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What
is my role in developmental screening of young children?
Early childhood professionals
Many programs,
such as Head Start, conduct screening on a regular basis,
for example, within the first 60 days of program entry. This
is an example of universal screening.
Targeted
screening happens when screening is conducted because of concerns
about a child. Early childhood professionals working with
children on regular basis often instinctively know when something
is unusual or different with a child in their care. There
are also instances when family members have expressed concerns
about a child's development or behavior. Conducting a developmental
screen may be a good way to either confirm the observations
or offer reassurance.
Tools
like the ASQ
and PEDS
are designed to be self-taught and don't require a formal
training prior to their use. Professionals who feel comfortable
administering the screen could conduct one after obtaining
parental consent. For professionals who don't feel comfortable
conducting the screen, it is important to know community partners
who offer developmental screening.
Examples
of programs performing screening include:
- Birth
to 3 Program
Birth to 3 is an early intervention program available to
eligible children in all Wisconsin counties. Birth to 3
Programs are required by law to identify children with developmental
delays or disabilities. Developmental screenings are conducted
free of charge. To find out if a child is eligible to receive
supports and services through this program, call Wisconsin
First Step at 1-800-64
- Public
Schools for children over the age of 3 years (Early
Childhood Special Education). Every school district in the
state of Wisconsin is required to provide early childhood
special education services to children who are found to
have a disability and are in need of these services. These
services are provided in a variety of setting including
settings with nondisabled peers.
- Head
Start/Early Head Start
- Pediatricians
or family doctors
- Public
Health nurses
- Home
Visiting Programs
- Family
Resource Center Staff in your community
- Child
Development Days in your community
After
conducting the screen (or obtaining results of the screen
if conducted by someone else) it is essential that professionals
have conversations with family members about the results.
To prepare, it is best to review the results in advance to
learn if your concerns about a child's development were validated.
If the results are concerning, the conversations with family
members may be difficult. Make sure to hold them in private
and allow for sufficient time. Parents may feel vulnerable,
so be empathetic and choose your words carefully. Consider
inviting other professionals involved in the child's care
to these conversations.
For children
with concerning screens, additional assessments are needed
to determine each child's unique set of strengths and needs.
Birth
to 3 and Early
Childhood Special Education Programs are available in
every community. These programs offer further assessment and
appropriate developmental intervention for eligible children.
These two programs are required by law to identify and serve
children with developmental delays and disabilities. For more
information on Child Find efforts, visit the CESA
6 website.
Health care professionals
Most pediatric
health care professionals, such as pediatricians, family physicians,
and pediatric nurse practitioners perform developmental surveillance
at nearly every well-child visit. Surveillance involves making
accurate observations of a child, taking a developmental history,
and talking with parents about their concerns. Surveillance
can detect children with significant delays, however screening
with a standardized tool is more effective at early identification
of developmental delays. Screening can be an excellent parent-education
tool on child development in general and their child's development,
in particular. Developmental screening also improves family
satisfaction, and has been recommended by the American
Academy of Pediatrics at the 9-, 18-, and 30-month well
child visits for all children.
There
are also instances when family members express concerns about
a child's development or behavior. Conducting a developmental
screen may be a good way to either confirm the observations
or offer reassurance.
Tools
like the ASQ
and PEDS
are designed to be self-taught and don't require a formal
training prior to their use. Both are written at a third-
to fifth-grade reading level, take 10 minutes to administer,
and less than five minutes to score. However, training on
screening tools can be helpful to increase professionals'
confidence with using a tool in their daily work with children
and families.
If your
practice is not conducting developmental screening currently,
it is important to know community partners who offer screening
or pursue how your organization may begin conducting developmental
screening.
Examples
of programs performing screening include:
After
conducting the screen it is essential to have thoughtful conversations
with family members about the results. Parents may feel vulnerable,
so be empathetic, choose your words carefully, and allow for
sufficient time. For children with concerning screens, it
is important to connect families with available resources
designed to offer ongoing, individualized support to the child.
Birth
to 3 and Early
Childhood Special Education Programs
are available in every community. These programs offer further
assessment and appropriate supports and services for eligible
children. These two programs are required by law to identify
and serve children with developmental delays and disabilities.
For more information on Child Find efforts, visit the CESA
6 website.
To read
"The role of the pediatrician in family-centered early
intervention services," (Pediatrics, 2001) (http://pediatrics.aappublications.org/cgi/reprint/107/5/1155.pdf
)
To learn
more about the American Academy of Pediatrics screening initiative
visit (http://www.aap.org/healthtopics/early.cfm).
Family members
When
to ask . . .
All children
develop at their own speed. Some children's development, however,
is markedly different from same-aged peers. Many parents have
an intuitive sense of what to expect at certain ages. You
may be concerned about how your child responds to you and
others, how she sees, hears, plays, learns, or walks.
Talaris
Research Institute offers a research-based timeline organized
by a child's age.
- Social
- Emotional - how children feel and how they learn to relate
to others
- Cognitive
- how children learn and think
- Language
- how children learn sounds, words, and sentences
- Sensory
- how children hear, see, taste, smell and feel
- Motor
Skills - how children learn to sit up, crawl, walk, and
run
Some physicians
are conducting universal screening of all children at 9-,
18- and 24- (or 30-) month well child exams. Screens can also
be conducted at any time to see whether a child's development
is on-track. If you have concerns about a child's development,
ask for a screen.
Who
to ask . . .
There
are many resources available to parents with concerns about
their child's development. Some programs, such as Birth to
3, have federal mandates to find and serve children with developmental
delays. Possibilities include:
- Your
county's Birth
to 3 Program Birth to 3 is an early intervention program
available to eligible children in all Wisconsin counties.
Birth to 3 Programs are required by law to identify children
with developmental delays or disabilities. Developmental
screenings are conducted free of charge. To find out if
a child is eligible to receive supports and services through
this program, call Wisconsin First Step at 1-800-642-7837).
- Your
Public
School for children over the age of 3 years (Early Childhood
Special Education). Every school district in the state of
Wisconsin is required to provide early childhood special
education services to children who are found to have a disability
and are in need of these services. These services are provided
in a variety of setting including settings with nondisabled
peers.
- Head
Start/Early Head Start
- Pediatricians
or family doctors
- Child
care providers
- Public
Health nurses
- Home
Visiting Programs
- Family
Resource Center Staff in your community
- Child
Development Days in your community
What
to expect . . .
Expect
a conversation with a professional about a typical day in
your child's life, his or her strengths and challenges. You
will be able to share your concerns and have an opportunity
to ask questions. The professional may suggest that a tool
be used to assess how your child's development compares with
other children his or her age.
Children
with reassuring screening results are likely to be on-track
with their development. The American Academy of Pediatrics
recommends that these children are re-screened at regular
intervals to make sure their development continues as expected.
Children with concerning screening results need referral for
additional assessment and appropriate supports and services.
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