materials for course: using the developmental screening ... · the goal of the behavioral...

Time required for this course: 6 hours

Materials for Course: Flip chart and markers; Using the Developmental Screening, Assessment, and Evaluation: Key Elements for Individualizing Curricula in Early Head Start Programs, a publication of the Task Force on Screening and Assessment of the National Early Childhood Technical Assistance System (NECTAS) in collaboration with ZERO TO THREE from www.zerotothree.org/child-development/mental-health-screening-assessment/thepowerofplay-1.pdf; “Search Engines: How to Become a Virtual Expert In Five Minutes” from www.websearch.about.com/od/dailywebsearchtips/qt/search-engine.htm.

The goal of the Behavioral Observation and Screening course is to provide introductory information, guidelines, best practices, and basic techniques used to observe and screen children in child care settings. It also describes how observation and screening can help children who are being abused or neglected, and explains the referral process for children who are at risk of developmental delay or disability.

The six-hour course is presented in six modules.

• Module 1: An Introduction to Observation and Screening

• Module 2: The Principles of Observation and Screening

• Module 3: Observation and Screening Basics

• Module 4: Methods of Observation and Screening

• Module 5: Children at Risk

• Module 6: Referral Process and Resources

Note to Trainer: These are the icons used in the Participant Guide as a visual reference.

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Approximate time required for this module is 65 minutes

Materials: Flip chart and markers.

Welcome to Module 1: An Introduction to Observation and Screening.

This module will introduce the topics of observation and screening. It will provide basic information about observation and screening in a child care setting, and show how assessment and evaluation relate to these topics. The module will explain actions to take if information supports a suspicion of abuse or neglect, and describe how to handle a suspicion of delay or disability.

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Module 1

Goal

Participants will define the terms observation, screening, assessment, and evaluation, as used by child care professionals, and describe appropriate use of each.

Learning Objectives

After successfully completing this module, you will be able to:

• State the three main reasons child care professionals observe and screen children

• Define terms used in child care related to observation, screening, assessment, and evaluation

• Give examples of professional groups that perform each of those four activities

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Approximate Time for this Lesson: 3 minutes

Child care professionals observe and screen children so they can facilitate the growth and development of every child in their program, detect early signs of developmental delay or disability, and identify signs of child abuse or neglect. Simply put, observation and screening describe how early childhood professionals use certain methods to help them pay attention to the behavior and development of children under their care.

Observation is an ongoing process in which child care professionals recognize and document identifiable developmental milestones as they appear using tools such as checklists, anecdotal records, and running records.

Screening is an ongoing process in which child care professionals use specialized observation and documentation tools to identify, document, and monitor typical development or possible developmental delay.

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Developmental milestones are observable behaviors, traits, skills, or abilities that typically appear at specific age ranges.


Why do child care professionals observe and screen children? Solicit responses.

The three main reasons child care programs observe and screen children are to foster growth and development in every child, detect early signs of developmental delay or disability, and identify signs of child abuse and neglect.

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These processes are also used to support quality curriculum development; help parents support growth and development at home; allow timely referral for early intervention services; and provide a common reference point and basis for interaction between parents, program staff, and other professionals.

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Early intervention is a system of services that helps children who have a developmental disability or delay.

There are three main reasons child care programs observe and screen children.

1. Observation and screening foster growth and development in every child by determining the child’s developmental age-appropriate level and by using the information to develop

• Inside and outside learning spaces

• Personal care routines

• Communication and interaction practices

• Learning activities

• Program policies and procedures

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2. Observation and screening can detect early signs of developmental delay or disability

when child care staff members are trained to identify and document signs of typical or atypical growth and development. Since staff members see children throughout the day and have training in child growth and development, they may be in the best position to spot the earliest signs of atypical development. Therefore, staff may be in the best position to help the child and family.

Note to the class that child care personnel should not attempt to diagnose delay or disability, which is the work of other professional groups. Instead, they should document typical and atypical patterns of development and take appropriate action as defined by their program’s written policies and procedures.

To find out more about typical and atypical child development, take the DCF courses Child Growth and Development, Special Needs Appropriate Practices, and Supporting Children with Developmental Disabilities.

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Atypical means the same thing as not typical or not expected.

3. Observation and screening can also help child care professionals identify the signs of child abuse and neglect. Every adult in Florida is required by law to report any suspected abuse or neglect and can do so anonymously. However, people who work with children are, by law, mandatory reporters. This means they must identify themselves when they report suspected child abuse or neglect. Failure to report suspected abuse or neglect is a felony of the third degree in Florida.

For more information about typical and atypical child development, take the Department of Children and Families’ courses Child Growth and Development, Special Needs Appropriate Practices, and Supporting Children with Developmental Disabilities.

To find out more about child abuse and neglect and the legal responsibilities of people who work in the child care industry, take the DCF course Identifying and Reporting Child Abuse and Neglect.

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Key Point: The three main reasons child care programs observe and screen children are to foster growth and development in every child, detect early signs of developmental delay or disability, and identify signs of child abuse and neglect.

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In addition to the three main reasons child care programs observe and screen children, there are some other reasons as well.

4. Observation and screening support quality curriculum development by focusing learning goals and objectives, lesson plans, and teaching strategies on the development and implementation of activities that strengthen the child's skills. The best child care professionals can recognize what each child knows and can do, and uses this information to help increase skills, abilities, and knowledge.

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5. Observation and screening can help parents support their child's growth and development at home by increasing the volume and quality of information available to them. When quality information is combined with the professional services provided by a child care program, a Child’s outcomes improve, both at the program and at home.

6. Observation and screening allow timely referral for intervention. The earlier signs of developmental delay or disability are identified, the better the outcome for the child. The American Academy of Pediatrics recommends that all children be screened for developmental delays and disabilities during regular well-child doctor visits at 9 months, 18 months, and 24 or 30 months. However, observation of a child can begin at birth. You will learn more about when and how to observe and screen children in child care programs throughout this course.

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Observation and screening provide an opportunity for communication between parents, staff, and child development specialists because they include written evidence of a child’s growth and development over time.

Child care programs observe and screen children because these processes support quality curriculum development, help parents support growth and development at home, allow timely referral for early intervention services, and provide a common reference point and basis for interaction between parents, program staff, and other professionals. Written records collected by a child care professional can be critical to a team of people who are helping a child with developmental delay or disability.

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Documented evidence refers to written data collected by the program. For example, there may be a file note stating when a child could stand on one foot.

Key Point: Observation and screening provide opportunities for communication between parents, staff, and child development specialists because they include written evidence of a child’s growth and development over time.

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Observation is an ongoing process conducted by child care providers and others to document a child's growth and development. During an observation session, a trained adult monitors a child as he or she demonstrates identified skills or abilities within a developmental domain. For example, a staff member observing children’s growth and development in the Physical Health and Motor Development domain may document an infant’s ability to roll over, a toddler’s ability to walk, a preschooler’s ability to kick a ball, and a school-age child's ability to use a swing.

Observation sessions should be performed by a familiar person in the child’s natural environment at a time when he or she is at his or her best. The goal is to allow the observer to document the child's skills and abilities fairly and objectively. In a quality program, results are carefully documented following set guidelines and written procedures.

Methods of documentation include checklists, anecdotal records, and running records.

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Developmental domains categorize children's skills and abilities. They include Physical Health and Motor Development, Cognitive Development and General Knowledge, Language and Communication, Social and Emotional, and Approaches to Learning..

Natural environment refers to places the child would typically be, such as home, the child care program, school, a place of worship, or the homes of family and friends rather than a director’s office, doctor/therapist’s office, or similar places.

Benefits of Observation:

• Facilitate curriculum development

• Guide developmentally appropriate practice

• Assist providing individualized care

• Help share information with parents and others

• Reveal signs of abuse and neglect

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Developmental appropriate practice is a research-based framework based on meeting children where they are individually, chronologically (i.e., by age) and culturally.

Individualized care refers to attention paid to a child that recognizes and adapts to his or her unique character and physical, emotional, and cognitive traits.

Key Point: Observation helps a program function at its best over several operational and functional areas.

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Screening is an ongoing process conducted by child care providers and others to verify that a child is developing typically or identify early signs of delay or disability.

During a screening session, trained adults identify and measure specific skills and abilities as indicated by a screening instrument.

Screening is conducted with the understanding that it is only one source of information that can help adults better understand a child's behavior and development, and the results of any single screen are never used in isolation. Screening takes place recurrently using an instrument that is proven to be valid, accurate, and reliable.

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Family members are always involved in screening, sometimes as active participants. Every effort is made to ensure that screening is culturally relevant to the child being screened and his or her family. Results are shared with adult members of the family in a way that allows for thought and follow-up. This part of the process is never rushed.

Like observation, screening should take place in the child's natural environment with familiar people, and performed when he or she is at his or her best. Again, the goal is to document the child's skills and abilities fairly and objectively.

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Benefits of Screening:

• Identify specific areas of concern

• Determine if further assessment or evaluation may be necessary

• Provide a basis for referral

• Empower parents with information to make decisions

• Present a basis for necessary and ongoing communication with parents and others

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Key Point: Screening determines if children are developing typically, identifies early signs of delay or disability, and provides a basis for referral.

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Sometimes, the results of a program’s observation and screening processes indicate a possible developmental delay or disability. When this happens, child care providers talk to parents so that parents can contact organizations that will provide further screening and assessment. Assessment is a process whereby an agency or organization gathers and reviews multiple sources of information about a child’s suspected or confirmed developmental delay or disability and uses data to improve a child’s outcomes.

Child care professionals in Florida refer families to the to the Florida Diagnostic and Learning Resource System’s Child Find.

For more information about Florida Diagnostic and Learning Resource System’s Child Find, visit

www.fdlrs.org/child-find.html

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Benefits of Assessment:

• Empower parents to help their child grow and develop

• Improve a family’s ability to navigate a complex system of services

• Result in a referral for evaluation so eligible children may receive benefits they are

• Entitled to under the individuals with disabilities act, or IDEA, which is a federal law

For more information about IDEA, visit www.idea.ed.gov/

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The Individuals with Disabilities Act (IDEA) mandates that children withdisabilities receive a free and appropriate public education (FAPE). IDEA PartB addresses children and youth (ages 3-21), while Part C addresses infantsand toddlers.

Key Point: Assessment can lead to an evaluation, which may qualify the child for benefits under IDEA.

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Assessment and evaluation are often confused. According to Children’s Medical Services (CMS), assessment refers to “…ongoing procedures used by appropriate qualified personnel throughout the period of a child’s eligibility to identify the following: (A) the child’s unique strengths and needs and the services appropriate to meet those needs, and (B) the resources, priorities, and concerns of the family and the supports and services necessary to enhance the family’s capacity to meet the developmental needs of their infant or toddler with a disability.”

