Early Childhood Screening ECS Updates and Recommendations Margo

Early Childhood Screening ECS Updates and Recommendations Margo Chresand, LSN, MPH, MS Margaret. Chresand@state. mn. us Minnesota Department of Education Early Childhood Screening Coordinator MNAFEE April 7, 2016

Early Childhood Screening Program Universal Quality Improvement All Children School Ready Cross Sector Partnerships Equity

What do we know about ECS? • ECS is mandated in all school districts and currently offered in 2 charter schools. • Offered in Head Start, Public Health (C&TC), Home Visiting and by Health Care Providers. • Universal and targeted measures are needed to reach all children equitably. • An equitable district ECS Program is aligned with closing the achievement gap by increasing access to early learning services, necessary health care and early learning opportunities.

MN District ECS 2014 -2015 ~60, 000 children completed ECS by districts per MARSS Data (percent of total screened by age) 3 year olds 4 year olds 5 -6 year olds prior to KG After KG

Other ECS 2014 -2015 ~4, 432 = Estimated number of children entering kindergarten screened elsewhere per ECS Annual Statewide Report Head Start 3392 Clinics 399 Public Health Agency 641

Screening at 3 Statewide: Moving in the Right Direction 50 45 40 35 30 25 2012 -2013 -2014 -2015 20 15 10 Number of 3 year olds screened by districts by year by census 25, 000 out of ~70, 000 children statewide = 35% for 14 -15 MARSS Data

Screening Demographics Tailor outreach materials and screening sites in order to improve equity of children screened: • Children of Color are less likely to be screened at 3 and 4. • Children who speak a language other than English are also less likely to be screened at 3 and 4.

Percent of enrolled Kindergartners Screened at 3 years by Race/Ethnicity 2014 -2015 MARSS Data 50 45 40 35 30 ECS completed 25 20 15 10 5 0 American Indian Asian Hispanic Black White **Data: public and charter schools (if entered). Data does not include children in private schools.

ECS is advertised and offered Equitably Assess and Ensure all know of ECS: • Families of diverse ethnic/racial backgrounds • Families of diverse socioeconomic backgrounds • Families of diverse language needs • Families of diverse immigrant, refugee or migrant backgrounds

Statute MN Statute 121 A. 17: Districts must inform all resident families with eligible children under seven (and Charters who perform screening must inform families who apply for admission…) … that their children may receive a developmental screening…conducted by either school district, public/private health care organization… and not required if a statement signed by the child’s parent or guardian is submitted… that the child has not been screened due to conscientious objection…

Statute • School Readiness (district Pre K program) and Early Learning Scholarship Statutes require ECS screening within 90 days. • Ideally, districts offer ECS quarterly at a minimum or, if not possible, partner with public health or clinics to ensure children are screened within 90 days.

Know your Current District Demographics 1. MDE website has race/ethnic data at district level: http: //w 20. education. state. mn. us/MDEAnalytics/Data. js p Click ‘Student’ at bottom of list. 2. Ask your MARSS Coordinator to run a report of all children screened last year by race/ethnicity. 3. Compare the district demographics to the screening demographics to see where these align or do not align. Target outreach and screening for those least likely to be screened at 3 and 4.

Racial and Ethnic Disparities • Hire diverse screening staff who are of the same racial/ethnic/culture as community. • Although parents can choose when to screen, work with cultural/racial/ethnic groups to encourage screening at 3 or 4. • Consider surveys to parents of KG (those without screenings), to help understand why parents wait. See survey example in Quality Indicators Framework on MDE website.

MDE Quality Indicators Framework • Goal: All children are Kindergarten Ready. • IF ECS is on the district , city & county strategic plans, it is more likely to be supported by the broader community. • The Quality Indicators Checklist may help community partners to plan, work and track progress. http: //education. state. mn. us/MDE/Stu. Suc/Early. Learn/Early. C hild. Screen/index. html

Income Disparities- Improve Access Some districts have successfully improved access by: • Transportation: ECFE van or other • Evening hours or Saturdays (for parents who work 2 shifts or second shift…) • Offer ECS in areas of city/district of most need • Screen during community events (walk-ins) • Offer ECS off-site by collaborating with: - Child Development Centers (if quiet) - Homeless Shelters or Clinics - Head Start sites (ask to screen general public)

ECS completed for 3 year olds by county Reach Levels and Composite Risk 2013 Source: Wilder Research analysis of data from the Minnesota Department of Education. http: //www. cehd. umn. edu/ceed/MN_Early_Childhood_Risk_and_Reach_Report_2015. pdf

Need for Interpreters • Hire diverse screening staff who are of the same racial/ethnic/culture and language of the population you serve (professional or paraprofessional). • Offer interpretive services as needed. • Use screening instruments standardized in multiple languages. • Learn how to say hello in other languages to best welcome families.

