Early Intervention Study

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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

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Early Intervention Study

• Purpose
• Early Intervention Task Force
• Target Population

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What is Early Intervention?

• WHAT IS EARLY INTERVENTION?
• 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?
• 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.

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IS EARLY INTERVENTION COST EFFECTIVE?

• The available data emphasize the long-term cost
  effectiveness of early intervention. On a
  short-term 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.

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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.

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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.

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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.

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Pediatric Practitionersare a Vital Link

• 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.

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DEVELOPMENTAL SURVEILLANCE, SCREENING AND
DIAGNOSTIC EVALUATIONS

• WHAT IS DEVELOPMENTAL SURVEILLANCE AND SCREENING?
• 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.

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WHY ARE DEVELOPMENTAL SURVEILLANCE AND SCREENINGS
IMPORTANT?

• 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 childrens
  developmental status.
• No national data tracking the use of
  developmental assessments and/or referral to
  early intervention services.

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WHEN AND WHERE SHOULD SCREENINGS HAPPEN?

• Screening relies on being able to access parental
  participation.
• 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.

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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.

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Parental Barriers Identifiedin Early
InterventionParent Survey and Focus Groups

• 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.

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Provider Concerns Identifiedin Early
Intervention ProviderSurvey 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.

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Lack of Communication BetweenProviders

• A consistent comment by providers was that they
  didnt communicate with each other. If a parent
  needed additional services, they didnt feel
  confident that they were knowledgeable enough to
  refer them to available services.

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Early InterventionStudy Recommendations

• 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
• Screenings should address areas including
  physical (fine and gross motor, vision, hearing),
  cognitive, communication (expressive and
  receptive), adaptive, social emotional.

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Early InterventionStudy Recommendations

• Educate the community
• Collaboration
• Develop a Data Tracking System.
• Identify Capacity
• Develop a Strategic Plan
• Collaborate with the Hispanic Community