Ages & Stages Questionnaires , Third Edition (ASQ -3 ) And .
AN INTRODUCTION TOASQ-3 & ASQ:SE-2 Ages & Stages Questionnaires , Third Edition (ASQ-3 )andAges & Stages Questionnaires :Social-Emotional, Second Edition (ASQ:SE-2 )ASQ-3 and ASQ:SE-2 Training Materials by J Squires, J Farrell, J Clifford, S Yockelson, E Twombly, and L PotterCopyright 2015 Brookes Publishing Co. All rights reserved. www.agesandstages.com1
What are ASQ-3 and ASQ:SE-2? Parent- or caregiver-completed screening toolsthat encourage parent/caregiver involvement Series of questionnaires for children ages 1month to 5 ½ years (ASQ-3) and 6 years (ASQ:SE2) Tools to accurately identify children at risk fordevelopmental or social-emotional delayASQ-3 and ASQ:SE-2 Training Materials by J Squires, J Farrell, J Clifford, S Yockelson, E Twombly, and L PotterCopyright 2015 Brookes Publishing Co. All rights reserved. www.agesandstages.com2
ASQ-3 and ASQ:SE-2 DomainsASQ-3 Communication Gross motor Fine motor Problem solving Personal-socialASQ:SE-2 Social-emotional developmentASQ-3 and ASQ:SE-2 Training Materials by J Squires, J Farrell, J Clifford, S Yockelson, E Twombly, and L PotterCopyright 2015 Brookes Publishing Co. All rights reserved. www.agesandstages.com3
Parent Report: Research Parent’s are highly reliable whenreporting on their child's development(Dinnebeil & Rule 1994) ASQ-3 research found 93% agreementbetween parents and professionals Many other studies agree that parentsare reliable reporters Parents ARE the experts on their child!ASQ-3 and ASQ:SE-2 Training Materials by J Squires, J Farrell, J Clifford, S Yockelson, E Twombly, and L PotterCopyright 2015 Brookes Publishing Co. All rights reserved. www.agesandstages.com4
Differences in Parent &Professional ReportResearch Indicates: Professionals mayunderestimate a child’s skills Higher agreement for easilyobserved behaviors Parents report moreemerging skills Children do different things indifferent settingsASQ-3 and ASQ:SE-2 Training Materials by J Squires, J Farrell, J Clifford, S Yockelson, E Twombly, and L PotterCopyright 2015 Brookes Publishing Co. All rights reserved. www.agesandstages.com5
Parental Characteristics that mayAffect Accuracy Low literacyCultural and language differencesImpaired mental functioningMental health issuesInvolvement with child protective agenciesParents with these characteristics will needdifferent levels of support.ASQ-3 and ASQ:SE-2 Training Materials by J Squires, J Farrell, J Clifford, S Yockelson, E Twombly, and L PotterCopyright 2015 Brookes Publishing Co. All rights reserved. www.agesandstages.com6
Using Parent Completed Tools Creates the expectation thatparents will be involved Conveys the value forand importance of theparent’s expertiseTrue collaboration involves the reciprocal sharingof information between parents and providersASQ-3 and ASQ:SE-2 Training Materials by J Squires, J Farrell, J Clifford, S Yockelson, E Twombly, and L PotterCopyright 2015 Brookes Publishing Co. All rights reserved. www.agesandstages.com7
Types of Assessment Screening Diagnostic On-Going(linked tocurriculum)ASQ-3 and ASQ:SE-2 Training Materials by J Squires, J Farrell, J Clifford, S Yockelson, E Twombly, and L PotterCopyright 2015 Brookes Publishing Co. All rights reserved. www.agesandstages.com8
What is Screening?Administration of a brief, accurate (valid) tool that: Identifies children developing on-schedule May identify children who would benefit frompractice/support in specific areas (e.g., ASQ-3 &ASQSE-2) Identifies children at risk for developmental delays(DD) who should be referred for further evaluationAnswers: "Does child need an in-depth assessment?"ASQ-3 and ASQ:SE-2 Training Materials by J Squires, J Farrell, J Clifford, S Yockelson, E Twombly, and L PotterCopyright 2015 Brookes Publishing Co. All rights reserved. www.agesandstages.com9
Keep in mind:Results of screening will informyou that . Most children are on-scheduleand doing great! Some children will benefit frompractice in specific areas(e.g., Fine Motor) or other family supports A Few children will need referral for evaluationASQ-3 and ASQ:SE-2 Training Materials by J Squires, J Farrell, J Clifford, S Yockelson, E Twombly, and L PotterCopyright 2015 Brookes Publishing Co. All rights reserved. www.agesandstages.com10
