Transcript presentation (PowerPoint)

Embedding Progress Monitoring in
Interventions to Support Social-Emotional
and Communication Development
I
Kathleen Baggett, Ph.D.
Kathryn Bigelow, Ph.D.
Prepared for the Head Start Center for Inclusion
November 3, 2010
Session Goals
 Explore the relevance and importance of
progress monitoring for improving child
outcomes in EHS
 Provide a brief overview of progress monitoring
 Consider some examples of progress monitoring
tools and their application to interventions
 Stimulate discussion about how progress
monitoring can be applied within your work
What is Progress Monitoring...
and why is it important?
 Scientifically-based practice used for assessing
child progress and thus, intervention
effectiveness
 Allows for documentation of progress and gives
us the ability to adjust the intervention to meet
intervention goals
 Provides data on intervention effectiveness that
can be provided to a wide audience
(administrators, parents, researchers, funders)
Adapted from National Center on Student Progress Monitoring
Progress Monitoring
 Measures should occur on a regular, frequent basis
 Should be brief and easy to administer
 Should be sensitive to the intervention after relatively
short periods of time
 Should provide information that is readily
understandable to a range of individuals
(administrators, parents, etc)
 Should allow for monitoring progress of individual
children, and groups of children
Adapted from National Center on Student Progress Monitoring
What is Fidelity Monitoring...
and why is it important?
 Documentation of the degree to which an intervention is
implemented as originally planned
 Without fidelity, we do not know if our results, good or
bad, are a result of the intervention
 Tells us where efforts to increase adherence to the
intervention protocol are needed
 Crucial to determining if an intervention is effective
Fidelity Monitoring
 Measures must be closely tied to intervention protocol
 Measures should be based on a clear and objective
description of the steps involved in the intervention
 After observations, calculate the percentage of accurate
implementation, provide feedback, and take steps to
increase accuracy, if necessary
 Measurement should take place on an on-going basis, as
implementation can change across providers or over time
IPCI
For checking growth in caregivers’ responsiveness
to their child in ways that promote positive socialemotional behavior.
EHS
Home
Visitors
Home Visiting
Nurses
Parent-Child
Interaction
Mental Health
Therapists
Part C
EI
Home
Visitors
Practitioners need practical tools that can:
Help interventionists know when intervention is needed
Help interventionists see when they are making a difference
Help interventionists know when an intervention change is needed
Help supervisors facilitate intervention-planning
Help program directors understand when programs need improvement
While there are many measures of parent-child interaction, tools
designed specifically for practitioners to guide intervention decisionmaking have been lacking.
IPCI Purpose
•Monitor
progress
•Identify risky interactions
•Guide intervention decision-making
Progress Monitoring for all children
If cautions are identified,
increase monitoring
If concerns are identified,
Begin intervention
IPCI Administration
 Administered in family homes or other caregiving settings
(biological home, foster home, center-based care)
Children 3-42 months of age and a familiar caregiver
 Four semi-structured activities are observed for a total of 10
minutes
Free Play
Looking at Books
Distraction Task
Dressing
 12 items are rated on a 4-point scale following observation
 Videotaping is not required (but useful for intervention
purposes)
IPCI Activities
Free play
Looking at Books
Distraction
Dressing
IPCI Activities
Free play (4 minutes)
“Whatever it is that you and your child like to do
together- something your child loves”
IPCI Activities
Looking at Books (2 minutes)
“Here are some books for you and your child to
look at together- however you and your child
would like to spend time with these books is
fine.”
IPCI Activities
Distraction Task (2 minutes)
“There are times when parents need to keep children
away from things- either because they may be dangerous
or just inappropriate”. Let’s see how your child responds
when there are materials that are off limits. Please keep
child on the blanket and away from the recorder and
keys”.
IPCI Activities
Dressing (2 minutes)
“Whatever it’s like to get
dressed in the morning”
(shirt, socks, shoes)
IPCI Domains and Behaviors
 Caregiver Facilitators




Conveys acceptance and
warmth
Makes descriptive comments
Follows child’s lead
Maintains and extends
 Caregiver Interrupters
 Uses criticism, harsh tone
 Uses intrusions and
restrictions
 Child Engagement



Positive feedback
Sustained engagement
Follow-through
 Child Distress



Fuss, cry
Tantrum
Frozen, watchful, withdrawn
Behavior Ratings
 Caregiver and Child Behaviors are rated on a 4-point scale




