A4. Support the identification of developmental delays or special needs by sharing observation and assessment information with families and specialists.

This lesson of the Assessment module will focus on the identification of developmental delays or special needs of the children in your care.

Part 1 of this lesson describes the role of the early childhood instructional staff in the identification process and how to establish instructional staff expectations accordingly.

In Part 2, your site/campus-based leadership team will learn about the steps instructional staff can take to effectively communicate with families about learning and development concerns and how to support children and families in the identification process.

Part 3 provides an example in action, describing the steps taken by one early childhood instructional staff member to communicate her concerns to the family of an infant in her care.

To get started, download the Implementation Guide for this component and refer to the Action Step for this lesson. Examine the Implementation Indicators for each level of implementation and note the Sample Evidence listed at the bottom of the chart.

Early childhood instructional staff cannot diagnose delays or special needs. However, they play a key role in the collaborative process of identifying children's needs and providing support to children with developmental delays or disabilities. Through the assessment process established at your site, you and your staff may become concerned about the learning and development of particular children. The purpose of this lesson is to provide guidance and resources so that instructional staff can offer the best support possible in the identification of possible developmental delays and disabilities.

Setting expectations for early childhood instructional staff

As leaders, you will want to communicate clear expectations to your staff regarding their role in the identification process. You and your team may establish these expectations by considering the following:

• What is governed by law (e.g., according to the Individuals with Disabilities Education Act, IDEA)? Information about what childcare providers need to know about disability laws can be found in this eXtension website article.
• What is reasonable given your instructional staff's expertise?
• What are the expectations you have set in place for instructional staff in collecting and using assessment data?
• What are the expectations you have set in place for instructional staff in communicating and collaborating with families?
• What resources, services, and specialists in your community are available to children with special needs?

As you establish appropriate expectations for instructional staff, you will need to plan any support they need to carry out those expectations. Professional development should advance staff's knowledge of best practices in identifying and supporting children with possible difficulties.

First, instructional staff may need continued support in effective ways to communicate and collaborate with families. (This topic is further addressed in Part 2.) Second, your team should continue to assess instructional staff's needs in collecting assessment data. Instructional staff members need to be very familiar with the developmental milestones for each age range, and they may need ongoing support in effectively observing child behavior and developmental skills. Third, instructional staff may need support in keeping up-to-date with collecting and reviewing data, following the system that you have established at your site. You may refer back to the content of Lessons 1, 2, and 3 of this module in planning staff support in these areas.

Finally, as leaders, you may need to raise awareness about the importance of early and accurate identification of delays and disabilities. The Center for Disease Control and Prevention and the Center for Inclusive Child Care provide rich information for instructional staff about developmental milestones, how to share concerns, and the importance of acting early.

As you set expectations and plan for staff support, always keep in mind what is reasonable given your instructional staff's level of knowledge and expertise. Instructional staff members should in no way present themselves as diagnosing a delay or special need. They only share a concern and communicate a possible need for a referral or further evaluation. Instructional staff members need to know about and feel comfortable connecting families with appropriate resources outside of the early childhood site. Families of children age 0–3 who share the concern should be encouraged to reach out to their primary care physician or contact Early Childhood Intervention Services (ECI) for further assistance. Parents and families of children age 3 and older should be encouraged to reach out to their primary care physician or contact their local school district.

Early childhood staff members are not responsible for administering any further evaluations or assessments, nor are they responsible for creating an intervention plan for a child if a delay or disability is identified. However, they may be asked to participate in the process of developing the child's Individualized Family Service Plan (IFSP) or Individualized Education Program (IEP).

Maximizing your assessment system to support the identification process

As you learned in previous lessons on assessment, valid and reliable data is necessary to provide the best daily instruction for the children in your care. Through this process of systematically collecting information and planning instruction, you and your staff may become concerned about the learning and development of particular children. Having accurate data and an informed and observant staff can help maximize your ability to support the identification of children with possible delays or special needs.

