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Oregon Online Screening Project Increasing Opportunities for
Early Developmental Screening in Oregon
Ages & Stages Questionnaires® is a registered trademark of Paul H. Brookes Publishing Co., Inc.
Presented by:
Jane Squires, PhD.
Director, Center on Human Development
Professor, Early Intervention/Special Ed.
University of Oregon
Purpose of early developmental screening
Introduce and describe the ASQ-3
and ASQ:SE
Introduce asqoregon.com
What we’ve learned
Future plans
Objectives Objectives
What is Screening?
• A brief, valid tool administered at regular intervals:
– Identifies children developing on-schedule.
– Identifies areas that need practice/ support.
– Identifies children at risk for developmental delays (DD)
• When given to all children at a
set time (entry into a childcare)
it is called “universal” screening
Clearly Typical
Under Detected
?
Adapted from Macias, M. (2006) D-PIP Training Workshop
Clearly Atypical
Copyright © 2011 Paul H. Brookes Publishing Co., Inc. All rights reserved. www.agesandstages.com
WHY SCREEN?
Clearly Typical
Under Detected
?
Adapted from Macias, M. (2006) D-PIP Training Workshop
Clearly Atypical
Copyright © 2011 Paul H. Brookes Publishing Co., Inc. All rights reserved. www.agesandstages.com
WHY SCREEN?
ASQ-3 training materials adapted with permission for use in the Oregon Screening Project. Copyright © 2014 by Paul H. Brookes Publishing
Co., Inc. All rights reserved. www.agesandstages.com
Detection Rates of Children with Existing Delays
Without Screening Tools
With Screening Tools
Developmental Disabilities
14-54% identified Sheldrick et al, 2011
70-80% identified Squires et al, 1996
Mental Health Problems
20% identified Lavigne et al, 1993
80-90% identified Sturner, 1991
Courtesy of START
Incidence of children identified as having a disability by age (2007)
2.79 % 10.76 % 5.99%
http://www.ideadata.org,
• Parent/Caregiver completed screening tool
to identify children at risk
for developmental delay
• Series of questionnaires for children ages 1 month up to 6 years
Ages & Stages Questionnaires 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. All rights reserved. For more information about the ASQ and ASQ:SE, see http://www.agesandstages.com
What is the ASQ-3
• Parent / Caregiver completed screening tool to
accurately identify children
at risk for Social Emotional delay
• Series of questionnaires for children ages 1 month to 5 ½ years
Ages & Stages Questionnaires : Social Emotional
What is the ASQ:SE
Domains Screened by the ASQ-3
ASQ-3
Communication
Gross motor
Fine motor
Problem solving
Personal-social
ASQ:SE:
Social-emotional development
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. All rights reserved. For more information about the ASQ and ASQ:SE, see http://www.agesandstages.com
Features: ASQ-3 Areas & Questions
5 developmental areas
6 questions in each area
Response options: Yes, Sometimes, Not Yet
Written at 4th to 5th grade level
ASQ-3™ and ASQ:SE Training Materials by Jane Squires, Jane Farrell, Jantina Clifford, Suzanne Yockelson, and Elizabeth Twombly
Copyright © 2012 by Paul H. Brookes Publishing Co., Inc. All rights reserved.
For more information on ASQ-3™ and ASQ:SE, see www.agesandstages.com
Features: ASQ-3 Areas & Questions
Questions ordered in a hierarchy
Questions #5, #6 are average skills for child of that age
ASQ-3™ and ASQ:SE Training Materials by Jane Squires, Jane Farrell, Jantina Clifford, Suzanne Yockelson, and Elizabeth Twombly
Copyright © 2012 by Paul H. Brookes Publishing Co., Inc. All rights reserved.
For more information on ASQ-3™ and ASQ:SE, see www.agesandstages.com
More Difficult
ASQ-3 Information Summary Sheet (Sections 1 & 2)
ASQ-3™ and ASQ:SE Training Materials by Jane Squires, Jane Farrell, Jantina Clifford, Suzanne Yockelson, and Elizabeth Twombly
Copyright © 2012 by Paul H. Brookes Publishing Co., Inc. All rights reserved.
For more information on ASQ-3™ and ASQ:SE, see www.agesandstages.com
ASQ-3 Information Summary (Sections 3 & 4 )
ASQ-3™ and ASQ:SE Training Materials by Jane Squires, Jane Farrell, Jantina Clifford, Suzanne Yockelson, and Elizabeth Twombly
Copyright © 2012 by Paul H. Brookes Publishing Co., Inc. All rights reserved.
