Early Childcare Provider TrainingModule 2: Developmental Screening and

RegulationsNvLEND

Presenter- Dr Mario Gaspar-DeAlba Developmental Behavioral Pediatrician University of Nevada School of Medicine Las Vegas

Nevada Act Early

• Review Child Care Regulations that address child screenings/assessments

• Learn about the Ages and Stages Questionnaire, 3rd Ed.

• Become familiar with the Centers for Disease Control (CDC) Milestone Booklets

• Learn about the Modified Checklist for Autism in Toddlers (M-CHAT)

• Review Ages and Stages Questionnaire - Social and Emotional (SE)

Learning Objectives

State of Nevada Child Care Regulations

• All child care facilities are required to assess children within three months of enrollment and twice per year.

• Assessments include the use of: Portfolios, observations, checklists, rating scales, and screening tools.

• The purpose is to monitor and support the learning and development of each child enrolled in the facility.

• Many facilities use Ages and Stages Questionnaire, Centers for Disease Control developmental checklists, and/or portfolios.

Regulations….cont.• Once the information is obtained from the

assessment the child care providers use the information to individualize curriculum.

• If there are concerns about a delay, the child care provider needs to discuss this with the parent and refer the parent to a professional for diagnostic assessment.

• If a child is already receiving services due to a developmental delay, the facility can request a copy of the assessment from the parent to incorporate the developmental goals into their curriculum.

Child Development• Child development addresses how a child

is able to do more complex things as they get older.

• It is more than just physical growth, which refers only to a child getting bigger in size.

• Children grow, change and acquire a broad range of skills starting at birth and continuing throughout their lives.

Child Development…cont.• Development is a continuous process.• Each new aspect of development includes

and builds on the skills a child has already learned.

• Each skill is the necessary foundation to the next set of skills a child learns.

Developmental Milestones• Developmental milestones are the things

most children can do by a certain age. • The skills children learn fall into several

major areas: Social/Emotional, Language/Communication, Cognitive (learning, thinking, problem-solving), and Movement/Physical Development.

Developmental Milestones…cont.• Children develop in predictable steps

within an age-range in months or years. • Although each milestone has an age level

associated with it, the actual age when most children reach that milestone can vary quite a bit.

Developmental Screening

• Developmental screening helps doctors, nurses, and child care providers tell if a child is learning basic skills when they should, or if they might have problems.

• It is important that parents talk with their child’s doctor at every visit about their child’s development.

Developmental Screening…cont.

• Parents can discuss the milestones their child has reached and ask the doctor what to expect next.

• Parents and child care providers can learn how a child is developing by watching how they play, learn, speak and behave.

Ages & Stages Questionnaire:Edition 3 & Social-Emotional

• Review both general Questionnaire & Social Emotional Questionnaire

• See the video entitled Developmental Screening Works below.

Ages & Stages Questionnaire

• Screens for developmental delays: 1 month to 5½ years.

• Recommended by the American Academy of Neurology, First Signs, The Child Neurology Society, and CDC.

• Takes 10-15 minutes and comes in English and Spanish.

• 21 age appropriate questionnaires2 month intervals from 2 months-24

months3 month intervals from 24 months to

36 months6 month intervals from 36 months to

60 months

Ages & Stages Questionnaire..cont

• Looks at communication, gross motor, fine motor, problem solving, and personal social skills.

• Can be administered by a parent, paraprofessional, or professional.

• For example: Observe the child during snack or lunch is associated with the following 24 month ASQ Personal-Social Question– Does your child drink from a cup, putting it

down with little spilling?

Ages & Stages: Social and Emotional Screening

• See the video entitled Ages & Stages – Social/Emotional below

Ages & Stages:Social and Emotional

Questionnaire• A screening tool that is designed to identify

children who may be at risk for social and emotional difficulties.

• It is a series of 8 questionnaires that correspond to age intervals from 3 months to 6 years.

• It contains questions about self regulation, compliance, communication, adaptive behaviors, autonomy, affect, interactions with people.

• The screening takes about 10-15 minutes to complete and it can be completed by parents, professionals, or paraprofessionals.

