Building Effective Screening Services  Understanding the Needs of Programs, Staff, & Families<br />A Brighter Tomorrow Sym...
Our Community Partner<br />Community-based providers<br />In-home and center-based services<br />Predominantly serves sing...
Why Screen?<br />Signs of delay and behavioral issues can be overlooked or dismissed<br />Screenings help better identify ...
Early intervention (EI) services support children’s healthy development and help them reach their potential.<br />
Nationally<br />12 %<br />Developmental delays <br />or behavioral concerns<br />(Cooper, Mast, and Vick, 2009)<br />2.4 %...
But, screenings are ONLY impactful if…<br />Administered correctly <br />Accurately identify children at risk for delays <...
Quality Screening Services<br />FOLLOW-<br />THROUGH<br />COMPLETION<br />IDENTIFICATION<br />
How Well Are Staff Identifying Children At Risk Through Screenings? <br />Identification Rate (% at risk among those scree...
Identification Rate <br />Developmental Skills<br />Children Correctly Screened (ASQ)<br />11%<br />Identified as At Risk<...
Identification Rate Alone Is Not Enough<br />We’ve identified 11% of children screened<br />SO WHAT? <br />What does this ...
Does 11% represent missed children?</li></ul>Benchmarks provide standards for comparing how well we’ve identified our popu...
Benchmarks <br />Developmental Skills<br />    Children Correctly <br />      Screened (ASQ)<br />22% <br />of the childre...
Benchmarks <br />Social-Emotional Skills<br />18% <br />of the children should have been identified as at-risk for social-...
How Well Are Staff Identifying Children At Risk Through The Screenings? <br />Identification Rate + Benchmarks demonstrate...
How well are staff connecting children identified as at risk to EI services? <br />Locally<br />Children evaluated by EI<b...
What happened?<br />
What data should programs collect?<br />Children whose parents agreed to recommendation<br />Children admitted for EI serv...
 How well are staff connecting at risk children to EI services? <br />Children admitted for services<br />Children whose p...
How well did staff connect at risk children to EI services?<br />Children admitted for services<br />Children whose parent...
Detailed documentation of the service delivery process can reveal areas where quality improvement efforts are needed by sh...
Policy, Supervision, <br />Communication & Confidence <br />Children admitted for services<br />Children whose parents agr...
Communication, Confidence, & Support<br />Children<br /> whose <br />parents <br />agreed to referral<br />Children admitt...
Communication & Support<br />Children admitted for services<br />Children whose parents agreed to referral<br />Children e...
Data Alone Cannot Explain Why<br />
Communicating Findings with Stakeholders<br /><ul><li>Facilitates critical thinking
Generates relevant questions
Provides insight not offered by the data alone
Educates  and empowers
Informs planning and decision making</li></li></ul><li>Dashboards<br />Big-picture view<br />Most essential information <b...
Sample Identification Rate Dashboard<br />Using the ASQ to Identify Children At-Risk for Developmental Delay<br />1020<br ...
Sample Follow-Through Dashboard<br />What happened to the children identified as at-risk for delay?<br />Children whose pa...
What Works?Listening to the Voices of Stakeholders<br /><ul><li>Screening staff
Administrative and supervisory staff
Parents
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Building Effective Screening Services: Understanding the Needs of Programs, Staff, & Families

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Building Effective Screening Services: Understanding the Needs of Programs, Staff, & Families

  1. 1. Building Effective Screening Services Understanding the Needs of Programs, Staff, & Families<br />A Brighter Tomorrow Symposium<br />July 19-21, 2011<br />Janell Smith-Jones, Ph.D.<br />Andrea Rudek, M.S.W.<br />Milena Nigam, M.S., M.A.T.<br />The Office of Child Development<br />University of Pittsburgh<br />
  2. 2. Our Community Partner<br />Community-based providers<br />In-home and center-based services<br />Predominantly serves single, minority, and low-income parents<br />Parenting education and child development (Birth – 5 years) <br />
  3. 3. Why Screen?<br />Signs of delay and behavioral issues can be overlooked or dismissed<br />Screenings help better identify developmental and behavioral concerns and determine when further evaluation is needed <br />
  4. 4. Early intervention (EI) services support children’s healthy development and help them reach their potential.<br />
  5. 5. Nationally<br />12 %<br />Developmental delays <br />or behavioral concerns<br />(Cooper, Mast, and Vick, 2009)<br />2.4 %<br />Receive EI services<br />(Hebbeler, et. Al., 2007)<br />
  6. 6. But, screenings are ONLY impactful if…<br />Administered correctly <br />Accurately identify children at risk for delays <br />Lead parents and professionals to take concrete “next steps” <br />
  7. 7. Quality Screening Services<br />FOLLOW-<br />THROUGH<br />COMPLETION<br />IDENTIFICATION<br />
  8. 8. How Well Are Staff Identifying Children At Risk Through Screenings? <br />Identification Rate (% at risk among those screened)<br />Appropriate Benchmarks (comparable population)<br />
  9. 9. Identification Rate <br />Developmental Skills<br />Children Correctly Screened (ASQ)<br />11%<br />Identified as At Risk<br />
  10. 10. Identification Rate Alone Is Not Enough<br />We’ve identified 11% of children screened<br />SO WHAT? <br />What does this mean for our service, families and children?<br /><ul><li>Is 11% on target?
