Turning Five Procedures:
Focus on
Child Development
Presented by:
Supervisors of School Psychologists
2008-2009
Turning 5 PD Goals
IEP Team Clinicians will be able to:
 Understand Federal and NYS requirements of preschool outcome
data
 Know the 5 Developmental Domains
 Understand Entry and Exit Assessment
 Know the 3 Outcome Areas
 Know how to apply outcome ratings in each area
 Know and apply the NYSED pre-K Learning Outcomes and PIs
 Know the major elements of the kindergarten curriculum
 Use and interpret an appropriate NYSED preferred assessment
tool (e.g., DAYC, PES)
 Understand typical and atypical child development
 Explain the CPSE to CSE transition
 Discuss the ASD-Nest program
Why Do We Need Outcome Data?
Pressure for Outcome Data at
the Federal Level:

GPRA (Government Performance and
Results Act)

IDEA (2004) goals and indicators established
Indicators were established (and revised) for
Part C and for 619 of IDEA

Linking Local Measures to OSEP
Reporting Requirements
5-year-old
level
Group A reaches
typical
levels
Group B makes
some progress
Group C made
no progress
2-year-old
level
Entry
Exit
Developmental Domains for Preschool
Outcomes established in IDEA
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Physical
Cognitive
Language and Communication
Social-Emotional
Adaptive
These domains inform us regarding the 3
outcome areas for indicator #7:
Indicator #7: 3 Preschool Outcomes
Indicator #7 from the State Performance Plan-Percent of preschool children with IEPs who
demonstrate improved:

Positive social-emotional skills (including
social relationships);

Acquisition and use of knowledge and skills
(including early language/communication
and early literacy); and

Use of appropriate behaviors to meet their
needs
Child Outcome Areas:
The Details
1.
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2.
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3.
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Positive social-emotional skills (including social relationships):
Relating with adults
Relating with other children
Following rules related to groups or interacting with others (if older
than 18 months)
Acquisition and Use of Knowledge and Skills:
Thinking, reasoning, remembering, and problem solving
Understanding symbols
Understanding the physical and social worlds
Use of Appropriate Behaviors to meet his/her 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) (if older than 24 months)
Getting from place to place (mobility) and using tools (e.g., forks,
pencils, strings attached to objects)
EXIT ASSESSMENTS


If a child is referred to the CSE, school district
evaluation staff will provide the following exit
assessment information to the CSE:
complete tables and supporting evidence for
questions 1a, 2a and 3a on the Child
Outcomes Summary Form identifying:
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the source of information (name of assessment
and edition),
date the assessment was given, and
a summary of relevant results in each of the three
outcome areas.
EXIT ASSESSMENTS
CSE must:

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.

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.

determine the child’s continuing eligibility for preschool special education
programs and/or services or his/her eligibility for special education as a schoolaged student.

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)

