child early childhood outcomes form virginia department of education

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					Student Name:                                  Summary Date:                                                           Summary Date:



1a. AGE APPROPRIATE SOCIAL-EMOTIONAL SKILLS
           (INCLUDING SOCIAL RELATIONSHIPS)
                                                                                      1b. AGE APPROPRIATE SOCIAL-EMOTIONAL SKILLS
Please refer to the guiding questions when discussing the child’s functioning level
and fill out the progress scale below.                                                       (INCLUDING SOCIAL RELATIONSHIPS)
                                                                                         Please refer to the guiding questions when discussing the child’s functioning
1a. To what extent does this child show same-age functioning,                            l evel and fill out the progress scale below.
    across a variety of settings and situations, on this outcome?
       (Circle one number)                                                               1b. To what extent does this child show same age functioning,
                                                                                             across a variety of settings and situations, on this outcome?
    Not Yet                   Emerging         Somewhat               Completely                (Circle one number)

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

                                                                                                  1         2          3          4          5          6                 7
Supporting evidence for answer to Question 1a

                                                                                               Source of
   Source of                                                                                  information       Date             Summary of Relevant Results
   information          Date             Summary of Relevant Results




                                                                                         Supporting evidence for answer to Question 1b.



                                                                                      Select the best description from those listed below to describe the child’s
                                                                                      progress since Time 1. (Check one option)

                                                                                      Student did not improve functioning.
                                                                                      Student improved functioning, but not sufficient to move nearer to functioning
                                                                                      comparable to same age peers.
                                                                                      Student improved functioning to a level nearer to same age peers but did not
                                                                                      reach it.
                                                                                      Student reached functioning comparable to same age peers.
                                                                                      Student maintained functioning comparable to same age peers.



VDOE       July 1 – June 30                                                                                                                                 Aug 6, 2007
                                                Virginia Department of Education
                                      Early Childhood Outcomes Progress Summary Form

Student Name __________________________________                      Student I.D. ___________________________________
Student D.O.B. __________________________________

Entry Status (Time 1)                                                Exit Status (Time 2)
Date of entry into program _________________________                 Date of exit from program _______________________
Age at entry _____________________________________                   Age at exit _____________________________________

Persons involved in deciding the summary ratings:

                                   Time 1                                                         Time 2
                           Name                    Role                           Name                            Role




       Family information on child functioning (Check all that apply) Family information on child functioning (Check all that apply)
       ___ Received in team meeting                                   ___ Received in team meeting
       ___ Collected separately                                       ___ Collected separately
       ___ Incorporated into assessment(s)                            ___ Incorporated into assessment(s)
       ___ Not included                                               ___ Not included




VDOE    July 1 – June 30                                                                                                    Aug 6, 2007
Student Name:                                  Summary Date:                                                           Summary Date:




2a. ACQUISITION AND USE OF KNOWLEDGE AND SKILLS
(INCLUDING EARLY LANGUAGE/COMMUNICATION AND EARLY LITERACY)

Please refer to the guiding questions when discussing the child’s functioning level   2b. ACQUISITION AND USE OF KNOWLEDGE AND SKILLS
and fill out the progress scale below.
                                                                                      (INCLUDING EARLY LANGUAGE/COMMUNICATION AND EARLY LITERACY)


2a. To what extent does this child show same-age functioning,                            Please refer to the guiding questions when discussing the child’s functioning
    across a variety of settings and situations, on this outcome?                        l evel and fill out the progress scale below.
       (Circle one number)
                                                                                         2b. To what extent does this child show same-age functioning,
                                                                                             across a variety of settings and situations, on this outcome?
    Not Yet                   Emerging         Somewhat               Completely

       1            2            3       4         5           6           7                   Not Yet of
                                                                                               Source              Emerging             Somewhat                  Completely
                                                                                              information       Date             Summary of Relevant Results
                                                                                                 1          2          3          4          5          6                 7
   Source of
   information          Date             Summary of Relevant Results




                                                                                                (Circle one number

                                                                                         Supporting evidence for answer to Question 2b.



                                                                                      Select the best description from those listed below to describe the child’s
                                                                                      progress since Time 1. (Check one option)



Supporting evidence for answer to Question 2a




VDOE       July 1 – June 30                                                                                                                                 Aug 6, 2007
Student Name:                                  Summary Date:                                                             Summary Date:


                                                                                        Student did not improve functioning.
3a. USE APPROPRIATE BEHAVIORS TO MEET THEIR NEEDS                                       Student improved functioning, but not sufficient to move nearer to functioning
                                                                                        comparable to same age peers.
  Please refer to the guiding questions when discussing the child’s functioning level   Student improved functioning to a level nearer to same age peers but did not
  and fill out the progress scale below.                                                reach it.
                                                                                        Student reached functioning comparable to same age peers.
3a. To what extent does this child show same age functioning,
    across a variety of settings and situations, on this outcome?
       (Circle one number)                                                              Student maintained functioning comparable to same age peers.

   Not Yet                    Emerging         Somewhat               Completely

       1            2            3       4         5          6            7

Supporting evidence for answer to Question 3a


                                                                                                 Source of
   Source of                                                                                    information       Date             Summary of Relevant Results
   information          Date             Summary of Relevant Results




                                                                                                 Not Yet             Emerging             Somewhat                  Completely

                                                                                                    1         2          3          4          5          6                 7




                                                                                           3b. USE APPROPRIATE BEHAVIORS TO MEET THEIR NEEDS

                                                                                           Please refer to the guiding questions when discussing the child’s functioning
                                                                                           l evel and fill out the progress scale below.

                                                                                           3b. To what extent does this child show same age functioning,
                                                                                               across a variety of settings and situations, on this outcome?
                                                                                                  (Circle one number)

                                                                                           Supporting evidence for answer to Question 3b.



                                                                                        Select the best description from those listed below to describe the child’s
                                                                                        progress since Time 1. (Check one option)



VDOE       July 1 – June 30                                                                                                                                   Aug 6, 2007
Student Name:             Summary Date:                                  Summary Date:



                                          Student did not improve functioning.
                                          Student improved functioning, but not sufficient to move nearer to functioning
                                          comparable to same age peers.
                                          Student improved functioning to a level nearer to same age peers but did not
                                          reach it.
                                          Student reached functioning comparable to same age peers.


                                          Student maintained functioning comparable to same age peers.




VDOE   July 1 – June 30                                                                                      Aug 6, 2007