Ages and Stages: Evaluating The Effectiveness of a New Screening and Intervention Model for Improving Outcomes Among Children in the Community

It is easier to build strong children than repair broken men” (Douglas, 1817). This quote is incredibly profound in its meaning. It is well known that children’s early relational experiences with their primary caregiver, particularly from conception to the third year of life, ultimately lay the foundation for development throughout the lifespan. Thus, given the significance of the first few days and years of life, early identification and intervention are pivotal to the successful outcomes of children.

Early Development Instrument

The Early Development Instrument (EDI) is a teacher-completed questionnaire that reflects the developmental status of young children upon school entry.  The EDI data for Niagara shows that over time, the vulnerability of children in their second year of kindergarten has been increasing in the Social Competence and the Emotional Maturity domains in particular.  Between 2011 and 2015, there was a significant increase in the percentage of children vulnerable in the Social Competence domain, and vulnerability was also higher in Niagara than the provincial average for 2015.  In 2015, 14.3% of children were vulnerable in Emotional Maturity in Niagara, which was higher than the provincial average of 12.3%. If these trends continue on the current trajectory, Niagara is at risk for continuing to increase in vulnerability over and above the rest of the province.

This recent data is discouraging, particularly because social competence and emotional maturity are critical to a child’s academic, occupational, and relational success, among many other key life outcomes in the later years. In fact, it has been suggested that socio-emotional skills in Kindergarten have been linked to outcomes at 25 years of age (Jones, Greenberg, & Crowley, 2015). As such, failure to thrive in these areas is likely to have dire consequences on children’s functioning in adolescence and adulthood, which further supports the use of early developmental screening and intervention to promote socio-emotional wellbeing.

Ages and Stages Questionnaires

While the region-wide implementation of the EDI has provided a thorough understanding of the current landscape of children’s developmental in Niagara, waiting to assess developmental status in Kindergarten is simply too late.

Fortunately, services supporting young children and families across the region of Niagara understand the importance of prevention, promotion, and early intervention (well before schooling years). In collaboration with Infant Mental Health Promotion at the Hospital for Sick Children, a number of community agencies serving children and families in the Niagara Region adopted a developmental screening (i.e., Ages and Stages Questionnaires) and child-centered developmental support planning model to respond to the developmental needs of infants, toddlers, and young children from 0-5 years.

The Ages and Stages Questionnaires have consistently been shown to accurately and reliably identify developmental delays in communication, gross and fine motor skills, problem-solving, and personal-social skills across a number of different age groups, contexts, populations, and cultures (Squires, Bricker, & Potter, 1997). In fact, it has been shown that early developmental screening, even in the absence of intervention, decreases the risk of delay over time (i.e., when children were re-screened at a later age interval; Drotar et al., 2008).

Evaluating Early Screening and Intervention

Motivated to locally evaluate the effectiveness of the new screening and intervention model in improving outcomes among children in the community, the planning body that presented the first round of training in 2014 looked to strike an Infant Mental Health Advisory Committee and Pilot Project. The Pilot Project aims to assess the validity of the Ages and Stages Questionnaire for Niagara and to increase awareness of Infant Mental Health amongst the broader Niagara community.

There are over 20 agencies in Niagara who sit on this committee and are part of the pilot project, all of whom participated in the training. Dr. Chaya Kulkarni from Infant Mental Health Promotion at the Hospital for Sick Children, the facilitator of the training session, also sits on this committee and supports Niagara in the data collection process. The data has been collected for almost three years and will conclude in Dec. 2017.

To date, the Niagara Pilot Project has conducted over 500 developmental screens with more than 70 frontline practitioners and 200 families. While the project is still underway, a very preliminary analysis of developmental outcomes on a selected 25 at-risk children demonstrated that the intervention significantly improved Problem Solving and Gross Motor domains. Other domains including Personal-Social, Fine Motor Skills, and Communication also improved over time, but it was the former two areas that responded most to the intervention. Given the small sample size of this first analysis, we hope to confirm these initial trends when conducting a more in-depth analysis of the entire sample.

These initial findings support Niagara’s beliefs and value in early identification and intervention and suggest that future research should aim to link developmental data from the Ages and Stages Questionnaire to data from the Early Development Instrument. It is through this linkage of longitudinal data, that we will be able to understand how to proactively build strong children at the outset.

The Niagara Pilot Project will be completed in December 2017, with the data presentation in early spring. The committee in Niagara will then move forward to continue the work that has been underway to increase the knowledge of infant mental health.

If you are interested in learning more about the project, please reach out.

Sandy Toth
Executive Director
Strive Niagara

Niagara Knowledge Exchange & Community Calendar

Strengthening Partnerships Focused on Serving People of Indigenous Heritage in Niagara @ Niagara Falls Public Library - LaMarsh Room
May 24 @ 9:00 am – 12:00 pm

Who Should Attend: People working with individuals of Indigenous heritage in Niagara, who want to strengthen partnerships to ensure clients are receiving the services they require.

