data driven goal setting

Data Driven Goal Setting

With a Focus on ASQ3 Developmental ScreeningPresenter: Roberta Payne

Part I : OverviewPart II : Recommended ToolsPart III : Referral ProcessPart IV: Implementation Strategies

Part: V Data Driven Goal Setting

• Identify developmental screening and early intervention as a valuable CECC goal

• Learn how tools to screen for developmental delays might be used

• How programs may Implement referral procedures for children who fail or pass but exhibit potential developmental concerns to expedite Early Intervention

• Employ parent/caregiver education materials as a strategy

Learning Objectives

20% of mental health problems identified

(Lavigne et al. Pediatr. 1993; 91:649-655)

30% of developmental disabilities identified

(Palfrey et al. JPEDS. 1994; 111:651-655)

80-90% with mental health problems identified

(Sturner, JDBP 1991; 12:51-64)

70-80% with developmental disabilities correctly identified

(Squires et al., JDBP 1996; 17:420-427)

Data on Detection RatesWithout Tools With Tools

Early Brain Development

• Americans with Disabilities Act (ADA) 1990

• Individuals with Disabilities Education Act (IDEA) 1975 (Amended in 2004)

Federal/Legal Requirements

Developmental or Behavioral Disorders◦ Speech and language issues ◦ Mental retardation ◦ Learning problems◦ Attentional disorders◦ Other behavioral difficulties

only ½ of children with these problems identified prior to school entrance

What to Expect

What to Expect

http://www.pedstest.com/test/peds_intro.html

Development exists on a continuum Children manifest skills variably,

inconsistently Latent period Developmental problems increase with

age◦ 2-3% of 0-18 month olds◦ 10% of 24-72 month olds◦ 16% of 0-21 year olds

Data to Consider: Children

Parents are reservoirs of rich information Screening structures observations,

reports, and communication about child development

Screening becomes a teaching tool for parents and child care professionals

Screening improves relationships

Parents/Caregivers

Explain tool and purpose to parents Discourage assumption of a “problem”

◦ addressing behavioral and developmental issues is an important part of your service

Assess ability to complete tool properly◦ with assistance?◦ in center or at home?

Preparing Parents/Caregivers

Focus on positivesPractice your language

“Learning too slowly”“Delayed in some areas”“Needs some extra attention and support”

Communicating Results

Stress the need for further evaluation and follow-up

Offer parents activities they can do right away

Help the parent to inform others

Communicating Results

Acknowledge parent’s fear Avoid judging parents Encourage communication, particularly

when recommendations are not followed Provide parent with information on the

referral Set a follow-up

Encouraging Next Steps

The importance of information to parents:◦Must explain situation to others◦Language barriers◦Logistics

“Demystify” the process

Encouraging Next Steps

Developmental Screening is:Recommended by AAPBeneficial to all childrenChallenging but rewarding to implement

Provides critical data for planning and decision making

Part I Summary

SensitivitySpecificityPositive predictive valueValidityReliability

Screening Test Features

ScoringTrainingAdministration

Screening Test Features

Parent report tool with exercises, 30-35 items Covers 5 skill/developmental areas Written at a 6th grade level Available in Spanish, English, and French Choices of responses (yes, sometimes, not

yet) Requires 10-15 minutes to complete, 5

minutes to score 21 color-coded age-appropriate

questionnaires and score sheets

Ages & Stages™ Questionnaire


Using the shapes below to look at, does your child copy at least three shapes onto a large piece of paper using a pencil or crayon, without tracing? Your child’s drawings should look similar to the design of the shapes below, but they may be different in size.

Yes Sometimes Not Yet


• Use ASQ Information Summary sheet to score and for child’s permanent record

• Ensure test is complete • Convert responses to point values: yes

(10), sometimes (5), not yet (0)• Add item scores by developmental area

and record totals• Use ratio scoring procedure for unfinished

sections


Refer or Follow-up


The specific answers to each item on the questionnaire can be recorded below on the summary chart.

1 in 88 childrenAge of diagnosis fallingParent concern ~18 months of age

Early detection crucial

Autism Spectrum Disorders

Distinguishing characteristics of children with autism at mental age of 12-24 months:

◦ Lack of joint attention◦ Lack of eye gaze to determine others’ intentions◦ Lack of proto-declarative pointing◦ Using another person’s body as a tool◦ Failure to “show objects” to adults◦ Lack of initiation◦ Lack of symbolic play

Autism Spectrum Disorders

Autism ScreeningAbsolute Indications for Immediate Evaluation-

Refer to Early Intervention System

• 12 months: No babbling, pointing, or other gestures

• 16 months: No single words• 24 months: No 2-word, spontaneous

phrases (not echolalic)• Any age: Any loss of any language or

social skills

Part II Summary

*Ages and Stages Questionnaire, Third Edition (ASQ-3), Brookes Publishing

Ages and Stages Questionnaire - Social Emotional, (ASQ:SE) Brookes Publishing

*Batelle Developmental Inventory 2, Screening Test (2005) Riverside Publishing

*Brigance Infant & Toddler Screen, Curriculum Associates, Inc.

