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Ages & Stages
Questionnaires®,
Third Edition (ASQ-3™)
and
Ages & Stages
Questionnaires®:
Social-Emotional (ASQ:SE)
Cross-Cultural Considerations
in the use of the
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
A child grows in and through contextually based
relationships, and assessment of her
developmental status is affected by her
cultural context as well as the perspectives of
the examiner and the reporting caregivers.
Kathy Hepburn, Georgetown University Center for
Child and Human Development
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
• 115.8 million identify as minority race or
ethnicity (2012, Esri)
– 52.8 million Hispanics
– 39.5 million blacks
– 15.2 million Asians/American Indian/Pacific
Islander
• By 2050, whites no longer in the majority
• 40% of children under 5 will be Hispanic
U.S. Demographics
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
Objectives
• Describe ASQ-3 and
ASQ:SE
• Discuss cultural
considerations in using
screening tools
• Present research on
cross-cultural uses of
ASQ
What are ASQ-3 and ASQ:SE?
• Parent- or caregiver-completed
screening tools that encourage
parent/caregiver involvement
• Series of questionnaires for
children ages 1 month to 5½ years
• Tools to accurately identify children
at risk for developmental or social-
emotional delay
From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
What are ASQ-3 and ASQ:SE?
From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
ASQ-3 and ASQ:SE Domains
ASQ-3
• Communication
• Gross motor
• Fine motor
• Problem solving
• Personal-social
ASQ:SE
• Social-emotional development
From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
Screening Assessment
• A brief assessment procedure designed
to identify children who should receive
more intensive diagnosis or evaluation
from local early intervention (EI), early
childhood special education (ECSE),
health, and/or mental health agencies
• Answers the question: "Does the child
need further evaluation?"
From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
Why Screen?
Clearly
Typical
Under Detected
?
Adapted from Macias, M. (2006) D-PIP Training Workshop
Clearly
Atypical
From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
Why Screen?
Clearly
Typical
Under Detected
?
Adapted from Macias, M. (2006) D-PIP Training Workshop
Clearly
Atypical
From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
Screening:
Potential challenges if process is not sensitive
• Over-referral of children for special
education services
• Under-referral of children who could
benefit from special education
services
From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
Features:
Cultural Adaptability
• Flexible administration methods (ASQ-3
and ASQ:SE)
• Alternative materials may be used
(ASQ-3)
• Scoring permits omission of
inappropriate items (ASQ-3 and ASQ:SE)
• Normative sample includes diverse
populations (ASQ-3 and ASQ:SE)
From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
• Ability to reframe questions if needed to
emphasize “intent” (ASQ-3 and ASQ:SE)
• Assesses parent concerns (ASQ-3 and
ASQ:SE)
• Subjectivity is inherent in behavioral
assessment (ASQ:SE)
• Allows for multiple caregiver completion
(ASQ-3 and ASQ:SE)
Features:
Cultural Adaptability
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
Cross-Cultural Considerations in
the Screening Process
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
What issues may arise when:
1) Meeting and introducing
concept of screening
2) Administering tool
3) Communicating
results/follow-up ideas
4) Interpreting scores/making
referrals
Cross-Cultural Considerations in
the Screening Process
From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
• What issues may arise introducing
screening?
• What is the family’s home language?
• Who should be at the meeting?
• What are possible family customs? (e.g.,
greeting, dress?)
• How does the family feel about screening?
• Do you need an interpreter or cultural
broker?
Cross-Cultural Considerations:
Introducing Screening
From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
How might culture or values
influence these activities?
• Feeding, Dressing
• Reading and Writing Tools
• Scissors, beading
• Playing with Toys
• Blocks, stuffed animals,
shopping carts, mirrors
• Sports (e.g., balls)
Cross-Cultural Considerations:
Administering Screening Tools*
Adapted from Cross-Cultural Lessons: Early Childhood Developmental Screening and Approaches to
Research and Practice. CUP Partnership, Alberta, Canada.
From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
• Who should be involved in discussion?
• What are appropriate follow-up activities?
• In some cultures, a mother "playing"
with her child may not seem appropriate
• As a helper, you bring your “best remedy.”
