4a. Developmental Screening Policy & Procedure

• Created 8/01
• Reviewed 8/26

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Program Policy

In collaboration with each child's parent and with parental consent, our program will complete or obtain a current developmental screening to identify concerns regarding a child’s development, behavioral, motor, language, social, cognitive, emotional skills, within 45 calendar days of when the child first attends class or, for the home-based program option, receives the first home visit.  The purpose of the developmental screening is to identify children who may need further evaluation or referral for special services and to support individualization for each child.

Early Head Start (EHS) Specific Procedures

1. Pre-Screening Mandates

Before any screening instrument is administered, staff must ensure the parent has signed the Parent Agreement Contract and the Permission to Reveal or Obtain Confidential Information with the local Part C Agency (Progress Center).

2. Tools, Administration, and Timelines
3. 1. Core Screening Instruments: EHS utilizes the Ages and Stages Questionnaire (ASQ-3) and the Ages and Stages Questionnaire Social/Emotional (ASQ: SE-2). This framework is used from two months through three years of age. Screenings are completed at a minimum of annually, or via the full schedule recommended by ASQ if delays or active monitoring are required.
   2. Home-Based Timeline: For home-based options, the ASQ-3 and ASQ: SE-2 is completed at any home visit within 45 days of the anniversary date of enrollment.
   3. Center-Based Timeline:  Parent will complete the ASQ-3 at or before the Welcome Visit and Teacher will complete ASQ SE-2 after the child has attended for three weeks and before the 45 day window.
   4. Under two Months Exception: If an infant is not yet two months old by the expiration of the 45-day window, staff may wait until the child reaches two months of age to complete the initial ASQ screenings.
   5. Prematurity Correction: When a child is born more than four weeks early, staff must use their corrected age to determine the appropriate age questionnaire. Upon reaching age two, chronological age must be used instead of adjusted age.

3. Data Entry & Record Keeping

1. 1. Data and Uploading Routing: All scored physical screenings must be routed to the Health Coordinator. The data will be logged into ChildPlus under the Education tab, and the physical documents uploaded and attached to the child's record.
   2. Parental Return: After the forms are successfully uploaded into ChildPlus, the Health Coordinator returns them to the teacher, who then returns the original paper document to the parent. All scored screenings must be reviewed with parents in their home language.
   3. Administrative Monitoring: Area Manager will monitor compliance to guarantee all children are screened within the 45-day window. The School Readiness Specialist will review Child Plus reports monthly to analyze data and if the program is meeting timelines.

4. EHS Referral & Rescreening Process

1. 1. Referral Thresholds: When a child's score in one or more domains is at or below the standardized cutoff, or when scores in two or more domains are borderline, EHS staff may initiate the Referral Decision Matrix process to establish next steps.
   2. Internal Staff Notification: If a concern is flagged, staff will email a summary of the concerns to the Area Manager, School Readiness Specialist, and Mental Health Specialist if it is a social/emotional concern.  A plan will be developed for next steps and a possible referral.  
   3. Formal Agency Referrals: After the options are discussed with the family and documented in case management, the next step may be a referral.   If the parents would like to pursue a referral, the home visitor or teacher will contact the School Readiness Specialist for next steps.
   4. Parental Refusal Support: If a family declines a referral, staff must consult the Area Manager to ensure the program is extending all necessary alternative supports to the family.
   5. Suspected Progress Delays / Rescreening: If a child from birth to three years old is suspected of not progressing, the teacher, home visitor, and/or parent should execute the next age-bracket ASQ-3 or ASQ: SE-2 questionnaire and continue to use the Teaching Strategies GOLD assessment process to support and track concerns.

Head Start & ECEAP Specific Procedures

1. Developmental Screening (ASQ-3) Administration
2. 1. Welcome Visit Completion: The ASQ-3 must be completed before or at the Welcome Visit by the parent. Parents are given a physical paper form to fill out. Staff will review the completed form and information with the family in their home language during the visit.
   2. Non-Completion Follow-Up: If the ASQ-3 is not completed prior to or during the Welcome Visit, staff must immediately establish a dedicated time to complete and review it with the family. Phone calls, texts, or follow-up home visits may be used to complete or review  the screening.
   3. Mandatory Teacher Completion: If a parent has failed to complete the ASQ-3 within 30 days of enrollment, the classroom teacher assumes responsibility and is required to complete it before the 45-day due date.

