Western States Early Intervention Outcomes Project Kathryn Kreimeyer, Ph. D. Shirin Antia, Ph. D. Tucson, Arizona Arlene Stredler Brown, CCC-SLP, CED Allison Sedey, Ph. D. Boulder, Colorado

Faculty Disclosure Information In the past 12 months, we have not had significant financial interest or other relationship with the manufacturer of the products or providers of the services that will be discussed in our presentation. This presentation will not include discussion of pharmaceuticals or devices that have not been approved by the FDA.

The first step in universal newborn hearing screening programs has resulted in the identification of a high number of babies with hearing loss. There is a need for qualified early intervention providers who can institute effective family-centered programs for these young children. One of the goals of this initiative is to promote the measurement and tracking of outcomes for children in early intervention programs Marion Downs National Center for Infant Hearing National Early Intervention Coalition for D/HH Mission Statement (March, 2001)

Examining Outcomes of Early Identification and Intervention A collaborative project between A collaborative project between –Early Intervention coordinators in six western states Arizona Arizona Colorado Colorado Idaho Idaho New Mexico New Mexico Utah Utah Wyoming Wyoming –Research faculty at two universities University of Colorado – Boulder University of Colorado – Boulder University of Arizona University of Arizona

Who are we? Colorado Colorado Arizona Arizona Idaho Idaho New Mexico New Mexico Utah Utah Wyoming Wyoming

How did we get here? The Western Region was established by SKI*HI ~ 1994; expanded in ~2000 The Western Region was established by SKI*HI ~ 1994; expanded in ~2000 Many similarities exist among programs in this western region Many similarities exist among programs in this western region –Most programs have an affiliation with the state school for the deaf –Each program offers all communication approaches –Services are regionalized –Services are coordinated with the state EHDI Program

How did we get here? January 2000 – First discussion of project at bi-annual administrators meeting with continuing discussion at each subsequent meeting January 2000 – First discussion of project at bi-annual administrators meeting with continuing discussion at each subsequent meeting February 2005 – With support from Marion Downs Center, met at EHDI to explore implementation process with EI and EHDI coordinators February 2005 – With support from Marion Downs Center, met at EHDI to explore implementation process with EI and EHDI coordinators May EI coordinators and researchers met at Marion Downs Center to finalize pilot May EI coordinators and researchers met at Marion Downs Center to finalize pilot September 2005 – pilot initiated and monitored through monthly phone conferences September 2005 – pilot initiated and monitored through monthly phone conferences

Project Goals Build capacity for a multi-state data bank Build capacity for a multi-state data bank Use outcome data to Use outcome data to –monitor progress of individual children –develop IFSP goals –generate norms for D/HH population in each state –examine progress of children as a group Support best practices for EI by examining relationship between Support best practices for EI by examining relationship between –service characteristics –child and family characteristics –child outcomes

Pilot Goals Identify a common core of instruments to evaluate child outcomes Identify a common core of instruments to evaluate child outcomes –General development –Language development Obtain demographic information on each child for whom assessment data are obtained Obtain demographic information on each child for whom assessment data are obtained Develop questionnaires to investigate Develop questionnaires to investigate –Quality indicators of EI services –Parent satisfaction with services

Participating Children Approximately 10% of children served within each state who meet the following criteria: Approximately 10% of children served within each state who meet the following criteria: –Nine to 36 months of age at first assessment –No additional severe disabilities –English the primary home language –Bilateral permanent hearing loss Conductive or sensorineural Conductive or sensorineural

Participant Selection EI coordinator to identify providers who see significant numbers of children and with whom can easily communicate EI coordinator to identify providers who see significant numbers of children and with whom can easily communicate From these caseloads, identify children who meet criteria From these caseloads, identify children who meet criteria Determine IFSP six- month review dates and select children in order of upcoming IFSP six- month review after September 1, 2005 Determine IFSP six- month review dates and select children in order of upcoming IFSP six- month review after September 1, 2005

Demographic Information Collected on each child with plans to update every six months Collected on each child with plans to update every six months –General information –Hearing Loss Information –Language Use –Additional Disabilities –Intervention Services Minimum of two data collection sessions for each child Minimum of two data collection sessions for each child

General Development Instruments Parent-report inventories Parent-report inventories –Kent Inventory of Developmental Skills (Reuter & Gruber, 2000) Children 9 months – 14 months Children 9 months – 14 months –Child Development Inventory (Ireton, 1992) 15 months – 36 months of age 15 months – 36 months of age Include situation-comprehension scale from original (1974) version of inventory Include situation-comprehension scale from original (1974) version of inventory Normed on typically developing children Normed on typically developing children Scales adapted to reflect both speech and sign performance Scales adapted to reflect both speech and sign performance Completed initially and updated every six months Completed initially and updated every six months

Language Instruments MacArthur-Bates Communicative Development Inventory (1992) MacArthur-Bates Communicative Development Inventory (1992) –Words and Gestures Comprehension and expression Comprehension and expression Normed on typically developing children 8-16 months of age Normed on typically developing children 8-16 months of age –Words and Sentences Expression Expression Normed on typically developing children months of age Normed on typically developing children months of age Part 1 – Words Children Use Part 1 – Words Children Use Parent-report assessment Parent-report assessment Adapted for sign and speech Adapted for sign and speech

Current Status Approximately 135 children proposed for data collection Approximately 135 children proposed for data collection –75 children from Colorado –10 to 15 children from each of the other states Demographic and assessment data sent to University of Colorado-Boulder for scoring and report generation Demographic and assessment data sent to University of Colorado-Boulder for scoring and report generation –Currently service project rather than research project IRB approval pending IRB approval pending –Research component will include only children for whom permission forms are obtained

Current Status Data submitted for 52 children Data submitted for 52 children Reports completed and returned for each of these children Reports completed and returned for each of these children Identified need for training of early interventionists Identified need for training of early interventionists –Assessment interpretation for parents –Utilizing assessment results to generate IFSP goals

Proposed Analyses Generate normative data for each instrument Generate normative data for each instrument Establish predictors of positive child outcomes Establish predictors of positive child outcomes Identify program strengths and weaknesses within and across states Identify program strengths and weaknesses within and across states

Challenges Everything takes more time than anticipated! Everything takes more time than anticipated! –Initial efforts have focused on assessment of child functioning –Once this process is established, we will move to assessment of parent satisfaction and program characteristics Some states require specific assessment instruments so project instruments may be additional Some states require specific assessment instruments so project instruments may be additional All data collection and submission currently paper and pencil All data collection and submission currently paper and pencil Funding needed to sustain and fully implement project Funding needed to sustain and fully implement project