Immigrant and Undocumented students/families • 30% of children under 8 nationally have undocumented parents. • Immigrant children have lower rates of Preschool enrollment. • Less likely to enroll in Pre. K, due to fear/mistrust of government/papers and cultural factors. http: //www. migrationpolicy. org/research/profile-uschildren-unauthorized-immigrant-parents

How to Respond to Parent Preference to Screen later… • Some parents suspect their child has developmental concerns, but they decline ECS --Meeting parents where they are at is essential. Offer follow up call. Ask if others are concerned about their child. Explain more time to access free services if child is screened earlier. • Parents who screen later with no concerns, what would be a good response to screen at 3? --ECS links families with early learning opportunities and other resources to enrich your child. Vision concerns are not obvious, all need screening.

How to Respond to Parent Preference to Screen later… • Some parents want to ‘wait until their child is older so they will do better’. --We can validate their concerns and: --We can explain ECS is done (normed) based on age of the child and we do not expect a 3 year old to complete a screening like a 5 year old. --We can also explain that if concerns show, it is best to get help sooner than later for their child.

Cross Sector Collaborations • Clinics (request copies of comparable screens) • Head Start (request copies. . . ) • Public Health, Child and Teen Check Ups (request copies…) • WIC • Libraries • Faith Based groups • Invite Non-Profit groups, Racial/Ethnic or culturally based groups to observe ECS and better partner in order to serve all populations • United Way other possible funding partners?

ABCD • Assuring Better Child Health and Development Initiative (ABCD pilots in Rochester, Mpls, St. Paul). • Cross Sector partnership with Medical Clinics and Education Community to “close the loop, ” by asking clinics to refer all 3 year olds (and 3 to 5 year olds not previously screened) to districts for screening with consent. Districts then send results back to clinics with consent.

Charters • ECS is not required for entry into Charter schools. Yet many Charters request a copy of ECS from parents to ensure all are screened. • Partnership is critical… to ensure all have ECS. Share copies of ECS with Charters who request them, if parent has lost copy.

ECS Outreach • District communications staff may get word out in multilingual Community Education mailings and through Major’s Office, County, Public Health • Send ECS info to child care centers, family day cares • Radio Stations/newspapers serving diverse populations – go live with bilingual staff /interpreter • Ask businesses to advertise/provide incentives • Parent Advisory Groups (district)- focus groups • ECFE may send ECS reminders at child’s 3 rd birthday using census data; work with public health

MDE ECS Brochure In 7 Languages http: //education. state. mn. us/MDE/Stu. Suc/Early. Learn/Early. Child. Screen/index. html

Help Me Grow Materials in 5 Languages ECS Bookmarks --Order on Help Me Grow Website: http: //helpmegrowmn. o rg/HMG/Helpful. Res --Put your district phone number on the back. English Spanish Somali Hmong Karen

ECS Resources and Statute ECS forms, standards, parent brochure, resource links: http: //education. state. mn. us/MDE/Stu. Suc/Early. Learn/Early. Child. Screen/index. html ECS Statute and Rule: www. revisor. leg. state. mn. us Statute: 121 A. 16 -121 A. 19, Rule: 3530. 3000 -3530. 3400 2 Charter Schools had a ECS program 14 -15 Help Me Grow website http: //helpmegrowmn. org/HMG/Helpful. Res Risk and Reach Report (Wilder) http: //www. cehd. umn. edu/ceed/MN_Early_Childhood_Risk_and_Reach_Report_2015. pdf PDSA: Improvement Guide: A Practical Approach to Enhancing Organizational Performance, 2 nd Ed. G. Langley, K. Nolan, T. Nolan, C. Norman, L. Provost. Josey-Bass Publishers. , San Francisco, 2009.

