rrfss child development module project presenters: wil ng, epidemiologist erin kennedy,...
TRANSCRIPT
RRFSSChild Development Module Project
Presenters: Wil Ng, Epidemiologist
Erin Kennedy, Epidemiologist
Toronto Public Health
Durham Region Health Dept.
City of Hamilton Public Health & Community Services Dept.
Financial assistance by Health Canada
RRFSS Child Development ModuleSteering Committee
Donna Reynolds - Durham Region Health Dept. Wil Ng - Toronto Public Health Erin Kennedy - Toronto Public Health Paul Fleiszer - Toronto Public Health Karen Wade - Toronto Public Health Kate Feightner - formerly City of Hamilton Public
Health & Community Services Dept. Philippa Holowaty - formerly City of Hamilton Public
Health & Community Services Dept., PHRED rep
Presentation Overview
Background– Project Impetus– Children’s Development– Screening Tests– Parents’ Evaluation of Developmental Status (PEDS)
Study Rationale/Objective Methods Results Next Steps
BackgroundProject Impetus
MoHLTC Perinatal & Child Health Surveillance Strategies funding for early years (0-6)
Building on existing RRFSS partnership Lack of data on children’s development for
public health program planning, monitoring & evaluation
Background (2)Children’s Development
• US data - 20% of young children have significant developmental problems.
• US & UK - > 70% of children with serious developmental/behavioural difficulties are not identified before school entrance.
• Canada - 28% of Canadian children (0-11 years) have at least one identifiable learning or behavioural problem (NLSCY data).
• No local prevalence data available.
Background (3)Screening Tests
• Criteria for suitability:
a) has been validated,
b) can be administered within 1-2 minutes,
c) designed to be completed by parents/care givers,
d) easily administered over the telephone, and
e) appropriate literacy level.
Parents’ Evaluation of Developmental Status (PEDS)
• 10-question instrument designed to screen children
• Captures parent concerns across range of domains
• Used for children 0 to 8 years of age
• Takes ~ 2 minutes to administer
• Written at a 5th grade reading level
• Validated and standardized in USA
• Copyrighted, small cost associated with administration
PEDS Questions Developmental Domain
Q1: your child’s learning, development & behaviour? Global / Cognitive
Expressive Language
Receptive Language
Gross Motor
Fine Motor
Social Emotional
Behaviour
Self Help
School
Other
Q2: how your child talks & makes speech sounds?
Q3: how your child understands what you say?
Q4: how your child uses his/her hands & fingers to do things?
Q5: how your child uses his/her arms and legs?
Q6: how your child behaves?
Q7: how your child gets along with others?
Q9: how your child is learning preschool or school skills?
Do you have any concerns about…
Q8: how your child is learning to do things for him/herself?
Q10: Please tell me about any other concerns about your child.
© 2000 Frances Page Glascoe, Ellsworth & Vandermeer Press, LLC, PO Box 68164, Nashville, TN 37206
PEDS (con’t)Scoring & Indicators
# & Significance ofConcerns
Risk Level Path
2 or more significantconcerns
High A
1 significant concern Moderate B
1 or more non-significantconcerns
Low C
Parental difficultiescommunicating (e.glanguage barrier)
Moderate D
No concerns Low E
PEDSAdministration
Normally administered to parents by a health professional, in written format
Response coding & scoring done by health professional
Study Rationale / Objective
• PEDS has not been used in a telephone survey to estimate the prevalence of children at risk for developmental disabilities.
• To investigate the feasibility of using the PEDS over the telephone as part of the RRFSS.
Methods (1)Development
Designed age group specific CATI screens
Distributed background document to RRFSS interviewers
Conducted pretest with 20 respondents
Methods (2)
Telephone interviews 3 geographic areas: Toronto, Hamilton & Durham
Region Adults with children aged 0-6 years in their
households. English-speaking persons
Methods (3)Phase A
Phase A - Objective
To assess the ability of RRFSS interviewers to correctly capture respondents’ concerns.
Methods (4)Phase A (con’t)
Phase A - Protocol RRFSS interviewers coded 200 telephone interviews. With respondents’ permission, these interviews were
taped. Dr. Frances Glascoe (PEDS developer) listened to
tapes of the same 200 interviews and coded the responses.
Coded results of RRFSS interviewers were compared to those of the professional.
Methods (5)Phase B
Phase B - Objective
To compare the telephone administration of PEDS with the written administration of PEDS.
Methods (6)Phase B (con’t)
Phase B - Protocol RRFSS interviewers coded 400 telephone interviews. Hardcopy of PEDS sent to respondents Completed written PEDS forms were coded by Dr. F.
Glascoe. Results from the written administration of PEDS were
compared to the results of the RRFSS-coded telephone administration of PEDS.
Results (1)
Overall response rate:
- telephone survey: 83%
- return of written questionnaire: 74%
Results (2)
Average # of concerns: less than 1 per respondent
Approximately 60% of parents had no concerns Three most common concerns:
– Expressive Language– Behaviour– Social/Emotional
Results (3)
Phase A - RRFSS interviewers’ coding vs. professional coding
Overall % Agreement: 83% Weighted Kappa: 0.74 (95% CI: 0.66 to 0.82)
Results (4)
Phase B - telephone administration vs. written administration
Overall % Agreement: 69% Weighted Kappa: 0.62 (95% CI: 0.53 to 0.70)
Results (5)
RRFSS interviewers recorded fewer “other” concerns, compared to the professional
RRFSS interviewers recorded fewer concerns that have been resolved, compared to the professional
Implementation in RRFSS
Feasibility Issues: There is per administration cost for the tool Complexity of coding responses Complexity of analysis # of calls required for sufficient sample
Next steps
Consult with experts and key stakeholders
Modify background information for RRFSS interviewers
Review results after several months of data collection
Contact Information
Toronto: Erin Kennedy (416.338.8121, [email protected]) Wil Ng (416.338.8077, [email protected])
Durham: Donna Reynolds (905-723-5338 ext. 2141,
Hamilton: Kate Feightner (905-525-4184, [email protected])
Acknowledgments
David Northrup , Renee Elsbett-Koeppen, Liza Mercier & all ISR interviewers who participated in this project (Institute for Social Research, York University)
Dr. Frances Glascoe (Vanderbilt & Penn State Universities)
Dr. Virginia Frisk (Hospital for Sick Children)
Health unit staff who supported project