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Promoting Early Childhood Development and Wellbeing with the Early Years Check-In and Play & Learn

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Promoting Early Childhood Development and Wellbeing with the Early Years Check-In and Play & Learn

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Join Dr. Anthony Levinson and Kalpana Nair, PhD from McMaster University as they discuss the Early Years Check-In (EYCI) and its companion web-based resource, Play&Learn. Designed for parents of children 18 months to 6 years of age, the EYCI helps parents quickly identify any concerns they may have about their child’s development across four domains: social and emotional, language, movement, and thinking and learning. The EYCI can be used as a discussion aid to foster dialogue about early child development between parents and practitioners providing early years services, creating opportunities to build relationships as well as provide education and support to parents to foster their child’s development.

Join Dr. Anthony Levinson and Kalpana Nair, PhD from McMaster University as they discuss the Early Years Check-In (EYCI) and its companion web-based resource, Play&Learn. Designed for parents of children 18 months to 6 years of age, the EYCI helps parents quickly identify any concerns they may have about their child’s development across four domains: social and emotional, language, movement, and thinking and learning. The EYCI can be used as a discussion aid to foster dialogue about early child development between parents and practitioners providing early years services, creating opportunities to build relationships as well as provide education and support to parents to foster their child’s development.

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Promoting Early Childhood Development and Wellbeing with the Early Years Check-In and Play & Learn

  1. 1. Date February 11, 2021 Presenters Anthony J. Levinson, MD Kalpana Nair, PhD Facilitator Emily Clark, MSc Promoting Early Childhood Development and Wellbeing with the Early Years Check-In and Play & Learn
  2. 2. Housekeeping • We are testing a new webinar platform • Connection issues • We recommend using a wired Internet Connection • If you are experiencing technical issues please send a private message to admin • Use chat to post questions and/or comments throughout the webinar • Post your questions in the public chat box • Send questions about technical difficulties in a private chat to admin • Polling
  3. 3. After Today After the webinar, access the recording (in English) at www.youtube.com/nccmt and slides in English and French at www.slideshare.net/NCCMT/presentations.
  4. 4. Poll Question 1 How many people are watching today’s session with you? A) Just Me B) 2-3 C) 4-5 D) 6-10 E) >10
  5. 5. Poll Question 2 Have you visited the National Collaborating Centre for Methods and Tools’ website or used its resources before? A) Yes B) No
  6. 6. Poll Question 3 If you stated YES on the previous question, how many times have you used the NCCMT’s resources? A) Once B) 2-3 times C) 4-10 times D) 10+ times
  7. 7. NCCMT Products and Services Registry of Methods and Tools Online Learning Opportunities Workshops Video Series Public Health+ Networking and Outreach
  8. 8. Presenters Dr. Anthony J. Levinson, Associate Professor, John R. Evans Chair in Health Sciences Educational Research, and Director of the Division of e-Learning Innovation at McMaster University Kalpana Nair, PhD, Research Associate in the McMaster School of Nursing
  9. 9. Promoting Early Childhood Development and Wellbeing with the Early Years Check-In and Play & Learn Anthony J Levinson and Kalpana Nair McMaster University
  10. 10. EarlyON Centre Child and Family Centre
  11. 11. Scenario: EarlyON Centre • Probably about 10 slides
  12. 12. Toolkit
  13. 13. Scenario: EarlyON Centre • Probably about 10 slides
  14. 14. Scenario: EarlyON Centre • Probably about 10 slides
  15. 15. Scenario: EarlyON Centre • Probably about 10 slides
  16. 16. Scenario: EarlyON Centre • Probably about 10 slides
  17. 17. Guided Conversation Between parent and R ECE
  18. 18. About us
  19. 19. Overview • Background • Surveillance vs. Screening • Tools and Supports • EYCI • Play&Learn • E-learning for ECEs • Implementation Toolkit
  20. 20. Learning Objectives To understand: 1. The rationale and development of the Early Years Check-In 2. The role of developmental surveillance 3. How to use the Early Years Check-In with parents 4. The development of Play&Learn 5. How to access various online tools: EYCI, Developmental Surveillance & EYCI Training Module; Play&Learn; Implementation Toolkit
  21. 21. Public health and early child development • Public Health Agency of Canada • Public Health Ontario • Ontario Ministry of Children, Community and Social Services (MCCSS) • HBHC • Enhanced 18-Month Well-Baby Visit • Ontario Ministry of Education • EarlyON Child and Family Centres
  22. 22. Where we started: The enhanced 18-month well-baby visit • Last immunization visit before school • Developmentally “rich” time / talk to parents about concerns • Recommend use of the NDDS + Rourke Baby Record
  23. 23. • Looksee and RBR • Risk factors • Concerns Assess • Educate • Community resources • Reduce/prevent risks • Assess and intervene early Support • Collaborate • Follow-up Monitor
  24. 24. Internet-Based Elements Looksee
  25. 25. Developmental Surveillance Initiative
  26. 26. What is it? • The Developmental Surveillance Initiative (DSI) is an important component of the Ontario Ministry of Children, Community and Social Services (MCCSS) Special Needs Strategy. • Goal of improving early identification of special needs in children and getting them the right help sooner
  27. 27. Definition of developmental surveillance • Developmental surveillance is a broad, flexible, ongoing process of monitoring development in young children in their clinical and social context, which also involves parents or caregivers. • Surveillance involves regular monitoring with a primary focus on attending to possible concerns and supporting families and making referrals as needed. • Supporting parents and others to identify developmental concerns and promote development for all.
