Introducing the Parent Completed Ages and Stages Questionnaire-3 Background, qualifications, award and pilot partner role. How/why we embarked on an integrated approach to the reviews

Session Objectives Understand what ASQ is and what it is not! Understand why and how the ASQ will be used in all Two Year reviews Roles and responsibilities relating to use of ASQ in the 2 year review Know the features of ASQ

Importance of early identification and prevention-Brain Hero DVD http://developingchild.harvard.edu/index.php/resources/multimedia/videos/brain_hero/

Current policy Revised Early Years Foundation Stage requiring A Progress Check at Two (EYFS Statutory Framework, Department for Education, 2014 ) Well being and development of the child aged 2-2.5 year old review (integrated review) and support to be ready for school (One of the ‘6 High Impact Areas’ Early Years High Impact Area 6. Department of Health ,2014) Child health population measure (utilising ASQ-3 TM)to be collected via the HCP 2 year review. National Integrated Review roll out September, 2015 (24-30 mths) Ch-Slide 3: Impact of policy (3mins) The reach of the Progress check is also increasing due to the expansion of the free two year old places for disadvantaged children. EYFS, Statutory Guidance- refer to Reference list 12 (IR additional resources)    Where possible, the progress check and the Healthy Child Programme health and development review at age two (when health visitors gather information on a child’s health and development, allowing them to identify any developmental delay and any particular support from which they think the child/family might benefit) should inform each other and support integrated working. This will allow health and education professionals to identify strengths as well as any developmental delay and provide support from which they think the child/family might benefit. Early Years High Impact Area 6 Health, wellbeing and development of the child age 2 – Two year old review (integrated review) and support to be ‘ready for school’ “all children and families will be offered a developmental review between the ages of 2 and 2 ½ where the child is in an early years setting, acknowledging that a holistic approach is important to good health and development and multi-agency/partnership working is essential” Talk: Prime areas and overlap with 2 year review Talk: From a parent’s point of view, there is potential for duplication and possible confusion fore parents and practitioners as there are two assessments in two different places by two different people which could be saying two very different things!

ASQ-3 Development ASQ initiated in 1980 at the university of Oregon ASQ skills selected were: easily observed or elicited by parents in the home Good, ‘discriminators’ Why? Current potential for duplication, confusion and conflicting advice and problems not identified as early as could be.

What is ASQ? Parent-or-caregiver completed questionnaire (developed in America as a monitoring tool) Questionnaires cover the range 1 month-5 yrs. Questionnaire is scored by a professional Administration is flexible e.g. by mail; at clinic; in home; at EY setting The ASQ should be completed for all 2-2.5yr olds as part of their review. (NHS England)

What ASQ-3 isn’t! Not to be used as a ‘screening/monitoring tool’ in UK (Used to provide information for a ‘population measure’) Not a ‘pass’ or ‘fail’ outcome

ASQ-3 Key Features The 5 Domains Communication Gross Motor Fine Motor Problem solving Personal-social

ASQ-3 Key Features Age specific 24 month questionnaire- 23 months 0 days through 25 months 15 days 27 month questionnaire 25 months 16 days to 28 months 15 days 30 month questionnaire 28 months 16 days to 28 months 15 days Choosing the correct ASQ interval is one of the major challenges to the ASQ system. Refer to example ASQ in pack and locate the administration window on the top left of the questionnaire

ASQ-3 Features Age specific (administration window) Each questionnaire covers 5 domains Each domain has 6 questions in it The 6 questions run in hierarchical order (they get progressively difficult) Caregiver responses: Yes; sometimes; Not yet

ASQ-3 Features 3 Questions Lets look at Communication on the 30 month questionnaire.

ASQ-3 Features 4 Overall Section Captures qualitative information that may not be picked up on the quantitative items Should be taken into consideration when considering whether to refer or not N.B . Does not include any nutrition questions or request weight information.

ASQ-3 Features Summary Sheet Each ASQ has a unique summary sheet The summary sheet has 5 sections: -Child/family information -Bar graph with cut offs -Overall section -Follow up action section -Optional section (must completed if sharing summary with another agency – To be agreed) N.B. In sharing with other agencies must ensure the receiving agency understands how to interpret the ASQ-3 scoring information.

Roles and responsibilities child & parents Health professional is the lead professional for the ASQ and are responsible for ensuring it is completed and scored accurately. Parent’s role is to complete the questionnaire before the meeting and bring it to the review. Healthy Child lead at the setting’s role is to remind the parent to bring the questionnaire to the IR and support the parent to fully understand the questions which should lead to a more accurate review healthy child champion/keyworker health professional

Roles and responsibilities Health professionals -the lead professionals for the ASQ and are responsible for ensuring accurate completion Parent-to complete the questionnaire before the meeting and bring it to the review. Healthy Child lead –ensure the parent brings the fully completed ASQ-3 to the Integrated Review meeting

Documentation The key priority is that ASQ is to be completed and scored accurately and fully. Ask EYS Service to support the completion of the ASQ WITH PARENTS

Conducting the review (Using ASQ-3) ASQ-3™ and the 2 Year Child Health and Development Review - Part 1-Page 10

Aims of the Integrated Review Identify the child’s progress, strengths and needs in order to promote positive outcomes in health and wellbeing, learning and development. Facilitate appropriate intervention and support for children and their families, where progress is less than expected. Generate information which can be used to plan services and contribute to the reduction of inequalities in children’s outcomes(public health outcome measure) Source: Implementing Integrated Reviews in health and early years, at age 2 (Slide Pack), slide 4, Department for Education and Department of Health, 2014) Talk: Our focus in Hackney has been largely on the first 2 aims describe why, we are n process of rolling out the ASQ 3.State aims and objectives of our partnership and 2 mins

Integrated Review Content Caroline 3mins- talk: about prime areas of learning   Task 2-Discussion boards (active move around each board)-30 mins (including feedback from facilitators) Integrated Working – discussion boards (5 groups) Talk: acknowledge at different stages of the journey Board 1: What in your opinion do we mean by integration of early years services and an integrated review? Board 2: What do you envisage parents experiencing if it is working well? Board 3: How will things be different for the practitioners working directly with families ? E.g. health visitors and early years staff Board 4: How will things be different for the workforce as a whole? Board 5 How will things be different for leaders, what will need to change? Talk: Share our view of integration (5) N.B. Facilitators feed -back key points and post any questions on board Watch: Vimeo, internet required ‘A parent’s view’ DVD Source: Implementing Integrated Reviews in health and early years, at age 2 (Slide Pack), slide 15, Department for Education and Department of Health, 2014)

Holistic Approach E-learning part 1, video clip 3

ASQ-3 Features Cultural Adaptability Alternative administration methods need to be used for families with differing cultural back grounds Alternative materials need to be used for children from different cultural backgrounds Scoring permits omission of inappropriate items e.g. A child that does not have access too or plays with a ball would not be able to demonstrate this aspect of gross motor development e.g. kicking so we can leave this section out Normative sample covers all cultural backgrounds