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Terrific 2 ’ s. Gilda Lewis Health Visitor Practice Teacher. What I ’ m going to cover. Brief over view of brain development up to age 2 What that means for behaviour and why How we assess two year old development, and the tools we use What we do if we find something of concern.
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Terrific 2’s • Gilda Lewis • Health Visitor Practice Teacher
What I’m going to cover • Brief over view of brain development up to age 2 • What that means for behaviour and why • How we assess two year old development, and the tools we use • What we do if we find something of concern
An embryo’s brain produces many more neurons, or nerve cells, than it needs, then eliminates the excess
Spontaneous bursts of electrical activity strengthen some of these connections, while other (the connections not reinforced by activity) atrophy
The axons spin out to create connection branches between many targets
The connections that are used most are now insulated to further speed up connections
Needs met Yes No Appropriate stimulation /external environmental factors Abusive or stressful situation continues Yes Hyperaroused or dissociated infant • Reinforcing of desirable pathways • Secure attachment established • Concentration skills improve • Learning takes place
The Healthy Child Programme • The Healthy Child Programme for the early life stages focuses on a universal preventative service, providing families with a programme of screening, immunisation, health and development reviews, supplemented by advice around health, wellbeing and parenting. • DoH 2009
The Health Visitor Implementation plan • levels of service delivery
What are Ages and Stages Questionnaires? • ASQs are developmental screening tools to identify infants/children in need of further assessment • ASQs development is the result of careful and thorough research and response to the need for a cost-effective, highly accurate tool for screening young children. • Tool developed in US
Why use ASQ? • Actively involves parents • Researched for sensitivity, specificity, reliability and positive predictive values. • Parent led questionnaires where parents answer a series of simple questions regarding child’s behaviour • Not a pass or fail approach
Enables assessment of child’s progress • Can be done by parent or WITH parent • Enables discussion regarding child’s development • Enables matching of child and parent with resources
ASQ as a Parent Education Tool • Each questionnaire discusses developmental activities tied to the age of the child being screened. • In completing and reviewing the questionnaire, parents learn about general developmental milestones as well as their own child’s strengths. • Parents find it helpful to receive suggested learning activities they can work on with their child. (Learning activity sheets can be photocopied from ASQ-3 User’s Guide, and more are available in the Ages & Stages Learning Activities.
Scoring • ASQ provides a score in each developmental area • ASQ: SE provides a total score • LOW scores in ASQ are an indication of concern • HIGH scores in ASQ:SE are an indication of concern
Conclusion • We now know how the brain develops from birth to three • How vital this period of brain development is as a basis for future development • How understanding the services for two year olds can support optimum development through working effectively together