What it Takes to Be a Useful Screener

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What it Takes to Be a Useful Screener
Screener needs to be relatively brief, yet
comprehensive - covering major areas of
development and school readiness, and parents
functioning Accurate - research based,
valid Easy to Use Parent, child and staff
friendly Fit within an existing system Low
Cost
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Screening Young Children using the Infant
Development Inventory and Child Development
Review - Parent QuestionnaireHarold Ireton,
Ph.D. and Heidi VaderHeidi_at_childdevrev.com
Ireton_at_q.comChildDevelopmentReview.com
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Parents Concerns Health
Development Behavior
Social Self-Help Gross Motor Fine
Motor Language School Readiness
Parents Functioning
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Why Screen?

• About 16 of children have disabilities such as
  speech-language impairments, mental retardation,
  learning disabilities, and emotional/behavioral
  disturbance
• Of those children, only 20 to 30 are identified
  prior to school entrance
• Without detection, they cannot receive early
  intervention
• (DBPeds.com)

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Screening Infants, Toddlers and
Preschoolers Using the Child Development Review
System

• Child Development Review is a Research-Based
  System for
• Obtaining information from parents
• Making your own observations of the child
• Integrating these two sources of information

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Screening Infants, Toddlers and
Preschoolers Using the Child Development Review
System
Child Development Review Helps You Appreciate
the childs strengths and identify any parent
concerns Determine whether a childs development
is typical for age or is delayed in some
regard Talk with parents and involve them more
effectively
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Parent Questionnaires
Two Parent Questionnaires Infant Development
Inventory (IDI-PQ) Child Development Review
(CDR-PQ) They both include Parent
Questionnaire and a Child Development Chart.
The parent questionnaire is brief yet
comprehensive. It saves time by helping you focus
your talk with parents to identify their
concerns. The Chart tracks development and is
also useful as a parent education tool.
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When to Use Parent Questionnaires

• Health Care American Academy of Pediatrics
  recommends surveillance at all visits, and
  screening at 9, 18 and 30 month Well Child
  visits.
• Education Settings
• At Enrollment
• For Periodic and Pre-K Screening
• Parent Teacher Conference

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Parent Questionnaire Focus

• Parent Questions and Concerns
• Childs Development
• Parents Functioning

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The Child Development Review Infant Development
Inventory

• Parents Questions and/or Concerns
• Infants Development
• Talking with Parents
• Parent Education

ChildDevelopmentReview.com
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Using the Infant Development Inventory With
Parents

• Questions for Parents
• Please describe your baby?
• What questions or concerns do you have about your
  babys Health? Development? Behavior? Other?
• How are you doing as a parent?

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Interpreting Parents Responses

• Parents Description gives you a picture of their
  baby and also
  indicates the parents satisfaction or
  frustration
• Parents Questions and Concerns provide more
  specific information about possible problems and
  help you focus your discussion with them
• Parents Functioning By asking How are you
  doing as a parent? the parent is able to ask for
  help if needed

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Infant Development Chart

• Covers Development in the First 21 Months in Five
  Areas
• Social Development
• Self-Help
• Gross Motor
• Fine Motor
• Language

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Lets Pretend!

• Tell us about a baby you know or imagine
• Complete the Infant Development Inventory
• You are the mother
• Remember to read the directions, please.

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Marla 3 wk
P
2/20/2008 3/12/08
Cindy
mom
very good - doesnt cry much very loved loves to
eat
Questions re Formula, Gas problems,
constipation. Doing well as parent
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IDI Chart Results for 3-week-old Marla
P
P
P
P
P
P
P
3/12/08
P
P
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John 2 mo
P
1/01/2008 3/12/08
Yvonne
mom
Likes to look around -looks at the animals, looks
at colors, looks at a man, likes it when his
sister picks him up. Cries at night. Happy
during the Day
Im tired
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IDI Chart Results for 2-month-old John
P
P
P
P
3/12/08
P
P
P
P
P
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Misty 4 mo
P
10/28/2007 3/12/08
Michelle
mom
Funny when she talk to her self. Kicks when
shes excited. She likes it when I come into
the room
Worried that shes waking up more at night.
Doing ok as a parent - used to having Dad gone
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IDI Chart Results for 4-month-old Misty
P
P
P
P
P
P
P
P
P
P
P
3/12/08
P
P
P
P
P
P
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Jake 15 mo
P
12/10/07 3/12/08
Laurel
mom
Quiet. Easy to handle
Not talking yet. Is clumsy. Im ok. Worried
about him
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IDI Chart Results for 15-month-old Jake
P
P
P
P
P
P
70 Age Level
P
P
P
P
P
P
P
P
P
NO
P
P
P
P
Actual Age
NO
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Doing A Developmental Interview

