (including positive social relationships) since the last outcomes summary? (Circle one number)

Yes	No	Describe Progress:
1	2

Acquiring and Using knowledge and Skills

Thinking, reasoning, remembering, and problem solving
Understanding symbols
Understanding the physical and social worlds

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

Entry

Not Yet		Emerging		Somewhat		Completely
1	2	3	4	5	6	7

Supporting evidence for answer to Question 2a

Source of information	Date	Summary of Relevant Results

Exit

Not Yet		Emerging		Somewhat		Completely
1	2	3	4	5	6	7

Supporting evidence for answer to Question 2a

Source of information	Date	Summary of Relevant Results

2b. (If Question 2a has been answered previously): Has the child shown new skills or behaviors related to acquiring and using knowledge and skills since the last outcomes summary? (Circle one number)

Yes	No	Describe Progress:
1	2

Taking Appropriate Action to Meet Needs

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

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

Entry

Not Yet		Emerging		Somewhat		Completely
1	2	3	4	5	6	7

Supporting evidence for answer to Question 3a

Source of information	Date	Summary of Relevant Results

Exit

Not Yet		Emerging		Somewhat		Completely
1	2	3	4	5	6	7

Supporting evidence for answer to Question 3a

Source of information	Date	Summary of Relevant Results

3b. (If Question 3a has been answered previously): Has the child shown new skills or behaviors related to taking appropriate action to meet needs since the last outcomes summary? (Circle one number)

Yes	No	Describe Progress:
1	2

What if We Can’t Reach Consensus?

Suggestions for Reaching Consensus

Team disagreement is a common concern, but this doesn’t happen often.
Structure the discussion to minimize the likelihood of reaching an impasse.
Adopt a policy/procedure for dealing with these situations. Possible options:
- Majority rules
- Supervisor decides
- No rating is given (ECO doesn’t recommend!)
Focus most of the discussion on the child’s skills related to the outcome; don’t go to selecting a rating number too quickly.
Discuss the rationales for the differing ratings; focus on concrete descriptions and explore how these support a rating.
Included more discussions on what skills and behaviors you would see in a typically developing child this age to provide more background for the discussion of this child.
If irresolvable differences are occurring fairly frequently, revisit how the rating is being decided.

Possible Conversation Prompts from Groups Having Difficulty Reaching Consensus

Suggest that they re-visit documents that give examples of the breadth of content covered in each outcome. Have they discussed the child’s skills regarding those aspects of the outcomes? Are the comments being considered relevant to the outcome up for rating discussion? Conversation prompts may include the following:

“I hear you describing the child’s skills with regard to [insert content], what information do you have about the child’s skills in [insert another relevant setting or situation or outcome component that hasn’t yet been discussed]?”

“Tell me about the kinds of evidence that suggest to you this child has [insert modifier] age-expected behavior or has [insert modifier] immediate foundational skills?

When have you observed or documented those skills?
In what situations?
How frequently does that occur?
Were the accommodations/supports available in that setting those that are usually available to the child? What were they?
You identified this as an immediate foundational skill. Are there other steps in the sequence of development that need to occur between developmental skills in this area?
Is there other information you need or want to be better equipped to make this decision?

JOHNSTON COUNTY SCHOOLS CHILD OUTCOMES DATA COLLECTION TOOL EC
REFERENCES FOR VOLUME II OF TOBIAS AND JOHNSTON VETERINARY
Regular Meeting Board of Trustees Johnstonville Elementary School District

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