1 ASQ-3 and ASQ:SE A Screening Tool For Pennsylvania’s Early Learning Practitioners 2 Definitions Screening Assessment Evaluation Screening is… A brief process that allows teachers, parents, or practitioners to determine whether a child is developmentally “on track” or not . 3 4 Screening… DOES help to identify children who should receive a more intensive evaluation DOES NOT lead to a decision about whether a child has a developmental delay! . 5 Assessment is… An ongoing process conducted by trained personnel, along with families, to identify a child’s strengths and needs and to create learning opportunities that will encourage developmental progress. 6 Multi-disciplinary evaluation (MDE) is… An in-depth evaluation of one or more developmental areas to: determine the nature and extent of a physical or developmental problem and determine if the child is eligible for more intensive services (early intervention) 7 Evaluations are completed by specialized programs: Early intervention (EI) Mental health/social service Health systems 8 Typically, screening involves… Information gathering activities What are some ways that you gather info about children?? 9 Tests don’t make decisions. People do!!!! (Neisworth and Bagnato) 10 Why screen? Screening young children is an effective, efficient way for professionals to catch problems and start treatment http://www.zerotothree.org/site/PageSer ver?pagename=ter_util_babybrainflash 11 Early detection is critical “Compensating for missed opportunities, such as the failure to detect early difficulties...often requires extensive intervention, if not heroic efforts, later in life.” —From Neurons to Neighborhoods 12 Formal Screening Tools Are based on the performance of a representative sample of young children Identify children who may have a developmental delay and need referred for further evaluation. 13 Why the ASQ System… Is quick and easy to use Sound research base Requires little training Fits well with PA’s standards Flexible and can be used in various types of programs 14 Ages and Stages Questionnaires:2 Components 15 Let’s look at the ASQ Divided into 5 developmental domains Communication Gross motor Fine motor Problem-solving Personal-social 16 Features of the ASQ 21 questionnaires between 4 and 60 months of age 2, 4, 6 , 8, 9, 10, 12, 14, 16, 18, 20, 22, 24 months 27, 30, 33, 36 months 42, 48, 54, 60 months 17 Features of the ASQ Each questionnaire includes a checklist of 30 items And an Information Summary page with a section for plotting scores and an area for general concerns. 18 The items… Written at 4th to 6th grade reading level, some illustrations Ordered from easy to average skill level 19 Cultural considerations Adaptations can be made for cultural backgrounds Substitute alternative items that will assess the targeted skill Or Omit the item and follow directions for scoring with unanswered questions (User’s guide page 72) 20 Selecting the appropriate questionnaire… Through 24 months, administer within 2-month (16 month is valid from 15-17 months) Over 24 months, the window is stretched so there are no gaps See Handout: Guide for selecting appropriate questionnaire Adjusting for Pre-maturity For infants up to 24 months of age who were born 3 or more weeks pre-mature, adjust their age by: Subtracting weeks of pre-maturity from present age to determine “adjusted age” Use the questionnaire that corresponds to “adjusted age”. 22 The User’s Guide For more information: Suggested readings Activity Sheets Complete technical information 23 Scoring Review the questionnaire for items with missing responses. Items are scored as: Yes – 10 points Sometimes – 5 points Not yet – 0 points 24 Scoring Total the points for each developmental area (Gross Motor, Fine Motor, Communication, Problem-Solving, Personal-Social). Transfer sheet. Record each total to the Information Summary the scores on the scoring grid and fill in the appropriate bubbles on the bar graph. 25 Scoring Transfer responses and any notes from the Overall section. Record any follow-up decisions 26 Interpreting Results Review the Summary sheet (the five total scores and the Overall responses). Review any additional information that you may have (discussions with family, notes). 27 Interpreting Results A score above the cutoff (the white area of the bar) indicates that the child appears to be doing well Providing an enriched environment will promote continued healthy development. 28 Interpreting Results Each developmental area has a “cutoff point”. A score in the light gray shaded area in the bar graph is close to the cutoff. A score in this area means that the child may need practice in this area and development should be closely monitored. 29 Interpreting Results A score below the cutoff or in the dark shaded section of the bar graph indicated that the child may need further assessment. 