1.3 Developmental Screening

1.3: Integrate developmental screening and assessment into the program/school

Developmental screening icon

Putting a universal screening and assessment process in use can support programs to foster children’s positive social-emotional development in order to prevent suspensions and expulsions. Universal screening is a fast and efficient way to identify children with potential areas of need or concern. Early identification through universal screening also helps programs match at-risk children with the services that benefit children and their families. This practice can result in stronger family partnerships (see Recommendation 1.2). It can also help establish formal collaborations with community partners to support the inclusion of young children with disabilities in your program. Targeted and intensive intervention services can help children who need them to begin and sustain positive relationships with their peers and with adults, possibly preventing and addressing the challenging behaviors that may lead to suspension and expulsion. For instance, many Head Start centers complete a social-emotional screener on all enrolled children within 45 days of the program start date. Screening is also a critical component of a multitiered system of support (to learn more, see Recommendation 1.8). To be most useful and beneficial to you and your program, it is important to use a universal screening and assessment tool that will provide accurate and specific information about what children know and are able to do.

A universal screening and assessment tool is characterized as a brief, cost-efficient tool that:

  • Is given to all children
  • Is accessible to all children (e.g., given in the child’s primary language)
  • Assesses critical skills and concepts
  • Is easy to administer and score
  • Has quick turnaround time so the information can be shared with teachers and relevant staff
  • Is reliable
  • Accurately describes children’s skills and competencies.

Accurate information about children’s social-emotional competencies and skills come from

  • multiple methods of assessment (e.g., direct observation and teacher ratings of behavior) and
  • multiple sources of information (e.g., number of absences from administrative records; medical records) that is gathered from
  • multiple informants (e.g., examining the correspondence between parent and teacher ratings and reports of behavior).

How do I do this?

Step 1. Select a screening tool. When you select a screening tool, consider

  1. the appropriateness of the screener for your context,
  2. the technical adequacy of the screener, and
  3. the usability of the information generated by the screener

Consider the following questions to determine the appropriate screener for your program:

  • When is the ideal time to assess children? How often should the tool be used?
  • What can we learn about children’s areas of concern and strengths by using this tool?
  • Have the format and content of the tool been used in past research and/or evaluation? What did other researchers and professionals learn about children from using the tool?
  • Is the assessment contextually, culturally, and developmentally appropriate? Does it make sense to use for the children in our program?

Looking for instruments to consider for universal screening and summaries of their technical adequacy and usability? Jump down to the lists and compilations in the Resources section.

Step 2. Determine the process for implementing the screening tool. This universal screener should be administered at the beginning of the school year to assess the achievement of developmental milestones for all children currently enrolled in the program. You will need to decide

  • when that screener will be administered and
  • by whom.

In general, administering the assessment with fidelity should be straightforward (e.g., it does not have a complex scoring procedure, or the complex scoring procedure should be streamlined). It would also be helpful to partner with local early intervention or early childhood special education programs to support your screening efforts. They may also offer practical advice, including suggestions for selecting screening tools, items, or tasks.

Step 3. Consider logistics and infrastructure needs. The assessment should not place a large burden on staff time or your program’s financial resources.

  • Consider that administering the assessment may require that children and, to a greater extent, providers/teachers will be taken out of instruction and care time.
  • Data collection, management, and interpretation require qualified staff, as well as tools that range from analytical software and a quiet testing space to personnel who can accommodate non-English speakers.
  • Additional personnel may be required. See section.
  • See the resources section for lists and compilations that summarize key characteristics such as the purpose of the instrument, cost of purchase, qualifications/training necessary to administer the tool – and can help in decision-making.

Step 4. Create staffing and implementation procedures. When preparing to put the screener in place, consider:

  • Staff selection. Select staff to administer the screening tool who have the qualifications and training required (if any) for the tool. If qualifications are not specified, think about who has the skill sets needed to:
  • Time to practice and debrief. If training is not required, it may be helpful for staff to practice giving the screener to each other or to a child who does not attend the program.

Step 5. Use the results to inform supports and services. When preparing to use the ratings and results from the screener to identify children in need of additional supports and services, consider:

  • Transforming scores into informed action. Once scores have been interpreted, they should be shared with providers/teachers, IDEA service providers, and families. If appropriate, a monitoring and follow-up procedure should be put in place.
  • What Barriers Might I Run Into and What Are Solutions?