  11. 11. Does 11% represent missed children?</li></ul>Benchmarks provide standards for comparing how well we’ve identified our population of children<br />
  12. 12. Benchmarks <br />Developmental Skills<br /> Children Correctly <br /> Screened (ASQ)<br />22% <br />of the children should have been identified as at-risk for developmental delays<br />conservative estimate based on multiple national samples<br />11%<br />identified as at-risk<br />
  13. 13. Benchmarks <br />Social-Emotional Skills<br />18% <br />of the children should have been identified as at-risk for social-emotional concerns<br />conservative estimate based on Ages and Stages manual<br />Children Correctly <br /> Screened (ASQ: SE)<br />8%<br />identified as at-risk<br />
  14. 14. How Well Are Staff Identifying Children At Risk Through The Screenings? <br />Identification Rate + Benchmarks demonstrated that children are being significantly under-identified as at-risk across the network<br />
  15. 15. How well are staff connecting children identified as at risk to EI services? <br />Locally<br />Children evaluated by EI<br />Children identified as at-risk by screenings<br />13<br />258<br />
  16. 16. What happened?<br />
  17. 17. What data should programs collect?<br />Children whose parents agreed to recommendation<br />Children admitted for EI services<br />Children identified as at-risk by screenings<br />Children evaluation<br />Children recommended for further evaluation<br />Children referred for further evaluation<br />Children qualified for EI services<br />
  18. 18. How well are staff connecting at risk children to EI services? <br />Children admitted for services<br />Children whose parents agreed to referral<br />Children identified as at-risk by screenings<br />Children evaluated<br />Children recommended for further evaluation<br />Children referred for further evaluation<br />Children qualified for services<br />8<br />13<br />10<br />47<br />57<br />90<br />2<br />2<br />21<br />258<br />1<br />9<br />13<br />31<br />1<br />55<br />2<br />113<br />No<br />Data Missing in MIS<br />
  19. 19. How well did staff connect at risk children to EI services?<br />Children admitted for services<br />Children whose parents agreed to referral<br />Children evaluated<br />Children identified as at-risk by screenings<br />Children recommended for further evaluation<br />Children referred for further assessment<br />Children qualified for services<br />8<br />13<br />10<br />47<br />57<br />90<br />258<br />5%<br />3%<br />
  20. 20. Detailed documentation of the service delivery process can reveal areas where quality improvement efforts are needed by showing the breakdowns<br /> in connecting children to EI services.<br />What might the breakdowns suggest?<br />
  21. 21. Policy, Supervision, <br />Communication & Confidence <br />Children admitted for services<br />Children whose parents agreed to referral<br />Children identified as at-risk by screenings<br />Children evaluated<br />Children recommended for further referral<br />Children referred for further assessment<br />Children qualified for services<br />8<br />13<br />10<br />47<br />57<br />90<br />2<br />2<br />21<br />258<br />1<br />9<br />13<br />31<br />1<br />55<br />2<br />113<br />No<br />Data Missing in MIS<br />
  22. 22. Communication, Confidence, & Support<br />Children<br /> whose <br />parents <br />agreed to referral<br />Children admitted for services<br />Children identified as at-risk by screenings<br />Children evaluated<br />Children recommended for further evaluation<br />Children referred for further evaluation<br />Children qualified for services<br />8<br />13<br />10<br />47<br />57<br />90<br />2<br />2<br />21<br />258<br />1<br />9<br />13<br />31<br />1<br />55<br />2<br />113<br />No<br />Data Missing in MIS<br />
