Follow the Yellow Brick Road: Monitoring Developmental Milestones

Transcription

1 Developmental Monitoring: Strategies, Resources and Tools to Inform Practice, Improve Early Identification of Developmental Concerns and Autism, and Share Concerns with Families Janet Kilburn, Act Early Ambassador, Vermont Department of Health Jamie Rainville, Autism Program Coordinator, Vermont Family Network Eileen McCoy, Early Essential Education Teacher, Richmond Elementary October 15, 2015

2 Follow the Yellow Brick Road: Monitoring Developmental Milestones Learn the Signs. Act Early. 2

3 You ll learn Why tracking each child s developmental milestones is important About free resources to help How you can help parents along the way Learn the Signs. Act Early. 3

4 Developmental Milestones Milestones are things most children can do by a certain age How a child plays, learns, speaks, acts, and moves You see these every day They offer important clues about each child s developmental health Parents may need guidance in recognizing All children develop at their own pace. Some will reach milestones slightly late or early. Learn the Signs. Act Early. 4

5 Tracking Milestones Helps You Understand each child s developmental progress Determine if a child needs extra help or additional challenges in a particular area Gather objective information for talking with supervisors and/or parents Tracking and sharing milestones with parents routinely will make conversations easier if there is ever a concern Learn the Signs. Act Early. 5

6 Tracking Milestones Helps Parents Understand that watching for milestones is important Better understand child development Pinpoint any potential developmental concerns Learn the Signs. Act Early. 6

7 Tracking Milestones Is Important Tracking a child s milestones gives you the chance to catch early signs of possible developmental delays so the child has the best chance to get the help he or she might need. Crawls Learn the Signs. Act Early. 7

8 Developmental Surveillance Developmental Screening Done by parents, teachers, health professionals Ongoing process-begins at birth Sample tool: Learn the Signs. Act Early. Milestone Checklists Both: Look for developmental milestones Important for tracking signs of development and identifying concerns Formal process Recommended by the American Academy of Pediatrics at 9, 18, and 24 or 30 months Done by health professionals and may be done by teachers with special training Uses a validated screening tool Sample tool: Ages and Stages Questionnaire

9 Milestone Checklists Checklists for ages 2 months through 5 years Milestones across 4 areas of development Help identify causes for celebration or concern Learn the Signs. Act Early. 9

10 Milestone Moments Booklet Learn the Signs. Act Early. 10

11 Milestone Moments Booklet Everyday use: Give each family a copy of the booklet Review milestones and development tips with each family regularly Discuss red flags if necessary Use the booklet as a reference Printing options: Find a local printer for printing Print directly from website using a desktop printer Learn the Signs. Act Early. 11

12 Fact Sheets Can Help You Developmental Screening What it is and why its important Information on Specific Conditions ADHD, Autism, Cerebral Palsy and more Tips for Talking With Parents Ideas about how to start conversation with parents if concerned Things to remember when having a difficult conversation Learn the Signs. Act Early. 12

13 Vermont Translations Act Early Milestones Brochure (see developmental milestones) Track Your Child s Developmental Milestones: Arabic, Bosnian, Burmese, English, French, Nepali, Somali, Swahili Autism Spectrum Disorder Fact Sheet

14 Multimedia Tools Post a button or widget to your website, blog, or social networking (find more information at

15 Milestone Widget Quiz Question: What milestone is this 6 month old showing? Answer: She s reaching for her toy! By the time most infants are 6 months old, they show curiosity about things and try to get things that are out of reach.

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17 Help Me Grow Vermont A system for improving access to existing resources and services for children (prenatal through age 8) Offers a population-based approach to early detection of children at-risk for developmental and behavioral problems and their linkage to programs and services. Proactively addresses families concerns about their child s behavior, development & learning by making a connection to community-based programs and services. Vermont will use the Help Me Grow system to implement effective, comprehensive early surveillance and screening for all children, and then link them to existing quality resources and programs.

18 Common Assumptions Children with developmental/behavioral problems are eluding early detection Many initiatives exist that provide services to young children and their families Child health and community providers face challenges in connecting vulnerable children with needed services Children and their families benefit from a coordinated, region-wide system of early detection and intervention for children at risk

19 Contact Center/ Access Point Learn the Signs. Act Early.

20 Imagine a world...where every parent had access to an accurate, up to date, comprehensive resource that was available 24 hours a day, every day - that this resource would: 1) answer parent questions about their children s development, and 2) Connect families to the necessary resources in their communities. Learn the Signs. Act Early. 20

21 Imagine a world...where every early care and learning provider had access to an accurate, up to date, comprehensive resource that was available 24 hours a day, every day - that this resource would: 1) answer parent questions about their children s development, and 2) Connect families to the necessary resources in their communities. Learn the Signs. Act Early. 21

