1. Evaluating the Effectiveness of Early Identification and Intervention
Kathryn Kreimeyer, Ph.D.
Lylis Olsen, M.S.

2. The Impact of Newborn Hearing Screening
Increased number of children receiving early intervention
Length of time receiving early intervention services has increased
Large number of children with mild hearing loss
Growing percentage of cochlear implants for children who are deaf
Provide data on specifics above. Include number of cochlear implant centers, data on changes in population (Phoenix)
Frustration in not having accurate data – perceptions of early interventionists rather than hard data

3. Arizona Service Delivery Model
Home based state-wide services initiated early 1970s
Model based on service coordinators with certification in education of deaf/hard of hearing
State divided into geographic regions
Part-time early interventionists
Backgrounds in Education of Deaf/Hard of Hearing, Audioloy or Speech and Hearing.

4. Arizona Service Delivery Model
NORTHERN
1 Regional Director
1 Coordinator
7 PT Parent Advisors
CENTRAL
1 Supervisor
2.5 Coordinators
17 PT Parent Advisors
1 FT Parent Advisor
1 Audiologist
SOUTHERN
1 Supervisor
27 PT Parent Advisors

5. What prompted us to look at what we do?
With national focus on accountability, impetus to critically evaluate what we do
Resources available through CDC cooperative agreement
Generation of state-wide data base to assess children from screening to outcomes of early intervention
Desire to provide evidence that early intervention makes a difference

6. Building on the Passions of Early Interventionists
What motivates us to share the accomplishments of our work with infants and families?
Intrinsic Motivation– internally perceived needs and desires (Most Motivating!!)
Extrinsic Motivation– driven by outside forces (Least Motivating!!)

7. Purposes That Motivate!
To know what works!
To show parents children’s progress and encourage their participation
To provide effective staff training
To identify areas for improvement and to monitor program changes
Activity to identify motivation. Things that are not motivating – justifying need for program

8. Purposes That DO NOT Motivate
To justify the need for our program
Being required to submit data to the agency
Submitting data that is not used to support or refine the program
Collecting data that is not meaningful or reflective of program
Being told we must be accountable!

9. What is Important? Critical Goals for Infants/Toddlers
What do you want children to know and be able to do by the time they are three years of age?
Used principles of Backward Design for process” 1. Identify desired results 2. Determine acceptable evidence 3. Plan learning experiences and instruction

10. What is Important? Critical Goals for Parents
What do you want parents to know and be able to do by the time their child turns three years of age?

11. Who Determines What’s Important?
Collaborative team
Parents
Experienced infant/parent program coordinators
Early interventionists
Preschool coordinators/teachers
Professional Literature

12. Assessments of Effectiveness
All programs administer assessments
Are there common assessments across children?
Do assessments align with critical goals?

13. Identified Assessments Currently Used
Identified Assessments Currently Used
Assessments
Schedule
Measures
Child Development Inventory (Teacher Observation Guide)
Every 6 months
Expressive & receptive language, social, self-help, gross & fine motor
Infant Development Chart
Child Development Inventory
Every 6 months, 2 and 3 yrs of age
McArthur Words & Gestures
McArthur Words & Sentences
Varies – at least once/year
WG: receptive & expressive voc. WS: expressive voc.
SKI*HI Language Development Scale
Expressive & receptive language
Different assessments, different schedules, Tucson used CDI teacher and MDC, SKI HI, Phoenix others

14. Evaluating Alignment Between Goals and Assessments
What do we want children to know and be able to do by the time they are three years of age?
Critical Goal
Source of Evidence
1. Communicate wants and needs, emotions, feelings and ideas with language.
McArthur Communicative Development Inventory
SKI*HI Language Scale
Rossetti Infant-Toddler Language Scale
Parent Report
2. Have age appropriate skills in all domains commensurate with their potential.
Child Development Inventory
Vineland Adaptive Behavior Scale
Therapist reports and evaluations.
3. Accept and use amplification (as appropriate)
Goal 4. Feel loved, accepted by and important to families, friends and community as evidenced by being happy, playful, curious, interactive and confident.

15. Evaluating Alignment Between Goals and Assessments
What do we want parents to know and be able to do by the time their child turns three years of age?
Critical Goal
Source of Evidence
1. Parents will know they are the most important and valued advocate in their child’s development.
Parent Survey
2. Parents will communicate meaningfully with their child using a common language.
3. Parents will feel connected with other families and professionals.
4. Parents will have a basic understanding of their child’s hearing loss and a commitment to the use of amplification, if appropriate.
5. Parents will have an understanding and expectation of age appropriate social behavior and positive discipline strategies.
Parents will know the preschool programs and other options available to their child.
Parents will be able to describe the impact of hearing loss on overall development as well as their child’s strengths and progress.

16. Obtaining Evidence on Critical Goals for Parents
Who evaluates attainment of goals?
Service coordinators say, “Not me!!”
Compromise relationship with parents
Parents will self-evaluate
Parents feel will help them generate IFSP goals
Collaboratively develop or modify a questionnaire
Potential resource is Gallaudet’s National Parent Project

17. NEXT: Aligning Goals, Instruction and Assessment
Does our current instruction support the goals identified for parents and children?
Evaluate learning experiences and instruction
Curriculum
Identifying other resources
Sequencing of instruction
Characteristics of the families we serve
Qualifications and training of early interventionists
Structure of our service delivery
Prioritizing goals – if family with us one year these are the things we will be sure they get, if more extended time other things

18. Challenges!! Structure of our service delivery
Part-time early interventionists
Organizational structure
Rural nature of our state
Frequency of services
Qualified early interventionists
Follow-up on program “graduates”
Organizational structure: Service coordinators report to regional directors who have primary responsibilities for school based programs, perhaps background in ECFE; I work on this on very part-time basis

19. Future Work Integration of outcomes into database
Ongoing data entry
Linking program data-base with state level public health data-bases
Making data available to
Audiologists
Medical home
Transition program

21. Resources
Holcomb, E. (1999). Getting excited about data How to combine people, passion and proof. Thousand Oaks, CA: Corwin Press.
Fitzpatrick, K. (1997). Indicators of schools of quality. Schaumburg, IL: National Study of School Evaluation.
Fitzpatrick, K. (1997). School improvement: Focusing on student performance. Schaumburg, IL: National Study of School Evaluation.
Meadow-Orlans K., Mertens, D., Sass-Lehrer, M. (2003). Parents and their deaf children. Washington DC: Gallaudet University Press.