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CMS defines evaluation as “…procedures used by appropriate qualified personnel to determine a child’s initial and continuing eligibility for Early Steps, consistent with the definition of “infants and toddlers with disabilities” in §303.16, including determining the status of the child in each of the developmental areas in 34 CFR §303.322 (c)(3)(ii).”

To summarize, evaluation is a process that determines a child's eligibility for federal, state, and local programs and services.

For more information about a Children’s Medical Services, visit www.cms-kids.com/families/families.html

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Key Point: Assessment is a process whereby an agency or organization gathers and reviews multiple sources of information about a child's suspected or confirmed developmental delay or disability and uses data to improve a child's outcomes.

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Key Point: Evaluation is a process that determines a child’s eligibility for federal, state, and local programs and services.

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Your role as a child care professional is observation, screening, and referral.

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In observation and screening processes, your main responsibility is to document the child's skills and abilities fairly, objectively, and accurately, and work with families to refer children for further assessment and evaluation. Remember, if data causes you to suspect child abuse or neglect, you must report it.

During an observation period, you will monitor a child as he or she demonstrates identified skills or abilities within a developmental domain or domains. You should conduct the screening in the child’s natural environment when he or she is at his or her best. After the observation, you will document the child’s file following guidelines presented in this course and your employer’s written procedures.

During a screening, you will identify and measure a child’s specific skills and abilities using a screening instrument. While you are working, bear in mind two things: One, your results are only one source of information that will be used to better understand a child's behavior and development, and two, it is critical to involve the child's family in the process. Sometimes, the results of a programs observation and screening processes will indicate a possible developmental delay or disability. When this happens, you or a designated coworker will talk to the child’s parents and assist them to make an appropriate referral.

Remember, the referral for assessment will play a role in empowering parents to help their child grow and develop, improving a family’s ability to navigate a complex system of services, and ensuring eligible children receive benefits they are entitled to by federal law.

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Reflect, Think, and Act:

Consider the observation, screening, and referral processes, as well as your role as a mandatory reporter of child abuse and neglect. Which of these responsibilities seems most comfortable to you? Solicit responses to allow reflection, and then allow participants time to record their thoughts.

Which is least comfortable? Solicit responses to allow reflection, and then allow participants time to record their thoughts.

During the rest of the course, take time to study all of the information presented on observation, screening, referral, and reporting until you can approach each of them with ease.

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Key Point: Child care professionals observe and screen children, and should work with families to make referrals.

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Key Point: Observation, screening, assessment, and evaluation are interrelated processes.

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Key Point: Child care programs should support families by observing and screening children through an ongoing, systematic process.

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What is the most likely outcome when children with special needs are not observed, screened, and referred to people who can help them and their families? Solicit responses to allow reflection, and then allow participants time to record their thoughts.

If you were the parent of a child with special needs, how important would it be to know about your child’s condition as early as possible? Solicit responses to allow reflection, and then allow participants time to record their thoughts.

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Module 1

Approximate time required for this activity: 10 minutes

For each scenario, let’s identify whether what action is occurring.

1. After reading a child’s file, a trained adult asks the child to perform specific tasks. The adult confirms the child has a developmental disability and therefore qualifies for programs and services by federal law. (Evaluation)

2. A trained adult watches a child for a half hour as she interacts with other children in the program. The adult documents the child’s typical growth and development in the Social Emotional Developmental Domain in the child’s file, writes a note to the parents, and uses the information to plan future activities. (Observation)

3. After reading a child’s file, a trained adult asks the child to perform specific tasks. The data indicates the child may have a developmental delay or disability, and could benefit from early intervention. The adult refers the family to a medical professional for diagnosis. (Assessment)

4. A trained adult watches a child for a half hour as she interacts with other children in the program. The adult documents the child's atypical growth and development as called for in a tool’s Social-Emotional Developmental Domain section, and makes plans to speak to a supervisor about a possible developmental delay or disability in this domain. (Screening)

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For each scenario, let’s identify if this is a role of the child care professional. Record the correct answers in your Participant’s Guide.

Alternatives: Have students use signs that show Yes on one side and No on the other side. Students could also show a thumb’s up for “Yes” or a thumb’s down for “No.”

1. Name the developmental domains and cite examples of related skills and abilities. (Yes)

2. Assess a child for delay or disability. (No – Explanation: In Florida, child care professionals refer families to the Florida Diagnostic and Learning Resource System’s Child Find for assessment, which may result in them being referred to Children’s Medical Services for evaluation of a delay or disability.)

3. Refer families to the Florida Diagnostic and Learning Resource System’s Child Find. (Yes)

4. Diagnose a disability. (No – Explanation: Disabilities are diagnosed by medical professionals in collaboration with Children’s Medical Services.)

5. Provide documented evidence of observation and screening. (Yes)

6. Make a referral for evaluation. (No – Explanation: In Florida, child care professionals refer families to the Florida Diagnostic and Learning Resource System’s Child Find for assessment, which may result in them being referred to Children’s Medical Services for evaluation of a delay or disability.)

7. Work with families who receive benefits under The Individuals with Disabilities Education Act (IDEA). (Yes)

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8. Use developmental milestone charts to confirm a suspicion of delay. (No –Explanation: Child care professionals do not confirm or diagnose a suspicion of a delay. Instead, they use developmental milestone charts to help them, and families, better understand a child’s growth and development.)

9. Provide a natural environment. (Yes)

10.Use the word abnormal instead of atypical. (No – Explanation: Atypical means the same thing as not typical or not expected. The word abnormal may be interpreted as being harsh or judgmental by a listener.)

11.Use developmentally appropriate practice for every child in the program. (Yes)

12.Determine a child's initial and continuing eligibility for services related to early intervention. (No – Explanation: In Florida, Children’s Medical Services performs assessment and evaluation processes to determine eligibility for programs and services under the Individuals with Disabilities Education Act (IDEA).)

13.Deliver individualized care. (Yes)

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Module 1 Summary

Here is a summary of Key Points for Module 1: An Introduction to Observation and Screening.

• The three main reasons child care programs observe and screen children are to foster growth and development in every child, detect early signs of developmental delay or disability, and identify signs of child abuse and neglect.

• Observation and screening provide opportunities for communication between parents, staff, and child development specialists because they include written evidence of a child’s growth and development over time.

• Observation helps a program function at its best over several operational and functional areas.

• Screening determines if children are developing typically, identifies early signs of delay or disability, and provides a basis for referral.

• Assessment can lead to an evaluation, which may qualify the child for benefits under IDEA.

• Assessment is a process whereby an agency or organization gathers and reviews multiple sources of information about a child’s suspected or confirmed developmental delay or disability and uses that information to improve a child’s outcomes.

• Evaluation is a process that determines a child’s eligibility for federal, state, and local programs and services.

• Child care professionals observe and screen children, and should work with families to make referrals.

• Observation, screening, assessment, and evaluation are interrelated processes.

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• Child care programs should support families by observing and screening children through an ongoing, systematic process.

Conclusion

Congratulations!

You have completed Module 1: An Introduction to Observation and Screening.

You have achieved this module’s learning objectives if you can:

• State the three main reasons child care professionals observe and screen children

• Define terms used in child care related to observation, screening, assessment, and evaluation

• Give examples of professional groups that perform each of those four activities

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Welcome to Module 2: The Principles of Observation and Screening.

This module will provide field-tested guidelines and best practices used by child care providers to ensure the information they collect during observation and screening sessions is as complete and accurate as possible. Taking these actions also helps child care programs gather information that can be used to implement developmentally appropriate practice and offer individualized care to children.

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A best practice is a specific action taken by experts in the field to achieve a desired result.

A guideline is a general course of action taken to achieve a desired result.

Goal

Participants will review fundamental guidelines and best practices for people who observe and screen children in child care settings. You will also be able to describe characteristics used by effective practitioners in child care settings.

Learning Objectives


• Relate guidelines for observations and screenings that take place in child care settings

• Name characteristics seen in effective child care professionals who observe and screen children

• Describe best practices used by skilled practitioners to obtain valid and usable results

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Module 2


This module will present four guidelines for observers and screeners of children. They are:

1. Be informed

2. Be objective and accurate

3. Be honest and fair

4. Be focused

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Module 2


The first guideline is to be informed. Effective child care professionals know the typical and atypical patterns of child growth and development, are familiar with the child being observed or screened, and understand the programs observation and screening policies and tools. They review appropriate general developmental information.

Next, they study the child's file. They compare specific information about the children with the general information they just reviewed. This helps them to recognize changes in growth and development when they are demonstrated by the child. However, skilled child care professionals never use this information to help them confirm a suspicion of delay, disability, abuse or neglect. Finally, they read the instructions for the observation or screening tool, even if they feel familiar with it. This helps them focus on the task ahead of them and the responsibilities that come with it.

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Module 2

Observation and Screening Tools are specific items that are used to guide an observation and screening session. This term may refer to documents, materials, and equipment, or any combination of these items. Depending on the purpose of the observation or screening, tools may be used, purchased, or created by the child care program.

The first best practice related to being informed is to review appropriate general information immediately prior to an observation or screening session. Effective child care professionals review appropriate general information immediately prior to an observation or screening session. This includes the developmental domains and milestones typically seen in peers in the child's age range. Reliable, authoritative resources on this subject are readily available on the Internet, such as these:

After reviewing general information about child growth and development for the child’s age range, it is important to review general information about the specific child you are observing, to better understand his or her abilities and unique needs. For example, if the child you are observing has dyslexia, you would read general information about dyslexia immediately prior to the session.

Resources may be supplied by the family, a specialist who is working with the child or any of the national associations or advocacy groups that supply information about specific conditions that may impact the individual you are observing or screening.

While it is true that one can find a wealth of information on child growth and development on the Internet, that is not a substitute for receiving child care training on the subject. In fact, the DCF course Child Growth and Development is part of Florida’s mandatory training requirement for people who work in child care. To find out more about typical and atypical child development, take the DCF online course, Child Growth and Development.

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Module 2

The second best practice related to being informed is to study the child's file. Effective child care professionals study a child’s file before observing or screening him or her.

They look at the results of previous observation and screening sessions, notes recorded by staff members, and all documentation provided by family members. If samples of the child's work are in the file, they look at those, too.

Additionally, experienced child care professionals review individual information, so they can use developmentally appropriate practice (DAP) when observing and screening a child. By keeping Developmentally Appropriate Practices in mind, the caregiver will remember to focus on the child’s age, individual characteristics, and the social and cultural environment in which the child lives. This helps them show sensitivity toward child's unique experiences. Using developmentally appropriate practice makes children feel safe and comfortable, and thus, more likely to behave naturally during an observation or screening session.