• Use a natural approach.
• Ask What has your child been doing lately?
• Then begin asking about specific skills in each
  area somewhat below the childs age
• Ask Is she. . .? or Does she. . .? rather
  than Can she. . .?
• Stop when 2 or 3 answers in a row in a
  developmental area are No, - or at age level.

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Child Observation Using the Infant Development
Chart

• The Childs spontaneous behavior provides
  critical information about his development and
  adjustment.
• Use Age-related behaviors on the Chart to know
  what to look for in a child this age.
• Have a few age-appropriate play materials
  available, ex. blocks, toy cars, dolls, crayons.
• For older children, the ability to answer
  questions and follow directions reveals childs
  level of understanding.
• Record your observations on the Chart

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Talking With Parents

• Be Parent-Centered as well as Child-Centered
• Sensitivity and Timing are Important
• Parents need affirmation of their babys
  strengths and their efforts as a parent

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Parents Concerns

• Childs Functioning
• Health - including Hearing and Vision
• Development
• Behavior
• Parents Functioning
• "How are you doing, as a parent and otherwise?

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Infant Development Chart Interpreting Results
Development Age vs. Child's Age Level of
development in each of the 5 areas equals age
level of oldest item checked in that
area Determine How Well The Child Is Doing In
Each Area Of Development By Comparing . . . the
childs level of development (behavioral level)
in that area to the child's actual age
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Results

• Classify The Results for Each Area as Suggesting
• Typical(T) Development around age level
• Borderline (B) Development below age -
  development at 70 of age level line or just
  above the line
• Delayed (D) Development below the 70 of age
  line
• Mark the headings on each of the five areas with
  a T, B or D

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IDI Validity (Accuracy)

• The Infant Development inventory (Ireton, 1994)
  is a research-based parent questionnaire (PQ) for
  obtaining the parents report of the infant's
  present functioning, with a primary focus on the
  infant's development.
• Norms Developmental skills are located in the
  Chart at an age level by/during which at least 75
  percent of children display the behavior. These
  norms are based on previous research with the
  Child Development Inventory (CDI).
• Validity (Accuracy) Our thanks to Diane
  Creighton, Alberta Children's Hospital for her
  research. Initial study of eight-month-olds
  (N86) compared parents' IDI reports to
  developmental test results (Bayley Scale).
  Results from the two sources, classified as
  Delayed or Typical for age, were quite
  comparable. The majority of children delayed on
  the test were identified by parental report
  (Sensitivity .85), while classification as
  "typically developing" was similar for both
  measures (Specificity .77).
• A second study of eight-month-olds (N252),
  including 48 low birth weight infants, compared
  the accuracy of the IDI and two developmental
  tests, ( Fagan Test of Infant Intelligence and
  the Bayley Infant Neuro-developmental Screen) for
  identifying children with delayed development.
• Among the three measures, the parents' IDI report
  was most strongly related to full Bayley test
  results indicating Delay or Typical development.
  IDI Sensitivity was .90 Specificity was .93
• Comment In most cases, parents' IDI reports
  provide an accurate indicator of their childrens
  developmental status. This is especially
  important when you consider the difficulties in
  testing infants and young children.

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Break Time!

