D-PIP Workshop 2007 Education Session

1. D-PIP Workshop 2007Education Session Screening Tools: Those used and others to consider I have no relevant financial relationships with the manufacturer(s) of any commercial product(s) and/or provider of commercial services discussed in this CME activity- Paul Lipkin

2. AAP D-PIP:Selected Screening Instruments

3. Developmental Screening Instruments • General developmental screening • Domain-specific developmental screening • Gross motor • Communication/Cognition • Disorder-specific developmental screening • Autism and pervasive developmental disorders (Autism Spectrum Disorders) • Parent Questionnaires • Directly administered

4. Developmental Screening Instruments: General • Ages and Stages Questionnaire • Battelle Developmental Inventory (BDI) Screening Test • Bayley Infant Neurodevelopmental Screener (BINS) • Brigance Screens-II • Infant Development Inventory • Child Development Review • Child Development Inventory (CDI) • Denver-II Developmental Screening Test • Parents' Evaluation of Developmental Status (PEDS)

5. 19 color-coded questionnaire for use at 4, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24, 27, 30, 33, 36, 42, 48, 54, and 60 months 30 – 35 items per form describing skills Completed by parent report Taps most domains of development Takes about 10-15 minutes, and 3 to score ASQ-Social-Emotional works similarly and measures behavior, temperament, etc. Can be photocopied Ages and Stages Questionnaire (ASQ) 4 months to 6 years

6. YESSOMETIMESNOTYET 0 x x 10 x 0 x 10 x 0 x 0 20

7. Jordan B.

8. PARENTS’ EVALUATION OF DEVELOPMENTAL STATUS PEDS • For children 0 to 8 years • In English, Spanish, Vietnamese, Somali, Chinese • Takes 2 minutes to score • Elicits parents’ concerns • Sorts children into high, moderate or low risk for developmental and behavioral problems • 4th – 5th grade reading level • Score/Interpretation form printed front and back • and used longitudinally

10. Jordan B. 1/9/2006 X X X X 1 3

11. JordanB. Referred to infants and toddlers

12. Developmental Screening Instruments: Disorder-specific • Autism & Pervasive Developmental Disorders: Perform at 18 (and 24*) month visit • Autism Behavior Checklist (ABC) • Checklist for Autism in Toddlers (CHAT) • Modified Checklist for Autism in Toddlers (M-CHAT) • Modified Checklist for Autism in Toddlers-23 (CHAT-23) • Pervasive Developmental Disorders Screening Test-II (PDDST-II) - Stage 1-Primary Care Screener • Pervasive Developmental Disorders Screening Test-II (PDDST-II) - Stage 2-Developmental Clinic Screener • Screening Tool for Autism in Two-Year-Olds (STAT) • Social Communication Questionnaire (SCQ) (formerly Autism Screening Questionnaire-ASQ)

13. The M-CHAT(Modified Checklist for Autism in Toddlers) • Free download at www.firstsigns.org • Takes 5 minutes to complete, 5 to score • Autism screening recommended by Autism Expert Panel at 18 and 24 months • Child is “at-risk” and needs further evaluation if: • Fails 2 critical items, or • Fails any 3 items Robins, D., Fein, D., Barton, M., & Green, J. (2001)

14. M-CHAT Sample Items • Does your child ever use his/her index finger to point, to ask for something? • Can your child play properly with small toys without just mouthing, fiddling, or dropping them? • Does your child take an interest in other children?

15. The M-CHAT Robins et al. 2001 • 23 Questions: 6 “Critical” Items • Interest in Other Children: Does your child take an interest in other children? • Proto-declarative Pointing: Does your child ever use his/her index finger to point, to indicate interest in something? • Bringing object to show the parent: Does your child ever bring objects over to you (parent) to show you something? • Imitation: Does your child imitate you? (e.g., you make a face- will your child imitate it?) • Responding to name: Does your child respond to his/her name when you call? • Following a point: If you point at a toy across the room, does your child look at it?