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.
Definitions for Outcome Ratings
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(7) Completely means: Child shows behavior and skills are
considered typical for his or her age
(6) Between Completely and Somewhat
(5) Somewhat means: Child shows behavior and skills expected
for his or her age some of the time across situations
(4) Between Somewhat and Emerging
(3) Emerging means: Child shows emerging behaviors and skills
expected of a child of his or her age in any situation
(2) Between Emerging and Not yet
(1) Not yet means: Child does not yet show behaviors and skills
expected of a child his or her age in any situation.
1. POSITIVE SOCIAL-EMOTIONAL SKILLS
(INCLUDING SOCIAL RELATIONSHIPS)
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demonstrate attachment with the significant caregivers in their
lives;
initiate and maintain social interactions;
behave in a way that allows them to participate in a variety of
settings and situations, for example, on a playground, at dinner,
at the grocery store, in childcare, etc.;
communicate wants and needs effectively;
build and maintain relationships with children and adults;
regulate their emotions;
understand and follow rules; and
solve social problems.
2. Acquisition and Use of
Knowledge and Skills
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display an eagerness for learning;
explore their environment;
attend to people and objects;
engage in daily learning opportunities;
use knowledge and skills (e.g., vocabulary,
complexity of language, problem-solving skills,
general knowledge, etc.) in a variety of everyday
routines and activities;
acquire and use the precursor skills that will allow
them to learn reading and mathematics in
kindergarten; and
show imagination and creativity in play.
3. Use of Appropriate Behaviors
To Meet His/Her Needs
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meet their self-care needs (feeding, dressing,
toileting, etc.);
use objects (spoons, pencils, crayons, clay,
scissors, other devices, etc.) as tools;
move from place to place to participate in everyday
activities and routines;
seek help when necessary to move from place to
place;
seek help when necessary to assist with basic care
or other needs; and
follow rules related to health and safety.
Preferred Assessment Tools Used in
New York State (NYSED, Feb. 2006)
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Battelle Developmental Inventory-2nd ed.
Bayley Scales of Infant Development-2
Brigance Inventory (Early Development)
Carolina Curriculum for Preschoolers-2nd ed.
Developmental Assessment of Young Children
(DAYC)
Hawaii Early Learning Profile (2004)
Preschool Evaluation Scale (PES)
Vineland Social Emotional Early Childhood Scales
(SEEC)
Learning Outcomes and Indicators
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NYSED Pre-K Learning Outcomes
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Personal Health and Safety Skills
Social and Emotional Development
Language Development and Communication
Skills
Cognitive Development/Intellectual Abilities
Approaches to Learning
Motor Development
http://www.vesid.nysed.gov/specialed/publications
/preschool/learnoutcomes.htm
Learning Outcomes and Indicators

NYSED Pre-K Performance Indicators:

ELA
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Reading
Writing
Listening
Speaking
Math
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Problem solving Strand
Reasoning and Proof Strand
Communications Strand
Connections Strand
Physical and Motor Development
During the 2nd year, typically developing
children:
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Walk well (do not need hand held, do not lose
balance easily)
Run (but running may be clumsy)
Climbs up and down stairs independently,
with a step-to gait, using hands on wall or
railing to assist
Jump off a bottom step with two feet
Can push a push toy
Can kick a ball (but may not be accurate)
The

nd
2
Year (continued)
By approximately 2.5 years of age, typically
developing children can
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walk on tiptoes
jump up with both feet
stand on one foot for 1 or 2 seconds
throw a ball overhand for a distance of 2 or 3 feet
catch a ball between the arms and body
Third Year of Life
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Ascends stairs while alternating feet, but may
still need to use a handrail
Continues to descend stairs with a handrail
and step-to gait
Rides a tricycle
May be able to complete a single hop on the
preferred foot
By the end of the Fourth Year, a typically
developing child:
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Descends stairs with reciprocal gait
Catches a ball with hands only
Can learn to ride a small bicycle or use roller
skates
During the Fifth Year, children learn to:
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Skip (but boys may refuse to do so)
Broad jump approximately 2 feet
Jump rope
Perform “acrobatic tricks” (cartwheels, somersaults,
etc)
It is important to note that many of these higher level
gross motor skills DO NOT develop without an
opportunity to practice. For instance, a typically
developing child may not know how to perform a
cartwheel if never permitted to attempt it.
Atypical Gross Motor Development


Often a result of disturbances in the
neuromuscular or musculoskeletal system
Parent may report delayed achievement of
milestones, particularly crawling, standing,
and walking
Warning Signs
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W-sitting (sitting on floor with hips and knees turned
inward so feet outside hips)
Using one or both hands on handrail to help pull self
up stairs
Leaning whole body on handrail or using two hands
on handrail to go down stairs
Inability to get up from floor without pulling on
furniture or nearby adult
Dragging feet when running or walking
Frequent falls
Fine Motor and Visual Motor
Development in the Second Year

18-24 months
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Inserts shapes into shape sorter independently
Stacks 4-6 blocks
Turns individual pages with a book with a thick
cover and thick pages
Imitates vertical strokes while scribbling
Fine Motor and Visual Motor
Development for 2 year olds

