Preschool Developmental Screening in Mill Woods An update on the Edmonton project

2 “Begin early, intervene often, intervene effectively.” (Ludwig and Sawhill, Brookings Institute) Why screen?

3 Alberta Health and Wellness RFP in November 2006, awarded April 2007 Budget $7.9 million over 3 years (to Dec. 2009) across Alberta Provincial Request for Proposal (RFP) Provincial Request for Proposals

4 4 East Central David Thompson Chinook Capital Palliser Five projects: Provincial Request for Proposals

5 Provincial Alberta Centre for Child, Family and Community Research Change in access to screen/service Impact on the workforce Developmental outcomes for children Local Early Childhood Measurement and Evaluation Resource Centre (ECMERC) Concurrent study of ASQ Validity with cultural groups Evaluation

6 ASQ Sample ASQ_Questionnaire.pdf Summary Sample eCHSA Month ASQ Information Summary Form.pdf ASQ

Build parent and community capacity 2. Develop an integrated multi-disciplinary, cross-sector parent support network Goals

8 8 Mill Woods in Edmonton Urban Culturally diverse Rapid growth Community

9 9 Alberta Health Services Community Health Services Child Health Clinics Edmonton Early Intervention Program Regional Pediatric and Mental Health Speech and Language Services Community Rehabilitation - Pediatric Occupational Therapy Glenrose Rehabilitation Hospital Go! Child and Family Early Intervention Service Stollery Child Health Partners

10 Child and Adolescent Services (CASA) Mill Woods Community Mapping and Beyond Multi-Cultural Health Brokers Child and Family Services Authority – Region 6 Millwoods Family Resource Centre (Parent Link) Edmonton Public Schools Edmonton Catholic Schools ABC Head Start Partners

11 “.. ensure that we’re all saying the same messages … starts to promote child development in Millwoods.” “… the kids come and they’re having a great time and the parents are there and they’re asking questions and the parents are connecting … that’s how you build community.” “Our collaboration with MFRC and MCHB with OT and Speech make it easier to serve families…” Partner voices

12 Process Recruitment 18 month old 36 month old Cultural adaptations Parent Capacity Building Community Capacity Building

13 Universal targeted clinical Capacity building Coaching Strengths based, child led Cultural conversion 13 Key Elements

14 Screening No Concerns Concerns ASQ, Parent or Staff Letter Explain what screening is/is not Review results, invite to learning events, community groups Community Resources information In-Person Follow-up Explain what screening is/is not Review results, offer learning event, community groups and home visit Intervention and Follow-up Key worker home visit do family interview, culture gram, secondary screens Results to Physician (with consent) maximum 2 contacts; individualized strategies, provide resources, workshop, community resources Referral Well Child Clinic Recruitment - 18 month Re-screen at 36 months

15 Concerns 310/1130 screened Recruitment Results – 18 month

referrals from 310 concerns Clinical Referrals – 18 month

17 Parent Voices “Opened my eyes to the things my child was doing well” “I enjoyed the idea of having the ASQ done in the health clinic; something while you are sitting there and waiting already.” “If you have not come or found me in this way I would have been lost and I wouldn’t have known what to do with my child”.

18 Screening No Concerns Concerns ASQ, Parent or Staff On-site Results Explain what screening is/is not Review results, invite to learning events, community groups Community Resources information In-Person Results Explain what screening is/is not Review results, offer learning event, community groups and home visit Intervention and Follow-up Key worker home visit do family interview, culture gram, secondary screens Results to Physician (with consent) maximum 2 contacts; individualized strategies, provide resources, workshop, community resources Referral 3 Year Old Celebration Recruitment - 36 month

19 Concerns 35/162 screened Recruitment Results - 36 month

referrals from 35 concerns Clinical Referrals – 36 month

21 Parent Voices “The best part was that I learned my child can do some things I never knew he could.” “It was wonderful to be able to get information from the professionals and get our questioned answered right there!” “This rocks! I wish there was something like this for older kids!”

22 ASQ as a learning tool… 97 % increased knowledge 98% better informed about child’s development 94% increased resource knowledge Parent voices

23 Recruitment – Cultural Adaptations Concerns 36/69

24 Community Referrals – 74 Clinical Referrals – 5/36 (14%) Secondary screens – 8 (20%) Clinical Referrals – Cultural Conversion

25 Parent voices “… So they want the whole family to be the part of it, Grandma, Grandfather, sister in law, mother in law. I have done the screen where the whole family sitting in the circle. Everybody’s picture is in. …Everybody is part of that child development”

26 Process Recruitment 18 month old 36 month old Cultural adaptations Parent Capacity Building Community Capacity Building

27 Parent Capacity Building

28 Parent Capacity Building Coaching model Child Parent Key worker specialists Learning Events Integrated key messages

29 Learning Events 339 parents attended 95% increased ECD knowledge 100% will try strategies 88% increased knowledge of resources Parent Capacity Building Results

30 Capacity Building Key messages for parents and community.

31 Capacity Building I learn through everyday activities. I learn in my community.

32 Capacity Building I learn through my interests.

33 Capacity Building I learn by people responding to me

34 Community Capacity Building Common messages across partners Community embedded services Community displays

35 The journey continues … questions?