Simplifying Reporting of Communication Development Outcomes for Infants and Toddlers with Hearing Loss Karen Anderson, PhD Florida EHDI Audiology Consultant.

Simplifying Reporting of Simplifying Reporting of Communication Development Communication Development

Outcomes for Infants and Outcomes for Infants and Toddlers with Hearing LossToddlers with Hearing Loss

Karen Anderson, PhDKaren Anderson, PhDFlorida EHDI Audiology ConsultantFlorida EHDI Audiology Consultant

Coordinator of EI Services for Hearing ImpairedCoordinator of EI Services for Hearing ImpairedKen McCain, Early Steps Data CoordinatorKen McCain, Early Steps Data Coordinator

March 26, 2007 March 26, 2007

Federal Pressure to Improve Outcomes Federal Pressure to Improve Outcomes of Children with Hearing Lossof Children with Hearing Loss

The Government Performance and Results Act (GPRA) of The Government Performance and Results Act (GPRA) of 1993 (Public Law 103-62) requires that Federal programs 1993 (Public Law 103-62) requires that Federal programs establish measurable goals approved by the US Office of establish measurable goals approved by the US Office of Management and Budget (OMB). The GPRA Measures for Management and Budget (OMB). The GPRA Measures for the EHDI program are:the EHDI program are:

The number of infants screened prior to dischargeThe number of infants screened prior to discharge The number with confirmed hearing loss by 3 mos of ageThe number with confirmed hearing loss by 3 mos of age The number enrolled in an EI program by 6 monthsThe number enrolled in an EI program by 6 months The number with confirmed or suspected hearing loss The number with confirmed or suspected hearing loss

referred to an ongoing source of comprehensive healthcare referred to an ongoing source of comprehensive healthcare (i.e. medical home)(i.e. medical home)

The number of children with non-syndromic hearing loss The number of children with non-syndromic hearing loss who who have developmentally appropriate language and have developmentally appropriate language and communication skills at school entrycommunication skills at school entry

Quality Indicators (draft JCIH 2006) Quality Indicators (draft JCIH 2006)

Quality Indicators for Early InterventionQuality Indicators for Early Intervention For infants with confirmed hearing loss For infants with confirmed hearing loss

who qualify for Part C, the who qualify for Part C, the percentage for percentage for whom parents have signed an IFSP before whom parents have signed an IFSP before 6 months of age6 months of age (for children with acquired (for children with acquired or later identified hearing loss, the or later identified hearing loss, the percentage for whom parents have signed percentage for whom parents have signed an IFSP within 45 days of the diagnosis). an IFSP within 45 days of the diagnosis).

Recommended benchmark is Recommended benchmark is 90%90%..

Quality Indicators (draft JCIH 2006) Quality Indicators (draft JCIH 2006)

Quality Indicators for Early InterventionQuality Indicators for Early Intervention Percent of infants with confirmed hearing Percent of infants with confirmed hearing

loss who receive the loss who receive the first developmental first developmental assessment using standardized assessment using standardized assessment protocolsassessment protocols ( (notnot criterion criterion reference checklists) for language, speech reference checklists) for language, speech and non-verbal cognitive development and non-verbal cognitive development by by 12 months of age12 months of age

Recommended benchmark is 90%Recommended benchmark is 90%

Yep – more still from JCIH 2006Yep – more still from JCIH 2006 Spoken and/or sign language Spoken and/or sign language

development should be commensurate development should be commensurate with the child’s age and cognitive abilitieswith the child’s age and cognitive abilities

Early-intervention programs must assess Early-intervention programs must assess the language, cognitive skills, auditory the language, cognitive skills, auditory skills, speech, and social-emotional skills, speech, and social-emotional development of all children with hearing development of all children with hearing loss loss at 6 month intervalsat 6 month intervals during the first 3 during the first 3 years of life, years of life, using assessment tools using assessment tools standardized on children with normal standardized on children with normal hearing. hearing.

Yep – more still from JCIH 2006Yep – more still from JCIH 2006

While criterion referenced checklists may While criterion referenced checklists may provide valuable information for provide valuable information for establishing intervention strategies and establishing intervention strategies and goals, these assessment tools alone are goals, these assessment tools alone are not sufficient for parents and intervention not sufficient for parents and intervention providers to providers to determine whether a child’s determine whether a child’s developmental progress is comparable to developmental progress is comparable to hearing peers.hearing peers.

