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Quality in Child Care and How to Measure it

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  1. Quality in Child Care and How to Measure it The Environment Rating Scales Training for Child Care Health Consultants Holly Clendenin, RN Child Care Health Consultation

  2. Training Objectives • Identify 3 reasons why we want to measure quality in child care • Identify 4 Environment Rating Scales and assess what scale is appropriate to use and when • Describe the role of the CCHC in using the Environment Rating Scales

  3. Training Objectives • Describe how to administer the ITERS Scales • Be familiar with scoring, alternate scoring, and the score sheet and profile of the ITERS • Be familiar with terms used throughout the ITERS-R and ECERS-R

  4. Training Objectives • Be familiar with the subscale Personal Care Routine and the indicators and items in the subscale • Video training and practice scoring the ITERS-R and ECERS-R • Practice with a center in your area scoring their personal care routine and giving feedback on your observations

  5. Ways to Measure the Quality of Childhood Programs There are two major approaches to measuring the quality of early childhood programs. One approach uses structuralindicators of the program such as staff-child ratio, group size, teachers’ educational levels, and square footage per child. Structural indicators form the basis for out-of-home child care regulation and they are important to insure that quality care has been documented.

  6. Ways to Measure the Quality of Childhood Programs The other approach measures quality through observation of ongoing processes, such as staff-child, child-child, staff-staff, and staff-parent interactions, and the interactions staff and children have with the early childhood setting and materials. This latter approach is calledprocess quality assessment.

  7. The Environment Rating Scales The Harms, Clifford and Cryer Environment Rating Scales (ECERS-R, ITERS-R, FCCERS-R and SACERS) are designed to assess processquality in an early childhood or school-age care setting. Assessment of process quality has been found to be more predictive of child development outcomes than structural indicators (Whitebook, Howes and Phillips, 1995).

  8. Harms, Clifford and Cryer Environment Rating Scales

  9. Four Environment Rating Scales These four scales share the same format and scoring system but vary considerably in requirements, because each scale assesses a different age group and/or type of child development setting.

  10. Four Environment Rating Scales The guiding principle of all the Environment Rating Scales is to focus on what we know to be good for children.

  11. SACERS • SACERS (1996) The School-Age Care Environment Rating Scale: Designed to assess before- and after-school group care programs for school-age children, ages 5 to 12 years. The total scale consists of 49 items, including 6 supplementary items for programs enrolling children with disabilities.

  12. FCCERS-R • FCCERS-R (2007) The Family Child Care Rating Scale-Revised: Designed to assess family child care programs conducted in a provider’s home with infants and children from birth through school-age. Total scale consists of 37 items. The FCCERS-R is a thorough revision of the original FDCRS.

  13. ECERS-R • ECERS-R (2005) The Early Childhood Environment Rating Scale-Revised: Designed to assess group programs for preschool through kindergarten-aged children, from ages 2 ½ through 5 years. Total scale consists of 7 subscales and 43 items. The ECERS-R is a thorough revision of the original ECERS (1980). The 2005 edition is an updated version of the 1998 ECERS-R. This scale is also available in Spanish. • The CCHC will most likely use this scale to access the Personal Care Routine This is a challenging area for most child care centers and the area they will often have their lowest scores. STARS will often request your assistance with improvement in this area.

  14. All About ECERS-R

  15. ITERS-R • ITERS-R (2006) The Infant/Toddler Environment Rating Scale-Revised: Designed to assess group programs for infants and toddlers ages birth to 2½ years. Total scale consists of 7 subscales and 39 items. The ITERS-R is a thorough revision of the original ITERS (1990). The scale is also available in Spanish. • The CCHC will most likely use this scale to access the Personal Care Routine This is a challenging area for most child care centers and the area they will often have their lowest scores. STARS will often request your assistance with improvement in this area.

  16. All About ITERS-R

  17. Characteristics of Scales Each scale has items to evaluate: • Physical environment • Basic care • Curriculum • Caregiver/child interaction • Schedule/program structure • Provisions for parent/staff

  18. Characteristics of Scales The scales are suitable for use in evaluating inclusive and culturally diverse child care programs. Inclusive programs enroll children with special needs as well as children who are typically developing.