22 There are NO wrong doors There are many ways families can connect to services Help Me Grow facilitates connections to a wide range of supports/services for a wide range of concerns using a personalized care coordination model. It connects families to parent education resources and services but does not provide services or replace other ways families access services. Parents and Pregnant Women Community Programs and Services Early Learning and Development Programs Child Health Providers Early Learning and Development and Other Community Providers HMG Contact Center Resources and Supports Maternal and Child Health Children s Integrated Services including Early Intervention and Family Support

23 Vermont s Next Steps Learn the Signs. Act Early. 23

24 Dial Learn the Signs. Act Early. 24

25 6 Community Provider and PCP Gets Feedback 1 Community Outreach Event or Well- Child Visit 2 Solicit Parent Opinions 5 Parent Connected to Resource Help Me Grow Care Coordination 4 HMG Child Development Specialist Connects to Resources 3 Contact Help Me Grow

26 Helping Parents to Track Milestones

27 Practice positive parenting skills: Learn how to handle common parenting challenges through fun, interactive activities, video s and more 27

28 FIVE PROTECTIVE FACTORS PARENTAL RESILIENCE SOCIAL CONNECTIONS KNOWLEDGE of PARENTING and CHILD DEVELOPMENT CONCRETE SUPPORT in TIMES of NEED SOCIAL and EMOTIONAL COMPETENCE of CHILDREN

29 Response to Survey Questions Parent Responses (%) As a result of my call to Child Development Infoline and the information and services I received: Extremel y or Quite a bit Not at all I have a better understanding of my child's development. 80% 4% 7% I am able to better understand and meet my child s needs. 79% 2% 5% I have a better understanding of services for me and/or my 81% 6% 1% child. I am able to access services if I need it. 84% 2% 2% There are people who can provide me with assistance when 87% 1% 4% I need it. I have people I can talk to for advice and emotional 79% 1% 4% support. There is improvement in my family s day-to-day 66% 5% 17% circumstances. My relationship with my child has improved. 71% 2% 27% My child s behavior has improved (e.g., mood, attitude, play, relationships with other children). N/A 45% 1% 32%

30 Key Lessons Understanding and tracking milestones are important parts of your job CDC has free resources to help. Visit today! Involve parents in tracking development Acting early can make a real difference Dial to get connected! Questions? Janet.Kilburn@vermont.gov Learn the Signs. Act Early. 30

31 Key Deficits of Autism Spectrum Disorder 1. Communication 2. Social communication and interactions 3. Restrictive/repetitive behaviors

32 Communication Delayed speech and language skills Repeats words or phrases over and over (echolalia) Reverses pronouns (e.g., says "you" instead of "I") Gives unrelated answers to questions Does not point or respond to pointing Uses few or no gestures (e.g., does not wave goodbye) Talks in a flat, robot-like, or sing-song voice Does not understand jokes, sarcasm, or teasing Source:

33 Social Communication Problems with coordination of eye gaze Manipulation of others body Lack showing off Lack of social referencing Lack of protodeclarative pointing Communication is primarily used for requesting, rejecting, and protesting Source:

34 Social Interactions Does not respond to name by 12 months of age Avoids eye-contact Prefers to play alone Does not share interests with others Only interacts to achieve a desired goal Has flat or inappropriate facial expressions Does not understand personal space boundaries Avoids or resists physical contact Is not comforted by others during distress Has trouble understanding other people's feelings or talking about own feelings Does not pretend in play (e.g., does not pretend to "feed" a doll) Source:

35 Stereotyped/Repetitive Behaviors Lines up toys or other objects Plays with toys the same way every time Likes parts of objects (e.g., wheels) Is very organized Gets upset by minor changes Has obsessive interests Has to follow certain routines Flaps hands, rocks body, or spins self in circles Source:

36 Other Symptoms Hyperactivity (very active) Impulsivity (acting without thinking) Short attention span Aggression Causing self injury Temper tantrums Difficulties with eating and sleeping Atypical mood or emotional reactions Lack of fear or more fear than expected Sensitivities to the way things sound, smell, taste, look, or feel Source:

37 Earliest signs American Academy of Pediatrics pinpoints the following risk factors: No babbling by 12 months No pointing or other gestures by 12 months No single words by 16 months No 2-word phrases by 24 months Loss of any language or social skills at any age

38 Resources Children s Integrated Services-Early Intervention

39 DON T WAIT! Build social routines into changing, dressing, washing hands (add songs, social games, joint attention and object play routines) Find ways within each routine to have the child be actively engaged When playing with the child, play face-to-face and create a back and forth interaction of sharing, taking turns, attending to one another and communicating Keep language simple Consider using visuals (ex. first/then or schedule) Transitional warnings Consistent routines Consider each child s sensory processing Look for an opening to discuss options with family

40 Questions?