Vision, Hearing, Developmental and Social-Emotional Screening Updates and Screening at 3 Katy Schalla Lesiak, MDH Child Health Consultant Katy. Schalla@state. mn. us Early Childhood Screening Training Day: 3 -22 -2016

Screening “how-to” resources • MDH Child and Teen Checkups (C&TC) website www. health. state. mn. us/divs/cfh/program/ctc / – Fact sheets for each screening component – Information for Providers on screening components: links to other resources • MN Department of Human Services (DHS) sets C&TC screening and billing policy

Why screen at three? • Much of learning in preschool is through vision and hearing • Later than 3 is too late for some conditions • Gives a child more time to receive services to be ready for school • Screening state aid is higher for ECS

Screening at 3 for parents • Educate families – What is Early Childhood Screening? • Not a “test” • Don’t have to “pass” to go to school • Compares child to same age group – Why is screening earlier important? • Earlier intervention is more effective, less expensive and improves outcomes • More time to address any potential problems, to be ready for kindergarten

Screening process for 3 year-olds • Use skilled screeners who are comfortable with preschoolers • Preparent and child for what will happen • Consider screener following child through instead of a new screener at each station • Hearing and vision first?

Developmental approach • Engage the child from the beginning • Ease in with the shy child • Use age-appropriate equipment; show & tell • Use stories/games • Offer small, real choices • Expect cooperation (Don’t ask a 3 -year-old for permission)

Link to hearing & vision modules http: //www. health. state. mn. us/divs/cfh/program/ctc/

Hearing Screening Guidelines 2015 • Hearing Screening Guidelines after the Newborn Period to Kindergarten Age (www. improveehdi. org) • JCIH risk factors for hearing loss – Refer as soon concern is identified • Pure tone audiometry – Immediate rescreen recommendation • OAE screening – Referral recommendations • Community screening and referral algorithms for audiometry and tympanometry

Pure tone audiometry PASS result: Responds to all sounds NOT PASS result: Does not respond to one or more sounds – (Perform an immediate rescreen: Repeat all 8 sounds) A different screener and audiometer can decrease Re-

Screening Algorithm: Pure tone Audiometry only 37

If audiometry is not passed 38

Follow up after primary care 39

MDH vision screening website www. health. state. mn. us/divs/cfh/topic/visionscreening/ To be updated VERY soon!!!

Legislative Changes • Early Childhood Screening programs must record the date of the most recent comprehensive vision exam (performed by an optometrist or ophthalmologist) – Child is not required to have a comprehensive exam – Only need to document if they did or not • Link to MDE information on the law: http: //education. state. mn. us/MDE/Stu. Suc/Early. Learn/ Early. Child. Screen/023550 • Link includes MDE recommended forms for documenting the exam date, if they had one: – Early Childhood Screening Summary Form – Health History Form

New Vision Screening Guidelines • Minnesota Vision Screening Guidelines for Children Post Newborn Through 20 Years of Age (www. health. state. mn. us) • Changes and updates: – Vision risk assessment – Eye occlusion – Red reflex and pupillary light reflex procedures no longer recommended for screeners (continue with corneal light reflex) – Uncover test for all ECS screenings – Updated PASS criteria – Plus lens screening for age 5 years and older – Recommendation for re-screening untestable children

Unilateral cover test: Near 6 months to 20 years • Purpose (instead of cross cover) – Find problems with alignment or muscle balance of eyes • Procedure – Hold object 15 inches in front of the child and make sure both of their eyes are fixated on it. – Cover the left eye with the occluder; watch the right (uncovered) eye for movement. – Uncover both eyes and have child reacquire fixation. – Cover the right eye with the occluder; watch the left (uncovered) eye for movement. – Repeat this procedure 2 -3 times. • Refer if movement is noted in uncovered eye or child resists having one eye covered but not the other

Unilateral cover test – Distance 3 years to 20 years • Purpose – Same • Procedure (same as “near”, but with distance target) – Point out an object 10 feet away from child and make sure both of their eyes are fixated on it. – Cover the left eye with the occluder; watch the right (uncovered) eye for movement. – Uncover both eyes and have child reacquire fixation. – Cover the right eye with the occluder; watch the left (uncovered) eye for movement. – Repeat this procedure 2 -3 times. • Refer if movement is noted in uncovered eye or child resists having one eye covered but not the other