• Are community referral agencies familiar
with, sensitive to family culture?
Cross-Cultural Considerations:
Communicating Results, Follow-Up
From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
Gather information from family
members when concerns arise:
• Is there a problem?
• Why is there a problem?
• What do you think caused the problem?
• What can be done?
• What interventions would be
appropriate?
• Who can help?
Recommendations for Practitioners
From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
Consider the following:
• Scores (ASQ-3 & ASQ:SE)
• Was an adaptation of ASQ-3/ASQ:SE used?
• Overall Responses & Parent Concerns
• Additional Factors (e.g., health, setting,
stress)
-Family culture, home language
Cross-Cultural Considerations:
Score Interpretation and Referrals
From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
Recommendations for Practitioners
Adapted from Cross-Cultural Lessons: Early Childhood Developmental Screening and
Approaches to Research and Practice. CUP Partnership, Alberta, Canada
• Consider families’ pre- and post-immigration
experiences
• Use cultural brokers and interpreters
• Ask families about cultural expectations of
early development
• Clarify language and meaning of each items
and reframe questions
From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
• Incorporate non-standardized methods into
the screening process
• Interpret screening results with caution
and integrate relevant cultural data
• Debrief the results with the family, determine
appropriate follow-up together
• Throughout the process, validate the family’s
cultural belief system
Recommendations for Practitioners
Adapted from Cross-Cultural Lessons: Early Childhood Developmental Screening and
Approaches to Research and Practice. CUP Partnership, Alberta, Canada
From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
• Learn about one’s own cultural
framework, world view, power and
privilege position
• Think about “culture” from your
family history, community, training,
and work setting
• What values, beliefs, or “cultural
messages” did you receive about
family interactions and childrearing?
Recommendations for Practitioners:
Self Awareness
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
BE AWARE OF YOUR THOUGHTS
• Children who come to school dirty are…
• Parents who smoke are …
• Parents who sleep with their kids …
• Children arrive in school in best dress …
• Parents who carry their children all the time …
• Families who don’t read to their kids …
• Parents who talk negatively toward their children are …
• Mothers who breastfeed their babies past age of 1 year…
• Children who are overweight …
• Angry family members who don’t trust helping professionals …
Recommendations for Practitioners:
Self Awareness
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
• Research on Early Childhood Screening in
Immigrant and Refugee Families in Canada
• Rebecca Gokiert (PI)
• Great Resource!
• Cross-Cultural Handbook
•Downloadable PDF from
www.cup.ualberta.ca
Community-University Partnership (CUP)
for the Study of Children, Youth, and
Families (Alberta, Canada)
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
Research
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
Selected Translations/Adaptations
of ASQ-3 and/or ASQ:SE
Aboriginal
Australian
Afrikaans
Arabic
Bengali
Bulgarian
Changana
Chinese (Simplified)
Chuukese
Czech
Danish
Dutch
Finnish
French
Galician
Georgian
Greek
Hmong
Hungarian
Italian
Japanese
Kinyarwanda
Korean
Marshallese
Norwegian
Portuguese (Brazil)
Portuguese (Portugal)
Russian
Somali
Swahili
Swedish
Tagalog
Thai
Turkish
Ukrainian
Urdu
Vietnamese
For more information about translations, visit
http://agesandstages.com/what-is-asq/languages/
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
Functional
LinguisticMetric
Cultural
28
Factors to Consider in Adaptations
(Peña, 2007)
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
• National Study
• Providers Surveyed: (6) Home visitors,
mental health specialist, public health
providers
• Measured Utility (usefulness) of ASQ:SE
• Majority Satisfied
• Areas with most diverse expectations or
confusion: self-feeding activities, floor time
questions
Can ASQ:SE be used with families
from diverse cultural backgrounds?
(D. Lyman, W. Njoroge, D. Willis, 2007)
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
Cultural variations found most
often in areas of:
• Self Regulation
• Attachment
• Feeding/Toileting Training
Can ASQ:SE be used with families from
diverse cultural backgrounds?
(D. Lyman, W. Njoroge, D. Willis, 2007)
From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
ASQ-3 Spanish
Refined Spanish Translation:
• Reflects all changes to ASQ-3 English
• Translation reviewed by a
panel of experts—focused
on issues of dialect, idioms, etc.
