Learn the Signs. Act Early.

Transcription

1 CENTERS FOR DISEASE CONTROL AND PREVENTION S CHLA Provider Training Fran Goldfarb, Danny Azucar, Bozena Barton, and Rachel Marshall February 16, 2015

2 Pre-Training Surveys We appreciate your time and your feedback! 2

3 Presentation Objectives 1. Discuss the campaign and materials 2. Review the AAP Guidelines and California screening statistics. 3. Identify barriers and solutions to providing anticipatory guidance 4. Review local resources for early intervention. 3

4 LTSAE: Background A CDC Campaign Development o Transtheoretical Model o Marketing Mix (4 P s) Target Populations o Parents o Health Professionals o Early Educators 4

5 Let s talk about Your essential, irreplaceable role in developmental monitoring and early identification FREE resources to make discussing screening and development with parents easier 5

6 AAP Developmental Screening Guidelines The AAP recommends developmental screening at well-child visits All children screened to assess their general development at 9,18 and 24 or 30 months All children screened for ASD at 18 & 24 months 9-Month-Old Child 18-Month-Old Child 24-Month-Old Child 6

7 Screening Statistics 1 in 6 children has a developmental disability 12-16% U.S. children have a developmental or behavioral disorder 1 Prompt identification can spur specific and appropriate therapeutic early interventions 2 Fewer than 30% are identified by clinician judgment before entering school 3 AAP Policy Statement, Pediatrics 2001 AAPA Policy Statement, Pediatrics 2006 Sand, et al. Pediatricians reported practices regarding pediatric screening. Do guidelines work? Pediatrics

8 Discussion What are your barriers? 8

9 Reported Barriers to Conducting Standardized Developmental Screening for Children 0-3 Years of Age Time limitations in current practice 89% Proportion of Pediatricians Reporting as Barrier to Screening, Lack of medical office staff to perform screening Inadequate barriers (ie, physician or staff members cannot speak language of family) 49% 46% Lack of confidence in ability to screen 19% Lack of treatment options for positive screening results 10% Lack of knowledge regarding referral options for positive screening results 9% Sand, et al. Pediatricians reported practices regarding pediatric screening. Do guidelines work? Pediatrics

10 LTSAE Materials Developed by CDC, in conjunction with the AAP Objective, researchbased Make visits more productive and more time-efficient Empower parents to become better partners in tracking development 10

11 LTSAE Materials Completely free Can be ordered online and mailed to your office for free. Some resources are printable online. 11

12 LTSAE Materials Designed for use by: Parents o Books, growth chart Professionals o How to discuss milestones o Tip sheets Parents and Professionals Together o Tracking tools 12

13 Campaign Posters Appropriate for: Waiting room Office wall It s time to change how we view a child s growth. 13

14 Waiting room Milestones Brochure Select milestones at a glance for ages 6 months to 4 years 14

15 Milestone Moments Booklet 15

16 Milestone Moments Booklet Free and customizable Can be ordered on the website Helps parents prepare for wellchild visits Milestone checklists 2 months 5 years Four domains of development Developmental red flags Activities to foster development 16

17 Milestone Checklists Free and printable onlinehttp:// arly/downloads.html#checklists Well Child Visits A checklist to be given at each corresponding well child visit 2 months through 5 years Same information as milestone booklets Parent tested Spanish translation on reverse 17

18 Story Time Celebrates typical development Age-appropriate activities Currently developing books for 1 and 2 year olds 18

19 Growth Charts fg Select milestones at a glance for ages 1 month to 5 years English and Spanish on reverse 19

20 Inglés y Español Additional languages: Arabic Korean Portuguese Somali *some materials 20

21 Explaining the Failed Screening Prepare Parents o Prior to administering screening tool, have staff explain to parent why they are being asked to complete the questionnaire. o Ensure parents understand what is happening and better prepare them for the results. 21

22 Explaining the Failed Screening Remember Purpose of Screening o Screening does not diagnose developmental disorders Use language consistent with the child s need for more comprehensive assessment o Phrases like the following can be used: may be delayed, this suggests, may be having difficulties compared to other children his age, may be behind other kids, seems to be learning more slowly, could be having difficulty learning. 22

23 Explaining the Failed Screening Provide referral telephone numbers and descriptions of services o Program descriptions enable families to visualize participation and increase chance they actually will participate Identify social worker to help families who are likely to have multiple barriers to following through with recommendations o E.g. single parents with low incomes and multiple life stressors 23

24 Explaining the Failed Screening fg Follow carefully those children who fail screens but don t qualify for services o Referrals to services for children at risk, e.g. Head Start, quality child care, after-school tutoring, and summer programs When children pass screening, offer praise and reassurance that learning and development appear to be coming along well. o Parents also may need additional training or social work services. AAP Section on Developmental and Behavioral Pediatrics Newsletter, Fall

25 Early Intervention Resources fg Regional Center Services Early Start 7 Regional Centers in LA County 21 Regional Centers in California Children 0-3 IDEA Part C Evaluation Intervention o Family-centered, o Natural environments No referral necessary No existing diagnosis necessary 25

26 Family Resource Centers Early Start Family Resource Centers o Within and outside regional centers o CHLA Family Resource Center 93/k.98C2/Family_Resource_Center Patient_H ealth_education Program_Support.htm#.VNpA XV47ZhI 26

27 Additional Resources Medical Insurance Benefits California Children s Services (CCS) Children older than 3 o Special Education IDEA Part B o Regional Center Eligibility: ASD, CP, ID, or Epilepsy 27

28 Free Continuing Education Free online courses eligible for CME, CNE and CEU credits MOC (Part 2) Approved Identifying Diagnosing Managing In-Class Curriculum Teaching Guide Video Library 28

29 Autism Case Training Early Warning Signs Screening Communicating Concerns Making an ASD Diagnosis Early Intervention and Education Treatments for ASD ASD-Specific Anticipatory Guidance 29

30 LTSAE Website c.gov/ncbddd /actearly/inde x.html 30

31 Discussion It is time to change the way we view a child s growth A 4 year old with Autism, was once a 3 year old with autism, was once a Everyday you see them reach milestones, this CD will you spot a few more 31

32 Post-Training Surveys We appreciate your time and your feedback! 32