What does staff need to know about developmental milestones?

Generally, five categories of skills are examined for developmental delays: gross motor, fine motor, language, cognitive, and social. You will find detailed descriptions at the My Child Without Limits website. There are age ranges within which specific developmental milestones are usually achieved. Some children may achieve the skill early in that time frame, while others may achieve it later but still within the expected age range. When a child has reached the upper age range of expected development for a skill and is not showing signs of that skill, there may be cause for concern.

Instructional staff members need to understand how each skill develops and consider whether the child has prerequisite skills in place. Instructional staff should watch for delays in other areas that may be associated with one another. They need to be aware of the other milestones that the child has already developed and when within the expected range of time they developed. Instructional staff members who are knowledgeable and informed in all of these areas will be able to provide the best support possible when communicating concerns to families and appropriate specialists.

Always keep in mind that some children may have had limited exposure or have received little reinforcement in developing a skill. For example, a toddler who lives in a one-story house without stairs may not have had opportunities to practice learning to climb stairs. An infant who does not have access to books at home may not have had opportunities to learn skills such as pointing to pictures in a book and turning pages. A toddler whose parents and family regularly spoon-feed her may show a delay in learning to feed herself.

When staff notice that a child appears to be delayed in a specific skill, it may be appropriate to ask the parent or guardian whether the child has had opportunities at home to practice that skill. If not, instructional staff can purposefully provide more opportunities for the child to practice that skill and observe how readily the child makes progress.

What does staff need to know about pre-literacy development?

As children begin to develop more advanced pre-literacy skills, instructional staff members begin to collect specific information about those skills and use the information regularly to plan instruction. In Lesson 2, you learned about the various pre-literacy assessments (e.g., screeners) you can use to identify potential difficulties in reading and writing readiness skills. You and your team want to ensure that instructional staff members are up-to-date in reviewing this information. They will need to use this data not only to plan daily individualized instruction, but also to stay informed about children who fall behind expected benchmarks and to monitor those children’s progress toward mastering skills. It can be helpful for you to review the Effective Instructional Framework module and support instructional staff in recognizing potential pre-literacy difficulties and responding with individualized instruction. Instructional staff members need to monitor children's response to instruction and know when to communicate a concern about a child who is not responding to that instruction or progressing in certain skills.

The most important role of early childhood instructional staff in this Action Step is effectively communicating with families and specialists about children with potential special needs. Along with families, instructional staff members are primary and invaluable sources of information regarding children's learning and development because they interact closely with children on a regular basis. As leaders, you want to support instructional staff in having the skills to fulfill this role. These skills include instructional staff's ability to collaborate and effectively communicate with families, to understand and talk about data, and to connect families to resources (at your site and within the larger community) that can provide support to children identified with special needs.

How can instructional staff begin the communication process?

Before approaching the family with a concern, instructional staff should ensure that the concern has been discussed with the leadership team at the site. Site administrators should be involved before moving forward with a family conference or referral. A concern should be brought up based only on multiple observations or assessments of the child over time.

When planning a conference with a family, you will need to choose a place where you can talk privately. Be sure to schedule the conference when both parties will have plenty of time to talk. Most importantly, a discussion regarding a concern should not be the first interaction the family and instructional staff have had about a child's development. Instructional staff members should already have established a relationship with the family of each child in their care, ensuring that the family is familiar with the site's assessment system, including what is assessed, how it is assessed, and why it is assessed.

Instructional staff should bring appropriate data to the meeting, including informal observations of the child's development and behavior, as well as results from formal assessments. The family should be encouraged to bring some observations regarding their child's development and behavior to foster the collaboration.

How can instructional staff help navigate parents’ and families' fears and emotions surrounding possible delays and special needs?

Instructional staff must understand that it is reasonable for a family to express strong emotions when a concern about their child is presented. This is why it is critical that staff remain supportive, caring, and respectful. Encourage staff to always keep in mind that the goal is the child's well-being.