Visual acuity screening Screen all children at 10 feet Occlusion: Kids peek! • Not okay: – Hands – Paper square – Paper cup • Recommended – Occlusion glasses: Buy or make your own – Adhesive screening patches or 2 inch Micropore paper tape – Plastic occluders ONLY for 10 years and older

Recommended charts: 3 -5 years old – It’s a matching game! LEA 10 foot HOTV 10 foot 46

Or 10 foot Lea/HOTV flip charts for 3 -5 years old Works great for kids who can’t focus with a wall chart 47

3 year-olds – HOTV and LEA pre-screening practice charts on website www. health. state. mn. us/divs/cfh/t opic/visionscreening/materials. cfm – Chairs and a table or a desk – Feet decals, a line, or HOTV or LEA symbols on the floor • Child can stomp on the symbol or letter to indicate a response • Center arches of the feet at 10 foot distance from chart

Pass Criteria Tip for screening 3 year olds • Pass criteria: 3 -5 year olds must identify any 4 out of 5 symbols on the lowest line they can see – 3 years old: 10/25 line - NEW! – 4 years old: 10/20 line – 5 years and older: 10/15 (10/16) line • Tip for screening 3 year olds: – Start on the 10/25 line – Identify one letter per line – Go down the chart from there – However if they balk going lower than the 10/25 line and they can read the 10/25 line - They PASS!

Recommended charts: 6 years and older RECOMMENDED: SLOAN 10 foot NO LONGER RECOMMENDED: SNELLEN 50

Plus lenses • Screen children 5 years and older – If they pass their visual acuity screening – Use same chart at the same 10 foot distance – Screen with both eyes together, uncovered, wearing +2. 50 (“cheater”) lenses • PASS: Cannot read letters with glasses on • REFER: Can read all letters with glasses on

Hearing & Vision Screening Resources • Vision Screening website www. health. state. mn. us/divs/cfh/topic/visionscreening/ • Hearing Screening website www. health. state. mn. us/divs/cfh/topic/hearingscreening/ • C&TC Web modules on Screening in the Clinic setting www. health. state. mn. us/divs/cfh/program/ctcmodules. cfm • E-Learning modules www. health. state. mn. us/divs/cfh/program/ctc/elearning. cfm

Immunizations • As always: review documented vaccines – MIIC is your best resource (Minnesota Immunization Information Connection) – Cannot rely on parent report for this requirement

Minnesota Interagency (MDH, MDE, DHS) Developmental Screening Task Force www. health. state. mn. us/divs/cfh/topic/devscreening/

Screening instruments • Instrument review criteria: – Instrument purpose – Developmental domains – Reliability/validity – Sensitivity/specificity – Recent standardization – Additional considerations: • • • Practicality Population and age span targeted by the instrument Cultural, ethnic, and linguistic sensitivity Minimum expertise of screeners Cost

Recommended developmental screening instruments Observational • Brigance Early Childhood Screens (2010 – 2 nd ed. ) • BDI-II (Batelle) • Bayley III Screening Test • Early Screening Profiles (ESP) • Minneapolis Preschool Screening Instrument. Revised (MPSI-R) • DIAL-4 • ESI-R, 2008 Edition • First. STEP Parent report Required for ECS • Ages & Stages Questionnaire 3 rd edition (ASQ 3) • Parents’ Evaluation of Developmental Status (PEDS) Need to do • Child Development Review separate (CDR) SOCIAL • Infant Development EMOTIONAL Inventory (IDI) screening

Recommended social-emotional screening instruments (Meets ECS requirement for parent report) • Ages & Stages Questionnaires: Social-Emotional (ASQ: SE) – 6 to 60 months • By 7/1/2017, use ASQ: SE-2 (2 nd edition) – 1 to 72 months • Pediatric Symptom Checklist (PSC) – ages 4 to 16 years

What’s new in the ASQ: SE-2 (2 nd edition)? • Expanded age range: 1 to 72 months of age – Added 2 month interval – 60 month questionnaire validated up to 72 months • New data and cut-off scores based on sample size of more than 14, 000 diverse children • Monitoring zone • New items specific to autism • Refined Spanish translation • Minor wording changes to questions & answers • Scoring and interpretation is similar

