Mill Woods Preschool Developmental Screening

1. Mill Woods Preschool Developmental Screening

2. Mill Woods Preschool Developmental Screening Provincial Request for Proposals • Alberta Health and Wellness • extended to RHAs in November 2006, approved in April 2006 • Criteria • collaboration, Ages and Stages Questionnaire (ASQ), innovation, service integration, comprehensive (screening to intervention) • Budget • Total provincial budget $7.9 million over 3 years

3. Mill Woods Preschool Developmental Screening Provincial Request for Proposals • Four proposals funded • Capital Health • East Central Health • David Thompson Health • Chinook Health • Evaluation • Alberta Centre for Child, Family and Community Research • Change in access to screen/service • Impact on the workforce • Developmental outcomes for children

4. Mill Woods Preschool Developmental Screening Goals: • To strengthen parent and community capacity through knowledge, skills and linkages to resources, to provide an enriching environment for healthy child development • To introduce an integrated and multi-disciplinary network of support for families if there are developmental concerns

5. Mill Woods Preschool Developmental Screening • Secondary Goals • Promote awareness of the importance of healthy early childhood development • Facilitate development of an early childhood network to promote coordination of services • Promote alternative health service delivery models

6. Mill Woods Preschool Developmental Screening Partners Capital Health • Community Health Services • Child Health Clinics • Edmonton Early Intervention Program • Regional Pediatric and Mental Health • Speech and Language Services • Community Rehabilitation Program • Pediatric Occupational Therapy and Physiotherapy • Glenrose Rehabilitation Hospital • 1-2-3 Go! Child and Family Early Intervention Service

7. Mill Woods Preschool Developmental Screening Partners • Child and Adolescent Services (CASA) • Infant and Preschool Mental Health • Multi-Cultural Health Brokers • Child and Family Services Authority – Region 6 • Millwoods Family Resource Centre (Parent Link Centre) • Edmonton Public Schools • Edmonton Catholic Schools • ABC Head Start • ECMERC (University of Alberta) – Local Evaluation

8. Mill Woods Preschool Developmental Screening Community • Millwoods • Urban area • Culturally diverse (6% Aboriginal, 20% immigrant and refugee) • Rapid growth • Increasing birth rate (est. 6 to 10% increase each year) • In-migration

9. Mill Woods Preschool Developmental Screening Process – 18 and 36 month old children • Recruitment • For 18 month olds (est. 1530/year) at immunization • 36 month olds (est. 800/year) invitation to ‘3 year old party’ • Screen • ASQ identifies approx. 24%, actual rate approx. 12% • Parent administered ASQ (as required support for language or other questions) • Questionnaires by mail, phone, e-mail

10. Mill WoodsPreschool Developmental Screening Follow up – 18 and 36 month old children • ALL families invited to session on healthy child development, strategies and community resources • key worker provides secondary screens as required • key worker coaches parents who are the primary interveners in home visits • key workers coached by specialists • key workers regularly case conference with specialists • referrals to other supports as appropriate • 36 month old children will be referred to appropriate education programs (PUF, MM, ELL, Head Start)

11. Mill Woods Preschool Developmental Screening Process – key elements • Service sequence • Screen – intervention – identify – intervention – assessment – referral (as needed) • Capacity building (parents, partners, community) • Coaching model • Child Parent coached by key worker coached by specialists

12. Parent attends 3 Year Old Party or 18 month • Immunization • project introduced and ASQ done by parent • Parent completes ASQ • Given to Key Worker to score • No Concerns: • On ASQ & • No parent concern & • No staff concern • Concerns: • On ASQ or • Parent concern or • Staff concern Mill Woods Preschool Developmental Screening ASQ Screening • Letter sent • explain what screening is/is not • results, etc. • invite universal parent workshop • inform re: community groups • what to do if concern develops • include information handouts Re-screen at 36 months

13. Concerns: • On ASQ or • Parent concern or Staff concern • Phone call to all families by Keyworker • Explain what screening is/is not • Answer questions • Review results • Invite to universal parent workshop • Inform about community groups • Set up HV • Intervention - Home Visit by Keyworker • Complete family interview if needed • Complete culturegram if needed • Complete secondary screens if needed • Obtain verbal consent to share information with Physician • Send letter to Physician with ASQ results and programs involved • Coaching between Broker and PDS as needed Mill Woods Preschool Developmental Screening Post ASQ Screen: Follow-up Note: Keyworker can be CH PDS employee or MCHB • Secondary Screens by Key Worker– (as needed) • Choose most appropriate: • ASQ – if not already completed • ASQ Social-Emotional • M-CHAT • CHS Speech screen • Infant-Toddler Checklist • CRP Feeding Screen • Motivational Assessment Screen • CRP Sensory Screen

14. Referrals as needed if family needs more than 2 contacts Single delay to OT/PT or Speech Other e.g. Home Care Family Doctor or Physician Early Intervention Program if two or more delays Connections Assessment Group to Glenrose if required Mill Woods Preschool Developmental Screening Post ASQ Screen: Intervention & Referral • Follow-Up (maximum 2 contacts) • Strategies • Individualized • Various handouts • Encourage/invite to workshop: • General Child Development • Targeted topics

15. Post ASQ Screen: Follow-up & Discharge Mill WoodsPreschool Developmental Screening Follow-up with phone call in two months to determine results of referral, how things went and how they are going now. Do they need further assistance? Record wait time for service? Letter to Family Doctor / Pediatrician regarding results Discharge

16. Mill WoodsPreschool Developmental Screening Milestones and Timelines • start 18 month screens Nov. 2007 • start 18 month interventions Nov/Dec 2007 • start 36 month screens Jan. 2008 • Start 36 month interventions Jan/Feb 2008 • project ends Dec. 2009

17. Mill Woods Preschool Developmental Screening • Discussion