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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

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

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