For more information on ASQ-3™ and ASQ:SE, see www.agesandstages.com
Standard Bell Curve
68% of
population
scores in this
“average” range
13.5% 13.5 %
+ 1 SD -2 SD +2 SD - 1 SD
2.5% 2.5%
Nu
mb
er
of
Peo
ple
Average (Mean) Performance on Test
Copyright © 2011 Paul H. Brookes Publishing Co., Inc. All rights reserved. www.agesandstages.com
Screening Results
Copyright © 2011 Paul H. Brookes Publishing Co., Inc. All rights reserved. www.agesandstages.com
Parents have concerns “Is my child ok?”
How to increase opportunities for developmental screening?
How to inform parents,
alleviate concerns?
How to empower parents,
to take Next Steps?
How can parents access reliable information?
Parents Have Concerns Is my child ok?
Launched in late 2009 with part funding from
Oregon Dept. of Education
To explore use of parent-completed,
online method to enhance statewide efforts
of Child Find in Oregon.
Identify children at risk for developmental
delay or disability in the birth to 5 age range
Provide Parent/Caregiver awareness of
resources and referral to services if needed
History
By Age Group
By Income
PEWResearch Internet Project http://www.pewinternet.org/2014/02/27/about-this-report-4/
Oregon Parents are Online
Parent driven-- free easy to use, confidential
Interactive— automated results available to all
Results -- help parents decide and take Next Steps
Personal follow up --for parent concerns or at-risk results
Parent resources and EI/ECSE contacts delivered directly to users
How Does it Work?
ASQ , ASQ:SE Results by email or download
Completed ASQ, ASQ:SE, pdfs
Next Steps guide
Play/Learning activities
Parent education links, resources
Personal follow up on request
Referral contacts, if needed
What Do Parents Receive?
• Eager for information about early development
• Online venue meets a larger population, not served by social services
• Oregon participants
89 % parent completed
72% are mid income or above
61% have AA/College education or above
Oregon Parents
Parent comments
“….appreciate this opportunity to find out
if my child is on track and if I am
too worried about things.”
“The web site was easy to use
and follow.
I emailed a link to my Birth to 3
friends.”
Parent Comments
data
Oregon families in 34 counties have participated
11,792 screens as of June 2014 256 avg/month
24% in Washington co 23% in Lane co 16 % Multnomah co
data
0
500
1000
1500
2000
2500
3000
2010-2011 2011-2012 2012-2013 2013-2014
Total Screenings Completed ASQOregon
Who Are Partners?
Early Intervention/Early Childhood Special
Education providers in
Lane, Marion, Washington counties Respond to at-risk cases
Encourage self referral if needed
Track self referrals
Who Are Partners?
• Total known referrals 1270:
Results of Screenings and Known Referrals
• 28.6% had 1 or more areas below cutoff:
• Of those, 14% show 2 or > areas
below cutoff
49.6% Early Intervention
43.5% Early Childhood Special Education
(6.9% age missing)
It’s a wonderful service, I’m proud to be part of it!
Partner Comments…
Families have an instant screening in hand for kinder registration to share with teachers and staff.
Self-refer parents send copies prior to appointment or call back to report ASQ online has been completed.
Many families provide information online that we don’t hear over the phone during the intake call.
…Partner Comments
I presented ASQOnline to PreK and Daycare teachers. Since that time our preschool referral rate has increased
• Many complete ASQ, ASQSE several times
• before taking self-refer step
• Parents/caregivers need help with Next Steps
…..What We’ve Learned
• Self monitoring benefits parent, child
and screening goals
(EI/ECSE and PEDS)
• Parents/caregivers appreciate self screen opportunity
“ Great resource for parents who do not get out, great community service.”
“This is the second time I have done it”
“I was able to get my child scheduled for an EI evaluation THANKS!!!!”
Parents Say…
72% said it takes < 20 mins to complete 90% said they would complete another ASQ online 90% said they would recommend to others
Future Plans
• New Results messaging
• Options to identify self or keep confidential
• Increase tracking of Referrals
• Smart phones / tablet use enable
• Update site to meet needs of Universal Screening in Oregon
• Webinars on Developmental Screening, training
• Child Care Providers as partners
• Options to send results direct to providers
Follow up asqoregon.com
Share the site with parents
Share site with childcare providers …See CCP toolkit
Support parents when there are concerns
• referrals for further evaluation and/or services
Parent /Caregiver Resources Early Development
Zero to Three Age based handouts
Center for Social Emotional Foundations and Learning Behavior guides , family tools
211 family info Warm line, local help
Parent/Caregiver Resources Services
“Do You Have Concerns ?” OR Dept. of Education handout
Reliable Parent – Education Links
Oregon 211 Family Info
Parent Support groups , Child Care Resource & Referral
All EI/ECSE websites and contacts by county