The Child Outcome Summary (COS) Scoring Tool streamlines the federal-required COS process for Part C providers. It guides you through rating all three outcome areas, captures the supporting rationale, uses AI to help draft narrative language, and generates a clean PDF ready for the IFSP team.
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Guided 7-Point Scoring
Decision trees and anchor descriptions guide you to the correct rating for each outcome area — reduces rating variability across the team.
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AI Narrative Drafts
After scoring, AI generates a supporting narrative for each outcome area based on the evidence you entered. Review and edit before finalizing.
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Progress Over Time
Track COS ratings across multiple evaluation points to document child progress in the federal reporting format.
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IFSP-Ready Export
Export a formatted PDF that includes all three outcome ratings, narrative summaries, and the progress indicator for use in IFSP meetings.
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Accessing the Tool
The COS Scoring Tool is accessed through the Provider Hub or directly at cos.childhoodinterventions.com. Your Hub login email is used for authentication — no separate sign-in needed when coming from the Hub.
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Coming from the Provider Hub: click COS Scoring Tool on your dashboard and you'll be taken in directly with your email pre-validated. Your child roster from EI Session Notes is also accessible in the COS tool.
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Completing a COS
COS ratings use a 7-point scale defined by federal Early Intervention guidelines. The scale below defines each rating point; how you arrive at a rating depends on whether you're completing an entry or an exit COS — both are covered right after the scale.
1
Child does not yet show skills in this area
2
Child shows a few early skills but they are not yet immediate foundational skills
3
Child shows some immediate foundational skills but not all — skills not age-appropriate
4
Child shows some age-appropriate skills but not consistently or across settings
5
Child's skills are age-appropriate and consistent across settings and situations
6
Child shows age-appropriate skills and some skills beyond age expectations
7
Child's skills are well beyond age expectations across all settings and situations
How ratings are set — entry vs. exit. The two COS types are scored from different sources, so the workflow is different for each.
Entry COS. Ratings come from the child's eligibility evaluation. On the Child Info step, use the Eval Entry card to bring the evaluation into the tool, then the crosswalk to set the ratings:
Paste the eval narrative. Open the eligibility evaluation that was written (the Assessment page), select all and copy it, then choose Eval Entry → Paste from Eval Doc, paste it in, and click Import. The tool reads the narrative and pulls each outcome's functioning.
…or complete the eval in the tool (Enter During Eval). Type your messy notes as you assess, polish them into IFSP-ready language, paste that onto the IFSP assessment page, then generate the COS narrative. The exact order is spelled out in Entering info during the eval just below.
Set the ratings with the crosswalk. Open the Eligibility evaluation crosswalk and enter the DAYC-2 (or BDI-3) subtest scores. The tool suggests and applies an entry rating for each outcome.
No skills checklist for entry. The Score Outcomes Yes/No checklist is an exit-COS tool — you don't use it for an entry COS.
Entering info during the eval — step by step. When you assess the child in the room, use Eval Entry → Enter During Eval and work through these steps in order:
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Enter your notes
For each outcome, jot quick, messy notes in the Does Well and Has a Hard Time With boxes as you go — plus any collateral/family information and clinical opinion. Bullet fragments are fine; you don't need full sentences.
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Polish the notes
Click Polish Notes. The AI turns your fragments into three clean, family-friendly paragraphs per outcome: Activities Your Child Does Well, Activities Your Child Has a Hard Time With, and a Present Levels of Development summary.
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Copy each block into the IFSP
Use the Copy button on each polished block (or Copy All 3 →) and paste the Does Well and Has a Hard Time With paragraphs onto the assessment page of the IFSP. These blocks are for the assessment page — they are not part of the COS narrative.
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Generate the COS narrative
Set the entry ratings with the crosswalk (subtest age-equivalent scores), then click Generate Narratives. The Present Levels summary carries onto the COS narratives page; the Highest Established Band, Concerns, Next Emerging, and Not Yet sections are built from the crosswalk. Review and edit before exporting.
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Enter the age-equivalent score — not just the standard score. The crosswalk sets the COS rating by comparing each subtest's age-equivalent (age-expected) score, in months, to the child's age. That age-equivalent value is what drives the rating, so it must be entered — a standard score on its own will not produce a rating.
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Bring in the narrative — not just the scores. The subtest scores set the numeric rating, but the tool writes each outcome's current-functioning narrative from the evaluation text you paste or enter. A specific, example-rich evaluation narrative produces accurate, defensible descriptions; scores alone give you a number without the story behind it. Bring in the full evaluation narrative, not just the subtest scores.
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Keep PHI out of Eval Entry. Whether you paste an eval doc or use Enter During Eval, the text is sent to the AI to polish. Enter only skills and behaviors — no child name, date of birth, diagnosis, or address. (Name and DOB are automatically removed if detected, but it is safest to leave them out.)