• Clearer wording to improve
utility for Spanish-speaking parents
From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
Item Functioning
DIF analyses
• 27 out of 90 items functioned differently
across groups
• Older age intervals—24, 30 months
• Difficulty of items represented evenly
across language versions
• Minor revisions to a few items
recommended
32
ASQ-3 Spanish: Research
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
ASQ-3 Scores
• MANOVA: For each of the 3 intervals (9, 18,
and 30 months)
• Language was statistically related to the
weighted multivariate combination of DV
measures in each age interval
• ANOVA showed statistically significant
mean differences between groups
• 9 m: version on communication and
personal-social
• 18 m: version on personal-social
• 30 m: version on fine motor
ASQ-3 Spanish: Scores
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
• Items easy to understand
• Clear, easy to respond
• ASQ-3 interesting, helped think about
children’s development
• 87% indicated would not introduce any
changes
• Pomes & Squires, under review
34
ASQ-3 Spanish:
Readability and Utility
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
• Developed cutoff points based on national
sample
• Adaptations to some items (e.g., chopsticks)
• In general, mean scores similar to U.S. (only
10% of means had > 5 point difference)
• Differences found in communication,
problem-solving, personal-social
• Fine motor skills means lower in younger
children, then surpassed U.S. sample at 36 -
60 months
ASQ Research: Korea
Heo, Squires, & Yovanoff (2008)
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
• French-Canadian (Quebec)
• High validity and reliability
• Used in child care centers, pediatric offices
• ASQ, 2nd Edition, French
• Dionne and colleagues (2004, 2006)
• Netherlands (Dutch)
• Translation and adaptation of 48 months
• High validity and utility
• Completing remainder of 3rd edition (ASQ-3)
• Kerstjens, Bos, and ten Vergert (2009)
ASQ Research:
Canada and Netherlands
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
ASQ Research: China
Chinese (Shanghai; complex characters)
• In general, minor differences in
means
• Most differences in Fine Motor
• Lower mean scores between 4 and
27 months, higher after 27 months
• Children born in winter walked later
than children born in
spring/summer
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
Equador
• Flower growing region
• ASQ administered to children as well as
growth measurement, blood test
• Children 24-61 months residing in high-
exposure communities scored significantly
lower on gross motor skills compared to
low exposure group
38
ASQ Research: Ecuador
Handal, Lozoff, Breilh, & Harlow (2007)
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
% of Children Displaying Developmental Delay
Related to Proximity to Flower Fields
0
5
10
15
20
25
30
35
40
45
50
Community C
Communities A and B
Percentdelay
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
• Minnesota--statewide
• ASQ:SE on small PDAs, paper
www.patienttools.org
• Screened 10,000 children
• Adapted scoring options for Hmong (4 point
scale)
• Extremely low cost—start up was most costly
part
• High satisfaction by programs and parents
• Identified between 5-28% of children
• Foundationforsuccess.org
ASQ:SE Research: USA on
Hmong, Somali populations
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
• ASQ-3 and ASQ:SE have been used
successfully with families from diverse
cultural backgrounds
• Important to consider the family’s
culture in the process of screening
• Research supports the use of these
tools with families from diverse cultural
backgrounds
In Summary
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
ASQ-3™ & ASQ:SE
Training Institute
June 5-7, 2013
Hyatt Regency Grand Cypress
Orlando, Florida
Register:
www.brookespublishing.com/asq-institute/
1-800-638-3775
Would you like to learn more?
Attend the
On-Site Training
• Training seminars at your location provided by
ASQ experts
• Introductory seminars and Training of Trainers
• 1 – 3 days
• 10 – 30 attendees
• Learn more at www.brookesonlocation.com
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
Thanks for joining us!
To order:
www.brookespublishing.com
1-800-638-3775
To learn more:
http://www.brookespublishing.com/
resource-center/screening-and-
assessment/asq/
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
For More Information,
Please Contact:
Jane Squires, Ph.D.,
Liz Twombly, M.S., or
Jantina Clifford, Ph.D.