9:00 am – Registration and coffee
9:15 am – Welcome
9:20 am – Evidence provided by Indigenous people in Niagara – Living in Niagara-2017 report highlights
9:35 am – Using Data to Strengthen Partnerships

  • June, 2018 Construction of the Indigenous Service Providers in Niagara Network Map – how you can help to build a tool to describe existing partnerships; illuminate opportunities to build new ones; and ultimately strengthen planning for ensuring Indigenous people in Niagara are receiving the services they require
  • What’s Ahead – Sharing Data to Measure Impact of Partnerships

10:30 am – Break
10:45 am – Partnerships in Action – Panel Discussion

  • NRNC Literacy Corrections Initiative – a partnership with Niagara Youth Detention Centre
  • Niagara Youth Court Screening Initiative (NYCSI)
  • Homeward Bound program in Niagara

11:40 am – Wrap-up and Next Steps

This event is hosted by Niagara Connects in partnership with Niagara Regional Native Centre.

Campus Suicide Prevention and Postvention, Part II @ Online
May 24 @ 1:00 pm – 2:00 pm

This webinar is a follow-up to March webinar where presenters looked at high-level guidelines for handling suicide postvention on campus.

This session will offer specific examples of policies from campuses that have established prevention and postvention strategies.

This webinar is hosted by the Centre for Innovation in Campus Mental Health.

Workshop Enrolment Deadline: Older Adults Living with Cancer – Psychosocial Considerations and Interventions @ Online
May 28 all-day

Approximately 60% of cancer incidence occurs in adults 65 years and older. And it is notable that older adults experience the majority of cancer deaths but also make up the majority of cancer survivors (Hurria et al, JCO, 2015).

This workshop will focus on the ways that older adults and their families may have different needs than younger adults and children. When it comes to older adults with cancer, many factors can be influencing how well any individual manages practical concerns, coping with the emotional challenges and navigating the system.

This four-week workshop will examine topics including:

  • Special consideration related to older adults with cancer
  • Understanding needs of family caregivers
  • Principles of palliative care and its importance to understanding psychosocial needs
  • Cancer survivorship

This workshop is hosted by the University of Toronto.

Workshop Enrolment Deadline: Using a Montessori Approach for Managing Dementia @ Online
May 28 all-day

This is an online workshop for healthcare and other professionals.

Course objectives:

  • To provide an overview and enhance existing knowledge about the Montessori-based Dementia Program principles in the context of an aging population
  • To gain an understanding of the various types of dementia and their causes
  • To gain an understanding of responsive behaviours and their triggers
  • To provide an overview of the Montessori Prepared environment, and the application of the principles of the Montessori pedagogy to everyday contexts of care for older adults
  • To gain an understanding of specific Montessori-based activities and their benefits to people living with dementia
  • To gain an understanding of ways to promote a social environment based on the Montessori principles

Week 1: An overview of dementia and an introduction to Montessori principles

Week 2: An overview of types of memory and responsive behaviours

Week 3: An overview of Cultural, Sensorial and creativity-based activities

Week 4: An overview of Cognitive and Communication-based activities

This online workshop is hosted by the University of Toronto.

Promoting Physical and Mental Wellness on Campus @ Online
May 29 @ 1:00 pm – 2:00 pm

This interactive webinar will introduce the Mood Walks for Campus Mental Health program to Colleges and Universities across Ontario. Mood Walks is designed to contribute to the development of alternative mental health promotion strategies on campus.

The presentation will offer a description of the many benefits of Mood Walks to campus life, including the physical and mental health benefits of being active, experiencing the healing effects of nature, increased social inclusion, and the positive impact this has on academic performance.

This will be followed by a detailed explanation of the support provided for Colleges and Universities to start their own program, and how to apply to be one of 20 Ontario campuses that will receive support from the Mood Walk provincial partners.

This webinar is hosted by the Centre for Innovation in Campus Mental Health.

Safe Messaging About Suicide and Mental Health @ Online
May 29 @ 1:00 pm – 2:00 pm

Join Jodie Golden from the Public Health Agency of Canada and Dr. Jijian Voronka from the University of Windsor as they share their experience and advise about how to talk openly, safely and responsibly about suicide, mental illness and mental health.

Participants will hear about practical “do’s and don’t”, hear about how to meaningfully learn from people with lived experience and gain the confidence to engage in conversations that are respectful and inclusive on topics related to suicide, mental illness and mental health.

The MHCC’s webinars on suicide prevention are designed for everyone involved in mental health services, including people living with mental health problems or illnesses and their families. Most of all, the webinars are intended for people who can help make the practical, organizational, and cultural shifts needed to recognize the importance of suicide prevention and how we can all work together to reduce the number of deaths by suicide.

This webinar is hosted by the Mental Health Commission of Canada.

The Evolving Landscape of MS Treatment @ Online
May 29 @ 1:00 pm – 2:30 pm

‘The Evolving Landscape of MS Treatment’ provides a brief overview of an assortment of subjects from a patient-oriented standpoint.

In particular, the presenter discusses the below topics as they pertain to the management of MS.

  • Drug development and patient safety
  • Biosimilars and their regulation
  • Recent drug news and future prospects
  • Drug support programs
  • The role for atypical and controversial therapies
  • Patient advocacy issues
  • The role of the pharmacist in MS management

This webinar is hosted by brainXchange.


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