24-36 months
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Begins using one hand to stabilize an object and the other
to manipulate
Removes lid with a screw-on top
Strings beads
Folds paper
Imitates horizontal lines and circles
Snips paper with scissors
Puts on shoes, socks, shorts
Removes socks, shorts
Can feed self with spoon
Fine Motor and Visual Motor
Development for 3 year olds

36-48 months
 Development of tripod grasp (holding a marker with the pads
of thumb and index finger, marker resting on the side of
middle finger with remaining fingers tucked into the palm)
 Transitions from full arm movements while scribbling to
movement initiated from the forearm and wrist
 Buttons and unbuttons large buttons
 Imitates a cross (intersecting vertical and horizontal lines)
 Cuts a line across paper within ½ inch accuracy
 Traces a line (vertical or horizontal) within ½ inch accuracy
 Feeds self with little to no spilling, drinks from cup held in one
hand
Fine Motor and Visual Motor
Development for 4 year olds

48-60 months
 Consistently uses tripod grasp, using forearm and wrist
movements to draw
 Performs serial opposition (touches each finger individually to
thumb within 8 seconds)
 Imitates square
 Cuts circles and squares within ¼ inch accuracy
 Imitates complicated block designs
 Folds paper with edges parallel and within 1/8 inch of each other
 Begins coloring within the lines
 Can dress and undress completely
 Holds fork in fingers, can spoon soup without spilling
Fine Motor and Visual Motor
Development for 5 year olds

60-72 months
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Mature use of scissors (smoothly coordinating both hands
together)
Cuts out small circles, squares and triangles
Strings small beads, reproducing color and shape
sequence
Copies from models of letters and numbers in correct
sequence
Imitates diagonal lines
Uses mature dynamic tripod grasp (with movement initiated
through the fingers)
Uses knife for spreading, and beginning to cut
Warning Signs
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Lack of consistent dominant hand use
Lack of ability to stabilize objects with one
hand while manipulating with the other
Holding writing implements with a fisted
grasp or with all five fingers on the tool
Movement of full arm when drawing instead
of isolating movement to wrist and hand
Warning Signs (continued)
Performing fine motor tasks (writing, cutting,
manipulating small objects) with thumb facing floor
and palm facing away from the body
 Inability to use scissors*
 Inability to copy vertical, horizontal or circular lines,
square or cross*
* Note that scissor or copying skills may not be present
if child has not had previous experiences with these
skills

Educational model vs. Clinical model

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ED Focus: Therapy addresses access to
special education & school environment
ED Focus: Works toward independence and
participation
ED Focus: Intervention for usually chronic
problems that interfere with the educational
process
Occupational Therapy
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OT must be required if it is to assist the
student to benefit from special education.
This implies:
The student has a disability
The OT service is educationally relevant and
clear in purpose
The OT service is necessary in order for the
student to access the general education
curriculum
Occupational Therapy