30 Interpreting Results Review the responses to the Overall section of the questionnaire. These responses may indicate the need for further assessment, even if total scores are well above cutoff points. Practice scoring: Michael’s ASQ Discuss findings - Scores-cut offs - Overall section Discuss recommendations 32 The Ages & Stages Questionnaires: Social-Emotional 33 The ASQ and ASQ:SE Relationship ASQ:SE was designed to focus on the social and emotional behaviors of children Should be used in conjunction with the ASQ or other screening tool 34 ASQ:SE Focuses on Social competence The ability to engage in positive interactions with peers, siblings, parents and other adults Emotional competence The ability to effectively regulate emotions to accomplish one’s goals 35 ASQ:SE Completed by the child’s parents or primary caregivers Completed in 10-15 minutes 36 ASQ:SE 8 questionnaires that can be used with children from 3 to 66 months of age Questionnaires English vary in length and Spanish versions available 37 ASQ:SE Covers 7 areas Self-regulation Compliance Communication Adaptive functioning Autonomy Affect Interaction with people Includes general concerns area Behavioral area Definition Self-regulation Ability/willingness to calm, settle, or adjust to physiological or environmental conditions Compliance Ability/willingness to conform to the direction of others and follow rules Communication Verbal/nonverbal signals that indicate feelings, affect, and internal states Adaptive Ability/success in coping with physiological needs Autonomy Ability/willingness to establish independence Affect Ability/willingness to demonstrate feelings and empathy for others Interaction with people Ability/willingness to respond to or initiate social responses with caregivers, adults, and peers ASQ and ASQ:SE Training Materials by Jane Squires, Jane Farrell, Jantina Clifford, Suzanne Yockelson, and Elizabeth Twombly Copyright © 2008 by Paul H. Brookes Publishing Co., Inc. All rights reserved. For more information about the ASQ and ASQ:SE, see http://www.agesandstages.com 39 ASQ:SE User’s Guide Case Studies Sample letters 40 Let’s look at a questionnaire! Louis’ 6 month questionnaire 41 Scoring Items Most are scored as of the time = 0 or 10 points Sometimes = 5 points Rarely or never = 0 or 10 points Is this a concern? Yes = 5 points X=10 Why pts; V=5 pts; Z=0 pts. does scoring happen this way? Because both competence AND problem behaviors are targeted within the tool 42 Scoring Scores for each item are combined for a total score which is recorded on the last page. A high score may be indicative of concerns. Each questionnaire has an age-specific cutoff score. What have we learned about Louis from his ASQ:SE screening? What recommendations might we make? 44 Reminder: The results from the ASQ and the ASQ:SE will not identify which children have delays and which do not. It simply suggests which children need to be referred on for further in-depth evaluation. 45 Discussing results with families Share the completed screener with family as quickly as possible Review Listen the purpose of screening to families’ perspective 46 Discussing results with families Discuss the scoring section On target - discuss & share activities In the shaded area- consider referral or monitor and follow up soon Beyond cutoff – consider referral for further evaluation, i.e. Early Intervention 47 Discussing Results with Families Avoid terms such as “test”, “fail”, “normal” or “abnormal” Together make a decision about next steps 48 Discussing Results with Families Provide parents with appropriate follow-up information such as Learning activities (intervention activities are included in the ASQ-3 box and Appendix C of the ASQ: SE User’s Guide) Referral options Information about community resources Reminders about when to schedule follow-up 49 Making a referral Where to call – contact information CONNECT- Early Intervention Helpline 1-800-692-7288 Parent permission to share information Participate permission in planning process, with parent 50 Early Intervention is: Free Voluntary A system of supports to the family and child in order to enhance the child’s developmental capacities 51 Early Intervention Evaluation A comprehensive look at a child’s skills and behaviors Determines eligibility for further early intervention services Makes recommendations to address areas of concern Resources for Early Education Practitioners about EI An Early Education Provider’s Guide to Early Intervention Services in PA http://www.pattan.net/category/Resources/PaTTAN %20Publications/Browse/Single/?id=4dc09560cd69f 9ac7f4b0000 53 Resource for Families A Family’s Introduction to Early Intervention in PA http://pattan.netwebsite.s3.amazonaws.com/images/2011/08/05/ what_is_EI_rack_card7_11.pdf Activity Case Study and role play- Emily Part 1 Use the scored screening tools Read the Background info that is provided on child/family Discuss with group possible recommendations for the family Part 2- Engage in a role play (groups of 5) Be prepared to share your experience with the group 55 Implementation in ECE program Share this training with your staff Decide how screening will be implemented Who, when, how often, how will results be shared with families Document your process in parent handbook Before beginning to screen, get parent permission (see pg 35/36 in manual for sample) 56 Consider your next steps? What What are your plans as you leave the session? support may you need to get started, or for follow up once you have started? 57 Questions?? Need assistance? Contact … Jennifer Murphy 484-955-8264 jenmur@berksiu.org