Exit COS. Switch the COS type to Exit COS. Ratings reflect the child's current functioning, drawn from your documentation:
Upload your documentation (preferred). In the Upload supporting documents panel, drop in session notes, progress summaries, periodic reviews, or FL ELDS checklists (PDF, Word, or text) and click Generate Exit Narratives. The AI reads them to draft each outcome's current-functioning and Progress-Since-Entry narrative.
…or score by hand. On the Score Outcomes step, mark each skill Yes/No within its developmental band — use All Y / All N to move quickly, and tap the ⓘ icon on any skill for FL ELDS examples.
Confirm the rating. Either way, the tool produces a suggested 1–7 rating for each outcome that you confirm or adjust on Review & Export.
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Your exit COS is only as good as your notes. The AI drafts exit ratings and narratives from the documents you upload, so specific, functional, example-rich session notes produce accurate, defensible ratings — vague notes produce vague results. This is exactly why strong documentation throughout the year matters: good session notes are what make a fast, accurate exit COS possible. You are the clinician — always review and adjust the AI's rating and narratives before exporting.
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Progress indicators are automatic — when entry ratings are on file. When you set the COS type to Exit COS, the tool loads the child's entry ratings and calculates each outcome's progress indicator (a, b, c) automatically once you enter the exit ratings — no manual calculation needed. This only works if the entry information is available: load it from the Entry COS save file (Option A) or enter it under Entry COS Data first.
Putting it together. Select or add the child and choose the COS type, set the rating for each of the three outcome areas — Social-Emotional (A), Knowledge & Skills (B), and Taking Action to Meet Needs (C) — using the entry or exit method above. You never pick a rating from a blank slate: the tool recommends a 1–7 rating from your evidence, which you compare to the scale and adjust with clinical judgment. When all three are set, click Generate Narratives, review and edit the drafts, confirm the ratings on Review & Export, and export the complete COS as a PDF.
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Team consensus required: Florida Early Steps requires COS ratings to reflect team consensus. The tool supports documentation of the discussion, but the rating entered should reflect the full IFSP team's agreed-upon score — not one person's opinion.
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Entry COS example — Outcome A (Social-Emotional) Child: 18-month-old, referred for speech delay
Evidence entered: "Child makes eye contact and smiles when greeted. Reaches up to be held and calms when comforted by familiar caregiver. Does not yet point to request items or show shared attention with objects. Parallel play observed — does not initiate joint play with peers."
AI-generated narrative: "At entry, [child] demonstrates emerging social-emotional skills consistent with a rating of 3. Strengths include appropriate emotional reciprocity and caregiver attachment. Joint attention and intentional social communication are not yet present at age-expected levels and represent priority areas for early intervention."
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Exit COS
An exit COS is completed when a child transitions out of Early Steps — either at age 3 or when services are discontinued. The exit COS is compared to the entry COS to calculate the federal progress indicator (a, b, or c) for each outcome area.
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Progress indicator is automatic — when entry ratings are on file: When you select "Exit" as the COS type, the tool loads the child's entry ratings and calculates the progress indicator once exit ratings are set — no manual calculation. This requires the entry ratings to be available (loaded from the Entry COS save file or entered under Entry COS Data); if they aren't on file, provide them first.
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Select the child and choose "Exit" as the COS type
Setting the type to Exit loads the child's entry ratings (from the Entry COS save file or Entry COS Data) so the tool can compute the progress indicator. From here the tool will generate a recommended exit rating for each outcome from your documentation — you review and adjust rather than scoring from scratch.
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Drop in session notes or progress summaries
Use the drop zone below to drag and drop session notes, progress summaries, or evaluation reports. The AI reads these documents to help generate evidence-based exit narratives — saving you from rewriting what's already documented.
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Drop session notes or progress summaries here
PDF or text files · Multiple files accepted · AI reads all uploaded content
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Review the recommended rating for each outcome
For each of the three outcomes, the tool generates a recommended 1–7 rating from your uploaded notes (and the skills checklist, if you use it), shown next to the entry rating for comparison. Review each recommended rating, adjust it to reflect the team's consensus, and add any evidence not captured in the uploaded notes.
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Generate exit narratives and progress indicators
Click Generate Narratives. The AI uses your uploaded notes, entered evidence, entry ratings, and exit ratings to produce a narrative that describes growth since enrollment. Progress indicators (a, b, c) are calculated and included in the export.
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Progress indicator key: a — Child did not show or showed less growth than same-age peers b — Child showed growth but did not reach age expectations c — Child reached or surpassed age-expected skills
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AI-Generated Narratives
Once ratings are complete, the tool uses the evidence you entered to draft supporting narrative language for each outcome area. These narratives explain the rating and can be included in IFSP documentation.
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Always review AI-generated narratives. The AI drafts language based on your evidence entries — but you must verify that the narrative accurately reflects the child's skills, your team's discussion, and the rating chosen. Edit anything that doesn't match.