When communicating with families, staff should use respectful, positive language and avoid loaded language (e.g., language that provokes unnecessary alarm or makes assumptions beyond what the data show). Of course, instructional staff should always remind families that staff members are not specialists in identifying delays or disabilities, but they are there to support the families as sources of information about their children's learning and development. There are two important messages to communicate to families: (1) concerns shared by staff members need to be evaluated further, and (2) there are significant benefits of getting assistance early for their children if delays are identified.

As leaders, you want to encourage instructional staff to base their communication with families on the evidence and data they have collected, providing specific examples. For instance, instructional staff may describe certain events that they observed and recorded, such as, "The other day a gust of wind blew the door shut. It made a loud bang and scared all of us. I noticed that Sara didn't flinch as would be expected."

When discussing formal assessments with numerical scores, you will need to guide and train instructional staff on how to describe results beyond just the numbers. Instructional staff will need to know how to communicate what the numbers mean and what they say about the child's learning and development. Tip Sheet 7, "Sharing Screening Results with Parents" on the Wisconsin Early Childhood Collaborating Partners website, offers some specific examples of language instructional staff can use to accomplish this:

• "These results are reassuring."
• "These results are somewhat concerning."
• "These results may show a need for more practice."
• "These results are concerning."
• "These results show a need for further assessment."

Further tips and guidance on how to communicate concerns with families can be found on the eXtension website.

How can instructional staff empower families in the process of identification?

Information is power. As leaders, you want to ensure that instructional staff have the knowledge to equip families with the information they need. This way, families can understand the process for receiving additional support and make the best educational decisions for their children. Families can be empowered by learning about and connecting to resources available to them. Instructional staff can guide families in working with their primary care physicians to seek further assessments. Connecting families with Early Childhood Intervention Services (ECI) (for children 0–3) or the local school district (children over the age of 3) is another way instructional staff can assist families as they seek additional assessments. Instructional staff can make the initial referral to ECI.

The Hand to Hold website provides guidance on the process for receiving services, both for children age 0–3 and children age 3–5. This information describes how to get help early, what to expect from the child's doctor, what to expect after the doctor's visit, how ECI can help, and how to make the transition between ECI and a Preschool Program for Children with Disabilities (PPCD).

It could be helpful to review the Effective Instructional Framework module to support instructional staff in continued collaboration with families, specialists, and other services throughout the time children with special needs are in their care.

TO LEARN MORE: For more information about supporting the identification of delays and disabilities, you may review the following resources:

Birth to 5: Watch Me Thrive! is a coordinated federal effort to encourage healthy child development, universal developmental and behavioral screening for children, and support for the families and providers who care for them.

Early Childhood Intervention Services is a statewide program for families with children, birth to three, with disabilities and developmental delays. ECI supports families to help their children reach their potential through developmental services. Services are provided by a variety of local agencies and organizations across Texas.

The Partners Resource Network (PRN) is a non-profit agency that operates the Texas statewide network of Parent Training and Information Centers (PTIs), which includes PATH, PEN, and TEAM. The Texas PTIs provide training, education, information, referral, emotional support, and individual assistance in obtaining services.

Prevention and Early Intervention is a division of Texas Child Protective Services that supports children and families through the prevention of child abuse and juvenile delinquency.

The Talking with Families section of the Early Childhood Technical Assistance Center describes resources and best practices related to talking with families about child and family outcomes.

The following scenario describes the steps taken by one early childhood staff member to communicate her concerns to the family of an infant in her care.