In all, students can benefit from some
services that are not educationally necessary,
but may be desired by parents and noneducational service providers. If OT does not
meet educational relevance, this may mean
the service is not the responsibility of the
public school system.
Cognitive and Academic Development
Skill Domains in Mathematics
Numbers &
Operations
Numbers can be used to tell us how many, describe order, and
measure
Geometry
Geometry can be used to understand and to represent the objects
directions, locations in our world and relationships between them
Measurement
Comparing and measuring can be used to specify “how much” of
an attribute (e.g. length) objects possess.
Data
Analysis
Algebra
Data analysis can be used to classify, represent, and use
information to ask and answer questions.
Patterns can be used to recognize relationships and can be
extended to make generalizations.
41
Jean Piaget: Cognitive
Development
Cognitive Development:
Piaget’s Sensorimotor Stage
Substage
Age
Behavior
Reflexes
0-1 mo.
Sucking, rooting to nipple
Circular Reactions I 1-4 mo.
Suck bottle/pacifier
Circular Reactions II 4-8 mo.
Push & watch objects fall
Secondary Schemes 8-12 mo. More deliberate actions
Circular Reaction III 12-18 mo. Curiosity, experiments
Mental Combinations 18-24 mo. Symbols, gestures
Cognitive Development:
Piaget’s Preoperational Stage
Qualities of Preoperational Thought (2-7 yrs.):
 Centration
 Irreversibility
 Egocentrism
 Animism
 Symbolic thought
 Empathy
 Theory of mind
45
CONSERVATION OF LIQUID
Conservation
The child sees two glasses of water and says that both contain the same
amount. The water from one is then poured into a tall, thin glass. The
child is asked, "Which glass has more water?"
CONSERVATION OF SUBSTANCE
The child sees two identical balls of clay and says that both have the
same amount. One ball is rolled out, making it longer. "Do the two
pieces have the same amount of clay?"
CONSERVATION OF NUMBER
The child sees two identical rows of pennies and says there is the same
number in each. Then, in one row, they are spread apart. "Do the two
rows have the same number of pennies?"
Egocentrism:
Piaget’s threemountain task. A
preoperational
child is unable to
describe the
“mountains” from
the doll’s point of
view- an indication
of egocentrism,
according to
Piaget.
Theory of Mind
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Hypothesis developed by Uta Frith, Simon Barron
Cohen and colleagues (1985)
Refers to the notion that persons with ASDs do not
understand that others have their own plans,
thoughts and points of view
People with ASDs have difficulty
comprehending when others don’t know something.
People with ASDs appear to be self centered,
eccentric, or uncaring
Theory of Mind: False Beliefs
Warning Signs of Cognitive Delay

13-18 months
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Does not point to or show others things that
interest him / her
Does not respond to name
Doesn't imitate actions or attempt to imitate
speech or songs
Early Warning Signs: Cognitive

19-24 months

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Does not recognize pictures of familiar objects or
persons by pointing or verbally labeling
Does not interact with others during play (for
example, showing, giving, looking up for a
reaction)
Early Warning Signs: Cognitive

25-36 months
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Does not listen to stories with pictures
Does not name pictures
Does not follow simple directives
Does not answer questions about recent
experiences
Does not follow two- or three-part directives
Speech and Language issues
Three Key Domains Research Says Predict Reading
Success
Oral Language
They acquire vocabulary that informs them about the world;
they use language to construct relationships
and categories, to figure things out, and to solve problems.
They also use language to express ideas and participate in
social contexts.
Phonological Awareness
They demonstrate sensitivity to, manipulation of, and use
of sounds in words.
Print Knowledge
They demonstrate knowledge of the units of print
(letters, words) and ability to translate print to sound
and sound to print (letter-to-sound) and understanding of
book and print concepts.
53
Language Development
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Receptive Language- the ability to derive
meaning from incoming auditory or visual
messages. Understanding a message from
another person
Expressive Language- the combination of
linguistic symbols to form meaningful
messages that is conveyed to another person
using speech, signing, or writing
Language Disorders and/or Delays
A language disorder can involve both receptive and
expressive language. It is generally classified according to the
four major components of the linguistic system:
1. Semantics- meaning of words, phrases and sentences.
Impairments can take the form of reduced vocabulary, word
retrieval deficits, poor word association skills, and difficulty with
figurative language forms.
2. Morphology- the structure of words and the construction of
individual word forms from the basic elements of of meaning.
Deficits are manifested as difficulties with plurals, past tense,
auxiliary verbs, possessives, etc
Delays: Four Major Components of the
Linguistic System
3. Syntax-rules governing the order and combination of words to
construct well-formed sentences. Deficits are characterized by
problems with simple and complex sentence types such as
negatives, interrogatives, passives, and relative clauses.
4. Pragmatics-rules governing the use of language in a social
context. Impairments can include a reduced repertoire of
communicative intentions, turn-taking difficulties in conversation,
inability to repair messages that are not understood by the
listener, and difficulty with narrative discourse (storytelling).
Language Development: Preschoolers