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Module 2

The third best practice related to being informed is to know how to use the observation or screening tool before attempting to use it. Effective child care professionals know how to use the observation or screening tool before they attempt to use it. They read the instructions before the session begins, attend observation and screening training opportunities offered by the program, and keep up with changes in policy and procedure on this subject. A professional neverinterrupts a screening session to read an instruction or ask a question about the tool, because that can distract the child.

Developmental Domains

• Florida Department of Education (www.floridaearlylearning.com/parents/parent_resources/floridas_early_learning_and_development_standards_birth_to_five.aspx)

• Developmental Milestone Charts Centers for Disease Control and Prevention (www.cdc.gov/ncbddd/actearly/milestones/index.html)

• National Institutes of Health (www.nlm.nih.gov/medlineplus/ency/article/002002.htm)

Special Needs

• Centers for Disease Control and Prevention (www.cdc.gov/ncbddd/index.htm)

• National Institutes of Health (www.nichd.nih.gov/health/topics/idds/conditioninfo/Pages/default.aspx)

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Module 2

Key Point: Effective child care professionals know the typical and atypical patterns of child growth and development. They are familiar with the child and understand the programs observation and screening policies and tools.

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Module 2


Note to the Instructor: To demonstrate the following scenario, you could ask two students to role-play. If you do not have a puzzle, you could have one draw a skillful picture of a tree or other simple object and one who refuses to draw at all, but only stares at the paper.

Imagine yourself screening two children, one of whom recently enrolled in your program. You have asked them both to complete a developmentally appropriate puzzle for you. The child you know loves puzzles, and finishes his quickly and skillfully. The child who recently enrolled stares at his puzzle, frowning. He makes no attempt to piece the puzzle together and seems relieved when it is removed.

Can you list some factors for each child that might have produced his behavior, not including physical conditions? Solicit responses to allow reflection, and then allow participants time to record their thoughts.

Notice how your thoughts are influenced by this child-centered approach to observation. This awareness can help you provide individualized care and observe and screen children with professionalism.

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Module 2

Approximate time required for this activity: 3 minutes (within the 10 minutes of the lesson)

Note to the instructor: Instruct the participants to take out a piece of paper. Tell them they are going to have a quiz. Once all students have taken out a piece of paper, show the following instructions to the class and tell the students to read the instructions silently to themselves, complete the quiz, and put their pencils/pens down when they are done so you know they are finished.

Read all of the instructions before beginning this quiz.

1. Write your name at the top of the paper.

2. Draw an X in all four corners.

3. Circle all of the Xs you drew.

4. Fold the paper so the Xs line up.

5. Write your name and address in the middle of the paper.

6. In the upper left corner, write the name and address of someone else.

7. Draw a square in the upper right corner, where a postage stamp would be located.

8. Follow only the first step.

Your paper should contain only your name. If it includes anything else, read the instructions at the top of the screen, shown in bold. Remember: Effective child care professionals know how to use the observation or screening tool before they attempt to use it. They read the instructions before the session begins.

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The second guideline is to be objective and accurate. Effective child care professionals create documentation that can be used by others to help children grow and develop to their full potential.

Effective child care professionals ensure observation and screening results are objective and can be measured, observed, or otherwise established as fact. They verify results do not reflect subjective feelings, set aside personal beliefs and consider only facts, document all relevant information, and make sure documentation is correct and complete. Accurate, effective child care professionals make sure documentation includes all relevant information, even if does not seem to support earlier documentation. Finally, they review the screening tool to ensure it is free of errors.

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Module 2

Objectivity involves the ability to set aside personal beliefs, values, opinions and biases, and consider only facts.

Subjectivity involves the application of ones point of view when determining a course of thought or action.

Activity: Approximate time required for this activity: 5 minutes (within the 10 minutes of the lesson)

For each observation, identify if it is written objectively or subjectively. Alternatives: Have students use signs that show "Objective" on one side and "Subjective" on the other side. Students could also show a thumb’s up for “Objective” or a thumb’s down for “Subjective.”

1. six years of age (Objective - Explanation: A child’s age is a fact, not an opinion.)

2. nice (Subjective - Explanation: This quality cannot be measured, observed, or otherwise established as a fact.)

3. left-handed (Objective - Explanation: A child’s preference for one hand over the other is an observable tendency.)

4. obese (Objective - Explanation: A child’s weight can be measured and interpreted using medical charts.)

5. happy (Subjective - Explanation: This quality cannot be measured, observed, or otherwise established as a fact.)

6. pretty (Subjective - Explanation: This quality cannot be measured, observed, or otherwise established as a fact.)

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Module 2

The first best practice related to being objective and accurate is to ensure observation and screen results do not reflect personal feelings. Effective child care professionals ensure observation and screening results do not reflect personal feelings. Before an observation or screening session begins, they take a moment to reflect on their own feelings about the child and the task ahead. Recognizing these helps professionals prepare to focus on the facts produced during the session and disregard any presumptions they may have.

The Halo Effect is a judgment error we make when we allow an overall impression of a person to influence the way we interpret his or her actions. For example, a person influenced by the Halo Effect might judge a favorite child’s abilities to be better than they actually are.

To experience the Halo Effect, think about a typical hero or villain in a movie, book, or video game. How do your early impressions of this character influence the way you think about him or her? Do you use these impressions to predict future behavior? If you’re like most people, you do. Effective child care professionals are aware of the Halo Effect and ensure it does not happen during an observation or screening session.

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A presumption is a belief about something or someone formed before experience shows it is true. For example, one may presume a child will perform a certain task with ease, only to learn through screening this is not an accurate assumption.

The second best practice related to being objective and accurate is to set aside personal beliefs and consider only facts, not only during observation and screening sessions, but at all times during working hours. This does not mean they abandon their own culture, traditions, and values when caring for children; instead, it means they use developmentally appropriate practice (DAP)for each child, follow the law, and honor a professional code of ethics.

To review the NAEYC Code of Ethics, visit: www.naeyc.org/files/naeyc/file/positions/PSETH05.pdf

Say you hold a personal belief that purple children possess an intellectual characteristic not shared by blue children. That bias cannot become a factor in your observation or screening sessions, nor can it be permitted to influence your daily work with any child at any time. During working hours, professionals of all types set aside any prejudices or biases they may possess.

The third best practice related to being objective and accurate is to document all relevant information. Effective child care professionals document all relevant information identified during an observation or screening session. Relevancy is determined by the observation or screening tool. For example, a checklist might require staff members to check a behavior off a list as it is observed, or to mark boxes labeled “always,” “sometimes,” or “never.” In this case, a behavior that is not on the list is not relevant to the session.

Behavior not relevant to the current session may be documented later in another type of record. For example, if the provider is observing a child’s social-emotional skills, but sees the child

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display a new skill in another domain, he or she makes a quick note so the child’s file can be documented later using the appropriate method.

The signs of typical and atypical development become apparent to trained providers during observation and screening sessions. The signs of child abuse and neglect might also be seen. As a mandatory reporter, it is critical that you can recognize the physical and behavioral indicators of abuse and neglect, and report them objectively and accurately.

For more information about child abuse and neglect, consider taking the DCF courseIdentifying and Reporting Child Abuse and Neglect.

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Approximate time required for this activity: 2 minutes (within the 10 minutes of the lesson)

Read the following poem aloud to the class or ask for a volunteer. Ask the class to follow along in their Participant’s Guide.

Eye halve a spelling checkered

It came with my pea sea

It plainly marques for my revue

Miss steaks eye kin knot sea.

Eye strike a key an type a word

And weight four it two say

Weather eye am wrong oar write

It shows me strait a way.

As soon as a mist ache is maid

It nose bee fore two long

And eye can put the error rite

Its rare lea ever wrong.

Eye have run this poem threw it

I am shore your pleased two no

Its letter perfect awl the weigh

My checkered tolled me sew.

Anonymous

Remind the class that every word in this poem is spelled correctly. This is why it is important to review your work, even if you have used a spell-checker.

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The fourth best practice related to being objective and accurate is to ensure documentation is correct and complete. To ensure documentation is correct and complete, effective child care professionals follow a four-step process. Here’s how:

First, they complete documentation as soon as possible after every session. This increases accuracy and ensures timeliness.

Second, they proofread for content errors by comparing their notes against the final document. They make sure they have accurately reported all of the facts, taking the time they need to recall what they saw. It is important that nothing relevant is missed.

Third, they check for writing and mathematical errors. They proofread sentences for clarity, and look for misspelled words, incorrect punctuation, and grammatical errors. Then they double check numbers and dates. Finally, they wait two or three days, then repeat the process to catch any errors that were not seen in the first review.

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Key Point: Objective, accurate child care professionals create documentation coworkers and other professionals can use to help children grow and develop to their full potential.

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The third guideline is to be honest and fair. Effective child care professionals observe children, conduct screenings, and document all relevant observations in good faith. They document children's development over time, observe or screen when children are at their best, conduct sessions in the child's natural setting with familiar staff, and never observe or screen with the intent of confirming a suspicion.

Being honest and working in good faith are essential in screening and observation sessions. It helps practitioners to avoid collecting only data that supports previously collected data, or using data to confirm or rule out a specific outcome.

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In good faith is a moral concept. It means to work with the sincere intention of doing the right thing, with honesty and integrity, and to perform the work at hand with the best effort possible.

The first best practice related to being honest and fair is to document children’s development over time. Effective child care professionals document children’s development over time. They do not base decisions about the actions they might take on a single observation. Instead, they look for trends and patterns that develop over days, weeks, and months. They bear in mind that while the developmental sequence is similar among children and the behaviors or skills emerge in the same order, individual children can take more or less time developing than peers. They can move forward, regress, and then move forward again. Some children may skip a behavior or skill as they move forward. And sometimes, children just have a bad day. Look for trends and patterns over time, because they provide more reliable indicators of a child's growth and development than the results of any single observation or screening session.

In her book, Alexander and the Terrible, Horrible, No Good, Very Bad Day, Judith Viorst tells the story of a child who starts his day like this: “I went to sleep with gum in my mouth and now there’s gum in my hair and when I got out of bed this morning I tripped on the skateboard and by mistake I dropped my sweater in the sink while the water was running and I could tell it was going to be a terrible, horrible, no good, very bad day. ”

Many adults can sympathize with Alexander because they, too, have had a “terrible, horrible, no good, very bad day.” Remember what that was like, and then think about being observed or screened on that day.

Do you think the data collected on that single day would be a fair representation of your skills and abilities?

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The second best practice related to being honest and fair is to observe and screen when children are at their best. Each time effective child care professionals observe and screen children, they make sure the child is at his or her best. They postpone observation and screening sessions if, at the scheduled time, a child cannot demonstrate skills to his or her best ability.

In all children, the surest way to tell if children are at their best is to know their individual physical and mental health patterns. This is true of children who are developing typically and those who are not.