  28. 28. Screening vs. Surveillance Screening • Screening involves intentional activities around identification and referral for treatment. Surveillance • Surveillance involves regular monitoring with a primary focus on attending to possible concerns and supporting families and making referrals as needed.
  29. 29. Screening vs. Surveillance • Lack of endorsement for standardized screening does NOT preclude the importance of surveillance • “Routine screening for developmental delay is not the same as developmental surveillance, which is a broader, flexible, ongoing assessment of development that physicians must continue to do.” • Leblanc and Williams, CMAJ, 2017
  30. 30. Challenges with screening COMPLEXITY CONTEXT MILESTONES AGE BANDING
  31. 31. Challenges with screening • often based on only one source of information, • using one measure, • at a single point in time. • This can be problematic due to the complex and variable nature of development in the early years.
  32. 32. From Screening to Surveillance • Based on limitations of screening, we decided on a different approach.
  33. 33. 4 M’s as a framework for surveillance
  34. 34. What was the rationale? • The 4 M’s address some of the challenges of screening • Highlights the importance of understanding parental concerns
  35. 35. Considerations for a New Tool Developmental milestone approach •Assumes knowledge •Age-banding (problem of intra-individual variability) Measurement / Scale Construction •Yes/no or ordinal responses limits variability (which in turn limits agreement) •Domain Coverage
  36. 36. Tools to support DSI EYCI, Play&Learn, DSI course, and Implementation Toolkit
  37. 37. EYCI Early Years Check-In
  38. 38. Items on the EYCI 1. Gets along with others 2. Moves their body 3. Learns 4. Behaves 5. Takes care of themself 6. Uses their hands and/or fingers to do tasks 7. Understands what others say 8. Focuses attention 9. Talks 10. Expresses emotion 11. Overall
  39. 39. Domains on the EYCI Social and Emotional • Behaves • Expresses emotion • Gets along with others • Takes care of themself Movement • Moves their body • Uses their hands and/or fingers to do tasks Thinking and Learning • Focuses attention • Learns Language • Talks • Understands what others say
  40. 40. The Early Years Check-In: Scoring for Paper Version Low Elevated High
  41. 41. EYCI Scoring Messages Low Concerns • Complete the Early Years Check-In again in a few months to see if there are any changes. Speak with your early years professional, child care, or health care provider to learn more about child development. Elevated Concerns • There may be many reasons why you have elevated concerns about your child’s development. Speak to your early years professional, child care, or health care provider to discuss your concerns and learn more about resources in your community that can provide more information and help determine if any follow-up is needed. High Concerns • With high concerns for your child’s development, speaking to your early years professional, child care, or health care provider is an important first step. They can identify the best ways to respond to your concerns and help connect you to additional services and supports or refer you to appropriate professionals in your community.
