Screening and Monitoring Programs for Children Who are At Risk National OSEP Early Childhood Conference February 7, 2005 Connecticut - Linda Goodman, Part C Coordinator Idaho - Mary Jones, Part C Coordinator Nevada - Carla Javier, Psychological Developmental Counselor

Part C Eligibility Criteria and Eligible Children Served Connecticut- moderate eligibility 12/1/03 3,701 (2.96%) No at-risk Idaho - moderate eligibility 12/1/03 1,490 (2.44%) No at-risk Nevada - narrow eligibility 12/1/03 930 (.94%) No at-risk

Connecticut Why Monitoring? Moderate eligibility chosen in 1990 to work towards implementation. ICC was concerned that children would be lost Minor eligibility changes in FY04 concerned lead agency Agency with mission to serve children at-risk for abuse funded to assist children at-risk for delay birth-5.

Connecticut What do we do? For children found not eligible or who exit prior to 3: ASQ administered by statewide intake office. Low scores prompt call to recommend re-referral to Birth to Three. For children in categories that were formally eligible: Quarterly face-to-face visits by ei professional to informally monitor development and re-evaluate, if needed.

Connecticut ASQ Data FY00 1,277 180 (14%) 134 (10%) FY01 1,331 Number Monitored Re-referred Eligible FY00 1,277 180 (14%) 134 (10%) FY01 1,331 213 (16%) 147 (11%) FY02 1,326 155 (12%) 108 ( 8%) FY03 1,383 132 (10%) 95 ( 7%) FY04 1,685 136 ( 8%) 95 ( 6%)

Connecticut % of re-referrals eligible % of all referrals eligible FY00 74% 70% FY01 69% FY02 72% FY03 71% FY04 65%

Connecticut Follow-along Data FY04 104 children qualified 7 families declined 38 (37%) were found eligible in FY04 (17) or in FY05 (21) FY05 34 additional children qualified First 6 1 family declined Months 6 (18%) were found eligible so far

Screening and Monitoring Programs for Children Who are At Risk Idaho

Idaho: History Moderate eligibility set to work towards implementation in 1991. ICC wanted tiered levels, a safety net, for children at risk: tracking and monitoring contracts with Pub. Health Dist. Minor eligibility changes in FY03 led to some previously at-risk to be eligible Addition of ASQ-SE to be sent at two intervals during enrollment in monitoring.

Idaho What do we do? Referrals to monitoring from hospitals, doctors, Early Head Start, CFS, WIC, etc. For children found not eligible or who exit prior to 3 ASQs sent by mail with follow up calls if concerns noted during scoring Average return rate of ASQs: 36%

Idaho ASQ Data PY00 5,741 9.9% 17.5% PY01 5064 8.5% 15.2% PY02 4,697 # Monitored % Birth-3 Population Eligible, previously Enrolled in Monitoring PY00 5,741 9.9% 17.5% PY01 5064 8.5% 15.2% PY02 4,697 7.7% 14.4% PY03 5,508 9.05% 16.5% PY04 6,483 10.6% 14.9%

ASQ considerations Data on percent previously monitored who become eligible: decreasing Other referral sources increasing and increase in the total numbers identified Concerns: Return Rate of ASQ’s Non-readers

ASQs, continued Secondary benefits of questionnaires: Increases parental knowledge of developmental expectations Age appropriate activity lists are included in each mailing Provides contact information for self-referral if concerns arise Linkage with Early Head Start and Parents as Teachers-face to face administration of ASQs

Multifaceted Approach to Child Find Developmental Monitoring needs to be one component of child identification Community Screening-diverse models Monthly clinics, multi-agency Multi-county Health Futures days Linked with pre-school screening Outreach, examples: Changing Booths at County Fairs Exhibits at Malls, Family Fun Days Regular Program on Spanish Radio

STATE OF NEVADA HEALTH DIVISION

2003-merger of two agencies serving 0-3 population into one Centralized services under state agency leads to teaming Merged into Health Division tasked with multiple services including early intervention Developmental Pediatrics Nutrition Audiology Specialty Clinics (metabolic, FAS, genetics, & craniofacial) for birth to 21 NICU developmental follow-up Part C early intervention

2004 SaM DATA January February March April May Intakes NICU DCFS CPS 44 43 36 51 37 NICU 11 17 26 19 DCFS 7 5 10 2 CPS 3 8 Dr. Self 6 4 Other 1 Monitoring 21 = 48% 20 = 47% 27 = 75% 36 = 71% 30 = 81% Referrals to Part C 15 = 34 % 19 = 44% 8 = 22% 15 = 29% 5 = 14% Exited 8 = 18% 4 = 9% 1 = 3% 0 = 0% 2 = 5% Total in SaM 99 117 305