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Box 2: CHECKLIST TO HELP IDENTIFY APPROPRIATE SCREENING AND ASSESSMENT INSTRUMENTS

Below are elements of screening and assessment instruments and their use that contribute to their usefulness for Head Start programs serving pregnant women and families with infants and toddlers. For each instrument under consideration, check the box beside each element that applies. The more boxes that are checked, the better is the match between the program’s needs and the instrument.

  Instruments
The instrument measures what the program wants to know.            
The instrument was designed for the purpose for which it will be used.            
The instrument is appropriate for the cultural backgrounds of children/families who will be assessed.            
The reliability and validity of the instrument are sufficiently high for the purposes for which it will be used.            
Sufficient resources are available to obtain and use the instrument.            
It is feasible to administer the instrument according to the instrument developer’s directions.            
The instrument facilitates sharing information about children (or families) with staff and parents.            
Staff members who will administer the instrument have (or will receive) the training needed to administer and score the instrument correctly.            
The instrument is appropriate for children with disabilities (or their parents).            

It is feasible to administer the instrument in settings children (or families) are
comfortable with.

            

 


Figure 2

THE DEVELOPMENT OF A CONTINUOUS IMPROVEMENT MODEL CLAYTON FAMILY FUTURES EARLY HEAD START PROGRAM
Frequently Asked Questions

Will what works in one program system work in other areas?

Ex. The system for providing Diet and Nutrition screenings was identified as very efficient. Could we apply this system to other program areas needing a similar process?

What actions can we take in areas that are not reaching the benchmarks established?

Several internal actions were taken to address the challenges in providing dental screenings.
However, they did not produce the desired outcomes. In response, the health team created a strong community collaboration with the School of Dentistry that was extremely effective in connecting children to dental services.

Is it all about the numbers?

Staff struggled with putting quality into numbers. Herein lies one of the basic challenges of the approach—how is it done so it is not seen as an either/or paradigm, either quality or accountability? It is a tendency to see these as opposing views. It is our belief that these are not separate concepts. Being able to provide consistent services (accountability) is basic to the quality and integrity of the program. It is the analysis of the data and how leadership is able to interpret its impact on quality that brings the process to life.

Developed by Chris Sciarrino, The Clayton Foundation, Denver, Colorado Consultation by Charmaine Lewis, Clayton Family Futures Early Head Start, Denver, Colorado

 Step One: Setting up tracking systems and monthly reporting formats for a limited number of outcomes (a good starting point is to ask, “Are we meeting the Performance Standards in all areas?”)
Actions Resources Time
Frame		 Program Implications
  • Identify what you want information about
  • Identify what is currently being tracked in those areas
  • Identify the data tracking forms that exist and/or that need to be created
  • Set up databases to support the collection of the information
  • Set up monthly summary reporting formats and ongoing deadlines for the report distribution
  • Analyze the budget –begin to allocate funds for supporting continuous improvement implementation (start small)
  • Designate existing and/or new staff to carry out the actions
 2-3 months
  • Questions about the link between reports and job performance
  • Training for supervisors to effectively utilize the reporting in supervision
  • Creation of meaningful dialogue about barriers encountered by staff in delivering quality services
Step Two: Beginning to use inquiry and analysis as a method of self-evaluation, reflection, and program improvement
Actions Resources Time
Frame		 Program Implications
  • Disseminating summary reports to appropriate staff
  • Program leadership leads the way for team analysis by working with the creator of the reports to identify trends, issues, and strengths.
  • Monthly team analysis meetings are established with key staff responsible for supervision of program implementation areas.
  • Action plans are created with time lines to address identified areas of need and how reports will be used in supervision
  • Establishment of benchmarks for every outcome area
  • This model utilized 1 FTE for supporting the development and ongoing implementation of the design
  • One formal meeting for the director to discuss the reports with the creator of the reports was established
  • A monthly administrative team meeting focused on analyzing the reports was established
  • Several informal discussions regarding implementation, analysis, and supervision strategies were needed to modify and adapt the approach
 1 year
  • Working with program coordinators to see reports as objective and representative of what families and children are receiving versus “what I have not done.”
  • Beginning to use a reflective process to create change
  • Ability to use tangible evidence is an opportunity to acknowledge and address needs
  • Creating pride in accomplishment of benchmarks
Step Three: Using Continuous Improvement data for program planning and communication with stakeholders
Actions Resources Time
Frame		 Program Implications
  • Utilize reports to draw conclusions and ask questions about the EHS experience for children and families. Link this information to reflective supervision with staff.
  • Reports collected over time are compared to demonstrate trends, highlight issues, program strengths and needs
  • Information is used in conjunction with yearly self-assessment and community needs assessment for program planning
  • Reports continue to be refined as adaptations needed present themselves.
    • Reports are summarized quarterly for dissemination to stakeholders
  • Meeting time
  • Staff commitment to a set of clearly articulated and shared values-
    • Quality-commitment to striving for excellence; doing the best possible job working toward a common vision
    • Accountability-commitment to a set of clear, well defined and high standards (i.e., performance standards); demonstrating through action our ability to meet those standards
    • Openness and collaboration-commitment to and examination of diverse perspectives and engaging in group processes and partnerships that help determine the path to high quality programs
    • Reflection- commitment to reviewing and dialoguing about current practices along with an acceptance of one’s personal responsibility in achieving high quality
    • Self-growth-dedication to each individual’s growth
    • Follow through-commitment to making happen what is planned, expected, and desired
 ongoing
  • As coordinators become invested in and comfortable with the reports, they begin meeting together to ensure integration of Continuous Improvement efforts and to identify barriers to quality implementation of services.
  • Analyses discussions became more complex as staff began to ask more questions.
  • Having aggregated data readily available on a monthly basis allows for staff to easily answer 1.)Are we doing what we say we are doing? 2.) Are we accomplishing the outcomes we want to accomplish?
  • Creating a meaningful dialogue and sharing of outcomes information with governing boards, policy council, parents. Readily available outcome data allows for timely and accurate reports to funders

