Policy brief: reforming outcomes measurement for deaf children in early intervention

This policy brief examines critical flaws in the Child Outcomes Summary Form (COSF), the primary tool used to assess developmental progress in early intervention (EI) systems, and highlights its discriminatory impact on deaf children. The COSF is built on an audist framework that systematically excludes signed language competence as a valid developmental indicator and fails to account for the diverse developmental trajectories of deaf infants and young children. This foundational bias is particularly harmful for deaf children identified through newborn hearing screening, who often enter Birth to Three services well before typical referral ages. When a deaf child's development naturally diverges from hearing monolingual norms over time, the COSF produces artificially declining scores that misrepresent genuine developmental progress. These biased measurements undermine family confidence, distort program evaluations, and jeopardize funding for specialized services proven to improve outcomes when initiated early. The current brief highlights the COSF's inconsistent and harmful theoretical foundations, demonstrates its misalignment with contemporary research on evidence-based assessment of deaf children, and proposes reform measures to ensure culturally responsive, linguistically valid evaluation. Implementing these reforms is essential to protecting the civil rights of deaf children and ensuring accurate, equitable EI assessment.