Ages & Stages:Social and Emotional

Questionnaire• This is not a diagnostic screening but instead a tool

to help identify children who would benefit from further evaluation or intervention.

• The questions are open ended and the answers are based on feelings and opinions about the child’s behaviors.

• For example for children 33 – 41 months:– Does your child like to be hugged or cuddled?– Does your child seem happy?– When upset does your child calm down within 15

minutes?– What are things you enjoy most about your child?

CDC Milestone Moments Booklet

• The Milestone Moments booklet is a wonderful resource that can help you check the milestones a child has reached by a certain age.

• The booklet has lists of the important milestones to look for ages 2 months to 5 years.

• NvLEND has adapted the Milestones Moments booklet that was developed by the CDC and added resources specific to our state of Nevada.

Milestone Moments Booklet…cont.

• Each age is divided into checklists in the following areas of development:

Social/Emotional Language/Communication Cognitive (learning, thinking, problem-

solving)Movement/Physical Development

CDC Milestones Website: www.cdc.gov/ncbddd/actearly/milestones/

Milestone Moments Booklet…cont.

• Next to the checklists are things that parents can do to help each baby’s and child’s development and a list of things to be aware of.

Milestone Moments Booklet…cont.

• If you are a child care provider it is important to let a parent know if their child is not doing one or more of these things.

• The last section of the Milestones Moment booklet has a list of resources and agencies to refer to for children in Nevada ages birth through three years old and children ages three plus years.

Modified Checklist for Autism in Toddlers (M-CHAT)

• The M-CHAT is an autism screening tool and is to be administered by a trained health care professional.

• The M-CHAT is designed to identify children 16 to 30 months of age who should receive a more thorough assessment for possible early signs of autism spectrum disorder (ASD) or developmental delay.

• The American Academy of Pediatrics (AAP) recommends that all children receive autism-specific screening at 18 and 24 months of age in addition to regular developmental screening.

M-CHAT…cont.• The M-CHAT is one of the AAP

recommended tools and can be administered at well-child visits.

• Parents can ask their pediatrician to provide an M-CHAT at a well-child visit.

• If the parent and their child’s physician agree that further screening is needed, he/she can request a free developmental assessment for their child through Nevada State Early Intervention Services.

Referral for Birth to 3• The contact information for the three State

Early Intervention offices in Nevada are: Nevada Early Intervention South 702-486-9200Nevada Early Intervention Northwest 775-688-1341Nevada Early Intervention Northeast 775-753-1214

Referral Birth to 3…cont.• Early Intervention sites offer further

evaluations of a child free-of-charge. • These developmental assessments may

involve a physical exam, a cognitive exam, a hearing assessment, and a speech and language assessment.

Other Autism Screening Tools

• Childhood Autism Rating Scale, 2nd Ed.• Social Communication Questionnaire• Gillian Autism Rating Scale, 2nd Ed• Please note: These can be provided by

other healthcare professionals for you and or the parent to complete.

Professionals for Evaluation Purposes

• Speech-Language Pathologist• Occupational Therapist• Physical Therapist• Child Developmental Specialist• Psychologist• Developmental Behavioral Pediatrician• Psychiatrist• Neurologist

Acknowledgements

SourcesRobins, D., Fein, D., & Barton, M. (1999). m-chat. Retrieved from https://www.m-chat.org/index.php

Allen, K. E., & Marotz, L. R. (2003). Developmental profiles pre-birth through twelve. (Fourth Edition ed.).Clifton Park: Delmar Learning.

NvLEND. US Department of Health and Human Services, Centers for Disease Control and Prevention. (n.d.). Milestone moments (220788)

Additional Training Opportunities

• Module 1- What is Autism?• Module 2 - Developmental Screening (ASQ, CDC

Milestones Booklet, MCHAT); Regulations• Module 3 - Additional Information Regarding

Conducting Developmental Screenings• Module 4 - Referral and Diagnostic Process; Working

with Parents• Module 5 - Individual Family Service Plans;

Individual Educational Plans• Module 6 - Strategies for Inclusion• Module 7 - Other Neurodevelopmental Disabilities• Module 8 - Dealing with Challenging Behaviors