To tell if a typical child is feeling well, look for the three A’s of health: Appetite, Appearance, and Activity. Children who aren’t at their best usually will not eat, play, or look as they usually do.

Here is a memory trick that can be of assistance when determining whether or not an observation or screening session should be postponed. Remember the word halt, which means to stop.

H.A.L.T. stands for:

• Hungry

• Angry/Anxious

• Lonesome

• Tired

In any of these states, no one is at their best. If a child is in any of these states, observations and screenings will typically not provide the most accurate results.

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The third practice related to being honest and fair is to conduct sessions in the child's natural setting with familiar staff. Effective child care professionals conduct observation and screening sessions in the child's natural setting with familiar staff. This action, when combined with developmentally appropriate practice, helps children feel safe and comfortable, and therefore more likely to behave naturally.

Children are most likely to demonstrate their skills with a person they know, in a familiar place, using materials they have seen before. Conversely, children may not be able to demonstrate their skills and abilities in the presence of a stranger, in an unfamiliar place, or when using things that are new to them. Such conditions can promote anxiety, a condition which is likely to impact results negatively.

External factors, such as strangers who are present, unfamiliar surroundings or new things can foster anxiety in children. So can internal factors, such as a lack in self-esteem or self confidence, a desire to avoid embarrassment, or fear of making a mistake.

To calm anxiety, help the child deal with the feeling using developmentally appropriate practice. When dealing with a very young child, you might say, “I’ll go first, then you try it.” Then, demonstrate the skill you want the child to perform. When working with older children, help them identify and address their feelings, and then teach them the skills they need to progress.

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Natural setting refers to places a child knows well, such as home, rooms usually occupied by children at the program, school, a place of worship, or the homes of family and friends.

The fourth best practice related to being honest and fair is to never observe or screen with the intent of confirming a suspicion of delay, disability, abuse or neglect. Effective child care professionals never observe or screen with the intent of confirming a suspicion of delay, disability, abuse or neglect. Instead, they watch for developmental milestones, document them as instructed, and take action required by their programs written policies and procedures. That ensures they meet their responsibilities to their program, their profession, and most importantly to the children in their care.

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Key Point: Honest and fair child care professionals observe children, conduct screenings, and document all relevant observations in good faith.

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The fourth guideline presented in this course is to be focused. Effective child care professionals dedicate themselves to the observation or screening session and give each child their full attention. Effective child care professionals dedicate themselves to the observation or screening session and give each child their full attention. They allow enough time to properly conduct a session, observe or screen one child at a time, pay attention to small differences and details, and work methodically and thoughtfully.

How do efficient practitioners achieve this level of focus in a busy child care center or in a family day care home in which they are the only adult present? Solicit responses.

Effective child care professionals concentrate their work, thinking, and attention on the child being observed and the task at hand.

The first best practice related to being focused is to allow enough time to conduct a session properly. They schedule time before the session to review appropriate general information related to the child’s age range in developmental domain and milestone charts, study the child’s file, and read the instructions for the observation or screening tool they will use. If they need to gather materials or organize a space for the session, they schedule time to do that. Efficient practitioners schedule enough time to conduct the session according to instructions. And, they schedule time after the session to review their notes and properly document the file.

It is critical that none of these steps be rushed, or the data collected may not be as accurate, as complete, or presented as professionally as it could have been. These are important tasks, and effective practitioners schedule time to do them properly.

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Methodically means in an organized, systematic, and deliberate way.

When people are rushed, it is hard for them to focus on details.

Can you think about a time when you were so hurried that you forgot something important, or did not see or hear something you should have?

Make a short list of key words that describe your feelings at that time. Solicit responses to allow reflection, and then allow participants time to record their thoughts.

Remember how that felt so clearly that you can make a strong association between that feeling and being too rushed. If you ever experience that feeling when you are observing or screening children, slow down, take a deep breath, and stop hurrying. You might miss an important detail!

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The second best practice related to being focused is to observe or screen one child at a time, in order to sharpen their focus and concentration. Even when two children will be called upon to perform an identical task on the same day, they schedule individual sessions for each child.

Although sessions often take place while the child is busy playing and learning, efficient practitioners do not allow attention to be drawn away by other children or what they are doing. In facilities, other staff members should work to accommodate the child's session. Those who work alone manage their schedule to allow each session to be conducted properly.

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The third best practice related to being focused is to pay attention to small differences and details, because it is in those one can see emerging trends and patterns of growth and development, the earliest signs of delay or disability, and some of the more subtle signs of abuse or neglect. For example, a focused observer may notice that a child has changed the way he grasps his pencils, or how harshly she disciplines her dolls.

If signs of delay or disability are documented, staff members refer parents appropriately. If signs of child abuse or neglect are observed, you must, by law, report it to the Abuse Hotline.

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Every week, you probably handle money. You’re very familiar with the differences between the various coins and paper money you use.

Take a moment to draw, from memory, one side of a penny in your Participant’s Guide. When you are finished, compare your drawing to a real coin. If you’re like most people, you’ll find differences.

This is very similar to observing and screening children you know well. It can be difficult to notice small changes in anyone you see daily. Be aware of this, and sharpen your focus when you are observing and screening children in your care.

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The fourth best practice related to being focused is to work methodically and thoughtfully during all observation and screening sessions. This helps to reduce, or even eliminate, errors and omissions. To work methodically, they are organized, systematic, and deliberate. To work thoughtfully, they think about what is happening carefully, using all of their knowledge, skills, and abilities to identify and document only useful information.

To work methodically, an efficient practitioner may follow a specific sequence of actions to prepare for and conduct an observation, and then document the results. This helps to ensure they won’t forget a step in the process. A thoughtful observer or screener considers what the child is doing, how it relates to the screening tool being used, and determines if it is relevant and should be documented.

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Key Point: Focused child care professionals dedicate themselves to the observation or screening session, and give each child their full attention.

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Distracted driving accounts for thousands of traffic injuries and fatalities each year, so many that the National Highway Traffic Safety Administration launched a media campaign to encourage people to focus on driving when they are behind the wheel. Why are so many collisions caused by distraction? Solicit responses to allow reflection, and then allow participants time to record their thoughts.

Distractions cause collisions because they alter the way the brain processes information. The speed at which a brain works, its ability to notice important details, and its capacity to make and act on decisions are all diminished by distraction. During an observation or screening session, you must focus and think.

Make a list of three things that can distract you, and try to reduce or eliminate them when you are observing or screening a child. Allow participants time to record their thoughts.

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Module 2 Summary

Here is a summary of Key Points for Module 2: The Principles of Observation and Screening.

• Effective child care professionals know the typical and atypical patterns of child growth and development. They are familiar with the child and understand the program’s observation and screening policies and tools.

• Objective, accurate child care professionals create documentation coworkers and other professionals can use to help children grow and develop to their full potential.

• Honest and fair child care professionals observe children, conduct screenings, and document all relevant observations in good faith.

• Focused child care professionals dedicate themselves to the observation or screening session, and give each child their full attention.

Conclusion

Congratulations!

You have completed Module 2: The Principles of Observation and Screening.


• Relate guidelines for observations and screenings that take place in child care settings

• Name characteristics seen in effective observers and screeners of children

• Describe best practices used by skilled practitioners to obtain valid and usable results

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Materials: Flip chart and markers. From the Appendix of the Trainer’s and Participant’s Guides:

Using the Developmental Screening, Assessment, and Evaluation: Key Elements for Individualizing

Curricula in Early Head Start Programs, a publication of the Task Force on Screening and

Assessment of the National Early Childhood Technical Assistance System (NECTAS) in

collaboration with ZERO TO THREE.

www.zerotothree.org/child-development/mental-health-screening-assessment/thepowerofplay-1.pdf

Welcome to Module 3: Observation and Screening Basics.

This module will provide an outline of some of the ways child care professionals select quality screening instruments, and describe a few of the guidelines and best practices used during implementation. It also includes methods to guide families through screening, assessment, and evaluation.

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Goal

Participants will be able to select and use quality screening instruments, and guide families through the screening process.

Learning Objectives


• List characteristics shared by quality screening instruments

• Explain how to select a screening tool for specific children

• Describe guidelines and best practices for implementation

• Guide families through the screening process

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Module 1 stated that observation, screening, assessment, and evaluation are interrelated, and that child care programs should support families by observing and screening children through an ongoing, systematic process. Working with other professionals, providers should help guidefamilies through this process, and work in collaboration with other professionals.

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Module 2 showed how effective practitioners prepare to observe or screen a child, how they create documentation coworkers and other professionals can use, and how they conduct screenings and document observations in good faith. It also discussed the importance of giving each child ones full attention during sessions.

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Module 3 will present detailed information on selecting screening instruments, guidelines and best practices, and actions you can take to help families as their child is being assessed or evaluated.

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Let’s say you are the parent of a child who was recently screened at a child care center. Your provider has just shared a series of screening results with you, and recommends an assessment.

At this point, what are some of the questions you might ask? Solicit responses to allow reflection, and then allow participants time to record their thoughts.

How important would it be to you to have a child care professional who could provide detailed information about the screening process, the guidelines and best practices for implementation that were used, and specific actions you can take to help your child right now? Solicit responses to allow reflection, and then allow participants time to record their thoughts.

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Some screening instruments are completed by providers, others are completed by parents, and some involve providers and parents working in collaboration. With so many different people using the same screening instrument, it can be difficult to find a quality tool that meets the needs of all of its users.

Child care professionals select screening tools based on quality considerations, such as ease of use, accuracy, affordability, availability, sensitivity, reliability, suitability of components, endorsements, and use of technology. Lets take a closer look at each of these nine quality components.

1. Quality screening instruments are easy to use. When a screening tool is easy to use, staff and parents understand it and the results it produces. They should be able to read the materials in their primary language, follow the instructions without much guidance, use familiar materials, and create usable documentation efficiently.

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2. Quality screening instruments are accurate. When a screening instrument is accurate, its results are proven to be true and correct. Accuracy is strongly correlated to an instruments validity. Before a quality screening instrument is released by its manufacturer to be used with children, experts test it. They study the content of the screen, or what is included or excluded; how children of different backgrounds respond to the instrument; how the instrument functions in various program types; whether or not the results can be replicated over people and time; and if data collected by the instrument is consistent.

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Validity refers to a screening instruments soundness and legitimacy.

Correlated is a term used in screening. It means related.

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3. Quality screening instruments are affordable. When a program is thinking about buying a screening instrument, it should consider its price. If the price of the instrument and any supplemental items (such as materials or updates) cannot be supported by a programs budget, it should be rejected. Think about the programs mission and goals; the needs of the children, families, and staff; current financial priorities and long-term plans; and the impact of the purchase on the program’s sustainability.

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Sustainability is a term used in business. It means continued operations.

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4. Quality screening instruments are readily available. A screening instrument should be easily obtained from its manufacturer.

