Selecting Tools to Present to Various Audiences
In this section, we highlight different training needs for differing audiences including which tools and training materials to present according to various settings. At the end is a table of tools with information on ordering, administration/scoring time frames, costs, etc. This is sorted according to screens workable in primary care versus other settings including electronic options.
Providers need choices among tools. There are indeed “different strokes for different folks”, i.e.,
a) some prefer one type of measurement approach over another;
b) some are comfortable relying on parents’ concerns such as PEDS;
c) others are OK with screens using information from parents, but are less fond of relying on parents concerns and prefer a more milestones-focused approach such as PEDS:DM or ASQ;
d) a rare few are not comfortable with any tools relying on information from parents and so want to use hands-on screening [e.g., such as the PEDS:DM administered directly to children or if time permits, a measure such as the Brigance Screens, Battelle Developmental Inventory Screening Test (BDIST)];
e) Some of comfortable with the “best approach” which is to gather parents’ concerns and view children’s skills [which is also the recommendation of the American Academy of Pediatrics (AAP)] and so want to learn about a combination of measures (e.g., PEDS+PEDS:DM). This is wise if presenting to health care providers;
f) Some providers need a very brief screen for all children but want a “gated” process wherein problematic results on brief measures such as PEDS or PEDS:DM are followed by the lengthier ASQ, Brigance Screens, BDIST. In health care, such an approach depends on staffing patterns (e.g., a nurse practitioner who can follow-up with lengthier screens when needed). Otherwise, referrals for additional in-depth screens should be a point of coordination for referrals between health care and EI/public schools.
g) Some will find the ASQ too long and the reading level demands overly challenging, most especially health care providers working with low-income families.
h) Some (especially those working in high-risk settings such as Early Intervention Intake, Neonatal Intensive Care Unit follow-up, or researchers conducting outcome studies) need tools that measure progress (e.g., PEDS:DM either Screening or Assessment Level, Developmental Profile-III) and thus alternatives to expensive multi-disciplinary team diagnostic evaluations.
i) Educators tend to prefer milestones type measures (which are indeed better for benchmarking progress) but they also need to understand the value of measures like PEDS that better engage families, facilitate attendance at well-visits and parent-teacher conferences, encourage parents to share their worries and child-rearing needs so that teachers can offer viable advise. For such an audience presenting PEDS plus skill-based measures like the PEDS:DM, ASQ, Brigance Screens, etc. is needed.
Bottom line: Anticipating the needs and interests of your audience is important. Considering the challenges, time constraints and policy mandates that drive each type of professional you teach is essential. Exposing different type of provider to measures workable in their settings is wise. Most helpful is to conduct a pre-presentation survey so that you know what your attendees need to learn, their measurement preferences, and how much time they currently spend and can realistically spend on early detection efforts. Some sample questions are below. You can mail/email these to participants before your presentation. You can also use our post-test questions as a pre-test if helpful:
Sample pre-presentation questions:
1. In what type of setting do you deal with families?
2. How much time do you spend on early detection including the time spent eliciting parents’ concerns and measuring milestones?
3. Do you work with families who have literacy problems or language barriers?
4. If so, what challenges are you experiencing?
5. How do you currently deal with such challenges? Is this working?
6. What early detection methods do you currently use?
7. Are you satisfied with these methods in terms of accuracy and detection rates?
8. What do you want to know about how families are encouraging development and how children are developing?
9. What tools have you considered?
10. Are you using/planning to use electronic records?
11. What do you see as the biggest obstacles to using quality tools in your setting?
Please see, on the next page, a table of accurate measures divided by what works in primary care versus other settings, including electronic options on the next page.