preschool developmental screening in mill woods

Preschool Developmental Screening in Mill Woods

An update on the Edmonton project

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“Begin early, intervene often, intervene effectively.” (Ludwig and Sawhill, Brookings Institute)

Why screen?

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• Alberta Health and Wellness • RFP in November 2006, awarded April 2007

• Budget• $7.9 million over 3 years (to Dec. 2009)• across Alberta

Provincial Request for Proposal (RFP)

Provincial Request for Proposals

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• East Central

• David Thompson

• Chinook

• Capital

• Palliser

Five projects:

Provincial Request for Proposals

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• Provincial• Alberta Centre for Child, Family and Community

Research• Change in access to screen/service• Impact on the workforce• Developmental outcomes for children

• Local • Early Childhood Measurement and Evaluation

Resource Centre (ECMERC)• Concurrent study of ASQ Validity with cultural groups

Evaluation

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• ASQ Sample • ASQ_Questionnaire.pdf

• Summary Sample

eCHSA-08-0646 18 Month ASQ Information Summary

Form.pdf

ASQ

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1. Build parent and community capacity

2. Develop an integrated multi-disciplinary, cross-sector parent support network

Goals

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• Mill Woods in Edmonton

• Urban

• Culturally diverse

• Rapid growth

Community

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Alberta Health Services• Community Health Services

• Child Health Clinics• Edmonton Early Intervention Program• Regional Pediatric and Mental Health• Speech and Language Services

• Community Rehabilitation - Pediatric Occupational Therapy

• Glenrose Rehabilitation Hospital• 1-2-3 Go! Child and Family Early Intervention

Service

• Stollery Child Health

Partners

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• Child and Adolescent Services (CASA)• Mill Woods Community Mapping and Beyond• Multi-Cultural Health Brokers• Child and Family Services Authority – Region 6• Millwoods Family Resource Centre (Parent

Link)• Edmonton Public Schools• Edmonton Catholic Schools• ABC Head Start

Partners

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“.. ensure that we’re all saying the same messages … starts to promote child development in

Millwoods.”

“… the kids come and they’re having a great time and the parents are there and they’re asking questions and the parents are connecting …

that’s how you build community.”

“Our collaboration with MFRC and MCHB with OT and Speech make it easier to serve families…”

Partner voices

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Process

Recruitment

• 18 month old

• 36 month old

• Cultural adaptations

Parent Capacity Building

Community Capacity Building

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• Universal targeted clinical

• Capacity building

• Coaching

• Strengths based, child led

• Cultural conversion

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Key Elements

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ScreeningNo Concerns

Concerns• ASQ, Parent or Staff

Letter• Explain what screening is/is not• Review results, invite to learning events,

community groups• Community Resources information

In-Person Follow-up•Explain what screening is/is not•Review results, offer learning event, community groups and home visit

Intervention and Follow-up• Key worker home visit do family interview, culture gram, secondary screens • Results to Physician (with consent)• maximum 2 contacts; individualized strategies, provide resources, workshop,

community resources

Referral

Well Child Clinic

Recruitment - 18 month

Re-screen at 36 months

www.capitalhealth.ca

Communication42%

Problem Solving20%

Fine Motor18%

Gross Motor12%

Personal Social8%

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Concerns 310/1130 screened

Recruitment Results – 18 month

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29%

14%

24%

14%

SL OT EIP MCHB16

49 referrals from 310 concerns

Clinical Referrals – 18 month

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Parent Voices

“Opened my eyes to the things my child was doing well”

“I enjoyed the idea of having the ASQ done in the health clinic; something while you are sitting

there and waiting already.”

“If you have not come or found me in this way I would have been lost and I wouldn’t have known

what to do with my child”.

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ScreeningNo Concerns

Concerns• ASQ, Parent or Staff

On-site Results• Explain what screening is/is not• Review results, invite to learning events,

community groups• Community Resources information

In-Person Results•Explain what screening is/is not•Review results, offer learning event, community groups and home visit

Intervention and Follow-up• Key worker home visit do family interview, culture gram, secondary screens • Results to Physician (with consent)• maximum 2 contacts; individualized strategies, provide resources, workshop,

community resources

Referral

3 Year Old Celebration

Recruitment - 36 month

www.albertahealthservices.ca

Fine Motor59%

Personal Social11%

Gross Motor9%

Problem Solving

7%

Communication14%

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Concerns 35/162 screened

Recruitment Results - 36 month

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44%

22% 22%

SL OT MCHB 20

9 referrals from 35 concerns

Clinical Referrals – 36 month

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Parent Voices

• “The best part was that I learned my child can do some things I never knew he could.”

• “It was wonderful to be able to get information from the professionals and get our questioned

answered right there!”

• “This rocks! I wish there was something like this for older kids!”

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ASQ as a learning tool…

• 97 % increased knowledge

• 98% better informed about child’s development

• 94% increased resource knowledge

Parent voices

www.albertahealthservices.ca

Communication36%

Fine Motor24%

Gross Motor11%

Personal Social8%

Problem Solving21%

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Recruitment – Cultural Adaptations

Concerns 36/69

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• Community Referrals – 74

• Clinical Referrals – 5/36 (14%)

• Secondary screens – 8 (20%)

Clinical Referrals – Cultural Conversion

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Parent voices

“… So they want the whole family to be the part of it, Grandma, Grandfather, sister in law,

mother in law. I have done the screen where the whole family sitting in the circle. Everybody’s picture is in. …Everybody is part of that child

development”

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Process

Recruitment

• 18 month old

• 36 month old

• Cultural adaptations

Parent Capacity Building

Community Capacity Building

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Parent Capacity Building

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Parent Capacity Building

Coaching model

• Child Parent Key worker specialists

Learning Events

• Integrated key messages

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Learning Events

• 339 parents attended

• 95% increased ECD knowledge

• 100% will try strategies

• 88% increased knowledge of resources

Parent Capacity Building Results

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Capacity Building

Key messages for parents and community.

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Capacity Building

I learn through everyday activities.

I learn in my community.

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Capacity Building

I learn through my interests.

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Capacity Building

I learn by people responding to me

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Community Capacity Building

• Common messages across partners

• Community embedded services

• Community displays

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The journey continues … questions?