*Brigance Early Preschool Screen II, Curriculum Associates, Inc.

Appropriate Screening Tools

*Brigance Preschool Screen II, Curriculum Associates, Inc.

*Denver II, Denver Developmental Materials, Inc.

*Developmental Observation Checklist System (DOCS), PRO-ED

*Developmental Indicators for the Assessment of Learning (DIAL) III, Pearson

Learning Group


*Early Screening Inventory – Revised (ESI-R), Pearson Learning Group

*Early Screening Profile, Pearson Learning Group

Learning Accomplishment Profile (LAP - D) Screen, Kaplan Early Learning Co.

* Assesses all 5 domains: Adaptive, Cognitive, Communication, Motor, and Social / Emotional


Prevention Programs◦ at risk

Early Intervention◦ birth to age 3◦ Suspected delay◦ qualifying condition

Special Education ◦ Age 3 to 21

Referral Overview

Early Head Start and Head Start ◦ serves birth-3 and 3-5 year olds◦ comprehensive health and education

services◦ low income families

Prevention Programs & Resources


services◦ low income families

HANDS◦ serves birth-up to age 3, first time parents◦ voluntary, home visitation program



services◦ low income families ◦ serves birth-2, serves first time parents◦ voluntary, home visitation program

Child Care Resource and Referral◦ connect to child care services and

subsidies◦ Training for child care professionals


Who you should be referring to EI (First Steps) When to refer - timeline for evaluation/services Where to refer What specific services the EI system provides

Early Intervention

Children Aged 0-3 with a Developmental Delay

Cognitive abilities Physical abilities - including vision and

hearing Language/speech/communication Social-emotional abilities Adaptive self-help skills

◦ At risk of substantial developmental delay

Early Intervention: Who

First Steps 15 Offices in State of Kentucky Functions:

◦ assist in screening/evaluation ◦ determine eligibility◦ assess needs◦ plan for services◦ identify providers

0-3: Early Intervention- Where

Occupational therapy

Physical therapy Speech/language

therapy Family training,

counseling, support Service coordination Audiology Vision services

Nursing Nutrition Psychological

services Social Services Developmental

therapy Transportation Medical diagnostic

services

0-3: Early Intervention- What

Autism Deaf-Blindness Deafness Emotional

Disturbance Hearing

Impairment Mental Retardation Multiple Disabilities Orthopedic

Impairment

Other Health Impairment

Specific Learning Disability

Speech/Language Impairment

Traumatic Brain Injury

Visual Impairment

3-5: Special Education

Designate steps for making a referral Designate person(s) to whom a referral may

be made Identify information to be provided Provide assistance necessary to meet

requirements Identify process for providing parents with

notice of their rights

3-5: Special Education- Referral Process

Early Intervention: When2 Working

Days

45 DaysFor EI

Identification

Referral for Evaluation and Assessment

(service coordinator assigned)

Evaluation/Assessment

Eligibility Determined

IFSP Developed

IEP Developed

60 DaysFor Spec Ed

QUESTIONS: Which tools at what intervals? How do Programs make time for screening? Who administers the screening, scores the

tests, and communicates results and documents data outcomes?

Incorporating Screening into Practice Using Data to Drive Goal Setting

ANSWER: The Team Approach

◦ Solves problems◦ Generates new ideas◦ Encourages participation◦ Requires training

Incorporating Screening into Practice

A Leader!

Tools can be: Distributed at designated times to be

completed and brought back Completed at enrollment or entry to

program Completed by phone interview Completed through a community

screening event

Screening Administration Considerations

Program Directors establish the

system choose the tools train staff provide feedback

to parents advise parents on

development and behavior

Front Line Staff implement the

system score

questionnaires provide routine

feedback distribute parent

education maintain and

update referral lists

Strategies and Roles- How it Might Work

Insuring Every Child is Ready to Grow, Ready to Learn and Ready to Succeed in

School

Establishing a Goal for Implementing a Screening and Referral Program in You

Community

Problem Solving Activity

“ Goals are the fuel in the furnace of achievement”

Brian Tracy

Contact Information:[email protected] Roberta PayneBreckinridge Grayson Programs Inc.201 E WalnutLeitchfield, KY 42754(270) 259-4054

mailto:[email protected]

The End!Questions Anyone

data driven goal setting

Documents

developmental disabilities

recommended screening

validated screening

pros of screening

good quality screening

early brain development5so

mental health problems

behavioral problems