Ages & Stages Questionnaires : A Screening Tool For Pennsylvania s Child Welfare Workers

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1 Ages & Stages Questionnaires : A Screening Tool For Pennsylvania s Child Welfare Workers 1

2 OFFICE OF CHILDREN, YOUTH AND FAMILIES (OCYF) POLICY: Required for Child Abuse Prevention and Treatment Act compliance Children under age 3, who have been the victims of substantiated abuse cases MUST be screened using ASQ/ASQ-SE within 30 days of case acceptance Those with qualifying score must be referred for EI Those who test normally must be screened periodically Recommended for all children under age 5 in agency service 2

3 Definitions Screening Assessment Evaluation 3

4 Screening A brief process that sorts those who probably have problems from those who do not. DOES NOT lead to a decision about whether a child has a developmental delay!. 4

5 Screening helps to identify children who should receive more intensive evaluations through a specialized program: Early intervention (EI) Mental health/social service Health systems 5

6 6 Assessment Ongoing process through which appropriately qualified personnel, along with families, look at all areas of a child s development in order to identify strengths and needs and to design a program that addresses the child s developmental goals

7 Multi-disciplinary evaluation 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 early intervention or mental health services. 7

8 Typically, when we think of screening activities, they are: Information Gathering activities: 8

9 Tests don t make decisions. People do!!!! (Neisworth and Bagnato) 9

10 10 Why screen? Screening young children is an effective, efficient way for professionals to catch problems and start treatment when it does the most good during the crucial early years when the child s brain and body are developing so rapidly. name=ter_util_babybrainflash

11 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 11

12 Formal Screening Tools Are based on the performance of a representative norming sample of young children Identify children who may have a developmental delay 12

13 13 Why the ASQ and ASQ:SE were chosen Can be completed by the child s parent, caregiver and/or the child welfare worker Series of questionnaires for children 3 months to 5 years

14

15 15 ASQ System: 2 Components ASQ ASQ:SE

16 Let s look at the ASQ Divided into 5 developmental domains Communication Gross motor Fine motor Problem-solving Personal-social 16

17 17 The ASQ 19 questionnaires between 4 and 60 months of age English, Spanish, French & Korean versions available Can be completed in minutes

18 18 Each questionnaire includes a checklist of 30 questions And an Information Summary page includes a section for scoring and an area for recording general concerns.

19 Items written at 4 th to 6 th grade reading level, illustrations included Questions are in order from easy to average skill level Questions alternate using male and female pronouns Can be adapted for children who are from culturally and linguistically diverse backgrounds 19

20 Adapting for Children who are Culturally and Linguistically Diverse Potential Solutions Omit the item and follow directions for scoring with unanswered questions Substitute alternative items that will adequately assess the targeted skill 20

21 A few key points about the tool Each questionnaire is valid for 1 month before and after the indicated age. There is a 2-month window for use. If a child was born more than 3 weeks premature calculate her corrected age. This can be done by adding the weeks of pre-maturity to the child s date of birth. Use the child s corrected age until the child is 24 months. 21

22 User s Manual- for more information Suggested readings Intervention Activities Sheets Complete technical information 22

23 Scoring Items are scored as: Yes 10 pts Sometimes 5 pts Not yet 0 pts Each response has a point value, total these values and compare the total score to the established cutoff points. Scoring can take as little as 1 minute, no more than 5 minutes. 23

24 24 The Ages & Stages Questionnaires: Social-Emotional

25 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 25

26 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 26

27 27 ASQ:SE Completed by the child s parents or primary caregivers and/or the child welfare worker Completed in minutes

28 ASQ:SE 8 questionnaires that can be used with children from 3 to 66 months of age Questionnaires vary in length English and Spanish versions available 28

29 29 ASQ:SE Covers 7 areas Self-regulation Compliance Communication Adaptive functioning Autonomy Affect Interaction with people Includes general concerns area

30 30 ASQ:SE User s Guide What can you find in there?

31 31 Let s look at a questionnaire! ASQ:SE 30 month questionnaire

32 32 Scoring Items are scored as Most of the time 0 points Sometimes 5 points Rarely or never 10 points Parents/Practitioner can check each item if it is a concern- 5 points Scores for each item are combined for a total score. A high score may indicate problems. Each questionnaire has an indicated cutoff score.

33 33 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.

34 Discussing results with families Share the completed screener with family Listen to family s perspective Discuss the scoring section On target- no need for referral On the border- monitor and follow up at intervals per DPW policy Beyond cutoff discuss need for referral for further evaluation to Early Intervention Together make a decision about next steps 34

35 Making a referral Who refers: worker must, if child is in custody; parent/caregiver may, if child is not in custody Where to call provide contact information to parent/caregiver Parent permission to share information Follow up to find out if child eligible 35

36 Early Intervention is: Free Voluntary A system of supports to the family and child in order to enhance the child s developmental capacities 36

37 37 Early Intervention Evaluation A comprehensive look at a child s skills and behaviors in all five developmental domains by qualified professionals Determines eligibility for further early intervention services Makes recommendations to address areas of concern

38 Next steps: Implementation 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 agency and/or parent handbook/manual Before beginning to screen a child not in custody, get parent permission (see pg in manual for sample) 38

39 Next steps and support for you What are your plans as you leave the session? What support may you need to get started, or for follow up once you have started? 39

40 Questions?? Need assistance? Contact Jennifer Murphy Dina Stipetic Jill Kachmar

41 The end! 41

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