  42. 42. Rationale for its development DOMAINS AND ITEMS EASE OF USE VISUAL ANALOGUE SCALE FLEXIBILITY ACROSS AGE BANDS
  43. 43. Scientific approach to EYCI development
  44. 44. Purpose of Each Testing Phase 3/1/21 56 Pilot Whether any changes are required to the tool. Initial validity. Validation More robust test of validity. Expansion Test the EYCI in a larger age group of children; in more geographically diverse settings; and inclusion of francophone families
  45. 45. How does it work and who is using it? • Conversation guide • Paper or electronic version • EarlyON Child and Family Centres and others
  46. 46. Implementation - Process Evaluation •Evaluation aimed to understand: § In what different ways can the EYCI be used? § What strategies have supported implementation of the EYCI? What worked and did not work? § What actions did parents take after completing the EYCI? Help to inform widespread implementation
  47. 47. Implementation Strategies & Evaluation • Implementation sought to capture both the provider and parents • All providers/educators completed a training module related to DSI and EYCI Implementation Method Evaluation Measure ***Providing the EYCI to a variety of child-focussed settings and asking providers/educators to use the EYCI for a period of 3-6 months. §Sites track # of EYCI given out §Interview/focus group with site staff (educator/provider) regarding experience using the EYCI INCH staff asked parents at EarlyOn and LCC to complete EYCI. Parent completion of EYCI, Demographic Form, ASQ Facebook Advertisements – allowed for a broader cross section of parents across Ontario to be reached. Parent completion of EYCI, Demographic Form, ASQ
  48. 48. Process Evaluation Sites Geographic distribution of sites in the centre-led implementation evaluation. Sites in blue are EarlyON centres, sites in red are Licensed Childcare centres, and sites in yellow are in the Other category (i.e. Public Health, Kindergarten Registration, Family Health Teams, and Children’s Mental Health Agencies). Not visible: Thunder Bay.
  49. 49. Summary of Sites Included • Overall 80 sites across Ontario took part: • EarlyON and Licensed Childcare = 70 • Kindergarten Registration=2 • Family Health Teams=1 (NP)+1 (Health Festival) • Children’s Mental Health=1 • Public Health=1 (SLP) • Children’s services access agency=1 • School readiness program=3 • 203 educators trained • Approx. 4500 EYCI provided to centres • Tracking sheet data available for 884 times the EYCI was used
  50. 50. How to Use the Early Years Check-In with Parents
  51. 51. Keys ways EYCI used in practice 1. Registration 2. Children moved between rooms (in LCCs only) 3. Providers approached parents and asked them to complete 4. Tools were made available for parents to complete or were sent home with them for completion. 5. Other - if parents expressed a concern; at a home visit
  52. 52. Actions as a Result of the EYCI Table 1. Conversation Tracking Sheet Descriptive Results. Occurrence Percentage EYCI CONVERSATION ACTIONS Support parent as usual 318 36.9 Offered resources/materials 251 29.2 A repeated check-in with parent 58 6.7 Referral 63 7.3 No action 171 19.8 PARENTAL CONCERN LEVEL Low 283 69.5 Elevated 90 22.1 High 34 8.4
  53. 53. Common benefits identified: ENCOURAGED CONVERSATIONS HELPFUL FOR FAMILIES TO SEE WHERE THEIR CONCERNS WERE WELL-DESIGNED, EASY TO USE, EASIER THAN OTHER TOOLS HELPS TO BUILD RAPPORT WITH PARENTS
  54. 54. Common challenges identified: LOGISTICAL CHALLENGES (E.G., PRIVACY IN BUSY SPACE, TIME) CHALLENGE ENGAGING WITH FAMILIES (EITHER COMPLETING OR RETURNING THE TOOL) PREFERRING A METHOD OR TOOL THAT IS ALREADY ESTABLISHED NEED FOR RAPPORT WITH PARENTS
  55. 55. Recommended Use of the EYCI • After building rapport with parents • When children transition rooms • Encouraging all families to complete it • Having one designated staff person as the champion • Using the tool after a parent starts to talk about a concern • Using alongside other tools currently being used • With the physician or other healthcare provider
  56. 56. Play&Learn
  57. 57. What is it? • A website and subscription service with games and activities to enhance development for children aged 18 months to 6 years old
  58. 58. Rationale for its development • Support parent education • Provide practical ideas • Support a conversation about development • Complement the EYCI
  59. 59. Approach to Play&Learn development • Games and activities • Map to domains of the EYCI • Loosely age-banded • Reviewed referenced activities • Web design and development • Focus group feedback on UI/UX • Complemented with multimedia, where feasible • Subscription option incorporated