16. M-CHAT (18-30 months)

17. Developmental Screening Instruments: Domain-specific • Gross motor • Early Motor Pattern Profile (EMPP) • Motor Quotient (MQ) • Communication/Cognition • Capute Scales (aka Cognitive Adaptive Test/Clinical Linguistic Auditory Milestone Scale-CAT/CLAMS) • Communication and Symbolic Behavior Scales- Developmental Profile (CSBS-DP): Infant Toddler Checklist • Early Language Milestone Scale (ELMS -2)

18. Directly Administered Tools • Capute Scales (CAT/CLAMS) • Brigance Screens-II • Bayley Infant Neurodevelopmental Screener (BINS)

19. Capute Scales Cognitive Adaptive Test/ Clinical Linguistic Auditory Milestone Scale (CAT/CLAMS) • Directly administered tool • Blend of screening and evaluation instrument • Measures visual-motor/problem solving (CAT) and expressive and receptive language (CLAMS) • Age range 3-36 mo • Results in developmental quotient and age equivalent • 100 items • 15-20 minutes administration time • English, Spanish, and Russian versions available • Available from Brookes Publishing

20. Capute Scales

21. Capute Scales CLAMS Language *Should be performed by child E = Expressive; R = Receptive Seven Months: Yes No 1.Orients toward bell (1.0)R* X __ (upwardly/indirectly) Eight Months: 1.”Dada” inappropriately (0.5)E X __ 2.”Mama” inappropriately (0.5)E X __

22. Capute Scales CAT Visual Motor Problem Solving All of these must be performed by child Seven Months: Yes No 1. Attempts pellet (0.3) X __ 2. Pulls out peg (0.3) X 3. Inspects ring (0.3) X __ Eight Months: 1. Pulls ring by string (0.3) __ X 2. Secures pellet (0.3) __ X 3. Inspects bell (0.3) __ X

23. CLAMS Language Basal Age 5.0 Ceiling Age 8.0 Points beyond Ceiling Age 0.8 Language age equivalent 8.8 CLAMS DQ 8.8 / 9.0 = 0.97 x 100 = 97 (Age equivalent / Chronological age x 100) Full Scale DQ (97 + 66) / 2 = 81 (CLAMS DQ + CAT DQ / 2) CATProblem Solving Basal Age 5.0 Ceiling Age 5.0 Points beyond ceiling age 1.0 Problem solving age equivalent 6.0 CAT DQ 6.0 / 9.0 = 0.66 x 100 = 66 (Age equivalent / Chronological age x 100) CAT/CLAMS Scoring

24. Brigance Screens • Takes 10 – 15 minutes of professional time • Produces a range of scores across developmental domains • Relies primarily on observation and elicitation of skills (0-2 year age range can be administered by parent report) • Detects children who are delayed as well as advanced • 9 separate forms across 0 – 7 years of age • Each produces 100 points and is compared to an overall cutoff • Available in multiple languages • Computer scoring software

25. Bayley Infant Neurodevelopmental Screener (BINS) • Takes 10 - 15 minutes • Assesses neurological processes (reflexes, and tone); neurodevelopmental skills (movement, and symmetry) and developmental accomplishments (object permanence, imitation, and language) • Uses 10 - 13 directly elicited items per 3 - 6 month age range • Categorizes performance into low, moderate or high risk via cut scores. Provides subtest cut scores for each domain • For use from 3 - 24 months

27. BINS Risk Scores

28. New Developmental Screening Instruments* 2007 • PEDS:DM (Parents' Evaluation of Developmental Status--Developmental Milestones) • Expansion of PEDS • 16 - 18 questions to be answered per visit • 6-8 items per age/encounter; designed to replace informal milestones checklists • For children birth to 7-11 years • http://www.pedstest.com/dm/ • Parents’ Observations of Infants and Toddlers – POINT • For children 2 through 36 months • Takes just 15 to 20 minutes for the parent or caregiver to complete • Designed for early intervention professionals’ use • http://www.firstpointkids.com/ *Note: Unreviewed