When concerns are identified, refer for more evaluation Medical evaluation Educational evaluation Mental health evaluation • Primary care provider • Diagnosis, treatment • Better insurance coverage • Help Me Grow or local school district • Early Intervention / ECSE services • Early childhood mental health provider • Services for infant/child and family

Making a referral for Early Childhood Special Education (ECSE) evaluation 0 -5 years • Call / fax the school district directly, or • Contact Help Me Grow: 1 -866 -693 -GROW (4769) or www. Help. Me. Grow. MN. org 60

State C&TC contacts • For questions about C&TC policy dhs. childteencheckups@state. mn. us • For questions or training on C&TC screening components health. childteencheckups@state. mn. us

Teach-Back Presented by: Margo Chresand Adapted from the Minnesota Health Literacy Partnership Health Literacy Program Training, Bloomington Department of Health, Hennepin County Public Health, HCMC and Minneapolis Public Schools ABCD Collaborative

The need for Teach Back The problem with communication is the illusion that it has occurred. >-- George Bernard Shaw

Teach-Back is. . . ● A method to ensure understanding of information being communicated, used between a provider and a family, by asking the receiver of the information to teach back what was said. ● NOT a test of the parent/guardian, but rather a gauge of how well a concept is explained. ● A chance for the provider to check for understanding and, if necessary, re-teach the information.

Teach-Back Creates an Empowering Environment For All • Comfort in speaking up about concerns. • Family more likely to follow up. • Better able to assess families ability to follow through.

Teach-Back. . . When? • When a student is 3 years old or shows a developmental concern. • When during ECS? Summary or as a ‘check in’ with parent during ECS.

Teach-Back. . . Who? • All staff interacting with families commit to using the teach-back method. • Or, determine the point person in your organization who will talk with the patient/ family about the referral.

Teach-Back. . . Why? Teach-Back is supported by research! ● “Asking that patients recall and restate what they have been told” is one of the 11 top patient safety practices based on the strength of scientific evidence. ” AHRQ, 2001 Report, Making Health Care Safer ● “Physicians’ application of interactive communication to assess recall or comprehension was associated with better glycemic control for diabetic patients. ” Schillinger, Arch Intern Med/Vo 640 l 163, Jan 13, 2003, “Closing the Loop”

Teach-Back. . . How? Ask parent/guardian to demonstrate understanding: • “I want to be sure I explained everything clearly, so can you please explain it back to me so I can be sure I did. ” Checking In: • “I want to make sure we have the same understanding” • “Can you tell me in your own words what I said”

Teach-Back Practice Hearing Referral Situation: child didn’t pass hearing. Staff is training a new colleague in the referral process. 1. Fill out the referral form with the parent 2. Review with parents that they need to: • Make an appointment at a clinic for a hearing check. • Be able to explain that they want their child’s hearing checked by the clinic and bring the ECS referral form. • Voice understanding that they will send results back to ECS in a stamped envelop.

Teach-Back Practice Hearing Referral Read the following as written; as if you are collaborating or training with a colleague from in a calm, unhurried and pleasant voice. “I want to make sure I have explained how to help a parent/guardian complete a hearing referral, so can you explain back to me how you would teach a new staff person to make a hearing referral? ”

Helpful Tips. . . ● Slow down. ● Be genuine, caring. ● Use plain language, rephrase if needed. ● Break it down into short statements. ● Focus on the 2 or 3 most important concepts. ● Use alternative communication strategies such pictures or a video.

Shift in Communication Style Not difficult to learn-just takes practice and making a small change in how we work. • Takes only minutes • More effective and efficient than re-training. • Increases provider’s confidence in patient/family knowledge level. • Increase patient/family satisfaction. Because you are involving them in planning care of their child.