IFSP-ready copy blocks — for the assessment page. However you bring the evaluation in — pasting the eval doc, dropping/uploading a file, or entering it in the tool — the tool lays out each outcome as three ready-to-paste blocks: Activities Your Child Does Well, Activities Your Child Has a Hard Time With, and a Present Levels of Development summary paragraph. Each block has its own Copy button, plus a Copy All 3 → button. The Does Well and Has a Hard Time With paragraphs are meant for the IFSP assessment page — they are not copied into the COS narrative. Only the Present Levels summary flows to the COS narratives page. The COS narrative's Highest Established Skills Band, Concerns, Next Emerging, and Not Yet sections are filled from your Yes/No scores or the DAYC-2 crosswalk.
Two recommended scores, side by side. When both are available, the tool shows the DAYC-2 crosswalk score and the AI narrative-based score as matched cards, with the selected one marked ✓ FINAL. The narrative-based score is selected by default because it reflects the full clinical picture; tap the other card to switch which score carries to the final COS. If you change your dates or scores after writing the narratives, a banner reminds you the wording may be out of date.
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Fully Editable
Click into any narrative to edit. Your changes are preserved as you move between sections.
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Add Score-Based Text
↻ Add score-based text appends mechanical, score-derived detail (band percentages and skill lists) below your existing narrative — it doesn't replace what's there.
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Rewrite From Scores (AI)
✍ Rewrite narrative from scores (AI) re-writes all five sections so the prose matches the Yes/No skills you've currently scored. It replaces this outcome's narrative; the rating is unchanged. Copy first if you want to keep the old draft.
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When to use "Rewrite from scores". If you change the Yes/No skills after the narrative was written, the rating updates but the prose can lag behind. Click ✍ Rewrite narrative from scores (AI) on that outcome to regenerate the wording so it matches what you scored — then review and edit as always.
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Tracking Progress Over Time
For children who have a prior COS on file, the tool can display entry ratings alongside current ratings to document progress. The federal progress indicator is calculated automatically.
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Saving & Exporting
What
Where stored
PHI?
Child records & ratings
Secure cloud (shared roster with Session Notes)
Yes
In-progress COS drafts
This browser and a backup against your account — so signing out, or moving to another device or browser, does not lose it. One draft at a time; not a file you can open from Downloads
Yes
Completed COS (.docx)
Your device (Download Completed COS) — or Google Drive (Save to Drive)
Yes
Save to Drive
Google Drive: [child] ▸ COS (shared-drive layout below)
Yes
AI narratives
Not stored server-side — only in your session
Redacted
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Windows or Mac makes no difference — the browser does. Downloads land in your usual Downloads folder either way, and on an iPad in Files ▸ Downloads. The one thing worth knowing is that Safari (the default on iPad and Mac) clears a site's saved data after roughly a week of not visiting, which is why in-progress drafts are also backed up against your account. Chrome and Edge don't do that. Nothing needs configuring on any of them.
All three provider tools now save to one shared Google Drive, organized by child — so a child's session notes, COS documents, and reviews live together in the same place:
Tool
Saves to (in the shared Google Drive)
Session Notes
EI Records (shared drive) ▸ [child] ▸ Session Notes ▸ <date>_session.pdf
COS
EI Records (shared drive) ▸ [child] ▸ COS ▸ COS_<name>_<type>_<date>.docx
Review
EI Records (shared drive) ▸ [child] ▸ Review ▸ <YYYY-MM> ▸ <child>_progress_summary.docx
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Save to Drive: Click Save to Drive on the Review & Export screen to file the completed COS .docx straight into the child's COS folder in the shared Google Drive. The file is named COS_<name>_<type>_<date>.docx.
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Or download to your device: Click Download Completed COS (.docx) on the finalize screen. The document includes all three outcome ratings, the progress indicator, narratives, evaluator information, and date. Store any local copy in a HIPAA-compliant location and provide a copy to the IFSP team as required by your program.
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Starting a new child? Use "✕ Clear". Clear wipes the whole workspace for a clean slate: it clears every score, removes any evaluation you dropped, pasted, or uploaded (and the exit documents), and clears all narratives, ratings, and DAYC-2 entries. Your provider name and discipline are kept, since that's the same across children. Clear cannot be undone, so download or Save to Drive first if you still need this child's COS.
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HIPAA & Privacy
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COS data is Protected Health Information (PHI)
COS ratings linked to a specific child constitute PHI under HIPAA. All data is stored in encrypted cloud storage keyed to your login. Access is controlled by your Provider Hub account credentials. Childhood Interventions operates under HIPAA as your Business Associate.
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Account-Locked Storage
COS data is stored under your account only — no other provider or organization can access it.
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AI & PHI Handling
Evidence descriptions are sent to the AI for narrative generation. Use functional descriptions rather than full child names or identifying details in evidence fields.
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Encrypted Connections
All data between your browser and our servers is transmitted over encrypted HTTPS connections.
Best practices:
Use the child's initials rather than full name in evidence fields when possible.
Lock your device when stepping away during a COS session.
Export PDFs only to HIPAA-compliant storage (organizational secure drive, not personal cloud).