Comments from staff:
“Having information about outcomes reported to me has really helped me plan for my whole class and individual children.”
“At first it felt vulnerable and scary that my job was out there in numbers, but now I realize how helpful it is to know just what is happening and how the reports help me to offer better services.”
“We know we are ’walking our talk’.”
“Rather than responding to a checklist for someone else, we are using the information with staff and for planning.”

 

Box 3: AN EXAMPLE OF A STATEWIDE APPROACH TO MEASURING OUTCOMES FOR EARLY HEAD START

Efforts to measure and report outcomes can be implemented at broader levels. In Kansas, for example, state Early Head Start programs developed and agreed to collect data on a core set of outcomes as part of a statewide system for assessing services for children and families. This system, called Connect Kansas, supports outcome-based community planning and community capacity building to create and sustain environments in which all Kansas children are safe, connected, nurtured, and supported by caring and involved adults and communities. Outcomes for Early Head Start programs were developed through four focus group discussions. These focus groups included a wide range of stakeholders, state administrators, federal Administration for Children and Families Region VII staff, Head Start Quality Improvement Center staff, Early Head Start directors, and parents.

The following core outcomes will be measured consistently by 13 state Early Head Start grantees in 32 counties. Families must be enrolled in Early Head Start for a minimum of 6 months to be included in outcomes measures.

Outcome 1: Pregnant women and newborns thrive.

___% of pregnant women who receive prenatal care within the first 45 days of enrollment

___% of new mothers who deliver an infant weighing 5.5 pounds or greater

Outcome 2: Infants and children thrive.

___% of teachers working on or having a minimum Child Development Associate (CDA) certificate Show Breakdown:

___are working on a CDA (any stage but not yet credentialed)

___have acquired a CDA

___have an AA/AS in ECE or related field

___have a BA/BS in ECE or related field

___have a MA/MS in ECE or related field

___have other degree, specify

___% of Early Head Start learning environments with a score of 5 or higher using the Thelma Harms Rating Scale (measured at entry, 6 months, 1 year, and every year thereafter. Data should be taken from the last score.)

___% of Early Head Start children who are up-to-date on immunizations

___% of Early Head Start children who are up-to-date on well child checks/Kan Be Healthy

Outcome 3: Children live in stable and supported families

___% of parents who demonstrate improved parenting skills (measured by the Parents as Teachers Parent Knowledge Questionnaire upon entry, 6 months, 1 year, and every year thereafter)

___% of enrolled families with one or more parents employed, enrolled in school, or attending a job training program 9 out of 12 months enrolled in Early Head Start Show Breakdown:

___less than 30 hours of employment

___greater than or equal to 30 hours of employment

___enrolled in school (part time or full time)

___attending a job training program

___% of families who have a supportive home environment for their child with a variety of learning experiences and materials (measured by the HOME upon entry, 6 months, 1 year, and every year thereafter. Data would be taken from the last score, middle half or higher. Data will not be collected on first time pregnant women until after the birth of the baby.)

Outcome 4: Children enter school ready to learn.

___% of children without a diagnosed disability who demonstrate age-appropriate development in the three domains of: Intellectual, Social-Emotional, and Motor Skills (measured by the Parents as Teachers Developmental Milestone Checklist)

___% of children who demonstrate age-appropriate language (as measured by the Early Communication Indicator, Juniper Gardens)

Other data needed for collection purposes only:

  1. Total # of children enrolled in EHS who are receiving child care services.
  2. Total # of non EHS children receiving quality child care services in EHS child care partnerships.
  3. 3% of children identified through screening for further intervention services.
  4. % of children with an IFSP, Individual Family Service Plan or IEP, Individual Education Plan, in place (IFSP/IEP denotes special services).

For additional information contact:

Mary Weathers
Kansas Early Head Start Manager
Social and Rehabilitation Services
915 SW Harrison, Room 681 W
Topeka, Kansas 66612
785-296-4712
mxkw@srskansas.org

Lynda Bitner
Administration for Children and Families
601 E. 12th Street, Room 276
Kansas City, Missouri 64106
816-426-5401
lbitner@acf.hhs.gov

 



 

 

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