Agencies and organizations also provide lists of instruments and links, as these do:

• Centers for Disease Control and Prevention (www.cdc.gov/ncbddd/actearly/hcp/)

• First Signs (www.firstsigns.org/screening/tools/rec.htm)

• National Early Childhood Technical Assistance Center (www.nectac.org/~pdfs/pubs/screening.pdf)

• American Academy of Pediatrics (http://www2.aap.org/sections/dbpeds/screening.asp)

They may also be obtained from publishers of educational materials.

5. Screening instruments are sensitive in regards to ethnicity, culture, and linguistics. Screening instruments should not be biased against any group.

6. Quality screening instruments are reliable. They always produce the same results in similar situations. People who test screening instruments sometimes refer to this trait as repeatability. Repeatability is highly desirable in any testing instrument, including ones used for screening.

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Linguistics refers to the type of language used (e.g., English, Spanish,etc.), and to the meaning and complexity of individual words in context.

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7. Quality screening instruments have specific components. These usually include such items as a record keeping system, documents to record basic information about children and their families, and scoring and interpretation guides for the screener. Some include items to be used during screens, such as cards with pictures or shapes on them.

8. Quality screening instruments are endorsed by individuals, agencies, and organizations that are respected within the early education or early intervention communities. This indicates the screening instrument is trusted by professionals. Sometimes, a list of trusted instruments is developed by an agency or organization.

Some of these, such as the ones by the American Academy of Pediatrics and the Centers for Disease Control and Prevention, have been shown earlier in this module.

Here are more some examples:

• Florida Partnership for School Readiness (www.unf.edu/uploadedFiles/aa/fie/resource.pdf)

• Florida Developmental Disabilities Council (www.snowstrategies.com/child_development_screening_initiative.php) (Click on Screening and Assessment Tools Report.)

• Children's Health Fund (www.childrenshealthfund.org/sites/default/files/dev-and-mental-health-primary-carescreening-tools.pdf)

• The National Association for the Education of Young Children (www.naeyc.org/store/node/17)

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9. Quality screening instruments using technology should be user-friendly, meet accessibility requirements, and fit the program’s needs. Technology includes both computer hardware and software. User-friendly technology is appropriate for the skill levels of the people using it or for users to learn how to use.

Technology that meets accessibility requirements complies with the requirements of the Americans with Disabilities Act (ADA) by accommodating users who have special needs. For example, if a user is blind, the computer software must be able to read the on-screen text aloud. Closed-captioning must be available to those who are deaf. If the user’s disability impairs mobility, the program must make its technology fit the user’s needs.

Technology that fits the program’s needs helps the screeners document screening results accurately and efficiently. In the case of staff, this might be computer software In the case of parents, the use of technology may not be necessary. For some screening instruments, the only tool needed is a pencil.

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After choosing a screening instrument, child care professionals ask the right questions about a tool before using it with a child, including, “What does the instrument screen? What is the target age range? What languages are available? Does the screener need to be specially trained? How many items are screened? How long does it take to administer? And how is it implemented and scored?”

To determine if a screening instrument is right for a child, the answers to these questions are compared to the principles of Developmentally Appropriate Practice for the child. The screening instrument must meet the needs of the child for its results to be valid.

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Key Point: Child care professionals select screening tools based on specific quality considerations to ensure they will meet the needs of the children, their families, and the program.

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Screening instruments should be easy to use, accurate, affordable, readily available, sensitive, and reliable. The components should be suitable for the program and the families it serves. It should be appropriately endorsed and make use of technologies that are used by the program.

If you are the director or owner/operator of a program, ask yourself: Do my screening instruments meet these quality standards? If not, what can I do to resolve my concerns? If you are not the director or owner/operator of a program, ask yourself: What will I do if I am asked to use an instrument that does not meet these quality standards? Remember to be professional in your approach. Allow participants time to record their thoughts.

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When using a screening instrument, child care professionals follow guidelines during implementation so that results will be accurate and usable. Now, turn to the Appendix in your Participant’s Guide and locate the document, Using the Developmental Screening, Assessment, and Evaluation: Key Elements for Individualizing Curricula in Early Head Start Programs, a publication of the Task Force on Screening and Assessment of the National Early Childhood Technical Assistance System (NECTAS) in collaboration with ZERO TO THREE. It contains ten guidelines you should follow when screening children.

To review the document, visit: www.zerotothree.org/child-development/mental-health screeningassessment/thepowerofplay-1.pdf

The key to this practice and feedback is to introduce the students to this valuable resource, which can be found in their appendix. Students should read the entire document on their own outside of class. Using this document as a reference, note at least one best practice for each of the guidelines listed. Alternative: Break the group into smaller groups and assign one or two of the guidelines to each group.

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Key Point: Child care professionals follow guidelines and best practices during observation and screening sessions so results will be usable.

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Child care professionals involve families in the observation and screening process because it facilitates a partnership that benefits the child. They understand the importance of families, the role of families in the screening process, and how to guide families through assessment and evaluation.

Child care professionals know that involving families in the screening process can increase their knowledge of child development and improve their parenting skills. For screening to achieve its maximum benefit, family involvement is necessary. They provide important documentation, such as permission to screen, enrollment information, results of previous screenings, and health records. Additionally, they may share information about the child that could impact screening results, such as family dynamics, health issues (including premature birth), the child's routines and behaviors at home, issues impacting the child and other concerns, and possible strategies, if further action is necessary. For example, it is important to know if children were born prematurely because, depending on their chronological age, this may impact screening results. Child care professionals always review the instructions of the screening instruments to find important information on how to handle screenings for children who were born prematurely.

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Ideally, the role of families in the screening process is to:

• be fully aware of the screening program and understand its purpose

• consider screening as a positive service

• give written consent for their children to participate

• provide information that could facilitate the interpretation of results

• participate in the observation and screening process appropriately

• meet with staff members in person to discuss screening results

• pursue intervention services when they may benefit the child

The child care provider can influence the family’s perception of the screening process by keeping them informed, conducting screenings in a professional manner, and working in partnership with them.

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To guide families through its screening and observation process, a program should have written policies and procedures, a plan for orienting families to the process, a developmentally appropriate screening schedule for each child, a system for documenting parental permission to screen, a strategy for communicating results to the parents, and knowledge about how, when, and to whom referrals should be made.

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Quality child care programs have written policies and procedures about their observation and screening process. They outline, at the minimum, an orientation process for parents, methods of obtaining parental permission, planning for and scheduling sessions, documenting results, confidentiality, sharing results with others appropriately, communicating results to parents, and making referrals.

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Confidentiality refers to keeping personal information private.

Module 3

Quality child care programs have a plan for orienting families to the observation and screening process. During orientation and enrollment, families should be told about the program’s processes and their role in it. Enrollment is a good time to obtain their written permission to proceed.

Families should know their role during implementation and the differences between observation and screening; the reasons for observing and screening; the types of screening tools used at the program; the method used to communicate results; and why, how, and to whom referrals are made.

The orientation process does not have to be lengthy, but it does need to be thorough. It is best if it is given verbally and in writing, so families can review the information after the orientation.

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Quality programs have a developmentally appropriate screening schedule for each child, and they share it with the parents. The American Academy of Pediatrics recommends that children be screened at 9, 18, and 24 or 30 months; and more often if the child is at risk of developmental disability or delay. Since screenings are conducted to monitor a child’s progress in gaining skills, they may be completed more frequently to guide classroom planning.

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Quality programs have a strategy for communicating results to the parents. It is best if families are given the chance to discuss the results of every screening session at a confidential meeting. This strengthens the partnership between provider and parent, and allows time for everyone to ask questions. At the minimum, the results of screening sessions should be given to parents with a cover letter. At no time should the results of a session be delivered where others might overhear them or when there is no time for discussion.

After a screening, if a child is developing typically, try to set up a meeting. If the parents say that’s not possible, schedule a call and follow up by giving them relevant documents.

During a meeting or call, review the program’s observation and screening process. Then, describe the screening instruments that were used with their child. Next, present the results in a professional manner, and as you share results, answer questions. Encourage parents to ask questions or discuss concerns, because this should be a conversation, not a presentation.

If the results of a screening session indicate a referral for further assessment might be in the best interests of the child and family, schedule a confidential meeting with the parents.

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Key Point: Child care professionals think of families as partners in the observation and screening processes.

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Child care professionals involve families in the observation and screening process because it facilitates a partnership that benefits the child. Can you think of ways observation and screening facilitates working relationships with families? Solicit responses.

How does a provider-family partnership benefit a child? Solicit responses to allow reflection, and then allow participants time to record their thoughts.

Now, list at least three ways a child benefits when his or her family works in partnership with a child care professional in your Participant’s Guide.

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Approximate time required for this activity: 15 minutes (Within the 30 minutes for InvolvingFamilies in the Process lesion)

In your Participant’s Guide, you will find a series of scenarios describing you at work. You will also see a list of the four primary responsibilities of a child care provider related to observation and screening, which are selecting screening tools, asking the right questions, following guidelines, and involving families in the process. Read each scenario and determine what duty you are performing.

Lets read each scenario and determine the responsibility you are meeting in each one. Record the correct answers in your Participant’s Guide.

Alternative: Have a sign for each of the four duties. Give students a sticky note with the scenario and have them match the sticky note with the correct sign.

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Module 3 Summary

Here is a summary of Key Points for Module 3: Observation and Screening Basics.

• Child care professionals select screening tools based on specific quality considerations to ensure they will meet the needs of the children, their families, and the program.

• Child care professionals follow guidelines and best practices during observation and screening sessions so results will be usable.

• Child care professionals think of families as partners in the observation and screening processes.

Conclusion

Congratulations!

You have completed Module 3: Observation and Screening Basics.


• List characteristics shared by quality screening instruments

• Explain how to select a screening tool for specific children

• Describe guidelines and best practices for implementation

• Guide families through the screening process

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Materials: Flip chart and markers. From the Appendix of the Trainer’s and Participant’s Guides:

The about.com article, “Search Engines: How to Become a Virtual Expert In Five Minutes.”

www.websearch.about.com/od/dailywebsearchtips/qt/search-engine.htm. Sample observation

tools.

Welcome to Module 4: Methods of Observation and Screening.

Module 4 provides an overview of some of the most common methods used to observe children, with opportunities to practice them.

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Goal

Participants will be familiar with observation methods commonly seen in child care programs.

Learning Objectives


• List observation methods commonly seen in child care settings

• Describe how and when to use different observation methods

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In Module 4, I will present common observation methods used in child care settings. During this module, remember that child care professionals observe children in order to foster growth and development in every child, detect early signs of developmental delay or disability, and identify signs of child abuse and neglect. Knowing why children are observed will help you retain the material presented in Module 4. I will cover ten different methods of observation.