Scenario: Tyler is a nine-month-old infant who has joined Ms. Nieves' class in the last three weeks. His parents always take the time to visit during both drop-off and pick-up and love hearing what Tyler, their only child, has done during the day. Ms. Nieves has recently noticed that Tyler rarely reaches for a toy and seems to have difficulty using his hands and eyes together when he does reach. In addition, Tyler does not follow objects with his eyes as Ms. Nieves moves them from side to side, a skill that typical four-month-olds have developed. After sharing her concerns with the leadership team at her site, Ms. Nieves decides that she needs to have a conversation with Tyler's family soon. She gathers information about developmental milestones and some examples from her observations of Tyler so that she can share them with Tyler's family. She has already established a relationship with Tyler's parents and knows they both have busy schedules during the day. However, she knows that Tyler's mom is usually available to talk after work when she picks up Tyler in the afternoon.

When Tyler's mother picks him up on Thursday afternoon, Ms. Nieves asks if she can set up a time to talk with Tyler’s mother and her husband about Tyler's learning and development. They decide to meet the next afternoon, and Ms. Nieves prepares to discuss her concerns. Below, you can read how Ms. Nieves uses caring and supportive language to communicate information about Tyler during the meeting:

Good afternoon, Mr. and Mrs. Jones. Tyler has adjusted to being in our class so well over the last three weeks. His smile always makes my day! I have noticed a few things about Tyler's development that I would like to discuss with you.

I have observed that Tyler doesn't usually reach for toys and other objects, and when he does, it seems that his eyes and hands are having a hard time working together. As I play with toys with him, I have observed that he has trouble following them from side to side with his eyes. Have you noticed any of these things at home?

[The Joneses share what they have noticed while Ms. Nieves listens carefully, allowing plenty of time for the Joneses to respond.]

Here is a little information on developmental milestones for a child Tyler's age. I would love to talk more about this next week after you have had a chance to read more about the milestones and talk with each other.

I know this is hard to talk about. I am not a qualified specialist in developmental delays, but I want to share my concern with you. If you agree, I think discussing this with Tyler's doctor in the next few weeks would be a good idea.

If you don't feel comfortable contacting Tyler's doctor, I can make a referral to ECI, which is the Early Childhood Intervention Services. They can help us gather some more information about Tyler and determine if we need to be concerned. Getting assistance as early as possible can make a huge difference in how Tyler develops.

We want to do all we can to help Tyler be his best! Thank you so much for talking with me today.

* A large portion of this conversation was adapted directly from the CDC "Tips for Talking with Parents."

NEXT STEPS: Depending on your progress in learning about and developing a system for sharing information with families and specialists to support the identification of delays and disabilities, you may want to consider the following next steps:

• Establish and communicate expectations for instructional staff with regard to communicating concerns about children with site leaders, families, and outside specialists.
• Assess staff's needs in communicating effectively with parents and families.
• Assess instructional staff's knowledge about developmental milestones and the resources and services available to families when a delay or disability is suspected.
• Plan professional development based on staff's needs.

A4. Support the identification of developmental delays or special needs by sharing observation and assessment information with families and specialists.

With your site/campus-based leadership team, review your team’s self-assessed rating for Action Step A4 in the TSLP Implementation Status Ratings document and then respond to the four questions in the assignment.

TSLP Implementation Status Ratings 0-SE

As you complete your assignment with your team, the following resources and information from this lesson’s content may be useful to you:

• Part 1 provides guidance in understanding the role of the early childhood staff in the identification process and establishing expectations accordingly.
• Part 2 provides suggestions and resources for effectively communicating concerns with families and empowering them during the identification process.
• Part 3 provides a scenario showing one instructional staff member identifying a possible delay and effectively communicating her concerns with the family.

Next Steps also contains suggestions that your site or campus may want to consider when you focus your efforts on this Action Step.

To record your responses, go to the Assignment template for these Action Steps and follow the instructions.

Centers for Disease Control and Prevention. (n.d.) Tips for talking with parents. Retrieved from http://www.cdc.gov/ncbddd/actearly/pdf/parents_pdfs/tipstalkingparents.pdf

Wisconsin Early Childhood Collaborating Partners. (2014). Tip sheet 7: Sharing screening results with parents. Retrieved from http://www.collaboratingpartners.com/screening-early-identification-howtoworksheets.php