First Steps Presentation for Assessment Class

1. First Steps Presentation for Assessment Class Sandra Wilson Program Consultant First Steps

2. What is the First Steps program? • Kentucky’s Early Intervention Program • Part C of IDEA • Funding sources – Federal and State monies • Serves Children birth to 3 years of age with developmental disabililities and their families • Criteria for participation – age, developmental delay, established risk, state residency

3. How children enter the First Steps system • Point of Entry – offices located in each district of state • Referrals – anyone can make a referral; can be medical professionals, teachers, daycare providers, friends, neighbors, parents

4. Developmental Observation Checklist System • Upon receipt of referral, the Point of Entry staff completes the Developmental Observation Checklist System ( DOCS) • Completedwith the parent(s) and/or caregiver(s) of the child

5. Developmental Observation Checklist System • DOCS is used as a screening to determine if child needs a referral for the next level of testing within the First Steps system • The DOCS, is presented in a checklist format • It can be administered by anyone receiving training and practice in its use. One of the stated purposes of the DOCS is:

6. Developmental Observation Checklist System • One of the stated purposes of the DOCS is: “To identify both those infants and children who are developing normally and those significantly below their peers in acquiring cognitive, language, social, and motor abilities and who may be candidates for additional assessment or intervention.”

7. Developmental Observation Checklist System • This instrument consists of 475 items. • The age of the child determines the number of the question where the screening begins. • If the 1st item is answered “no”, then the examiner or parent/caregiver will count back 5 items and begin again. This will go on until a “yes” answer is given. Then they will go forward with the items checking “yes” or “no” until the answer “no” is marked 5 times in a row. • The examiner uses the scoring protocol to determine the child’s score in each of the 4 areas.

8. Developmental Observation Checklist System • If the scores indicate a delay or delays, then the child will be referred, with parental permission, to the next level within the First Steps system. • The next level is called the Primary Level Evaluation. • Note: if the screening does not indicate delay but the parent still has concerns, the child may be referred on for the PLE.

9. Evaluation vs. Assessment in First Steps The terms “evaluation” and “assessment” are used differently in the First Steps program and there are different requirements for each.

10. Evaluation in First Steps • “’Evaluation’ means the use of standardized norm-referenced procedures to determine eligibility for First Steps services” (from definitions section of 911 KAR 2:100 Kentucky Early Intervention Definitions.) • Can include any instrument meeting the regulatory requirement. • It is called a Primary Level Evaluation

11. Primary Level Evaluation • Must be completed by a person who has been credentialed and approved as a Primary Level Evaluator • Must include the use of a standardized testing instrument which can be adjusted for pre-maturity if needed, which is appropriate for use with children with disabilities, and which addresses the following 5 areas:Total Communication, Adaptive, Total Motor,Cognitive, and Social/Emotional

12. Eilgibiltiy for First Stepsusing Primary Level Evaluation The child must have scores of -1.5 in 2 or more areas or -2.0 in 1 area.

13. Examples of instruments used for the Primary Level Evaluation • Battelle Developmental Inventory II (BDI II) • Bayley Scales of Infant Development • Merrill-Palmer • DAYC • LAP-D • PEDI • Mullen • Vineland

14. Battelle Developmental Inventory II • A standardized instrument consisting of 450 test items that are grouped into the 5 domains mentioned earlier • Each domain is contained in a separate Item Test Book. • Starting points are determined by calculating the child’s exact age.

15. Battelle Developmental Inventory II • Standardized on a nationally representative sample of 2500 children age birth through 7 years 11 months of age. • All items were reviewed to ensure they could be administered to children having various disabilities. • Also reviewed for bias in such areas as gender, ethnicity, cultural, religious and socioeconomic issues.

16. Battelle Developmental Inventory II • Administration of this instrument requires formal training as well as practice prior to actual use. • This instrument has numerous components and manipulatives with which the examiner mustbe very familiar. • No instrument should be used without following the prescribed training requirements.

17. Assessment in First Steps • “’Assessment’ means activities completed to develop a service plan for an eligible child and his family.”(from definitions section of 911 KAR 2:100 Kentucky Early Intervention Definitions.)

18. Assessment in First Steps • Used for children with established risk conditions as defined in First Steps regulations – these children are automatically program eligible • Used for program planning for children who are program eligible via the Primary Level Evaluation

19. Assessment for Service Planning • Results of 5-area assessment are used for children with established risk • Children eligible via Primary Level Evaluation will receive discipline specific assessments in the areas of delay indicated by the evaluation.

20. 5 Area Assessment in First Steps • A 5 Area Assessment is completed on children who are eligible for First Steps due to Established Risk • This assessment must also address all 5 areas and must be completed by a person approved to be a Primary Level Evaluator.

21. 5 Area Assessment in First Steps The Assessment must include the use of measures that include a criterion-referenced instrument and must address all 5 areas. Examples of this type of instrument would include: • Hawaii Early Learning Profile • AEPS • Brigance • Carolina Infant-Toddler • ELAP • Ounce Scale • TPBA

22. Discipline Specific Assessments • Both formal and informal assessment is required • Must use of multiple methods – these can include: observations, interview and parent report, behavioral checklist and inventories • Must include direct assessment which includes one or more instruments appropriate for an infant or toddler, that allows for adaptations for a disability as needed, that allows for adjustments for pre-maturity if needed and that is criterion-referenced.

23. Discipline Specific Assessments • May use any instruments that meet First Steps criteria Some examples: HELP, Infant/Toddler Sensory Profile, Peabody, etc. • The choice of instrument would be made by the individual administering it. • Choice of instrument should be incumbent upon such factors as whether the assessor is trained to administer the instrument and whether the instrument addresses the areas that are of concern.

24. Hawaii Early Learning Profiles • This instrument can be used for the 5 area assessement and is also used by individual disciplines to assess specific areas • Assesses the areas of motor, communication, cognition, social/emotional, and self-help (or adaptive) behaviors. • Is a curriculum-based instrument • Has both Infant/Toddler and Preschool versions, • Is criterion-referenced, is used for curriculum planning, and considers parents as a vital part of the process. • Can be adjusted for pre-maturity

25. Hawaii Early Learning Profiles • The domains of regulatory and sensory organization have more recently been added to the instrument. • The HELP identifies 685 developmental skills and identifies an age range for each. • The skills are divided into strands. • The examiner bases the starting point in each strand on the child’s age and then proceeds through the instrument per the instructions until the child misses 2 consecutive skills or behaviors in the strand.

26. Hawaii Early Learning Profiles • Additional tools with this instrument include Activity Guides and HELP charts which were developed as curriculum guides for early intervention. • The examiner should be very familiar with testing materials and should have a good understanding of the developmental skills being assessed. As with any instrument, the examiner needs to be knowledgeable and well-practiced.

27. Considerations for choosing and administering assessments • Was the child premature and is the child under 24 months of age chronologically? (if so, must choose an instrument which allows for adjustment – not all do) • Does the assessment address the areas of concern as identified by the family/team? (i.e., if there are sensory issues which seem to underlie the delays, does this instrument address it?) • Is at least one assessment tool criterion-referenced?

28. Considerations for choosing and administering assessments • Is more than one measure being used to assess the child? (Formal instrument, informal, ongoing, parent report) • If an instrument is being used, is it the most recent version of the instrument – this is a must for the results to be valid – as practitioners, it will be your responsibility to keep up with the latest research, information and updates for instruments you are using.