Resources Minnesota Health Literacy Partnership (MHLP) http: //www. healthliteracymn. org/ American Medical Association (AMA) http: //www. ama-assn. org/ Agency for Healthcare Research & Quality (AHRQ) http: //www. ahrq. gov/browse/hlitix. htm Centers for Disease Control and Prevention (CDC) http: //www. cdc. gov/healthliteracy/

Early Childhood Screening Program Administration and Requirements Margo Chresand Minnesota Department of Education MNAFEE April 7, 2016

Early Childhood Screening in Minnesota • For children 3 -5 years of age (target age 3 - 4 years) • Required for public school entrance • If not screened, ECS must be done within the first 30 calendar days of kindergarten • Connected to other early childhood programs – School Readiness and Scholarship Programs • Coordinated with Public Health, Head Start, Clinics, Child Cares, Homeless Shelters, Non-profit groups

MN Early Childhood Screening Process (3 -5 yrs. ) COMPREHENSIVE SCREENING Growth Hearing Vision Development (cognition, fine & gross motor skills, speech & language, social/emotional) Immunizations Identification of Risk Factors which may impact learning Health Care Coverage Optional: Health (lab, dental, nutrition, history) problems ONGOING HEALTH AND DEVELOPMENTAL No suspected SCREENING Documentation and recording of child’s progress. Ideally enroll in early learning opportunity. Whethe r Eligible or Ineligible… EVALUATION OR HEALTH ASSESSMENT Suspect ed problems: Refer thru Help Me Grow to ECSE and/or Refer to Health Care Provider Evaluation and determination of eligibility for early intervention or ECSE Assessment by health care provider and determination of medical intervention INDIVIDUALIZED EDUC. PLAN (IEP) If eligible, plan for specialization and related services to meet child’s needs Medical Evaluation Plan for intervention to resolve and/ or treat identified health concern (glasses, hearing aid, PAE, mental health, etc)

Minnesota Law Overview • Minnesota Statute, 121 A. 16 – 121 A. 19, Rule 3530. 3000 to 3530. 3400 • – Purpose – Program components and program information – Screening record – Data use – State aid https: //www. revisor. leg. state. mn. us/statutes/? id=121 A. 16&year=2013&keyw ord_type=all&keyword=early+childhood+screening • Coordinators and Program Administrators are responsible for knowing the law.

Written Notice Requirement “The district and the person performing or supervising the screening must provide a parent or guardian with clear written notice that the parent or guardian may decline to answer questions or provide information about family circumstances that might affect development and identification of risk factors that may influence learning. The notice must state that declining to answer questions or provide information does not prevent the child from being enrolled in kindergarten or first grade if all other screening components are met. ”

Conscientious Objection “If a statement signed by the child’s parent or guardian is submitted to the administrator or other person having general control and supervision of the school that the child has not been screened because of conscientiously held beliefs of the parent or guardian, the screening is not required. ”

Early Childhood Screening Program Requirements • Required Vision Hearing Development Physical growth Immunization review Identification of risk factors that influence learning – Health coverage – Summary interview – – – • Optional – Health history – Nutrition – Review of family circumstances – Dental assessment – Physical assessment – Blood pressure – Laboratory tests

Minnesota Developmental Screening 1. Standardized Observational Developmental Screening Instrument • norms for the age range screened • written procedures for administration, scoring, and interpretation

Minnesota Developmental Screening 2. Parent report of child’s development skill development emotional status behavioral status concerns about child’s development 3. Professional judgment-child observation

Minnesota Early Childhood Screening Standards and Protocols Includes overview of required and optional components • • Staff requirements (who may do what component) Screening areas Screening measures/instruments Statute reference http: //education. state. mn. us/MDE/Stu. Suc/Early. Learn/Early. Child. Screen/index. html

Early Childhood Screening Forms Required in the Cumulative Folder • Registration Form for Early Childhood Screening • Consent to participate in the Early Childhood Screening program • Release of information (even if screening is provided by the school district) • Screening Summary form that includes the results of the screening requirements (or this may be kept in Health file per your district policy)

Screening Summary Form • Use Updated version: 2016 on MDE website • The Summary is kept in cumulative file (or electronic school record/health file per your district policy ) • Observational instrument (must be from the MDE/MDH approved list) • Parent report of a child’s development • Includes the screening results by required and optional components (if optional completed) • Provide the screening summary (copy) results to the parent

Registration Form for Early Childhood Screening • Required for all children receiving screening, screened by another providers, or if parent is a conscientious objector to the Early Childhood Screening program for their child. • Essential for establishing the MARSS PS Record (preschool screening/Early Childhood Screening Record). • May not be changed by programs. • Part of the cumulative record.