1. A checklist is a list of skills and abilities to be observed. When an observer sees the child demonstrate one, he or she places a mark next to the item. The date the observation was made is often recorded, but usually nothing else. Use a checklist when the goal is to note the presence or absence of demonstrated skills and abilities.

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2. An anecdotal record is a narrative account of an event written shortly after it occurred. It tells what a child did, when he did it, how he did it, and what happened afterward. It does not contain references to emotions, feelings, or other details that cannot be measured. Use an anecdotal record to write about the development of a skill or ability.

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3. A running record is an account of what a child is doing as it is happening. Running records are also used to document how children are responding to their environment. For example, children’s actions are recorded as they move between chosen activities. Use a running record to track a child's choice of activities or behaviors over a short period of time.

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4. A frequency count records how often a behavior happens. It can be used in almost any aspect of the program that involves human behavior, whether it occurs in a child, a staff member, an entire classroom, a group of staff, or any of these combined. Use this method to identify behaviors to be encouraged and those which may need to be addressed or accommodated.

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5. Conversations are word-for-word accounts of what children said while being interviewed by a provider. Many times, this is done phonetically. Non-verbal communication, or body language, is also recorded. Transcribe a child's conversations with both peers and adults to document their ability to translate their thoughts into words, and to document development in the Language and Communication, Social and Emotional, and Approaches to Learning domains.

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Phonetically refers to the way words sound, rather than how they are spelled. For example, you might record that a child said, “Cookie peas,” as opposed to writing, “Cookie, please.”

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6. A time sample records what activities a child chooses to do during a given time period, which is usually a half hour. When a child abandons one activity and begins another, the time is noted. Use time samples to document children's attention spans, social interactions, or to see how equipment and materials meet their needs.

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7. Standardized tests are used to document a child’s ability to compare and contrast, solve a problem, classify objects, put things in sequential order, arrive at conclusions, and other skills. Standardized tests have specific procedures for administering, scoring, and interpreting the results. Typically, standardized tests are norm-referenced. Use standardized tests to document the development of a child compared to other children of the same age.

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Norm-referenced means the results are used to compare the skills of the child to typically developing peers.

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8. A rating scale is used to measure a behavior, skill, or ability based on a series of quality points or a continuum. If you’ve ever been asked to rate a service or product “on a scale of one to ten,” then you have used a rating scale to communicate your thoughts. Every number you could have chosen represented a quality point. Use rating scales to quantify a child’s performance of a skill or a set of skills or see where a behavior or skill is on a developmental continuum. Rating scales can also be used to rate environments on their developmental appropriateness.

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Quantify means to assess somethings numerical value. This is a highly subjective process and is often used to gather an observers judgements, based on expertise.

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9. A work sample is a product created by a child that becomes documentation of the development of a skill. The work sample can be two dimensional, such as a drawing or writing sample, or three dimensional, such as a sculpture. It could be a photograph or a video of a child building a block tower, or a recording of one singing a song or telling a story. Use a work sample to allow others to observe children or their work for themselves.

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10.Documentation refers to everything in a child’s file, but that word can have a special meaning when it is used in reference to child observation. Then, documentation refers to records that help identify a child who may be at risk of maltreatment, delay, disability, or to relay a suspicion of child abuse or neglect.

When you are documenting a possible delay or disability, gather documentation through a variety of methods, such as incident reports; notes from meetings, staff members, and parents; and observation tools. Work toward establishing a pattern of behavior or traits. However, when you suspect abuse or neglect, document and report it immediately, following your lawful duties. A child’s life may be at stake.

There are multiple ways to report suspicions of child abuse and/or neglect. Child care professionals can:

• call the Abuse Hotline (1-800-96Abuse or 1-800-962-2873) or call through the TDD line

• report online through the Abuse Hotline website at https://reportabuse.dcf.state.fl.us/

• fax the information to the Abuse Hotline at www.dcf.state.fl.us/programs/abuse/docs/faxreport.pdf

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Key Point: Child care professionals choose their methods of observation based upon the types of information they need to collect.

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Approximate time required for this activity: 10 minutes (Within the 75 minutes for the lesson)

In your Participant’s Guide, you will see a series of observation scenarios. You will also see a list of observation tools. Select the tool you would use in each scenario, following the guidance provided in this module. Alternative: Use index cards and have students find their matching card.

1. Anecdotal Record

2. Checklist

3. Conversations

4. Documentation

5. Frequency Count

6. Rating Scale

7. Running Record

8. Standardized Tests

9. Time Sample

10.Work Sample

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After watching a brief video of a child, use your Participant’s Guide to record your observations using the anecdotal record method. Then, watch the video again to change observation techniques and complete the checklist. Watch the video a third time to complete a running record.

Alternative: Have a student volunteer to be observed performing an activity. Then have students record their observations.

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Key Point: Child care professionals use the Internet to find information about observation methods and tools used to perform observations.

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Child care is a dynamic profession, and resources improve with each passing year. As a child are professional, you must be able to find up-to-date information and resources on your own. One of the best ways to do this is on the Internet, using a search engine.

Using the computer, or have the students use their smartphones, and search for the following screening tools:

• Checklist

• Anecdotal Record

• Running Record

• Standardized Test

• Rating Scale

Alternative: Bring examples of screening tools to share with students.

In the Appendix of your Participant’s Guide, locate the about.com article, “Search Engines: How to Become a Virtual Expert In Five Minutes.” www.websearch.about.com/od/dailywebsearchtips/qt/search-engine.htm

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Module 4 Summary

Here is a summary of Key Points for Module 4: Methods of Observation and Screening.

• Child care professionals choose their methods of observation based upon the types of information they need to collect.

• Child care professionals conduct their observations in an informed, objective, accurate, honest, fair, and focused manner.

• Child care professionals use the Internet to find information about observation methods and tools used to perform observations.

Conclusion

Congratulations!

You have completed Module 4: Methods of Observation and Screening.


• List observation methods commonly seen in child care settings

• Describe how and when to use different observation methods

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Approximate time required for this module is 50 minutes.


Welcome to Module 5: Children at Risk.

This module will show how observation and screening helps children who are at risk of delay, disability, abuse, or neglect. It describes how these processes help providers identify the signs of atypical development or maltreatment reflected in a child’s behavior, physical well-being, and cognitive processes.

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Goal

Participants will be able to explain how observation and screening plays a key role in the early detection of developmental delays, developmental disabilities, and at-risk populations of children in child care programs.

Learning Objectives


• State the role of observation and screening as it relates to developmental delays, developmental disabilities, and at-risk populations

• Describe ways to support children with delays or disabilities, or who are at risk, by observing and screening them

• Identify laws related to children with disabilities or who are at risk

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This module will present specific information on identifying the earliest signs of developmental delay, disabilities, abuse and/or neglect. If you work in child care for very long, it is likely you will see signs of these during an observation or screening. It will not happen often, but when it does, you need to be able to recognize these signs when you see them and take appropriate action. Remember, child care professionals do not diagnose children based upon these signs. Instead, they identify and document indicators that they observe, report them as required by law, and observe and screen regularly.

Child care professionals do:

• Not diagnose

• Identify and document indicators

• Report them as required by law

• Observe and screen regularly

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Key Point: Child care professionals can provide other professionals with information that can help a child at risk.

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Licensed doctors are the only professionals who can diagnose the signs of delay and disability.

The Department of Children and Family’s child abuse investigators, working with law enforcement officials, are the only professionals who can verify the signs of abuse and neglect and take appropriate legal action. Think about your role in supporting these professionals as they carry out their duties. Can you name some actions you can take to help them assist a child whose well-being may be at risk? Solicit responses to allow reflection, and then allow participants time to record their thoughts.

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Child care professionals speak and write in ways that help them communicate with other professionals and with parents. This is especially important when the documentation they create may be used by another professional to arrive at a diagnosis for disability or begin an investigation for possible abuse or neglect.

They use people-first language, which is a method of sentence construction that places people before any condition they have. They say, “Sarah has Autism,” instead of referring to her as an Autistic child. Similarly, they say, “Timothy is in foster care,” instead of saying, “Timothy’s a foster child.” Sarah and Timothy are children first, and all communication about them should recognize that.

Child care professionals use terms related to their profession and at-risk children expertly, and, when creating documentation, they construct concisely-written sentences with care. It is important to write clearly, especially when documenting or presenting data that results from observation and screening sessions. Remember, others may use this documentation to help them arrive at conclusions or take action on behalf of a child.

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At Risk is a phrase used after a noun to describe a condition or situation of vulnerability or of being in danger.

At-Risk is an adjective used immediately before a noun (a person or a thing) that is vulnerable or in danger. (Note hyphenation.)

People-First Language is a method of sentence construction that places people before any condition they have.

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Key Point: Child care professionals use terms related to their profession and to at-risk children expertly, and when creating documentation, they construct concisely-written sentences.

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In your Participant’s Guide, you will see a list of professional terms that have been used in this module and in previous modules. You will also see a word bank of terms. Match each term with its definition. Note to instructor: Although many terms have been presented in this course, this activity includes those related to delay and disability, abuse or neglect.

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When you are working with people who are providing you with information or a service, how do you judge their professionalism? For example, what types of behaviors make you skeptical? Solicit responses, and then allow participants time to record their thoughts.

Which ones earn your trust? Solicit responses, and then allow participants time to record their thoughts.

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Children who are at risk tend to share certain characteristics. The next few screens will present information on these traits.

According the CDC, children who are at the highest risk for developmental disabilities tend to be male and living in poverty. Such children are twice as likely to have a developmental disability as their peers. Other research shows genetics and physical environment play a role in putting children at risk for a developmental delay or disability. For example, it is known that Down syndrome is related to a missing chromosome.

But, environmental factors are not limited to exposure to toxic substances such as chemicals, drugs, alcohol, and tobacco products. Abuse, neglect, a parent’s mental illness, and violence in the home are very stressful to children. They can create a condition known as Toxic Stress Response, which can impact development in all domains and the child’s future health.

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The risk factors for child abuse and neglect fall into three categories: child, parent and family, and societal. Children who are at risk of abuse and neglect tend to:

• have parents who live in poverty, did not finish high school, abuse alcohol or other drugs, and/or do not have supportive relationships

• be born prematurely, have a chronic illness or disability, and/or possess a characteristic identified by a parent as undesirable

• live in communities that have high rates of poverty and violence and/or a cultural acceptance of abuse and neglect

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Key Point: Knowing who is at risk helps when observing and screening children, because it allows you to watch for and identify the earliest signs of developmental delay, disability, abuse or neglect.

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In Module 2: The Principles of Observation and Screening, you were introduced to developmental domains and developmental milestones. You were also given basic information about developmental delay and disabilities. Now, take a closer look at these topics as they relate to what you might see during a screening or observation session.