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24-36 months (2-3 years)- Phrases of 2-3 words turn into 4-5
word sentences. Child will ask questions “why”, “what”, and
“where”. Will mispronounce many sounds at this age.
36-48 months (3-4 years)- Uses increasingly complex
sentences. Can recount stories and events that happen from the
recent past. Can be the year for the occurrence of nonfluency or
dysfluency.
48-60 months (4-5 years)- Vocabulary exceeds well over 2000
words. Tells long stories and talks about their feelings.
Sentences are grammatically correct 90% of the time. Is
generally easy to understand by others, however child may still
make a few errors in speech sounds.
Language Development: Kindergarten

60-72 months (5-6 years)- By age six, the
child is able to understand from 13,000-over
20,000 words. The average length of the
child’s expressive language is 6.6 words. At
this stage the child makes leaps from the
spoken, signed, or cued word to the written,
and then to reading words.
Warning Signs for Possible Speech and
Language Delays/Disorders
Language Delays: Turning 5
4-5 years
 Doesn’t ask several questions a day
 Has difficulty formulating sentences, as shown by
word omissions, confused word order, or deleted
word-endings
 Can’t retell a simple story that links several thoughts
together in an orderly sequence
 Can’t talk about the past and future
 Can’t follow instructions involving three or more
steps
Language Delays: Kindergarten
5-6 years
 Can’t verbalize her/his name and basic information
about where she/he lives
 Doesn’t attend to a task for more than a few minutes
 Becomes frustrated during shared reading time
 Struggles with pre-literacy skills like rhyming and
sound recognition
“Look Who’s Talking”: Laura Dyer, MCD, CCC-SLP, Meadowbrook
Press
Unified Service Delivery System-Continuum of
Services for Students with a Disability:
Related Services

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Eligibility for Related Services
Frequency and Duration
Group/Individual Services and Group Size
Continuation, Modification or Termination of
Services
Considerations for Type and Intensity of
Services
Key Early Social Domains
Understanding Emotions: Inferring basic emotions from
expressions or situations and understanding the consequence of
basic emotions.
Behavioral & Emotion Regulation: Use of emotional gestures
and verbalizations to express feelings in a social situation;
inhibition of socially disapproved expressions of emotion
(hitting, tantrums, biting)
Initiating and Maintaining Positive Engagement with Peers:
Ability to be effective in interactions with peers, the result of
organized behaviors that meet short-term and long-term
developmental needs
(cooperating, listening, turn taking, seeking help)
Link Preschool Skills to Kindergarten Skills
Connect expectations to those that lay ahead…
Social Skills
Preschool
Primary Grades
• Regulation of:
Attention,
emotions, behavior
• Adjustment:
Control of emotions,
behavior
• Cooperating with
requests
• Sharing
• Turn Taking
• Social Competence:
Cooperative, prosocial,
Makes friends, takes
initiative
64
Early Warning Signs: Social-Emotional

25-36 months
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Does not engage in
symbolic play (for example,
using a banana for a phone,
or a block for a car)
Does not show objects to
another person
Does not give objects to
another person
Does not respond to or
initiate joint attention
Shows negativism,
tantrums, anger, aggression
Overactivity/hyperactivity
Anxiety
Severe Social-Emotional Warning Signs
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Interest in nonfunctional elements of play
materials/toys
Sensory examination of self and others
Stereotypic mannerisms, hand-flicking
Self-injurious behavior
Repetitive or stereotyped interests
Warning Signs: Maladaptive Behavior
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Hurtful to Self. Behavior that causes injury to a person's own body.
Hurtful to Others. Problem behavior that causes physical pain to other
people or to animals.
Destructive to Property. Problem behaviors such as deliberately
breaking, defacing, or destroying things.
Disruptive Behavior. Problem behavior that interferes with the activities
of others.
Unusual or Repetitive Habits. Problem behavior that involves excessive
repetition of unusual actions.
Socially Offensive Behavior. Problem behavior that is offensive to other
people.
Withdrawal or Inattentive Behavior. Problem behavior that reflects the
individual's difficulty in associating with other people or maintaining
attention.
Uncooperative Behavior. Problem behavior that reflects difficulty in
following rules or working with other people.
Ingram-Troxell Preschool Observation
Checklist for Autism