• Heidi Vader heidi_at_childdevrev.com
• Harry Ireton ireton_at_q.com

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More Children

• Please tell us about a toddler or preschooler you
  know or imagine - Problem if possible
• Complete the Child Development Review -Parent
  Questionnaire
• You are the mother
• STOP at the end of the first page

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Johns 3 year CDR-PQ
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Interpreting CDR-PQ

• OK - Child and Parent Well or OK?
• ? - Possible Problem
• P - Possible Major Problem

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6 Questions

• 1) Please describe your child briefly very
  positive to very negative descriptions
• 2) What has your child been doing lately? learn
  present skills
• 3) What are your childs strengths? helps you
  get a more balanced picture of the childs
  functioning
• 4) Does your child have any special problems or
  disabilities? Need to know this for sure
• 5) What questions or concerns do you have about
  your child? learn about less serious problems
  and the parents concerns.
• 6) How are you doing as a parent and otherwise,
  at this time? parent can report any problems of
  their own

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Possible Problems Checklist

• The Problems Checklist helps parents
  systematically report their concerns and the
  childs possible problems.
• Health Parents report relatively few health
  problems (45 percent).
• Development When parents are concerned about
  their child's development, it is most often that
  the child does not talk well (9 percent) and
  more often for boys than girls.
• Behavior Starting at age two, behavior problems
  are the most commonly reported concerns, more
  often for boys than girls.

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Child Development Chart

• Covers Development in the First Five Years in
  Five Areas
• Social Development
• Self-Help
• Gross Motor
• Fine Motor
• Language

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John
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Talking with Parents about their Childs
Functioning

• Review Parent Questionnaire answers
• Use Chart for further screening, if needed

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CDR-PQ Validity (Accuracy)

• PRESCHOOL SCREENING THROUGH THE SCHOOLS USING THE
  CDR - Parents' CDR concerns were related to
  developmental screening test results in one study
  (The DIAL). In a second study, parents' CDR
  concerns were related to play-based observations
  of the children made by teachers. The first study
  included 220 three to five-year-old children,
  The second study included 2,225 2 1/2 to 3 1/2
  year olds (Statewide, in Wisconsin). Both studies
  found that parents' CDR concerns provide accurate
  indicators of children's developmental problems
  and need for followup assessment.
• In the first study, children who tested poorly
  much more often had concerned parents (44 percent
  vs. 10 percent). CDR overall results (Questions
  plus Problems list) identified the majority of
  children who received preschool special education
  (68 percent) and indicated no significant
  problems for the majority of other children (88
  percent).
• In the second larger study of three year olds,
  among the 2,225 children seen, eight percent were
  referred for team evaluation for possible special
  education placement. Of the 160 children who
  were assessed, 73 percent (3 out of 4) were
  service eligible and received early intervention.
  An additional nine percent were directed toward
  community services such as Head Start, Public
  Health, Social Service.
• One additional benefit - by having parents
  complete the CDR PQ before the direct child
  screen - parents were more involved and the
  process was more parent and child-friendly

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CDR-PQ Validity (Accuracy) continued

• EARLY CHILDHOOD SCREENING BY SCHOOLS 22O 3-5
  YEAR OLDS CDR RESULTS IDENTIFIED 68 OF
  STUDENTS PLACED IN EC/SE CORRECTLY CLASSIFIED
  88 OF CHILDREN WHO PASSED SCREENING AS
  TYPICALLY DEVELOPING
• CHILD DEVELOPMENT DAYS WISCONSIN-STATEWIDE 10
  YEARS 2,225 THREE YEAR OLDS OF 160 CHILDREN
  REFERRED FOR ASSESSMENT, 73 QUALIFIED FOR EC/SE
• AGE NORMS- FOR CHILD DEVELOPMENT CHART SKILLS
  (75 YES POINT) ESTABLISHED IN EARLIER CHILD
  DEVELOPMENT INVENTORY RESEARCH
• PEDIATRICIANS DISCUSSION OF BEHAVIOR PROBLEMS -
  CDR USE INCREASES RATE OF DISCUSSION AND PROBLEM
  IDENTIFICATION (122 TODDLERS AND PRESCHOOLERS)
• HI-RISK AND TERM INFANTS (48 154) AT AGE 8
  MONTHS IDI AND BAYLEY MENTAL SCALE SHOWED 90
  AGREEMENT
• More information available in the book, CDIs In
  Education and Health Care.

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Ongoing Assessment Tools

• Child Development Inventory (CDI)
• Teachers Observation Guide (TOG)

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ChildDevelopmentReview.com

• Heidi Vader heidi_at_childdevrev.com
• Harry Ireton ireton_at_q.com