Transcript Early Intervention Study

Early Intervention Study
Early Intervention Task Force Members:
Carla Tanner, Ed.D., CSC
Leslie Gudgel, Laura Dester Shelter, Neonatal Follow Up Clinic
Kim Wofford, Parent Advocate; Laura Dester Shelter
Suzie Drover, HeadStart
Lyn Lucus, Family and Children Services, working with HeadStart
Jan Figart, CSC
Sherlyn Walton, TARC, Family Support Coordinator
Zaida Castro-Kepford, TARC, Hispanic Outreach Specialist
Ellen Schmeder, SoonerStart Regional Director
Gina Ferman R.N., Regional Coordinator, Sooner Success, University of
Oklahoma
DeeAnn Brown, Resource and Referral Specialist, CCRC
Brenda Butcher, Tulsa Health Department, Child Guidance Program
Colleen Ayers-Griffin, Tulsa Healthy Start, CSC
Barbara Fyfe, Parent Child Center of Tulsa
Early Intervention Study
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Purpose
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Early Intervention Task Force
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Target Population
What is Early Intervention?
WHAT IS EARLY INTERVENTION?
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Early intervention applies to children of school age or
younger who are discovered to have or be at risk of
developing a handicapping condition.
Early intervention consists of the provision of services that
such children and their families may need, to lessen the
effects of the condition.
WHY IS EARLY INTERVENTION IMPORTANT?
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Developmental disabilities are present in 17 percent of
American children; with as many as one in eight children
having mental retardation and /or a developmental disability.
However, many children with behavioral or developmental
disabilities are missing vital opportunities for early
identification and intervention.
IS EARLY INTERVENTION
COST EFFECTIVE?
The available data emphasize the long-term cost
effectiveness of early intervention. On a shortterm basis, Early Intervention is more costly
than traditional school-aged service delivery
models. However, there are significant examples
of long-term cost savings that result from early
intervention programs.
Cost Effectiveness of Early
Intervention
Perry Preschool Project found that when
schools invest about $3,000 for 1 year of
preschool education for a child, they
immediately begin to recover their investment
through savings in special education services.
Early Intervention In Oklahoma
Approximately 17% percent of Oklahoma children have a disabling
condition.
 We identify a small percent of these children early enough to
provide an appropriate Early Intervention program.
 Sooner Start child count in 2003 was 2.24% of the children birth
to 36 months of age.
 Tulsa Public Schools enrollment 2003 data indicates that 17
percent of children in elementary schools have a disability.
 Less than 50% of the children are identified as having a
problem before starting school.
Why is there a disparity?
Two factors were identified as contributing to
the disparity between estimated populations
and those served.
–The
role played by pediatric practitioners in
screening, surveillance, and referral to early
intervention services, and
–Barriers faced by parents in seeking early
intervention services for their children with
developmental and/or behavioral delays.
Pediatric Practitioners
are a Vital Link
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Pediatric Practitioners play a substantial role in
identifying children with development and/or
behavioral disabilities and referring these children for
early developmental intervention.
Historically, however, pediatricians have only been
minimally effective as Child Find linkage
Research indicates that physicians often do not
conduct regular developmental screening and
surveillance
Physicians often adopt a “wait and see” attitude.
DEVELOPMENTAL SURVEILLANCE,
SCREENING AND DIAGNOSTIC
EVALUATIONS
WHAT IS DEVELOPMENTAL SURVEILLANCE AND
SCREENING?
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Developmental surveillance is the routine monitoring and
tracking of developmental milestones of all children at well-child
visits to identify those at risk for any type of atypical
development.
Screening refers to the use of standardized instruments applied
to a population to identify those children at risk for a
developmental disorder.
WHY ARE DEVELOPMENTAL
SURVEILLANCE AND SCREENINGS
IMPORTANT?
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Many children with developmental disabilities miss the
opportunity for early detection and intervention.
17% of children have a developmental or behavioral disability.
Less that 50% of these children are identified as have a
problem before starting to school.
Parents want and seek guidance from their personal care
provider, but 65% of pediatricians feel inadequately trained
children’s developmental status.
No national data tracking the use of developmental
assessments and/or referral to early intervention services.
WHEN AND WHERE SHOULD
SCREENINGS HAPPEN?
Screening relies on being able to access parental
participation.
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Screening can occur at a time when other assessments are
being done.
Screening should be an ongoing process and occur at
regular intervals.
Screening can be provided when children visit a primary
care or other medical provider to receive services such as
immunization.
Screening can be done by other providers during routine
visits or for the specific purpose of screening.
WHAT IS A DIAGNOSTIC
EVALUATION?
A diagnostic evaluation is a multifaceted
process involving assessments, interviews, and
observations.
A comprehensive evaluation includes:
Review of relevant background information.
Parent/caregiver interview.
Child health history – prenatal and perinatal histories,
past medical history.
Developmental and behavioral history.
Parental Barriers Identified
in Early Intervention
Parent Survey and Focus
Groups
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Parents expressed appreciation for the services.
Concerns about how confusing it can be when
accessing other services.
Lack of access to programs that have income
eligibility criteria was the most significant barrier
identified by parents.
Parents are facing catastrophic medial costs
Stress and constant demands result in a high
divorce level among parents of children with
disabilities.
Provider Concerns Identified
in Early Intervention Provider
Survey and Focus Groups
Growing numbers of special needs children who are Hispanic
and whose families do not speak English.
– Teachers and Early Intervention providers were concerned
because of the inability to communicate with the parents.
– The providers are concerned with the lack of trained
Hispanic early intervention professionals.
– Fear that Hispanic families did not seek Early Intervention
services for their special needs children due to fear of their
illegal immigration status being identified.
Lack of Communication Between
Providers
A consistent comment by providers was that
they didn’t communicate with each other. If a
parent needed additional services, they didn’t
feel confident that they were knowledgeable
enough to refer them to available services.
Early Intervention
Study Recommendations
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Promote the importance that all infants and young children
should be screened for developmental delays.
Recommended screening schedule
Birth
 2, 4, 6, 9, 15, and 18 months
 2, 3, 4, 5, and 6 years of age.
In Tulsa County, that would be:
 approximately, 9,300 at birth
 55,800 screens in the first 2 years
 46,500 screens from age 2 years through 6 years of age
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Screenings should address areas including: physical (fine and
gross motor, vision, hearing), cognitive, communication
(expressive and receptive), adaptive, social emotional.
Early Intervention
Study Recommendations
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Educate the community
Collaboration
Develop a Data Tracking System.
Identify Capacity
Develop a Strategic Plan
Collaborate with the Hispanic Community