    Potential Barrier: How do we tell the difference between a rough week and clinically significant problems?
    Solution: We recommend that you use a standardized, validated tool that is psychometrically/technically sound. Such instruments provide specific guidance or interpretation of what scores mean, including the threshold for clinical significance. There are multiple benefits to using a standardized instrument, such that

    • individual items have been closely studied to determine whether the tool meets the technical standards established through research, and
    • scores are computed based on nationally representative samples, allowing good comparisons with other children of the same age.

    To make a determination about a child’s risk status, it is useful to compare performance or behavior relative to a similar group of peers (e.g., Does this child perform or behave similarly to other English language learning boys his age?). Local (school-, district-, or state-level) or national norms can also be used. Local norms may be especially useful for identifying the lowest performing children, but national norms tend to be more stable across subgroups over time.

    Potential Barrier: My program is worried about misidentifying children.
    Solution: When children are misidentified, it can lead to missed opportunities for instruction and intervention services or reduced opportunities for learning and growth. False positives and false negatives can also be prevented through initial and ongoing training for staff on how to implement the tool with fidelity.

    • Invest the time to participate in the training recommended by the tool developers.
    • Arrange for your staff to have opportunities to practice administering the tool to children before the screener is formally implemented.
    • Provide a mechanism for those administering the screening to check in with each other, as well as with an expert in the tool or expert in assessment (e.g., program/school psychologist, psychologist through local university). These meetings help ensure that screening administrators are scoring consistently with each other and their actions and interpretations are in-line with the guidelines provided by the manual or best assessment practices.
      • For example, a staff member may have a question about whether or not a child’s behavior should be interpreted as aggressive. This question could be posed to the group, who may also witness such behavior. The group, ideally led by an expert or master teacher/practitioner or coach, should come to a consensus about whether that behavior should be considered aggressive.

    Potential Barrier: How can my program make sure the screening results and data are used in a meaningful way?
    Solution: It is important that you hear the reactions and requests of providers/teachers and other staff who work with the children on a day-to-day basis on what information and data would be useful to them in their work.

    • For example, consider sharing the screening options with your staff and having a conversation about the pros and cons of each tool. Consider structuring the conversation using the following prompts:
      • Is this information useful? Why or why not? If not, what would make this information more useful?
      • Can you see yourself using such information in your day-to-day work (e.g., planning group work or activities; diagnostic criteria)?
      • Can you think of an example of when this information will be used or useful?
    • Providers/teachers are more likely to participate in screening when the data
      • help to solve a high-priority problem or question,
      • do not require excessive effort to administer, and
      • are central to the core mission and values of the program/school.

    Potential Barrier: My program doesn’t have the resources or funding to conduct universal screening.
    Solution: Your local Child Care Resource and Referral agency can help you find local free and low-cost training opportunities. They can also help you find grants for additional funding and resources.

    • You can locate Child Care Resource and Referral agencies in your area through Child Care Aware’s search tool. Its State by State Resource Map can point you in the right direction for local resources on child care, health and social services, financial assistance, support for children with special needs, and more.
    • Another approach is to refer that child and their families to local early intervention service (EIS) providers or to the local school district. Your local EIS or school district will contact the family to arrange for an evaluation to determine if a child is eligible for infant and early intervention or preschool special education services.
      • The Birth to Five website summarizes the general steps that should be followed when a child is being considered for early intervention services.

    Potential Barrier: My program doesn’t have the right staff or enough staff to do universal screening.
    Solution: Consider building partnerships with your local universities and/or colleges. They may have the human resources necessary to implement screening into your program. Colleges of Education as well as Psychology Departments are filled with undergraduate and graduate students who would benefit from internships that will help them to translate academic knowledge from coursework into relevant professional skills. Having preservice teachers administer the assessment for course credit is cost-effective and provides students with the opportunity to work one-on-one with a child in a program setting. Educational psychologists would also benefit from such experiences, given the centrality of assessment in their training.

    Where do I go for more resources?