WHY SCREEN?To prevent us from missing childrenClearlyTypicalUnder DetectedClearlyAtypical?Adapted from Macias, M. (2006) D-PIP Training WorkshopASQ-3 and ASQ:SE-2 Training Materials by J Squires, J Farrell, J Clifford, S Yockelson, E Twombly, and L PotterCopyright 2015 Brookes Publishing Co. All rights reserved. www.agesandstages.com11
Universal ScreeningBeyond Cutoff(high risk)Monitor Area(low risk)DiagnosticAssessmentEligibleNot Near cutoff(no risk)Monitor (re-screen) &On-Going AssessmentMild delay or on-scheduleASQ-3 and ASQ:SE-2 Training Materials by J Squires, J Farrell, J Clifford, S Yockelson, E Twombly, and L PotterCopyright 2015 Brookes Publishing Co. All rights reserved. www.agesandstages.com12
Features: ASQ-3 CulturalAdaptability Alternative administration methods for individualsfrom different cultural backgrounds Alternative materials for individuals from differentcultural backgrounds Scoring permits omission of inappropriate items Normative sample includes diverse populationsASQ-3 and ASQ:SE-2 Training Materials by J Squires, J Farrell, J Clifford, S Yockelson, E Twombly, and L PotterCopyright 2015 Brookes Publishing Co. All rights reserved. www.agesandstages.com13
ASQ-3 Information Summary(Sections 3, 4, & 5)ASQ-3 and ASQ:SE-2 Training Materials by J Squires, J Farrell, J Clifford, S Yockelson, E Twombly, and L PotterCopyright 2015 Brookes Publishing Co. All rights reserved. www.agesandstages.com14
ASQ-3 Score Interpretation andRecommendation for Follow-UpAdditional Considerations Biological / Health factors Family and cultural context stressful life events caregiving environment Environmental factors opportunity to practice skills Developmental history Extent and frequency of contact Availability of resourcesASQ-3 and ASQ:SE-2 Training Materials by J Squires, J Farrell, J Clifford, S Yockelson, E Twombly, and L PotterCopyright 2015 Brookes Publishing Co. All rights reserved. www.agesandstages.com15
ASQ-3 and ASQ:SE-2 Training Materials by J Squires, J Farrell, J Clifford, S Yockelson, E Twombly, and L PotterCopyright 2015 Brookes Publishing Co. All rights reserved. www.agesandstages.com16
Why Assess Social-EmotionalDevelopment? Part C of IDEA calls for the Social-Emotionalarea to be assessed and services provided ifnecessary Programs such as Head Start mandate thatthis area be addressed in their performancestandards Research linking earliest social-emotionalbehaviors with subsequent outcomesASQ-3 and ASQ:SE-2 Training Materials by J Squires, J Farrell, J Clifford, S Yockelson, E Twombly, and L PotterCopyright 2015 Brookes Publishing Co. All rights reserved. www.agesandstages.com17
Social-Emotional Research Behaviors in infancy, signal the need forintervention Links exist between early risk factors,poor outcomes, and violence Social and emotional competencies areformed through interactions withprimary caregivers.ASQ-3 and ASQ:SE-2 Training Materials by J Squires, J Farrell, J Clifford, S Yockelson, E Twombly, and L PotterCopyright 2015 Brookes Publishing Co. All rights reserved. www.agesandstages.com18
What are our Concerns? Aggression Anxiety Eating/sleeping/elimination problems Hyperactivity, Short attention span Oppositional, non-compliant Social avoidance Limited play interests, perseverative play Prolonged tantrums, self harmingASQ-3 and ASQ:SE-2 Training Materials by J Squires, J Farrell, J Clifford, S Yockelson, E Twombly, and L PotterCopyright 2015 Brookes Publishing Co. All rights reserved. www.agesandstages.com19
Features of ASQ:SE-2 that SupportCultural Sensitivity Flexible administration Ability to reframe/omit items Balance of strengths as well as problem behaviors Subjectivity is a critical part of assessment data Adaptations in multiple languagesASQ-3 and ASQ:SE-2 Training Materials by J Squires, J Farrell, J Clifford, S Yockelson, E Twombly, and L PotterCopyright 2015 Brookes Publishing Co. All rights reserved. www.agesandstages.com20
