Birth%20to%203%20Child%20Outcomes

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Birth to 3 Child Outcomes

• Marylands Approach to Converting Assessment Data
  to OSEP Outcome Categories
• August 28, 2007
• Deborah Metzger
• Dmetzger_at_msde.state.md.us

Funded by IDEA General Supervision Enhancement
Grant (GSEG) CFDA84.326X
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Outcome Data CollectedWhen the Child Enters and
When the Child ExitsExample
Child enters at 20 months Initial Present
Levels of Development data are extracted
from the IFSP database
Child exits at 36 months Present
Levels of Development data at Exit are extracted
from the IFSP database and compared to
entry data to determine progress
Progress At Exit Data
Status At Entry Data
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How Do We Get The Data? (for Status At Entry and
Progress at Exit)Data Extracted from Present
Levels of Development and Electronically Linked
to 3 Outcomes to Produce Answers
Alignment of broad outcomes to Present Levels of
Development
Is the childs acquisition and use of knowledge
and skills (including early language/communication
) at the level expected for his or her age? 
Are childs social-emotional skills (including
social relationships) at the level expected for
his or her age? 
Does the child use appropriate behavior to meet
his or her needs at the level expected for his or
her age?
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Protocols for Linking Age Levels/Age Ranges with
Outcomes

• For the outcome acquisition and use of knowledge
  and skills (including early language/communication
  ), two domain categories (cognitive and
  communication) will be used. If both domains have
  quantitative data, the category that has the
  lowest range of data will be used.
• When an age range has been entered, the midpoint
  of the range will be used.

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Rationale for Marylands Approach

• Decision to align outcome process with the IFSP
  process
• Focus on improving evaluation and assessment
  practices (Online Tutorial)
• Focus on ensuring data is collected in all
  domains (Monitoring)
• Have a data system that collects Present Levels
  of Development (PLOD)
• Could get started by generating electronic
  reports from data entered into PLOD
• Response to local input

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Most Commonly Used Toolsin Maryland

• Early Learning Accomplishment Profile (E-LAP)
• Early Intervention Developmental Profile (EIDP)
• Hawaii Early Learning Profile (HELP)
• Battelle Developmental Inventory II
• Ages and Stages

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How will Local Programs Measure and Report Status
at Exit Data

• Assessment at exit results will be entered on the
  IFSP form, Section II Present Levels of
  Development (PLOD). The form will be revised so
  that providers can check off if the PLOD are from
  an entry, interim, or exit assessment.
• The name of the assessment(s) that were used will
  be documented on the IFSP form.
• The results of the assessments at exit will be
  entered into the new screens in the IFSP
  database.

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Need to Validate the DataCompare Domain Results
to Functional Results
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Child OutcomesValidationWHY?

• Maryland has elected to use the information from
  domain-specific assessment results to determine
  the results of functional child outcomes.
  Therefore it is important that the electronic
  results be validated.
• In other words, we are asking the following
• Are the responses derived from the
  electronically-extracted domain data consistent
  with direct responses from providers about a
  childs functioning in the three outcomes?

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How Will We Validate the Results?

• In December 2006, local Infants and Toddlers
  Programs began completing the Child Outcome
  Summary Form as soon as possible following
  initial evaluation and assessment.
• Local programs are completing COSFs at exit for
  children
• Who were referred since December 2006
• Who received services for at least six months,
  and
• For whom a COSF was completed at entry
• COSF results will be entered into the IFSP
  database.

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What if the electronic results and validation
results are different?

• During 2007-2008, we will begin to conduct a
  validation study by comparing electronic results
  and COSF results, conducting focus groups with
  local programs, and discussing discrepancies in
  results with local provider teams.
• Based on the validation study results, we will
  determine how our approach should be modified or
  changed, whether we will continue our progress
  reporting by using Present Levels of Development
  data or through the COSF.

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Converting Assessment Data to OSEP Outcome
Categories
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Measuring Progress Based on the Rate of Growth
Between Entry and Exit

• Working with Evaluation and Assessment
  Consultant to identify a methodology for
  measuring developmental gains during
  participation in early intervention
• Testing child data using two existing indices
• Intervention Efficacy Index
• Proportional Change Index

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Intervention Efficacy Index

• Relates changes in child capabilities to time
  spent in program describes individual and group
  progress in terms of developmental gains within
  and across domains for each month in an
  intervention program. (Bagnato Neisworth)

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Intervention Efficacy Index

• IEI Developmental gain in months
• Time in intervention in months
• IEI Exit DA - Entry DA
• Time in Intervention
• IEI 34 months-20 months
• 12 months
• IEI 1.17

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Proportional Change Index
Controls for childrens developmental status
before intervention Calculation is a ratio of
a childs rate of development at pretesting to
the rate of Development during intervention
defined at posttesting (Wolery, 1983)

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Proportional Change Index
PCI Exit DA-Entry DA / Entry DA
Time in Intervention Entry CA PCI
34months-20months/ 20 months 12 months
24 months PCI 14 /.83 12 PCI
1.40

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Linking Results to OSEP Categories
Test both Indexes with real-child
data Determine numerical ranges for linkage
to OSEP categories Decide which index yields
most meaningful results and most accurately
matches the OSEP categories

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Pros, Cons, Challenges!
Pros Existing IFSP data and statewide
database Use of COSF for validation has
generated good discussions of functional
performance Possibility of more meaningful
results using factors such as time in
intervention and relationship of chronological
age to developmental age at entry

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Pros, Cons, Challenges!

Cons Using domain-based assessment results to
Measure developmental progress in
functional Outcomes Using multiple assessment
tools, rather than single or limited number of
tools Challenges Making decisions thoughtfully
with regard to Impact on local programs and
families, but quickly enough to ensure meaningful
data and analysis Sleeping at night without
outcome nightmares!

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Ultimate GoalPositive Results for Infants,
Toddlers, and Families