O = Not at all
1 = Rarely
2 = Sometimes but inconsistently
3 = Often and consistently
The IPCI’s Home:
With other early childhood general outcomes
measures
Early Communication Indicator
Early Social Indicator
Early Problem Solving Indicator
Early Motor Indicator
Types of IPCI Reports
 Home Visitors and Supervisors
 Program Administrator
 Agency Administrator
Kansas Model Demonstration
Center
 Goal of project is to support early intervention
providers in using evidence-based practices to help
build the capacity of parents and educators in
promoting communication of young children
 Fidelity and progress monitoring include
documentation of:
 Parent and teacher use of communication
strategies to monitor intervention progress and
fidelity and provide feedback , and child
communication
 Parent and teacher self-report of communication
strategies to monitor progress, provide feedback,
and prompt use of strategies
 Fidelity of implementation of communication
strategies by providers, who are delivering
intervention to parents and teachers
Monitoring Parent/Teacher Strategy
Use and Child Communication
 Parent and teacher use of communication promoting strategies
measured using a frequency count of strategy use during 30-min
observations
 Also measure child communication (gestures, vocalizations, words,
multiple words)
 Providers share graphs with parents and teachers monthly to provide
feedback on use of strategies, illustrate connection between adult
and child communication, and show growth in child communication
over time
 Provider uses this as an opportunity to provide positive feedback,
address challenges, and prompt further use of strategies throughout
routines
Parent/Teacher Use of Strategies and Child
Communication
Dotted line shows
frequency of use of
communication
promoting strategies
by a parent, and bars
show child
communication
Parent and Teacher Self-Report Use
of Communication Strategies
 Parent and teacher complete self-checks of their use of
communication promoting strategies during a variety of
routines
 Rate frequency with “not today”, “rarely”, “sometimes”, and
“often”
 Providers collect forms and use data to prompt discussion with
parent/teacher about use of the strategies, provide positive
feedback, and share additional ideas for embedding strategies
in new routines or activities
 Functions as a prompt to remember to use strategies, but also
allows parents or teachers to self-monitor their use of
strategies
Communication Strategies Self-Check: Teacher
Model Demonstration Center on Promoting Communication
Free Play
Reading
N R S O
Date: _________________
Never
Rarely
Sometimes
Often
Provider: _________________________
Child Name: ______________________
Never
Rarely
Sometimes
Often
Person Completing: __________________
Never
Rarely
Sometimes
Often
Please fill out the form based on how often you used each strategy during daily routines over the course of one week:
Group/
Meal/
Other:
Outdoor
Circle Time
Snacktime
________
N R S O
N R S O
N R S O
N R S O
N R S O
N R S O
N R S O
N R S O
N R S O
N R S O
N R S O
N R S O
N R S O
N R S O
N R S O
N R S O
N R S O
Comment and Wait
Described actions, toys, or activities
Ask Questions and Wait
Asked "Yes/No" and Open-Ended Questions
Respond by Adding a Little More
Imitated child talk and expanded by adding new info
Comments:
Date:_________________________
Dressing &
Parent :________________________
Child: _________________________
Person Completing: _______________
Commented and Labeled
Described actions, toys or activities
Play
Toileting
Outings
Reading
Mealtime
Other
Not Used
Not Used
Not Used
Not Used
Not Used
Not Used
Rarely Used
Rarely Used
Rarely Used
Rarely Used
Rarely Used
Rarely Used
Sometimes
Sometimes
Sometimes
Sometimes
Sometimes
Sometimes
Often Used
Often Used
Often Used
Often Used
Often Used
Often Used
Environmental Arrangement Strategies
Books, activities provided?
yes
no
Books available throughout the day;
have a book area
Materials available and arranged?
Toys out, arranged in view to
encourage interaction
NOTES:
Daily schedule and activity changes?
yes
no
yes
no
Flexible schedule; activity changes smooth;
minimal waiting
yes
no
Family Interactions?
Surroundings encourage family interactions
Measure of Fidelity of
Implementation: Providers
 Simple checklist used to document the strategies shared with