    • Looking for screening and assessment specific to social-emotional development? The Developmental screening and assessment instruments with an emphasis on social-emotional development for young children ages birth through five compiled by the Early Childhood Technical Assistance Center at the University of North Carolina, Frank Porter Graham Child Development Institute. This document contains a helpful list of instruments in a table that is organized by instrument name; provides a brief description, the appropriate age range on which the instrument can be used, the time it takes to administer the tool, how scoring works, and psychometric information (if available); and identifies the most appropriate party to administer the instrument (e.g., parent, practitioner, home visitor).
    • The Screening for social-emotional concerns: Considerations in the selection of instruments brief developed by the Technical Assistance Center on Social Emotional Intervention (TACSEI) includes profiles on several validated assessment and screening tools. The profiles include summaries of the properties of each tool:
      • Utility
      • Acceptability
      • Authenticity and equity
      • Congruence and sensitivity
      • Collaboration and convergence
      • Time to administer and score
      • Age range
      • Readability
      • Cost
      • Data management system
    • Looking for a comprehensive list of screening tools for young children? Check out Early childhood developmental screening: A compendium of measures for children ages birth to five, developed by the Office of Planning, Research and Evaluation (OPRE) and Administration for Children and Families (ACF) in the U.S. Department of Health and Human Services. This document also describes the standards that instruments need to meet in order to be considered “technically adequate” (read: reliable and valid). It also contains profiles of 16 individual measures. Information includes:
      • Background and purpose of instrument
      • Availability and cost
      • Training and other requirements for assessors
      • Information reporting system
      • Approaches to family/parent input
      • Options for use with special and diverse populations
      • Characteristics of the norming sample
      • Reliability and validity information
      • Follow-up guidance
    • In the process of selecting a developmental and behavioral screening tool to use as part of early childhood mental health consultation? Check out the Early childhood mental health consultation: An evaluation tool kit. The purpose of this tool kit is to increase capacity to evaluate the quality of early childhood mental health programs and services. Appendix C contains a list of outcome measures appropriate for providers/teachers to administer. If you are interested in childhood mental health consultation, please see Recommendation 2.1) of this guide.
    • Looking for more resources to promote universal screening? Go to the Birth to 5: Watch Me Thrive! website. Birth to 5: Watch Me Thrive! is a coordinated federal effort to encourage healthy child development, universal developmental and behavioral screening for children, and support for the families and providers who care for them. There are links to resources for families and different kinds of providers serving infants, toddlers, and young children.
    • Need training materials for your staff on developmental screening or resources for families? Go to the Centers for Disease Control and Prevention (CDC): Learn the Signs, Act Early website. This CDC site has resources for tracking children’s milestones from birth through age 5, including training modules for staff. If parents have concerns about their children’s development, suggested follow-up steps are provided.
    • Want a way to involve families in early identification of concerns? Easter Seals Offers a Free, Confidential Online Screening Tool: Ages and Stages Questionnaire, Third Edition (ASQ-3). This screening tool will help families guide and keep track of their children’s growth and development during the first 5 years. The questionnaire takes 10 to 20 minutes, and families are encouraged to come back and learn about their children’s development over time.
    • If you work alongside a school psychologist or partner with an educational psychologist and are interested in issues related to technical adequacy, please see Principle IV-C2 of the National Association of School Psychologists’ Professional Conduct Manual (2000).
    • If you are interested in reading more about assessments and screening tools, see the NWEA (Northwest Evaluation Association) blog.

    References

    American Education Research Association & American Psychological Association. (1999). NCME: Standards for educational and psychological testing. Washington, DC: American Psychological Association.

    Glover, T.A., & Albers, C.A. (2007). Considerations for evaluating universal screening assessments. Journal of School Psychology, 45, 117-135.

    Hepburn, K. S., Kaufmann, R. K., Perry, D. F., Allen, M. D., Brennan, E. M., & Green, B. L. (2007). Early childhood mental health consultation: An evaluation tool kit. Washington, DC: Georgetown University, Technical Assistance Center for Children’s Mental Health; Johns Hopkins University, Women’s and Children’s Health Policy Center; and Portland State University, Research and Training Center on Family Support and Children’s Mental Health. Retrieved from http://gucchd.georgetown.edu/products/ECMHCToolkit.pdf

    U.S. Department of Education and Health and Human Services (2015). Policy Statement on Inclusion of Children with Disabilities in Early Childhood Programs. Retrieved from http://www2.ed.gov/about/inits/ed/earlylearning/inclusion/index.html

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