  60. 60. How does it work and who is using it? • As a standalone resource/website that parents can access directly • R ECEs may recommend a particular game/activity for parents • Suggested activities after completion of the EYCI, personalized based on age and item of highest concern
  61. 61. New micro- learning campaigns • Weekly email or text message based on an age group • Over 4,500 subscribers • Post-campaign survey indicates “excellent” feedback and high Net Promoter Score • “Love the simple quick activity ideas that you can try without much preparation when there is down time in the house”
  62. 62. Developmental Surveillance Initiative Online Training Program dsi.machealth.ca
  63. 63. Training for Registered ECEs • Asynchronous online course at dsi.machealth.ca • Can be completed in about 30 minutes • Includes concrete examples of how to introduce the EYCI and how to facilitate conversations • Certificate of completion that can be used for professional portfolio • Also available in French
  64. 64. Course Access and Feedback • Access via dsi.machealth.ca after creating free account • Over 500 course completions to date • High degree of satisfaction • 100% agree they would recommend the course to a colleague • Developing a second course to provide an overview of implementation strategies and tools
  65. 65. Implementation Toolkit
  66. 66. What is it? • 58-page PDF document, available in both English and French • Comprehensive guide to support implementation of EYCI and Play&Learn in practice • Materials to support successful implementation • Real life examples, tips and case studies • Promotional tools (e.g. posters)
  67. 67. EYCI Implementation Toolkit Development • Draft toolkit developed; includes case scenarios; tools for use with parents. • 20 sites across Ontario asked to use in practice for 8 weeks • Onset of COVID-19 impacted ability for all sites to use Toolkit in practice • Completed interviews with site staff as well as focus groups with parents • Evaluation resulted in modification to the tools included in the Toolkit • Suggested next steps included: • Translation of EYCI and supporting documents into other languages • Continued development of online tools and resources • Further engagement with primary care and public health March 1, 2021 96
  68. 68. Discussion
  69. 69. Conclusion
  70. 70. Key Points • The EYCI is a flexible tool designed to support developmental surveillance with children 18-months to 6 years of age • It can be used to guide conversations related to parental concerns to help foster early child development • Play&Learn offers a range of expert-reviewed games and activities to help foster a range of child development domains • The Implementation Toolkit, e-learning and other resources can help with implementation • Work continues with respect to the implementation and evaluation of these various tools and initiatives
  71. 71. Relevant Links • Training Module and Toolkit: dsi.machealth.ca • EYCI: eyci.ca • Play&Learn: playandlearn.healthhq.ca • Publications: • EYCI Rationale: https://link.springer.com/article/10.1007/s40474-016- 0095-5 • EYCI Validation: https://www.frontiersin.org/articles/10.3389/fped.202 0.00157/full
  72. 72. Acknowledgements
  73. 73. Webinar Feedback Your responses will be kept anonymous. Please indicate your level of agreement with the following 1. Participating in the webinar increased my knowledge and understanding of evidence-informed decision making. Strongly agree Agree Undecided Disagree Strongly Disagree
  74. 74. Webinar Feedback Your responses will be kept anonymous. Please indicate your level of agreement with the following: 2. I will use the information from today’s webinar in my own practice. Strongly agree Agree Undecided Disagree Strongly Disagree
  75. 75. Webinar Feedback Your responses will be kept anonymous. 3. Which of the following statements apply to your experience with the webinar today (check all that apply): □ The webinar was relevant to me and my public health practice □ The webinar was effectively facilitated □ The webinar had opportunities to participate □ The webinar was easy to follow along □ The webinar met my expectations
  76. 76. Your responses will be kept anonymous. 4. Can we contact you in the future to discuss how the NCCMT can improve its webinar series? □ Yes □ No
  77. 77. Webinars from the NCCMT Learn more about our webinars: http://www.nccmt.ca/capacity-development/webinars 106
  78. 78. Share your story! • Are you using EIDM in your practice? We want to hear about it! • Email us: nccmt@mcmaster.ca • Need support for EIDM? Contact us for help! • Email us: nccmt@mcmaster.ca • We typically respond within 24 business hours 107
  79. 79. For more information: NCCMT website: www.nccmt.ca Contact: nccmt@mcmaster.ca

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