  19. Characteristics of Scales The scales also have proven reliability and validly, which makes them suitable for research and program improvement. Reliability is the extent to which an experiment, test, or any measuring procedure yields the same result on repeated trials. Validity refers to the degree to which a study or tool accurately reflects or assesses the specific concept that the researcher is attempting to measure.

  20. Basic Components Of Quality In Child Care Harms (1997) proposes three basic components of quality in child care. In order to provide quality child care, programs should strive to meet the individual and group needs of children in these three areas: • Physical needs: Protection of children’s health and safety and prevention of abuse and neglect • Social/Emotional needs: Building relationships with children, parents/guardians, extended family, and community • Cognitive needs: Opportunities for stimulation and learning from experience

  21. Why Do We Measure Quality?

  22. We Measure Quality • To use in Research • For Program Improvement • To Predict Success

  23. Measure Quality for Research Because quality of child care is such a strong predictor of school and social success, the ECERS, ECERS-R, ITERS, and ITERS-R have been used in many prominent studies as a comprehensive measure of quality.

  24. Measure Quality for Program Improvement The second use of the Environment Rating Scales is measuring quality with the intent of using the results for program improvement. The scales are used in a variety of ways including self-assessment by center staff, preparation for accreditation, and voluntary improvement efforts by licensing or other agencies in the US and around the world such as National Association for the Education of Young Children (NAEYC) and STARS.

  25. Measure Quality to Predict Success Thirdly, using the ECERS, the Cost, Quality, and Child Outcomes Study found that the quality of child care was related to cognitive development and social skills through second grade (Peisner-Feinberg, et al., 1999).

  26. The Role of the CCHC The Child Care Health Consultant (CCHC) plays a significant role in improving the health and safety and overall quality of child care programs. The CCHC will need to: • Develop competence in using a guided observation tool for rating quality in child care settings • Develop good observational skills through practice in child care settings • Apply collaborative consultation skills inmaking a plan of action to improve quality in child care settings

  27. The Role of the CCHC By observing in a classroom for several hours using the appropriate environment rating scale, the CCHC can become well acquainted with the day-to-day functioning of the child care program. Such realistic knowledge of the program enables the CCHC to provide practical, relevant support and encouragement to the child care staff for the improvement of quality. Knowledge of the realities of child care helps the CCHC to adapt health-related materials and approaches for implementation in child care settings.

  28. Observation in the Classroom Observation is an essential tool for consultation. It is the key to understanding the current child care situation so practical recommendations can be made for improvements in child care quality. A good observer minimizes the effect of his/her presence on the classroom. See the “Classroom Observation Guidelines” in Appendix A.

  29. How the CCHC Can Use the Scales • The CCHC should use the scales to identify the child care center’s strengths and needs. • The CCHC should use the scales to collaborate with the staff to improve quality in the center. The CCHC may also collaborate with STARS in working towards a higher stars rating.

  30. How Not to Use the Scales • The CCHC should not use the scales for any other purpose other than consultation. • The CCHC should not share the rating scales with anyone external to the child care facility, including any organization, agency, regulatory body including the state child care regulatory agency.

  31. ITERS-R

  32. Instructions for using the ITERS-R Turn to page 5-9 of ITERS-R • Administration of the Scale • Scoring System and Alternate Scoring • The Score Sheet and Profile • Explanation of Terms Throughout the Scale • Overview of Subscales and Items

  33. ITERS-Scoring and Score Sheet Profile • Scoring system, Page 6 • Alternate Scoring, page 6 • The Score Sheet and the Profile, page 6 • Sample of a filled in Score sheet and Profile, page 62

  34. ITERS- Understanding Scoring Because of many variables such as cultural preference, or beliefs of adults involved, the curriculum approach used, the physical conditions of the building, finances, or staffing issues, it is unlikely that programs will score uniformly high on all the requirements of the scale. Instead, programs will have both strengths and weaknesses in their scores.

  35. ITERS- Understanding Scoring Evaluating the scores with the center gives program staff the opportunity to consider where change is needed, and to determine how to create desired improvement. The important thing to remember is that the individual requirements of the scales is far less important than the average total score for any classroom. It is the average total score that is related to positive child development.