Recommended Follow-up Above Cutoff Refer to EI/ECSERefer for behavioral/mental health evaluationRefer to primary health care providerRefer to local community agencies Feeding clinicFaith based groupsCommunity groups, YMCA, Birth to ThreeParenting groupsEarly Head StartASQ-3 and ASQ:SE-2 Training Materials by J Squires, J Farrell, J Clifford, S Yockelson, E Twombly, and L PotterCopyright 2015 Brookes Publishing Co. All rights reserved. www.agesandstages.com21
Infant Mental Health Intervention1. Assess basic needs and provide support toaccess (i.e., food, housing)2. Emotional support3. Developmental guidance4. Parent/Child relationship support5. Advocacy6. Parenting Strategies7. Positive Behavior Supports8. Parent Child Interactional Therapy(Requires a trained mental health professional)ASQ-3 and ASQ:SE-2 Training Materials by J Squires, J Farrell, J Clifford, S Yockelson, E Twombly, and L PotterCopyright 2015 Brookes Publishing Co. All rights reserved. www.agesandstages.com22
ASQ:3 Results Looking at zip codes noted ECCS Impact Grant ASQ:3 Communication: 1216 children above cutoff: 94.7-%68 children below cutoff: 5.30%Statewide:5073 children above cutoff: 96.33%193 children below cutoff: 3.67%Gross Motor Skills: 1228 children above cutoff : 95.64%56 children below cutoff : 4.36 %Statewide:5073 children above cutoff: 96.33%193 children below cutoff: 3.67%
ASQ: 3 Results Continued Fine Motor Skills: 1189 children above cutoff: 92.60 % 95 children below cutoff : 7.40 % Statewide:4953 children above cutoff : 94.06% 313 children below cutoff: 5.94 % Problem Solving : 1213 children above cutoff : 94.47 % 71 children below cutoff: 5.53 % Statewide:5049 children above cutoff : 95.88% 217 children below cutoff: 4.12%
ASQ:3 Results Continued Personal Social Skills: 1223 children above cutoff: 95.25 % 61 children below cutoff: 4.75% Statewide:5067 children above cutoff: 96.22% 199 children below cutoff: 3.78%
ASQ:SE:2 Results ASQ :SE:2 : 127 children above cutoff: 9.54% (concerns)1141 children below cutoff: 85.73% Statewide: 326 children above cutoff: 6.84 % (concerns) 4256 children below cutoff: 89.32 % Monitoring: 63 children 4.73% Statewide:183 children: 3.84 %
Interesting Data Information Statewide numbers have lower number of concerns than those withinthe impact grant area. Areas of greatest concern to lowest concern: ASQ:3 Fine motor 7.40%Problem Solving 5.53%Communication 5.30%Personal Social 4.75%Gross Motor 4.36%
Communication Below CutoffGross Motor Below CutoffFine Motor Below otal for Selected ZipsNo8524115317883322391151216No 4.70%Yes2146512242368Yes 624615118188324371151228No 5.64%Yes19827224356Yes 23814417384319411111189No 92.60%Yes817151011270795DE 90521561191415022124771206123222466921# Overall Areas Concern2347322583115112329542712105111441Total for Selected Zips8402461104124193DE Total3252114148621210654102281112
elow CutoffProblem Solving Below CutoffSocial Below CutoffYes 225115117586318371131213No 4.47%Yes54889284571Yes 24714817885328371161223No 5.25%Yes3811510184261Yes 4%504995.88%2174.12%506796.22%1993.78%All ASQ 3 Results1/1/2015- 10/20/2016For Zips: 19703,19720,19801,19802,19804,19805,19806,19809
% of De TotalRepresented bySelected Zips25.83%21.56%22.63%19.34%22.64%35.19%30.00%
ZipAbove Cutoff% Above CutoffBelow Cutoff% Below .43%2.16%4.40%2.42%0.00%9.14%2.33%3.70%4.73%DE Total3266.84%425689.32%1833.84%% of De TotalRepresented bySelected Zips38.96%26.81%Monitoring % Monitoring558534.43%All ASQ 2 Results1/1/2015- 10/20/2016For Zips: 19703,19720,19801,19819804,19805,19806,19809
All ASQ 2 Results1/1/2015- 19809
Help Me Grow DelawareAdvancing Developmental Promotion, Early Detection& Linkages to Services
Help Me Grow – A National Model What is Help Me Grow Why is it important? Children at risk for developmentaland behavioral problems are toooften eluding early detectionCDC reports: HMG is an effective system thathelps to identify children withpotential developmental andbehavioral problems, then helpsfamilies find community-basedprograms and services. 14% of children 3-18 years havedevelopmental-behavioral disabilities ordelays High school drop out rates average 16%nationally but rates can reach 40% higheramong at risk children Most of these students did not receive thebenefits of early intervention.