Advantages of a state Communication Advantages of a state Communication Development Monitoring ProtocolDevelopment Monitoring Protocol

Consistent biannual assessment protocol in stateConsistent biannual assessment protocol in state Involves parents in all aspects of data gatheringInvolves parents in all aspects of data gathering Provides data-based information to parent and team Provides data-based information to parent and team

on which to base decisions about serviceson which to base decisions about services Provides information that can be used to analyze child Provides information that can be used to analyze child

outcomes on an individual, regional, and statewide outcomes on an individual, regional, and statewide basis (demands for accountability, outcomes basis (demands for accountability, outcomes measures federally)measures federally)

Children transition to Part B with a documented history Children transition to Part B with a documented history showing rate of developmentshowing rate of development

Parent involvement leads to more informed advocacy Parent involvement leads to more informed advocacy and fairer expectations for student development and and fairer expectations for student development and learninglearning

Components of Florida’s CDMComponents of Florida’s CDM

Collection and biannual updating of Collection and biannual updating of demographic and hearing and service demographic and hearing and service related informationrelated information

Norm referenced vocabulary checklist (3 Norm referenced vocabulary checklist (3 levels - customized MacArthur Scales)levels - customized MacArthur Scales)

Criterion referenced SKI*HI Language Criterion referenced SKI*HI Language Development ScaleDevelopment Scale

Auditory Skills ChecklistAuditory Skills Checklist Parent Interview Progress ReportParent Interview Progress Report

Vocabulary ChecklistVocabulary Checklist

Language Language DevelopmentDevelopment

ScaleScale(LDS)(LDS)

Auditory Skills ChecklistAuditory Skills Checklist

Parent Interview Progress ReportParent Interview Progress Report

Inquires about practicesrelated to providingcommunication access.

If a child is not progressing at the desired rate it may be due to family skills or consistency in providing access to language and/orsound.

New way to report CDM results!New way to report CDM results! Providers complained of paper report forms and Providers complained of paper report forms and

faxingfaxing Providers complained of having to look at norm Providers complained of having to look at norm

charts for vocabulary test resultscharts for vocabulary test results Providers confused about how to obtain Providers confused about how to obtain

information to indicate growth in expressive information to indicate growth in expressive vocabulary per 6-month periodvocabulary per 6-month period

EVERYONE WANTED AN E-VERSION!EVERYONE WANTED AN E-VERSION! http://www.cms-kids.com/SHINE/shineCommunihttp://www.cms-kids.com/SHINE/shineCommuni

cationDev.htmcationDev.htm

Submitting the CDM ReportSubmitting the CDM Report

Person prints out a copy Person prints out a copy Enter service coordinator email addressEnter service coordinator email address

Service coordinator receives an abbreviated Service coordinator receives an abbreviated report report

Submit button at bottom directs an email Submit button at bottom directs an email that sends the data to an Excel data sheet that sends the data to an Excel data sheet at the state officeat the state office

General Information

Baseline or Review:   baseline

Submitted by:   LH

Email:   [email protected]

Completion Date:   2.26.07

Child Unique ID:   XXXXXXXX28

Birth Month:   03/06

Early Steps Region:   Gold Coast

Hearing Loss checked for progression:

  3_months

Degree of Hearing Loss - Left Ear:

  41-55dB

Degree of Hearing Loss - Right Ear:

  41-55dB

Gender:   Male

SHINE Vocabulary Checklist

Total raw score for production:   0

Percentile Rank:   below 5th

50th Percentile Rank occurs at age:

  Below 8

Language Development Scale

Highest Receptive Unit attained:   2

Highest Expressive Unit attained:   4

Auditory Skills Checklist

Total number of skills Acquired:   6

Total number of skills Inconsistent:

  0

Total number of skills Emerging:   3

Report receivedby service Coordinator

Used in 6-monthperiodic IFSPprogress report

Now the hard part – making sure the Now the hard part – making sure the CDM information is submitted for every CDM information is submitted for every

young child with hearing loss!young child with hearing loss!

A FINAL WORD: Another state could A FINAL WORD: Another state could certainly use the source code for their own certainly use the source code for their own CDM but they would need to process the CDM but they would need to process the forms their own way.  The code would forms their own way.  The code would need to be modified to fit the state’s need to be modified to fit the state’s individual needs.individual needs.

QUESTIONS?QUESTIONS?

For more information on SHINE materials go to http://www.cms-kids.com/SHINE/index.htm