  36. Explanation of Terms Used Throughout the Scale Example of terms used, page 7-8 • Accessible • Appropriate • Hand washing • Infants and Toddlers • Much of the day • Some and many • Usually • Weather permitting

  37. ITERS-R Video Guide and Training Workbook Part I ITERS-R Workbook • Play Part I Introduction on video • Turn to p.1, Video Guide and Workbook and review subscales and items • Turn to p.2, Sample Item Display for children. Note progression from 1 to 7 • Turn to p.3, Scoring Instructions

  38. ITERS-R Video Guide and Training Workbook 5. Turn to page 5-6, Scrambled Item Activities and work in pairs deciding the proper order of 1,3,5,7 progression. Explain rationale. 6. Page 6-8, Sample Situations for Scoring Practice. Work in pairs to score items. Why did they score what they did? What changes would they make for improvement?

  39. ITERS-R Guide and Training Workbook Part II ITERS-R Workbook • Play Part II Introduction on video • Read p.9, Items for Scoring the Video Observation • Score Items on page 10-16

  40. ITERS- R Personal Care Routine • Page 18-29 • Greeting and Departing • Meals and Snacks • Nap • Diapering/ Toileting • Health Practices • Safety Practices

  41. Observing the Right Thing at the Right Time When completing the scales some things that need to be observed happen only at certain times of the day, while others can be observed at almost any time. For example, Meals and snacks must be observed as soon as preparation for the feeding process begins to see proper sanitation of tables and proper hand washing of staff and children.

  42. ITERS- R Personal Care Routine-Greeting/Departing Warm greetings/departures with children and parents are necessary to meet children’s social/emotional needs. Greeting children in a positive way helps them feel welcome in the classroom and sets the tone for the whole day. Infant and toddlers experience heightened separation and stranger anxieties and a warm greeting will help them feel more confident about leaving their parents. When parents and staff calmly exchange child related information, children get the message that they will be well cared for and that they are valued.

  43. ITERS- R Personal Care Routine-Greeting/Departing Warm greetings to children and parents are necessaryto provide an opportunityfor communication and share required information. This is important especially with infants/toddlers because they are vulnerable to problems in a wide range of health, safety and developmental issues.

  44. ITERS- R Personal Care Routine-Greeting/Departing Warm greetings/departures with children and parents are necessary to ensure children’s safety. From the safety point of view, greeting and departing helps, staff and parents to formally transfer responsibility for the child. Through greeting, staff register in their minds each child who is present. At departure, staff know who picked up the child and when they left their care.

  45. ITERS- R Personal Care Routine-Meals and Snacks The feeding of infants and toddlers requires a combination of specialized information about each child’s nutritional and developmental needs along with emphasis on the essential sanitary procedures that protect children’s health in group care.

  46. ITERS- R Personal Care Routine-Meals and Snacks A meal/snack schedule that meets individual needs is one in which each child is fed according to the standards of the US Department of Agriculture (USDA) Child and Adult Care Feeding Program (CACFP). These standards are to be used whether or not the program is participating in the USDA Child and Adult Care Feeding Program.See Child and Infant Care Eating Patterns Handout.

  47. ITERS- R Personal Care Routine-Meals and Snacks TheBasic Sanitary Procedures considered when scoring this item they are: • Hand washing of adults and children’s hands • Clean and sanitized eating equipment and surfaces • Uncontaminated Food

  48. ITERS- R Personal Care Routine-Nap This item considers aspects of nap that go beyond schedule and includes evaluating the measures required for the protection of the children’s health, safety and comfort while sleeping. Children should sleep on a clean nap surface not directly on the floor, alone and not a shared place, at least 36” from another cot or mat, with clean individual bedding, with bedding stored separately, and sleep surface easy to wash.

  49. ITERS- R Personal Care Routine-Nap This item considers aspects of nap that go beyond schedule and includes the type of adult supervision. A staff member should be actively supervising in the room and another immediately available for emergencies. Regular ratios should be maintained for infants since they nap all day at varies times. Supervision should be pleasant, responsive, and warm.

  50. ITERS- R Personal Care Routine-Nap This item considers aspects of nap that go beyond schedule and includes the extent to which nap is personalized. Nap routine is carried out with each child’s preferences in mind, ensuring the comfort and security of every child. Examples might include, pictures of familiar people placed where child can see them, infants placed the same direction each time in crib, child’s cot placed near same friend, same individual routine used to get infant settled such as rocking each time. Make provisions for early risers or non- nappers. Gracie