Detection/Enrollment RatesIn the US, Centers for Medicaid and Medicare require: Payment/reimbursement Deployment of accurate screening test; most common are:o Parent Evaluation of Developmental Stages (PEDS)o Ages and Stages Questionnaire (ASQ)o Enrollment rates in programs funded through the Individuals withDisabilities Education Act (IDEA) for Part C (birth to three years)are 7%
Help Me Grow - An Evidenced-based ModelCORE COMPONENTS Healthcare Provider Outreach Family & Community Outreach Centralized Access Point Data Collection & AnalysisSTRUCTURE REQUIREMENT Organizing Entity Strategy for Statewide Expansion Continuous Quality Improvement (CQI)
Help Me Grow DelawareAssist Primary Care Providers The Division of Public Health adopted PEDS On-line because of itsaccuracy, compliance with AAP policy on early detection, brevityand focus on primary care. PEDS on-line is a web-based service that enables providers tocomplete 1 or more screening tests. Tests are automaticallyscored, results rendered, and the site generates referral letters,take home parent summary reports and supports billing andpayment reimbursement. PEDS also retains a database of each physician practice.Child DevelopmentWatch and Help MeGrow/2-1-1 are able toview results and assistproviders with referrals.
Help Me Grow DelawareFindings from PEDS On-line In 2014, more than 18.000 children between 0-8 years of age receivedscreening through primary care clinics Among all children screened in 2014, 13,356 screens were administered inthe 0-3 years range. Of the 13,356 screens mentioned, 79% passed all screening testsadministered, while 3% met DE referral algorithm criteria for high risk(indicating a need for a CDW referral) and 18% were at moderate risk(showing a need for HMG referral)
The Last Five Years201220132014 2Q Delaware 2-1-1becomes the Home ofHelp Me Grow Call workflow,PerformanceMeasures (includingIndicators and targets)established Child DevelopmentSpecialist hired &trained; 300 requestsfor assistance Quality Assurancestandards set HMG promotedas “go-to” placefor services forchildren birth toeight Education ofPhysicians andPractitioners PEDS screeningtool used bymajor HealthcareSystems Referrals to ChildDevelopmentWatch, ChildFind, HomeVisiting, etc.increase 2668 requestsfor assistance2015 4Q model shift toincrease carecoordination Strengthencollaboration withtargeted partners(e.g. FQHCs)2016 2H HMG conductsPEDS and PEDS DMscreenings overphone Navigation and carecoordination tosupport low, mediumand high-riskpathways
Help Me Grow DelawareCare Coordination & Management Child Development Specialist to conduct PEDS Screenings at targetedoutreach events and over the phone Risk algorithm established to ensure parent/caregiver is connected to amedical home and other services Data collection methodology improved to strengthen linkages betweenPEDS, ASQ and Delaware 2-1-1/Help Me Grow repository of resources. Follow up calls and care coordination continue until child and families needsare met.