A developmental delay occurs when a child does not display the skills and abilities typically seen in peers in the same age range. Delays can occur in any developmental domain, but the most common ones occur in the Language and Communication and Social and Emotionaldomains.

Take a moment to review a milestone chart and information on developmental domains. Pay particular attention to children’s development in the Language and Communication and Social and Emotional domains.

Note: Open a milestone chart on the computer to show to the class or have students open a milestone chart on their smartphones.

Developmental Milestone Charts Centers for Disease Control and Prevention

www.cdc.gov/ncbddd/actearly/milestones/index.html

National Institutes of Health

www.nlm.nih.gov/medlineplus/ency/article/002002.htm

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Many children can overcome a developmental delay with classroom interventions. However, if several different types of screening methods conducted over time indicate the child is not making progress, talk to the parents about assessment and evaluation following the guidelines presented in Module 3.

Recall that child care professionals in Florida refer families to the Children’s Forum’s Central Directory or the Florida Diagnostic and Learning Resource System’s Child Find. For more

information, review Module 1.

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Key Point: A developmental delay occurs when a child does not display the skills and abilities typically seen in peers in the same age range.

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Key Point: Child care professionals in Florida refer families to the Florida Diagnostic and Learning Resource System’s Child Find when they feel intervention may benefit the child.

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A developmental disability is a chronic condition that is diagnosed in childhood and substantially limits major life activities in adulthood, and impacts a child’s abilities to perform activities in one or more developmental domain. Some common developmental disabilities are Autism, Down syndrome, and those related to cognitive/intellectual development.

The term “autism spectrum disorders” (ASD) refers to a group of neurodevelopmental disorders characterized by social impairments, communication difficulties, and restricted and repetitive patterns of behavior.

The term “group” is used because the characteristics of ASD can be present in a variety of different ways, combinations, and degrees in individual children. Because of this, medical professionals, parents, and other people who work with children with ASD refer to it as “autism spectrum disorders.” You may also hear people refer to children as being “on the spectrum.” Here are some of the early signs of ASD: Infants (birth to 18 months of age) may avoid gazing directly into the eyes of their parents; when spoken to, may not babble in response; and may not smile in response to a smile. Toddlers (18 to 36 months of age) may not point to an object of interest or follow someone’s point; may not look to a trusted adult for help; may flap or wave their arms; may rock back and forth; may become fixated on an activity or object; and can be prone to tantrums.

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Neurodevelopmental disorders affect the growth of nerves, nerve tissue, and the central nervous system.

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Down syndrome is a genetic disorder characterized by distinct physical traits and intellectual impairments. Children with Down syndrome share a number of physical characteristics, including a small head in proportion to his or her body, flattened facial features, a small mouth and ears, eyes that slant upward and may be rounded, broad hands, a single crease in their palms, and short fingers. Children with Down syndrome may also have intellectual impairments, stomach problems, problems with memory, concentration, and judgment, and hearing problems.

Cognitive or intellectual disabilities may be diagnosed in children based on the way they process and use information and perform self-help skills. Children who have an intellectual disability may have difficulties, when compared to peers who are developing typically, in caring for themselves, understanding health and safety issues, communicating with others, learning necessary life skills (such as eating and toileting), and directing their own activities.

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Genetic disorders are conditions that are due to an abnormality in the way a body’s cells are structured. If a disorder is genetic, it is present at birth, even if it is not diagnosed at that time.

Distinct physical traits refers to the similar facial and body features that are shared by many people with Down syndrome.

Intellectual impairments means that people with Down syndrome may have a difficult time understanding and processing information.

Cognitive abilities are intellectual processes that can be measured on standardized tests. Also known as intellectual functioning.

Self-help skills are a wide variety of abilities that are useful in everyday life. Also

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In addition to Autism, Down syndrome, and cognitive or intellectual disabilities, there are other developmental disabilities and disorders that are commonly seen by child care providers. They include:

• Attention Deficit Hyperactivity Disorder

• Bipolar Disorder

• Cerebral Palsy

• Fetal Alcohol Syndrome

• Fragile X Syndrome

Activity: Describe the Condition


In your Participant’s Guide, you will see descriptions of developmental disabilities commonly seen in child care. You will also see a word bank containing the names of these disabilities. Match each disorder with its definition.

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Key Point: It is important for child care professionals to be familiar with common developmental disabilities that may affect children in their care.

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During the next few minutes, specific information about child abuse and neglect will be presented. Some of the material in this section may be uncomfortable for you to study. If you would like to talk to a trained counselor about how this issue affects you, you can call the Florida Coalition Against Domestic Violence at 1-800-500-1119 or the Florida Council Against Sexual Violence at 1-888-956-7273. This information is printed in your Participant’s Guide for future reference.

You may notice the physical and behavioral signs of child abuse and neglect during observation and screening sessions, because these tasks cause you to focus your attention on a child for a period of time. Recording your findings also sharpens your ability to notice small details about a child’s appearance and behaviors. Child abuse is defined by Florida law as any non-accidental injury, sexual battery, or injury to the intellectual or psychological capacity of a child by the parent, adult household member, or other person responsible for the child’s welfare. Abuse falls into three categories: physical, sexual, and emotional.

The signs of child abuse fall into two categories: physical and behavioral. Physical signs are observable in the appearance of a child. Behavioral signs are observable in the way a child acts.

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Remember, these are signs that a child may be a victim of abuse or neglect. Only a qualified professional can determine if child abuse or neglect is occurring. Your job as a child care professional is to report suspicions of abuse and/or neglect to the DCF Abuse Hotline.

Physical signs of child abuse include bruises, welts, burns, lacerations, abrasions, fractures, wounds and other injuries. Be alert for ones that tend to occur in the same place or repeatedly, and for which there is no plausible explanation.

Behavioral signs include reluctance to go home, wariness of adults, strong startle response, depression, poor memory and concentration, and behaviors that are age-appropriate. For example, the child may be aggressive or passive, seek attention indiscriminately, be overly affectionate, or withdraw from others.

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Key Point: Child abuse can be physical, sexual, or emotional, and children may display physical and behavioral indicators of such maltreatment.

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Child neglect is defined by Florida law as failure to provide things necessary to sustain life, such as adequate food, clothing, shelter, health care, hygiene, and supervision.

Neglect also includes situations in which the child is deprived of emotional support, love and attention, which causes a disorder called Failure to Thrive.

The signs of neglect fall into the same two categories: physical and behavioral.

Physical signs of neglect include untreated medical conditions (major and minor), inadequate clothing, consistent hunger, and poor hygiene.

Behavioral signs include fatigue, disinterest, stealing food, inability to trust, self-destructive behaviors, poor self-control, consistent absence or tardiness, or trying to take on adult responsibilities for other children.

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REMEMBER

As a child care provider, it is your duty and your legal responsibility, according to Chapter 39 of the Florida Statutes, to report any suspected case of child abuse or neglect.

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Key Point: Child neglect is the failure to provide things necessary to sustain life, and children may display physical and behavioral indicators of such maltreatment.

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Key Point: Child care professionals know and must report the physical and behavioral signs of child abuse and neglect.

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Approximate time required for this activity: 10 (Within the 12 minutes for the lesson)

In your Participant’s Guide, you will see a list of indicators abuse and neglect. For each indicator, let’s identify if it is a sign of abuse or neglect. We will also identify if it is a physical or behavioral indicator. Record the correct answers in your Participant’s Guide.

Alternative: Have students identify the four statements that go under each category:

1. Physical Sign of Child Abuse

2. Behavioral Sign of Child Abuse

3. Physical Sign of Neglect

4. Behavioral Sign of Neglect

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It is one thing to take a course and study children at risk. It is quite another to see it for yourself.

Take a few moments to think of a child you know. Now, imagine identifying the early signs of delay, disability, neglect or abuse in that child. Be aware of how you are feeling, and try to come to terms with these emotions before the day you must take action in a child care setting.

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To use observation and screening to help children with developmental delays or disabilities, child care professionals:

• observe and screen regularly

• watch for signs and changes

• document professionally, over time, using a variety of methods

• are familiar with the Central Directory and Child Find

• refer when appropriate

• provide appropriate support during sessions

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Talk to the child’s parents and other professionals who are working with the child so you can provide appropriate support during sessions. Ask them how you can make the data you collect more usable for their purposes.

Child care providers have specific responsibilities under the Americans with Disabilities Act (ADA), a federal law that prohibits discrimination of people who are disabled.

Specifically, they must:

• make reasonable modifications in policies, procedures, and practices

• remedy barriers to mobility and communication

• provide auxiliary aids and services necessary to communicate with children with disabilities

In short, they must ensure that children with disabilities can participate in their program as fully as possible. That includes the program’s observation and screening processes. Ask parents and other people who are working with the child to share how you can modify sessions to comply with the ADA, as it applies to their child.

To learn more about the ADA and child care providers, visit www.ada.gov/childq%26a.htm

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Child care professionals can also make a substantial contribution toward the progress of children who receive benefits under the Individuals with Disabilities Education Act, federal law that guarantees a free and appropriate public education to every child. This is best done by interacting with others who are helping a child with disabilities through a team approach. Offer to:

• share results of your observation and screening sessions

• provide expertise related to the child’s activities at the program

• be on the child’s intervention team

Be sure to ask parents and other people who are working with the child to share how you can help them improve outcomes by sharing your knowledge about the child’s skills and abilities.

To learn more about IDEA and child care providers, go to

www.childcarelaw.org/docs/Q&A%20IDEA%20&%20Child%20Care%2009%20Update%20final.pdf

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Key Point: Child care professionals improve the outcomes for children receiving benefits under the ADA and IDEA by sharing their screening results, preferably in person.

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To help children who are victims of abuse or neglect by observing and screening them, observe regularly for signs of abuse or neglect, watch for changes in behavior, document professionally and immediately, and be familiar with the Florida Abuse Hotline.

Provide appropriate support during sessions by being aware that children who are being abused or neglected may avoid unfamiliar people and activities. Pay attention to what they are saying and doing, and help them process situations that are making them uneasy.

Be aware that some developmental delays and disabilities can mimic the signs of abuse and neglect. For example, children with Autism may bang their heads, leaving bruises. Children with a disability that is impacting motor development may fall easily, and have abrasions or lacerations.

A child with a cognitive impairment might be overly or inappropriately affectionate. The best way to discern the differences between delays, disabilities, abuse and neglect is to observe and screen children often and know what is typical for each individual.

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Key Point: Observation is the best way to identify the earliest signs of abuse and neglect.

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Take a moment to reflect on your feelings about working with children who have a disability or are being abused and/or neglected.

If thinking about it makes you uncomfortable, training might help. As a part of your mandatory Part 1 child care training, you will take the DCF course, Identifying and Reporting Child Abuse and Neglect. Consider taking Special Needs Appropriate Practices and Supporting Children with Developmental Disabilities as well. These courses contain practical information that may help you to feel more comfortable when working with children who are at risk, have a delay or disability, or have been abused or neglected.

