Johnston County Schools
EC Preschool Program
Child Outcomes Data Collection Tool
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
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
Role
Johnston County Schools
EC Preschool Program
1.
Child Outcomes Data Collection Tool
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
1
Emerging
2
Somewhat
3
4
5
Completely
6
7
Supporting evidence for answer to Question 1a
Source of information
Date
Summary of Relevant Results
Exit
Not Yet
1
Emerging
2
Somewhat
3
4
5
Completely
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
1
2
Describe Progress:
Johnston County Schools
EC Preschool Program
2.
Child Outcomes Data Collection Tool
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
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
1
Emerging
2
Somewhat
3
4
5
Completely
6
7
Supporting evidence for answer to Question 2a
Source of information
Date
Summary of Relevant Results
Exit
Not Yet
1
Emerging
2
Somewhat
3
4
5
Completely
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
1
2
Describe Progress:
Johnston County Schools
EC Preschool Program
3.
Child Outcomes Data Collection Tool
Taking Appropriate Action to Meet 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)

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
1
Emerging
2
Somewhat
3
4
5
Completely
6
7
Supporting evidence for answer to Question 3a
Source of information
Date
Summary of Relevant Results
Exit
Not Yet
1
Emerging
2
Somewhat
3
4
5
Completely
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
1
2
Describe Progress:
Johnston County Schools
EC Preschool Program
Child Outcomes Data Collection Tool
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:

o
Majority rules
o
Supervisor decides
o
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] ageexpected behavior or has [insert modifier] immediate foundational skills?
o
When have you observed or documented those skills?
o
In what situations?
o
How frequently does that occur?
o
Were the accommodations/supports available in that setting those that are usually
available to the child? What were they?
o
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?
o
Is there other information you need or want to be better equipped to make this decision?