Registration Form for Early Childhood Screening • Race/ethnicity categories – Two-part question as per federal requirements – Definitions on Registration Form • State Aid Category (SAC) – who provided the screening • Status End Codes (SEC) – provides information about the outcome of the screening process

Status End Codes (SEC) • • Relates to the purpose of screening Report primary type of referral Must have a SEC for SAC 41 Status End Codes: 60: no referral 61: referral to special education 62: referral to health care provider 63: referral to special education and health care provider – 64: referral to early childhood programs – 65: referral, parent decline – –

School District Responsibilities • School districts must provide screening – District may contract with another party to provide screening – Districts may accept comparable screening from Head Start, Public Health (C&TC) or Clinics • School district must inform each resident family with an eligible child about the screening program and requirement • District is responsible for reporting data to MDE

Check to see if child was screened in another district MARRS Coordinator may run a WES 52 Report: -Children previously screened in district -Children previously screened elsewhere These reports will show completed screenings for enrolled students in the previous school year. It is not possible to run a report on enrolled students in the current school year, since not all districts report ECS throughout the year.

Minnesota Law Overview • Screening 3 year olds • Children screened at least once • Screening state aid: – $75 for three year olds – $50 for four year olds – $40 for a child screened at five or six prior to kindergarten – $30 for a student screened within 30 days after first enrolling in a public school kindergarten, if child has not previously been screened.

Screening Aid for Kindergartners who transfer MN Statute 121 A. 19: If a child transfers to another public school kindergarten within 30 days after first enrolling in a MN public school kindergarten program, --And if the child was not screened in the initial district, --The district to which the child is enrolling may receive aid if ECS is done within 30 days of the transfer date.

Screening State Aid Payments • Paid to school districts through a metered schedule (dependent upon when other aid payments are made to the district) • Based on the data reported on the MARSS PS record established for each child/student • Also requires submission of: – Early Childhood Screening data through the online Early Learning Services Data System – Submission of Statement of Assurances signed by the school district superintendent that the screening has been provided in accordance with Minnesota Statutes and Laws

State Data Reporting Requirements for Early Childhood Screening • Establish MARSS PS Record – (refer to MARSS Procedure #26 in the MARSS Manual and work with the school district MARSS Coordinator) • ECS Annual Report due July 15 • Statement of Assurances signed by school district superintendent mailed to MDE by July 15 • NOTE: screening aid payment is made only when all these are received by MDE.

Step 1: Referrals for Potential Problems * Potential problem identified through screening. Referral is made. Of referrals made, problems found to be normal. A Of referrals made, referrals in process. C Of referrals made, problems confirmed. B 96 Of referrals made, Parent declines referral. D

Step 2: Potential Problems confirmed ** Of referrals made, problems confirmed through health assessment or educational evaluation. Of problems confirmed, resolved by/ or receiving medical intervention. E Of problems confirmed, served in special education. F Problem resolved by other methods. G not yet resolved. H

Annual Data Submission

Annual Data Submission

Annual Data Submission

PDSA: Fundamental Questions for Improvement – What are we trying to accomplish? – Team Aim Statement – How will we know that a change is an improvement? – Measures – What changes can we make that will result in an improvement? – Changes and change concepts Model for Improvement What are we trying to accomplish? How will we know that a change is an improvement? What change can we make that will result in improvement? Act Study Plan Do

Where to go for more information PDSA: Improvement Guide: A Practical Approach to Enhancing Organizational Performance, 2 nd Ed. G. Langley, K. Nolan, T. Nolan, C. Norman, L. Provost. Josey-Bass Publishers. , San Francisco, 2009. MDE website – Early Childhood Screening – http: //www. education. state. mn. us/MDE/Stu. Suc/Early. Learn/Early. Child. Screen/ index. html Minnesota Statute, 121 A. 16 – 121 A. 19 and MN Rule 3530. 3000 – 3520. 3400 – https: //www. revisor. leg. state. mn. us/statutes/? id=121 A. 16&year=2013&keyw ord_type=all&keyword=early+childhood+screening MARSS Manual – http: //education. state. mn. us/MDE/Sch. Sup/Sch. Fin/MARSSStu. Acc/MARSSRep. I nst/index. html

Contact Information • Margo Chresand, MDE (Program Coordinator) – Margaret. Chresand@state. mn. us • Debbykay Peterson, MDE (Fiscal) – Debbykay. Peterson@state. mn. us