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Screening Tool
15 items
General Scoring
 ½ or more checked, than high chance of autism
 5 Key Items (1,2,3,7,10)
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Pointing to show interest or direct attention
Uses another’s body to obtain a desired object or action
Communication triad
Fails to look-up or orient when name called in normal tone
Does not exhibit functional or symbolic play
Ingram-Troxell Preschool Observation
Checklist for Autism
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
Rarely uses pointing to show interest or direct attention but may point to
request a desired object
Hand leads or uses another’s body to obtain a desired object or action
Does not pair gestures with eye gaze and verbalizations/vocalizations
(communication triad)
Exhibits lack of meaningful functional communication
Does not understand words out of context
Does not direct attention of others to an object or event in their environment
Fails to look-up or orient when their name is called in a normal tone of voice
Is not attentive to or interested in activities or events in their environment
Exhibits minimal spontaneous engagement in reciprocal play activities
Does not exhibit functional or symbolic play
Displays restricted interest in specific toys or activities
Has difficulty adjusting to unexpected or unplanned changes in their
environment
Has difficulty self-regulating or gaining control of their emotions or behaviors
Exhibits unusual or repetitive mannerisms involving hands/fingers
Exhibits the need for specific rituals or routines
Functional Behavior Observation Checklist for AutismPlayground
Ingram & Troxell (Copyright 2005)

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

Developed to provide a structured framework to observe children
at play
10-items that are operationally defined
15 minute playground observation
Scoring:
1= behavior is present and observed
0= behavior is absent or not observed
Ingram & Troxell
Playground Observation Checklist
(Copyright 2005)
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1. Engages in social play with peers
2. Uses playground equipment functionally
3. Shows awareness and adherence to the rules of a game
4.Shows a response to winning or losing
5.Initiates a communication with other children
6. Does not exhibit social isolation from other children
7. Engages in reciprocal social conversation
8. Respects boundaries and personal space
9. Does not exhibit gross motor incoordination
10. Does not exhibit socially inappropriate behavior such as
picking nose or skin, fondling genitals, or other behaviors that are
considered socially inappropriate or offensive
Transition from Preschool to Kg.
CPSE to CSE
Comparison of CSE vs. CPSE

There is a continuum of service rationale from Early Intervention all the way
through to public school age services

EI→ medical model
Preschool → school readiness with an emphasis on “extra push” of services to
allow children to be ready for school
School age → academic structured curriculum.
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“Services at CPSE are fundamentally different in nature and concept from CSE
services”
“CPSE services are designed to support children wherever they are- home, daycare, preschool…”
“Emphasis at this age is the development of adaptive, social and communication
skills. Pull out from the classroom or having a facilitator is an integral part of the
educational program especially if the child isn’t attending school full-time”
“Kindergarten is the entry into the educational arena where the emphasis is on
academics. Special education service is based on LRE and the continuum of
school based services.”
SEIT
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What is a SEIT?? SPECIAL EDUCATION ITINERANT TEACHER
SEITs have to be special ed teachers, not ABA providers, speech therapists,
undergraduate students working part-time…
SEIT is a service that was devised to serve the preschool population and is
based on preschool LRE principles.
What is LRE for a preschooler?- Natural setting (home, day-care, pre-k…)
SEITs is a less restrictive option compared to Integrated, special ed preschools.
A SEIT goes to the home/ day care where there is no special ed teacher
because you can’t expect the parent/ day care provider to focus on this aspect
of the child’s development.
There is simply no need for an itinerant teacher in a program that has a teacher
in it already – this is the reason why is discontinued through the turning 5
process.
Teacher within teacher programs simply do not exist here or any where else in
the country
We educate children in groups not one on one.
ASD-Nest Program
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If you think a child may be appropriate, speak to a contact at the
preschool/ SEIT provider so that they can approach the parents…
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Gauge the parent’s interest after the preschool’s/ SEIT’s initial response
and request permission from the parents to forward the child’s
information to the Nilofer Naqvi, point person at CSE 9.
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The NEST program consideration occurs in parallel to the turning 5
process.
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Checklist items….
Consider with care…
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Special Education Transportation
 Eligibility
 Medical
and other forms