parents/teachers, strategies observed during visits, and
routines in which strategy use was addressed
Providers fill this out themselves after each visit and regular
reliability checks are completed by intervention coach
Data are summarized and a report is provided monthly,
summarizing data for each family
Intervention coach distributes reports to providers in meetings
or in person, and posts on password-protected web site
Coaches use this as an opportunity to discuss provider’s
strategies for sharing intervention with parents/teachers,
provide positive feedback, address challenges, and plan next
steps in intervention
Juniper Gardens MDC Communication Strategies
□ Environ. Arrangement □ Following child’s lead
□ Commenting/labeling □ Imitating/expanding
□ Open-ended questions □ Positive attention/praise
□ Providing choices
□ Fill in blank/time delay
Strategies discussed or taught in:
□ Play □ Meal/snack time
□ Toilet/personal care
□ Household routines
□ Reading/ books □ Circle/Group
□ Outings
□ Outdoor
□ Other (desc): ________
Observed parent using strategies in:
□ Play □ Meal/snack time
□ Toilet/personal care
□ Household routines
□ Reading/ books □ Circle/Group
□ Outings
□ Outdoor
□ Other (desc): ________
Discussed Manual/DVD? □ Yes □ No
Reviewed Self-Checklist? □ Yes □ No □ N/A
Discussed Graph?
□ Yes □ No □ N/A
Juniper Gardens MDC Provider _____ Child ________ Date ___ / ___ / ___
Worked with (check all that apply):
□ Child (directly) □ Parent □ Teacher
Language is the Key Strategies used, taught or discussed:
□ Comment and Wait
□ Ask Questions and Wait
□ Respond by Adding More (expansion)
□ Following Child’s Lead
□ Other (desc): __________________
Strategies discussed or taught During:
□ Play
□ Reading/ books
□ Daily Activities
□ Other ____________
Observed parent/teacher using strategies during:
□ Play
□ Reading/ books
□ Daily Activities
□ Other ____________
Introduced Lang is the Key Manual/DVD for first time? □ Yes □ No □ n/a
Reviewed Self-Checklist? □ Yes □ No
Reviewed Self-Checklist? □ Yes □ No
Discussed Graph?
□ Yes □ No □ n/a
MDC Parent Summary for Providers
Site:
Child(ren):
Parent:
Part C Provider:
Data Summary from the Provider Observation Checklist
Total visits with checklist to
Most recent checklist entered:
18
4/15/2010
(Date of Visit)
Strategies Addressed with This Parent So Far
Activities in Which Strategies Were Addressed
Environmental arrangement
Following child's lead /
Commenting / labeling
# Visits
8
7
10
Imitating / expanding
Open-ended questions
Positive attention and praise
13
3
7
Household routines
Reading / looking at books
Circle time
8
9
0
Providing choices
Fill in blank / time delay
Other
9
9
1
Outings
Outdoors
Other
0
0
2
Strategies Observed During Visits
Play
Meal / snack time
Toileting / dressing / personal
Report Date:
5/26/2010
Group:
No Graphs
# Visits
16
4
6
# Visits
Environmental arrangement
Following child's lead /
Commenting / labeling
12
16
17
Imitating / expanding
17
Open-ended questions
Positive attention and praise
13
17
Providing choices
5
Fill in blank / time delay
Other
4
0
Intervention
Start:Date:
4/25/2009
Notes:
__________________________________________
__________________________________________
__________________________________________
Provider Summary Report
showing strategies
addressed with a given
family so far, activities in
which strategies were
addressed, and strategies
observed throughout the
visits.
Fidelity and Progress Monitoring
Working Together
 Fidelity monitoring through observations of parents and
teachers, and of early intervention providers offers a wealth of
information on whether intervention is being implemented as
planned
 Fidelity monitoring through observations of parents, teachers,
and providers tells us the degree to which intervention is
being implemented as originally planned (and initially
evaluated)
 Progress monitoring shows us how parents and teachers are
using strategies and how child communication is growing and
how social-emotional behavior is changing
 Provides greater confidence in effectiveness of the
intervention
References and Resources
 Carta, J., Greenwood, C., Walker, D., & Buzhardt, J. (Eds.).
Individual Growth and Developmental Indicators: Tools for
Monitoring Progress and Measuring Growth in Very Young
Children. Baltimore, MD: Brookes.
 IGDI website: http://www.igdi.ku.edu/
 National Center on Student Progress Monitoring –
www.studentprogress.org