2. Social-Emotional Screening (ASQ: SE-2) Protocol

1. 1. Classroom Timeline: The ASQ: SE-2 must be completed by the classroom teacher annually after the child has attended class for at least three weeks and before the 45-day mark.
   2. Parent Role: Parents will only be asked to complete a physical ASQ: SE-2 form if a specific social-emotional concern has been formally identified by the teacher, school readiness specialist and area manager.
   3. Review screening with parent
   4. Staff review screening results with families in their home language.

3. Tracking, Database Entry, and Monitoring

1. 1. Data and Uploading Routing: All scored physical screenings must be routed to the Health Coordinator. The data must be logged into ChildPlus under the Education tab, and the physical documents uploaded and attached to the child's record.
   2. ECEAP-Specific Tracking: For ECEAP students only, teachers are required to add the exact screening date and specified 'next steps' directly into ELMS.
   3. Parental Return: After the forms are successfully uploaded into ChildPlus, the Health Coordinator returns them to the teacher, who then returns the original paper document to the parent. All scored screenings must be reviewed with parents in their home language within two weeks.
   4. Administrative Monitoring: Area Managers monitor compliance to guarantee all children are screened within the 45-day window. School Readiness Specialists pull routine ChildPlus and ELMS reports to analyze and share tracking metrics with leadership.

4. Head Start / ECEAP Scoring, Referral, and Rescreening

1. 1. Collaborative Determination: Decisions regarding school district referrals are made collectively by the DST, School Readiness Specialist, and/or the parent, incorporating ASQ-3 'Overall Section' responses, ASQ: SE-2, DIAL-4, and Teaching Strategies GOLD assessment data.
   2. Scores 'Well Below' (Black Zone): Generally, an official evaluation referral is generated if an ASQ-3 cutoff score lands in the black zone ('well below') in one or more areas, and ongoing GOLD assessments corroborate a developmental delay.
   3. Fine Motor Exception Rule: If a child's cutoff score is 'well below' (black) strictly in fine motor, staff will review scores to assess if the deficiency is due to a lack of experience at home. Staff must design and monitor targeted fine motor activities to evaluate progress before generating a formal referral.
   4. Scores in 'Monitoring' (Gray Zone): If cutoff scores fall into the gray monitoring area for two or more domains, staff must closely observe and assess the child using the GOLD framework. Results must be reviewed with the School Readiness Specialist, Area Manager, and parent prior to establishing a referral decision.
   5. Speech Intelligibility Provision: Preschool classroom teachers may consult with the School Readiness Specialist and refer children exhibiting poor speech intelligibility, even though there is no explicit standalone screener for this on the ASQ-3. This must be backed by parent/teacher reports and documented in TS GOLD under Language with detailed observations.
   6. Exclusionary Rule (Active IEP/IFSP): Children who possess a pre-existing Individualized Family Service Plan (IFSP) or Individualized Education Program (IEP) will not be referred to in the specific domains where they are already actively receiving services from a school district or Part C agency.
   7. Rescreening Criteria & Alternate Tools: If scores land in the gray monitoring zone for one or more areas, the teaching team monitors progress using TSG and determines if deploying the next age-bracket ASQ-3 or ASQ: SE-2 is necessary. Screenings may also be repeated if accuracy concerns arise regarding the initial administration or if data from external providers conflicts with classroom observations. Alternate standardized tools, such as the DIAL-4 (covering motor, language, and concepts), may be used to substantiate a preschool referral.

 

Cross References and Guides: HLTH 12a. Hearing Screening Policy and Procedure - link coming soon and HLTH 12b. Vision Screening Policy & Procedure - link coming soon. Early Head Start staff should additionally consult policy EDUC 1a1 for expanded screening guidelines. All data logging steps must align with the official program ChildPlus guide.