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Module 5 Summary

Here is a summary of Key Points for Module 5: Children at Risk.

• Child care professionals can provide other professionals with information that can help a child at risk.

• Child care professionals use terms related to their profession and to at-risk children expertly, and when creating documentation, they construct concisely-written sentences.

• Knowing who is at risk helps when observing and screening children, because it allows you to watch for and identify the earliest signs of developmental delay, disability, abuse, or neglect.

• A developmental delay occurs when a child does not display the skills and abilities typically seen in peers in the same age range.

• Child care professionals in Florida refer families to the Florida Diagnostic and Learning Resource System’s Child Find when they feel intervention may benefit the child.

• It is important for child care professionals to be familiar with common developmental disabilities that may affect children in their care.

• Child abuse can be physical, sexual, or emotional; and children may display physical and behavioral indicators of such maltreatment.

• Child neglect is the failure to provide things necessary to sustain life, and children may display physical and behavioral indicators of such maltreatment.

• Child care professionals know and must report the physical and behavioral signs of child abuse and neglect.

• Child care professionals improve outcomes for children receiving benefits under the ADA and IDEA by sharing their screening results (with parental permission), preferably in person.

• Observation and screening are the best ways to identify the earliest signs of abuse and neglect.

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Conclusion

Congratulations!

You have completed Module 5: Children at Risk.


• State the role of observation and screening as it relates to developmental delays, developmental disabilities, and at-risk populations

• Describe ways to support children with delays or disabilities, or who are at risk by observing and screening them

• Identify laws related to children with disabilities or who are at risk

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Approximate time required for this module is 45 minutes.


Welcome to Module 6: Referral Process and Resources.

This module will describe how to share the results of screening and observation sessions, and provide referrals in a professional manner.

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Goal

Participants will describe best practices and techniques for communicating screening results, making referrals, and helping families that have received a referral for assessment.

Learning Objectives


• Describe best practices used by skilled practitioners when they communicate results supporting further assessment or evaluation

• List agencies and organizations that participate in the screening, assessment, and evaluation processes

• Describe the function of each of these organizations and agencies

• Help parents appropriately and responsibly after learning their child may be at risk of developmental delay or disability

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When the results of screening and observation sessions suggest assessment or evaluation might benefit the child, apply these best practices in this order:

• Prepare carefully for the meeting.

• Begin the meeting with a brief overview.

• Present a blank sample of the specific tool or tools.

• Present the child’s results in writing.

• Be an active listener.

• Keep the meeting positive.

• Talk about the program’s role.

• Make an appropriate referral and provide information.

1. Prepare for the meeting. First, schedule a specific time to discuss results with parents when they are not dropping off or picking up their children. When setting the date, try to provide the results as soon as possible. Be sure to hold the meeting where you can maintain confidentiality. It is very important to share results in writing, so gather copies of key documents: the screening instruments with results, a copy of the parents written permission to screen their child, referral information, and parent support materials, as needed during the meeting. Just before the meeting, review the materials. Reflect on what you need to say and the best way to say it.

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Proactive means to address concerns or problems.

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2. Begin the meeting with a brief overview of the programs observation and screening processes. Keep this part of the meeting short and speak plainly, using words parents can understand. First, define the terms observation and screening, and state that these are routine processes in quality programs. Explain some of the reasons why the program observes and screens enrolled children. Talk about when and how the program conducts observation and screening sessions, and describe how the program uses the data to help children learn and grow. Respond to questions as they occur.

3. Present a blank sample of the specific tool or tools that were used. Explain the tool, the skill areas it addressed, and its scoring system. Clarify that the instrument is not an intelligence test, nor is it an assessment or evaluation tool. Describe when and how the tool was used with the child.

4. Present the child’s results in writing. Emphasize the child’s current strengths and skills, and then explain areas in which their child might benefit from classroom interventions or further assessment. Tell parents that the results of screening tools used by only one screener cannot be used to determine the status of a child’s development. Finally, relate your desire and willingness to assist and collaborate with the parents in deciding how to proceed.

5. Be an active listener while parents share their concerns and questions. Listen very closely to what parents say, and think before responding. Ensure everyone has a chance to speak without interruption. If you do not completely understand what was said, or if you feel a person needs encouragement to continue, ask respectful questions. When changing the topic of conversation or moving into a more complex discussion of it, check for understanding Watch facial expressions and non-verbal responses for clues about unstated thoughts or to gain a deeper understanding of what is being said.

6. Keep the meeting positive. Some parents may react emotionally when you share observation or screening results. If this happens, remember that this is an opportunity to share information that strengthens a family’s abilities to help their child grow and develop to the fullest potential. Negativity works against that goal. Focus on what you know is true, according to the results, but refuse to speculate on possible diagnoses or outcomes. If parents ask what you think the results mean, tell them you are not licensed or trained to assess or diagnose children, but you can help them by providing information, resources, and the programs support. Be calm and focused, and help parents to do the same. One way to do this is by avoiding negative terminology or words parents could perceive adverse, such as “fail,” “abnormal,” “atypical,” and “test.” Additionally, use objective terms and avoid subjective ones.

7. Talk about the program’s role. Relate the programs relationship to organizations that perform assessment and evaluation, and how the program provides vital

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information to them. Some parents will be worried about the anticipated cost of assessment, evaluation, and possible interventions. If they are, describe IDEA Parts B and C, letting them know that this Act ensures intervention services are provided at no charge to children who have a disability. Explain how the program can assist a child who qualifies for IDEA benefits by adapting materials, equipment, and activities.

8. Make an appropriate referral and provide information. At this point in the meeting, encourage the parents to make the first call to the assessment provider. Show them how all of the information they need has been provided in the packet you assembled prior to the meeting: the date of the screening, type of screen, name of the person who administered the screening, and results of the screening. If they ask you to make assessment arrangements, explain the benefits of the family in seeking services themselves, but assure them you are there to support them through this process. Let them know that the key to obtaining good outcomes is for them to make informed decisions about their child, and then take action. Clarify how the program can best participate by sharing information and providing individualized care. If they want you to share information about their child with others, ask parents to sign a release of information form. Check for understanding before continuing.

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Key Point: When the results of screening and observation sessions suggest a referral for assessment or evaluation might benefit a child, the programs role is to supply appropriate information, resources, and support to the families while continuing to provide individualized care.

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Module 6

When you are delivering the results of a screening to parents, some may react emotionally. You may see some of the emotions listed in your Participant’s Guide:

• Fear/Doubt

• Denial

• Sadness

• Helplessness

• Anger

Lets think about ways you can control your own emotions and maintain professionalism if parents an emotional reaction after hearing the results of a screening. Solicit responses.

Alternative: Have students role play scenarios for each emotion.

In your Participant’s Guide, list three ways you can help yourself stay calm when someone else is displaying a strong emotion. Ensure that your response is both professional and considerate of a person who may be feeling a significant amount of stress. Allow participants time to record their thoughts.

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Key Point: If parents display a strong emotion when results are shared, the best way to support them is to stay calm, focus on the facts, and be compassionate.

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Once you have shared the results of a screening with parents, take the following steps: continue to provide individualized, developmentally appropriate care, supply parents with information upon request, and participate in the child’s intervention team if asked.

It is very important you do not interfere with the decision-making process of the parents as they decide how to act on the information you provided. Try not to encourage them to choose any specific course of action. Continue to be their knowledgeable and reliable partner in child care.

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Key Point: As families move through the assessment or evaluation processes, adjust the child’s learning experiences as new information emerges, and be willing to share your expertise (as long as you have written parental consent).

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Remember, referrals from child care providers should be made to the following organizations: The Florida Diagnostic and Learning Resource System (FDLRS), which is a statewide organization that also conducts free developmental screening, primarily for young children. The Children’s Forum’s Central Directory and the Florida Office of Early Learning Child Care Resource & Referral Network (CCR&R), which helps parents find child care that best meets their children’s needs. The local Child Find office would be a good agency to contact for free screening and evaluation for hearing, vision, speech, behavior, and general development.

These organizations and their websites can also be used to obtain resources you can use to provide individualized care and follow developmentally appropriate practice. They can also provide information suitable for sharing with parents.

You should also keep federal agencies in mind as you are helping children and families. The U.S. Department of Justice is a good source of information regarding both general and technical questions about the American’s with Disabilities Act (ADA). The U.S. Department of Education is a good source of information regarding children with special needs and the Individuals with Disabilities Education Act (IDEA). Child care providers seeking information about specific disabilities could start with organizations such as the National Center on Child Care Quality Improvement (NCCCQI); the National Information Center for Children and Youth with Disabilities (NICHCY); and the National Early Childhood Technical Assistance System (NECTAS). Finally, remember to search the Internet for information you need. Look for websites that represent a well-known agency or organization, such as a governmental agency, a not-for-profit, or a professional association. When you find information, ask yourself three questions before using it as a resource: Is this information provided by an expert? Can this information be verified by another source? Is this the most current information available on this subject?

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Key Point: Child care professionals rely on local, state, and federal agencies and professional organizations to help them assist parents appropriately and responsibly.

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Key Point: After reviewing screening results, a child care professional may encourage the family to refer a child, report suspicions of abuse or neglect, or do neither of these.

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After reviewing screening results, a child care professional may encourage the family to refer a child, report suspicions of abuse or neglect, or do neither of these; in that case, they report the results to the parents and document the file. Read the following scenarios and determine the correct course of action. Then, let’s discuss your answers. After our discussion, write the correct answers in your Participant’s Guide.

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Module 6 Summary

Here is a summary of Key Points for Module 6: Referral Process and Resources.

• When the results of screening and observation sessions suggest a referral for assessment or evaluation might benefit a child, the program’s role is to supply appropriate information, resources, and support to the child’s family while continuing to provide individualized care.

• If parents display a strong emotion when results are shared, the best way to support them is to stay calm, focus on the facts, and be compassionate.

• As families move through the assessment or evaluation processes, adjust the child’s learning experiences as new information emerges, and be willing to share your expertise (as long as you have written parental consent).

• Child care professionals rely on local, state, and federal agencies and professional organizations to help them assist parents appropriately and responsibly.

• After reviewing screening results, a child care professional may encourage the family to refer a child, report suspicions of abuse or neglect, or do neither of these.

Conclusion

Congratulations!

You have completed Module 6: Referral Process and Resources.


• Describe best practices used by skilled practitioners when they communicate results supporting further assessment or evaluation

• List agencies and organizations that participate in the screening, assessment, and evaluation processes

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• Describe the function of each of these organizations and agencies

• Help parents appropriately and responsibly after learning their child may be at risk of developmental delay or disability

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