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Delaware Birth to Three Early Intervention System Evaluation: Child Outcomes

Delaware Birth to Three Early Intervention System Evaluation: Child Outcomes. July 15, 2004 Conference Call Series: Measuring Child Outcomes “Examples of using changes in growth rates to measure child outcomes in Part C” Rosanne Griff-Cabelli, Delaware Part C rosanne.griff-cabelli@state.de.us.

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Delaware Birth to Three Early Intervention System Evaluation: Child Outcomes

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  1. Delaware Birth to Three Early Intervention System Evaluation:Child Outcomes July 15, 2004 Conference Call Series: Measuring Child Outcomes “Examples of using changes in growth rates to measure child outcomes in Part C” Rosanne Griff-Cabelli, Delaware Part C rosanne.griff-cabelli@state.de.us

  2. Delaware Birth to Three Child Outcomes Evaluation Primary purposes: 1. To document changes in the children served by Part C Programs 2. To collect data, systematically so that programs can communicate their impact on children and families to various audiences.

  3. Impetus for Delaware’s Child Outcome Evaluation • The State Budget Office, as part of the Interagency Management Resource Committee (IRMC), requested child change data from federal and state funded programs. • Part C’s evaluation was linked through the IRMC to early childhood programs, such as Head Start and Part B 619. • The IRMC Annual Report includes Part C evaluation results, distributed to Department Secretaries and Legislative Joint Finance Committee. • Part C formed an Ongoing Program Evaluation Committee (OPEC) to coordinate, review and update components of child outcome evaluation. • Results are shared annually at ICC and Part C regional staff meetings.

  4. Outcome Areas: Focus and Scope Outcome Measures: • Describe changes in eligible children’s development and functioning over time, while active in Part C programs by: • Developmental Domains • Motor • Cognitive • Play and Functional Changes

  5. Outcome Areas: Focus and Scope Demographic Variables: • Describe socio-economic factors of family • Describe demographic information such as gender, race/ethnicity, county of residence, age child started program, primary language spoken

  6. Design/Method Population to Sample: • Children selected are Part C eligible, have their first MDA completed, and not older than two years and six months • Random sample of every 15th child in New Castle County and every 10th in Kent and Sussex Counties • Children will have at least two points of evaluation, approximately one year apart • No service coordinator will have more than three children actively involved in Child Change at any given point

  7. Design/Method Measurement Instruments: • Bayley Scales of Infant Development II, administered as part of MDA • Fewell Play Assessment Scale (PAS) with adaptations for children with more severe disabilities • Demographic Information Form, administered by service coordinators • HOME [Home Observation for Measurement of the Environment] Inventory – Birth to Three, administered by service coordinators

  8. Design/Method • All assessments are administered by Part C program staff. • The PAS is a valuable addition to the battery of assessments conducted with children. • The PAS can be implemented by Part C program personnel but additional resources are needed for annual training. • A contract is in place with the University of Delaware, Center for Disabilities Studies for data analysis and reports.

  9. Analysis Using Proportional Change Index (PCI) • Delaware’s Part C Child Change Evaluation is analyzed through a contract with the University of Delaware, Center for Disabilities Studies. The statistical procedure used is PCI. • The PCI is a method devised by Mark Wolery of the University of Kentucky that “compares children’s rate of development at pretesting to their rate of development during intervention.”1 • The following link is to a paper on measuring developmental change. It refers to the PCI and its strengths and drawbacks. http://www.aare.edu.au/94pap/konzd94260.txt 1Mark Wolery, Exceptional Children, Volume 50, Number 2, page 168, 1983

  10. Analysis Using Proportional Change Index (PCI) Design/Method Developmental Gain / Pretest Developmental Age Time in Intervention / Pretest Chronological Age Divide second rate of development by first rate of development to calculate PCI. • Children who continue to develop at the same rate during intervention as they did prior to intervention will have a PCI of 1.0 • Children whose rates of development are slower during intervention will receive a PCI of less than 1.0 • Children whose rates of development accelerated during intervention will receive a PCI greater than 1.0