Help Me Grow DelawareEngagement Strategies Increase Partner Engagement to strengthen relationships andidentify shared opportunities to educate caregivers and providers. Increase Community Engagement to increase awareness onavailable “wrap-around” resources and care coordination servicesfrom birth to eight. Dedicated Child Development Specialist for New Castle County Collaborate to execute Delaware 2-1-1 Resource Summitsstatewide
Help Me Grow Delaware – OutcomesCommunityPartnersUnited Way of Delaware Potential development delaysare detected early andservices are provided toimprove a child’s future. Pre-screened referrals tocommunity-base servicesfrom Physicians. Children are moreprepared for school andlife long learning. Caregivers have knowledge ofand easy access (dial 2-1-1) toservices through a statewidesystem. Providers are focused onchildren who need moresupport.
Questions?
UPDATED 11/2/16Wilmington Education Improvement CommissionMeeting the Needs of Students in Poverty CommitteeOpportunities for “Early Win” Impact Projects and “Immediate” Action StepsOverviewIn order to ground its work, the Meeting the Needs of Students in Poverty (MNSP) Committee ofthe Wilmington Education Improvement Commission collected and analyzed feedback fromparents, school principals, and other community stakeholders on addressing the “real” needs ofstudents living in Wilmington. During the period from May to October 2016, parents, caregivers,and other community stakeholders participating in two Wilmington community educationevents were surveyed; and school principals from seven elementary schools in Wilmington wereinterviewed. The data collected from both groups of participants were aggregated and analyzedfor common themes and reported as findings. These findings were further analyzed torecommend opportunities for “early win” impact projects and “immediate” actions to beundertaken by the MNSP Committee. Finally, the MNSP Committee reviewed therecommendations and suggested additional opportunities for consideration in formulating itswork plan for 2016-2017.Opportunities for “Early Win” Impact Projects and “Immediate” Actions Categorized byFindings from Needs AnalysisThe opportunities for “early win” impact projects and “immediate” actions categorized by findingare summarized below:1. Better integration of services and linkages between schools and communityBetter integration of services and linkages between school and community such as communityschools and co-location of services in schools, including connection of families to State andcommunity services available to help them address basic needs and employment, and a formalprocess and support for transitioning children from childcare centers to kindergarten“Immediate” Action Steps Work with schools to include the name of the pre-school or child care center the child lastattended on school registration forms and to request cumulative folders from theidentified child care providers on the children enrolledConduct a campaign to encourage families to register their children for school early, suchas having a Fire Engine from the Wilmington Fire Department to travel around the city inthe su
6. Parenting Strategies 7. Positive Behavior Supports 8. Parent Child Interactional Therapy (Requires a trained mental health professional) ASQ-3 and ASQ:SE -2 Training Materials by J Squires, J Farrell, J Clifford, S Yockelson, E Twombly, and L Potter Copyright 2015 Brookes Publishing Co. All rights reserved. www.agesandstages.com 22
In the beginning, electronic questionnaires should be relatively concise (not more than 50 questions, preferably closer to 30 for a 3. rd. or 4. th. degree charge). All questionnaires must include standard questions about juror qualifications. Questionnaires must not include questions that seek a juror's individual demographic information.
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The Feelings Book by Todd Parr (Ages 3-8) I Am Happy by Steve Light (Ages 3-6) . If You’re Happy and You Know It! by Jane Cabrera (Ages 3-6) Lizzy’s Ups and Downs by Jessica Harper (Ages 3-9) My Many Colored Days by Dr. Seuss (Ages 3-8) On Monday When It Rained by Cheryl Kachenmeister (Ages 3-8) Smudg
Middle Ages Dorothy Mills Edited by Memoria Press. www.MemoriaPress.com The Book of T he Middle Ages dorothy Mills edited by Memoria Press isBN 978-1-5477-0239-8 . Middle Ages Timeline . 393 Bibliography 8. Part i The early Middle Ages 9. CHAPTER 1 The Foundations of the Middle Ages In A.D. 476 Rome fell, the Western Empire came to an end
Post-Visit Lesson Plan #2: Ages and Stages: The Life of a Hawaiian Volcano 1 Ages and Stages: The Life of a Hawaiian Volcano Next Generation Science Standards: 4-ESS1-1 Identify evidence from patterns in rock formation and fossils in rock layers to support an explanation for changes in a landscape over time.
Ages & Stages Questionnaires is a registered trademark and ASQ-3 and related log
Ages & Stages Questionnaires is a registered trademark and ASQ-3 and related logos are trademarks of Paul H. rookes Publishing Co., Inc.
