Growing Together Project

Growing Together Project The Growing Together Project offers a new model of coordinated community based screening, assessment and intervention services for children aged 18-26 months in the communities of Red Deer, Rocky Mountain House and Olds.

Access: To Developmental Check-Ups Prior to The Project Developmental Check-ups: Were not available at immunization clinics Were just beginning at Parent Link Centres Were offered through home visiting programs Numbers of Developmental Check-Ups offered in 2006-2007 prior to Growing Together: 82 (aged 4 months to 5 years)

Access: To Developmental Check-Ups Growing Together has increased access to developmental check-ups for children. We have completed 1536 check-ups since the Project began. Current sources of check-ups include: Immunization Clinics (93% of all check-ups) Parent Link Centres Pediatric Rehabilitation Program Community Speech-Language Programs Home Visiting Programs

Access: To Developmental Check-Ups Sources of developmental check-ups continued… Physicians Red Deer Aboriginal Head Start Project Central Alberta Women's Emergency Shelter Native Friendship Centres Central Alberta Refugee Effort

Developmental Check-Up Access: What’s Working? Immunization Clinic Universal Access Strong Process in Place – resulting in an ASQ return rate of 82% for the Project Marketing HUTV video, posters, newspaper ads Request from Physicians For a “Red Flags in Child Development” poster Requests from Community Agencies To join in offering developmental check-ups

Developmental Check-Up Access: What Are The Challenges? Children’s Developmental Milestones: Lack of Parental Awareness Physician Engagement presentations, dinner, articles Aboriginal Community Engagement Meeting the Needs of Immigrant and Refugee Families language barriers, some mistrust of larger systems

Developmental Check-Up Access: How Are We Doing? Data collected from a Quarterly Mail Out Survey: 88% of parents stated that they were satisfied with the developmental check-up that they received for their child. 89% found the staff completing the check-up to be helpful 89% felt their questions were answered to their satisfaction at the developmental check-up 52% found the handouts provided to be useful.

Access: To Follow-Up Assessments Children who have areas of need identified on the ASQ in communication, gross or fine motor domains are offered a follow-up assessment with a Growing Together therapist. The Project target is for children to be seen for assessment within 4 weeks from their developmental check-up

Access: To Follow-Up Assessments A total of 516 children have been recommended for assessment with a therapist on the Growing Together team.(410 below cutoff on ASQ, 84 above cutoff with <10 words and 22 at parent request.) Most referrals were in regards to Speech-Language concerns.(SLP:420, OT:130, PT:104) 66% of children have been assessed within the 4 week time frame.

Assessment Access: What’s Working? Reduced assessment wait times Introduction of OT and PT assessment and intervention services in Olds Assessment outcomes: Children are being identified who require services, many more with moderate to severe areas of need than were anticipated. Age Appropriate: 52 children (17%) Mild Area of Need: 87 children (28%) Moderate Area of Need: 115 children (37%) Severe Area of Need: 54 children (18%)

Assessment Access: What Are The Challenges? Decline rate of 20% Typically by parents who are unconcerned or who want to wait until their child is older Larger than anticipated numbers of children being identified with areas of need Over-referral in the areas of gross and fine motor

Assessment Access: How Are We Doing? 310 children have had assessments completed by Growing Together. The parents of 105 children have declined assessments. Data from Phone Survey Completed Post-Intervention: 100% of parents surveyed felt that the wait time for assessment was short or acceptable. 100% of parents felt that their child’s assessment results were explained clearly to them.

Access: To Intervention Services Children with identified areas of need following their assessment are referred to follow-up intervention through Growing Together. 83% of the children assessed so far have been recommended for treatment intervention. Treatment Options Include: Growing Together Groups: Communication and Motor Hanen Groups: Communication Individual Intervention With: SLP, OT, PT Psychology Parent Coach Support (no assessment required to access)

Access: To Intervention Services All children receiving intervention services for communication, gross motor, fine motor or psychology needs are seen for a re-assessment 16 weeks after starting treatment. Treatment goals are established for each child at their assessment and are measured at the re-assessment.

Intervention Access: What’s Working? Timely intervention Using paraprofessionals to offer treatment groups. Reducing barriers to treatment childcare and transportation Parent Coach Role Gains made by re-assessment

Intervention Access: What Are The Challenges? Difficult to get numbers needed to offer groups in the rural areas Difficult to get enough children with the same need Offering individual treatment within 10 weeks if no group is available. Video-conferencing in year 3

Intervention Access: How Are We Doing? Growing Together has provided intervention to 147 children. 51 more children are currently awaiting start dates for treatment groups. The parents of 47 children have declined treatment intervention. Growing Together has completed re-assessments for 87 children. Almost 80% of those children showed significant improvement in skill levels by their re-assessment date (enough to move from a severe area of need to a moderate or mild one etc.). Almost 50% of the re-assessments completed have resulted in age appropriate outcomes for children in previous areas of need.

Intervention Access: How Are We Doing? 81% of children fully achieved their treatment goals by their re-assessment date. Of those that did not, 8% were greater than 50% achieved and 10% less than. Wait time reduced. Data from Phone Surveys completed Post-Intervention 100% of parents completing a phone survey stated that they were satisfied with the treatment their child received from Growing Together. (78% stating “very satisfied”) 100 % of parents stated that they would recommend the Growing Together Project to other families.

Intervention Access: How Are We Doing? Parent Coach data from completed phone surveys 100% of parents accessing Parent Coach support identified increased confidence in handling parenting issues. 90% of parents stated that their knowledge about parenting resources increased as a result of Parent Coach involvement

The Growing Together Partnership The Growing Together Project is a partnership between Alberta Health Services (formerly the David Thompson Health Region) and the Parent Link Centres in Red Deer (Family Services of Central Alberta), Rocky Mountain House (Evergreen Parent Link) and Olds (Mountainview Parent Link). Our Steering Committee has representation from each of these partners as well as from the local Child and Family Services Authority.

The Partnership What’s Working? The Common Beliefs of All Partners Need for improved access to services for children Family centred care Commitment of Front Line Staff Enthusiasm from Community Partners Creativity: different backgrounds, multi-disciplinary team

The Partnership What’s Working? Elimination of barriers due to Relationships Sharing work and problem solving (discharge surveys) Childcare ( FSCA and Collicutt) Workload (PHN completing check-ups) RSWs on the team Free ASQ training to partners in community Promoting Parent Link programs and ongoing developmental check-ups through Growing Together 12 Month Immunization Magnet (dual purpose) Reaching hard to engage families PRP Tummy Time promotion Growing Together Gazette

The Partnership What Are The Challenges? Difficulties that arise from two different systems coming together (Nonprofit and Larger Systems) Additional workload for already busy individuals Availability of partners

The Partnership How Are We Doing? The Partnership Survey addresses factors related to: Purpose Resources Communication Structure/Procedure Membership Environment

Questions? a