  11. Analysis Using Proportional Change Index (PCI) Design/Method Developmental Gain / Pretest Developmental Age Time in Intervention / Pretest Chronological Age Divide second rate of development by first rate of development to calculate PCI. • Children who continue to develop at the same rate during intervention as they did prior to intervention will have a PCI of 1.0 • Children whose rates of development are slower during intervention will receive a PCI of less than 1.0 • Children whose rates of development accelerated during intervention will receive a PCI greater than 1.0

  12. Analysis Using Proportional Change Index (PCI) Strengths of the PCI • It is not a measure solely of the actual number of months gained in intervention, but takes into account the number of months in intervention and the child’s rate of development at pretesting. • Comparisons can be made between children at various levels of delay, chronological age, and developmental age. Drawbacks of the PCI • Assumes children’s rates of development at pretesting would be stable in the absence of intervention. • Larger sample and three measures for each child would allow use of Growth Curve Analysis.

  13. Major Findings (sample in child change as of January 2004) • 43 children tracked • 22 Northern CDW • 21 Southern CDW • 23 male; 20 female • Disabilities: • 8 VLBW • 11 developmental delay • 24 VLBW and developmental delay • Ethnicity • 15 African American, 18 Caucasian, 6 Hispanic, 4 bi-racial The Children and Families:

  14. Major Findings (as of January 2004) • Family SES • 15 families below poverty level • 20 families above poverty level • 8 unknown • Education Level of Mothers • 2 less than 8th grade • 4 less than high school • 7 high school graduate/GED • 15 some college or technical school • 9 college degree • 2 graduate degree • 4 unknown The Children and Families:

  15. Major Findings (as of January 2004) 32 children with two PAS scores; 11 with three scores • Time between PASs (M=12.9 months) • Play skill changes (M=11.2 months; this is a .87 rate of development) • Expected rate of development (M=.72 or 8.64 months in 12 months time) • 1.21 times the rate of development expected for this group of children • There was no significant difference in rates of development for girls or boys or children living in poverty and those not living in poverty Play Skills Development:

  16. Major Findings (as of January 2004) 32 children with 2 Bayley Mental scores; 11 with three scores • Time between Bayleys (M=12.3 months) • Mental score changes (M=10.6 months; this is a .86 rate of development) • Expected rate of development (M=.67 or 8.0 months in 12 months time) • 1.28 times the rate of development expected for this group of children • There remains no significant difference in rates of cognitive development for girls and boys or children living in poverty and those not living in poverty Mental Skills Development:

  17. Major Findings (as of January 2004) 32 children with 2 Bayley Motor scores; 11 with three scores • Time between Bayleys (M=12.3) • Motor score changes (M=10.3 months; this is a .84 rate of development) • Expected rate of development (M=.69 or 8.3 months in 12 months time) • 1.22 times the rate of development expected for this group of children • No differences in rates of development for children living in poverty and those not; no differences between boys and girls Motor Skills Development:

  18. Major Findings (as of January 2004) • Of the 43 children, 36 had rates of development greater than 1.0 for at least a one year period of time in both motor and mental skills • Seven children had rates of development equal or greater to 1.50 for at least a one year period of time in at least one domain of development • Seven children had rates of development below 1.0 for at least a one year period of time • After at least one year of services, only two children had rates of development lower than that which they entered the program (usually attributed to a progressive or degenerative disorder) Additional Findings:

  19. Lessons Learned • Early intervention seems to be having a positive effect on children’s play, and mental and motor skill development across demographic groups. • Child Change assessments are conducted systematically and program staff are able to implement the Bayley assessments as part of MDA annual timelines. • Child Change results are reported in context of Birth to Three Evaluation Plan. • Recommendations • Report the trend of children’s outcomes in three year intervals so that a long-term trend can be determined; the cohort should always be between 40-60 children. • Efforts are in place to increase the number of males in the evaluation to 55-60% (currently at 54%). • Continued efforts need to be in place to encourage families to participate in the evaluation since a sampling method is used.

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