  23. 23. Communication & Support<br />Children admitted for services<br />Children whose parents agreed to referral<br />Children evaluated<br />Children identified as at-risk by screenings<br />Children referred<br /> for <br />further evaluation<br />Children recommended for further evaluation<br />Children qualified for services<br />8<br />10<br />13<br />47<br />57<br />90<br />2<br />2<br />21<br />258<br />1<br />9<br />13<br />31<br />1<br />55<br />2<br />113<br />No<br />Data Missing in MIS<br />
  24. 24. Data Alone Cannot Explain Why<br />
  25. 25. Communicating Findings with Stakeholders<br /><ul><li>Facilitates critical thinking
  26. 26. Generates relevant questions
  27. 27. Provides insight not offered by the data alone
  28. 28. Educates and empowers
  29. 29. Informs planning and decision making</li></li></ul><li>Dashboards<br />Big-picture view<br />Most essential information <br />Streamlined, simple, and digestible<br />What does this information mean for an individual child and family?<br />
  30. 30. Sample Identification Rate Dashboard<br />Using the ASQ to Identify Children At-Risk for Developmental Delay<br />1020<br />1020children received one ASQ<br />(109 children’s records did not meet the criteria for a correct ASQ)<br />483<br />children<br />911<br />89% of the 1020 children screened received the correct ASQ<br />191<br />22% of the 911 children should have been identified as at-risk for developmental delays<br />(conservative estimate based on multiple national samples)<br />97<br />11% of the 911 children were identified as at-risk<br />
  31. 31. Sample Follow-Through Dashboard<br />What happened to the children identified as at-risk for delay?<br />Children whose parents agreed to referral<br />Children evaluated<br />Children identified as at-risk by screenings<br />Children admitted for services<br />Children qualified for services<br />Children recommended for further evaluation<br />Children referred for further evaluation<br />8<br />13<br />10<br />47<br />57<br />90<br />2<br />2<br />21<br />258<br />1<br />9<br />13<br />31<br />1<br />55<br />2<br />113<br />No<br />Data Missing in MIS<br />
  32. 32. What Works?Listening to the Voices of Stakeholders<br /><ul><li>Screening staff
  33. 33. Administrative and supervisory staff
  34. 34. Parents
  35. 35. Other experts associated with screening, assessment, and referral services</li></li></ul><li>Boosting Competence and Confidence Staff Needs<br /><ul><li>Clearly defined and communicated policies and procedures
  36. 36. Training and professional development</li></ul>Value and benefit of screenings and EI<br />Communicating difficult and sensitive information<br />Supporting families: understanding the parent perspective is critical<br /><ul><li>Supervision and mentoring</li></li></ul><li>Understanding the Caregiver PerspectiveCaregiver Needs<br />Recognize, acknowledge, and normalize feelings <br />Strengths-based approach<br />Create a partnership <br />Parents are in control<br />School readiness focus<br />
  37. 37. Dee Dee and Dahnayl<br />
  38. 38. It is critical to have systems in place to monitor the impact of screening services and to identify improvement needs and opportunities.<br />
  39. 39. Discussion<br />How can your program utilize currently collected data to better understand the quality of your screening service? <br />What current challenges impact your program’s screening service?<br />How can programs successfully address the needs of staff who provide screening, and EI referral and coordination services to families?<br />How can programs successfully support families through the screening service and EI referral and coordination process?<br />How can programs involve stakeholders in improving:<br />the capacity of programs and staff; and<br />the quality of screening services and supports provided to families?<br />
  40. 40. Building Effective Screening Services Understanding the Needs of Programs, Staff, and Families<br />For additional questions, please contact us:<br />Janell Smith-Jones janells@pitt.edu<br />Andrea Rudekarudek@pitt.edu<br />Milena Nigam mkn11@pitt.edu<br />Developmental Screening and EI — OCD Webpage<br />

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