University of Oregon
541-346-0807
eip.uoregon.edu
www.agesandstages.com
© 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

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Using the ASQ with Diverse Families

  • 1. Ages & Stages Questionnaires®, Third Edition (ASQ-3™) and Ages & Stages Questionnaires®: Social-Emotional (ASQ:SE) Cross-Cultural Considerations in the use of the © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 2. A child grows in and through contextually based relationships, and assessment of her developmental status is affected by her cultural context as well as the perspectives of the examiner and the reporting caregivers. Kathy Hepburn, Georgetown University Center for Child and Human Development © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 3. • 115.8 million identify as minority race or ethnicity (2012, Esri) – 52.8 million Hispanics – 39.5 million blacks – 15.2 million Asians/American Indian/Pacific Islander • By 2050, whites no longer in the majority • 40% of children under 5 will be Hispanic U.S. Demographics © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 4. From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved. Objectives • Describe ASQ-3 and ASQ:SE • Discuss cultural considerations in using screening tools • Present research on cross-cultural uses of ASQ
  • 5. What are ASQ-3 and ASQ:SE? • Parent- or caregiver-completed screening tools that encourage parent/caregiver involvement • Series of questionnaires for children ages 1 month to 5½ years • Tools to accurately identify children at risk for developmental or social- emotional delay From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 6. What are ASQ-3 and ASQ:SE? From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 7. ASQ-3 and ASQ:SE Domains ASQ-3 • Communication • Gross motor • Fine motor • Problem solving • Personal-social ASQ:SE • Social-emotional development From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 8. Screening Assessment • A brief assessment procedure designed to identify children who should receive more intensive diagnosis or evaluation from local early intervention (EI), early childhood special education (ECSE), health, and/or mental health agencies • Answers the question: "Does the child need further evaluation?" From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 9. Why Screen? Clearly Typical Under Detected ? Adapted from Macias, M. (2006) D-PIP Training Workshop Clearly Atypical From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 10. Why Screen? Clearly Typical Under Detected ? Adapted from Macias, M. (2006) D-PIP Training Workshop Clearly Atypical From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 11. Screening: Potential challenges if process is not sensitive • Over-referral of children for special education services • Under-referral of children who could benefit from special education services From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 12. Features: Cultural Adaptability • Flexible administration methods (ASQ-3 and ASQ:SE) • Alternative materials may be used (ASQ-3) • Scoring permits omission of inappropriate items (ASQ-3 and ASQ:SE) • Normative sample includes diverse populations (ASQ-3 and ASQ:SE) From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 13. • Ability to reframe questions if needed to emphasize “intent” (ASQ-3 and ASQ:SE) • Assesses parent concerns (ASQ-3 and ASQ:SE) • Subjectivity is inherent in behavioral assessment (ASQ:SE) • Allows for multiple caregiver completion (ASQ-3 and ASQ:SE) Features: Cultural Adaptability © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 14. Cross-Cultural Considerations in the Screening Process © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 15. What issues may arise when: 1) Meeting and introducing concept of screening 2) Administering tool 3) Communicating results/follow-up ideas 4) Interpreting scores/making referrals Cross-Cultural Considerations in the Screening Process From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 16. • What issues may arise introducing screening? • What is the family’s home language? • Who should be at the meeting? • What are possible family customs? (e.g., greeting, dress?) • How does the family feel about screening? • Do you need an interpreter or cultural broker? Cross-Cultural Considerations: Introducing Screening From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 17. How might culture or values influence these activities? • Feeding, Dressing • Reading and Writing Tools • Scissors, beading • Playing with Toys • Blocks, stuffed animals, shopping carts, mirrors • Sports (e.g., balls) Cross-Cultural Considerations: Administering Screening Tools* Adapted from Cross-Cultural Lessons: Early Childhood Developmental Screening and Approaches to Research and Practice. CUP Partnership, Alberta, Canada. From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 18. • Who should be involved in discussion? • What are appropriate follow-up activities? • In some cultures, a mother "playing" with her child may not seem appropriate • As a helper, you bring your “best remedy.” • Are community referral agencies familiar with, sensitive to family culture? Cross-Cultural Considerations: Communicating Results, Follow-Up From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 19. Gather information from family members when concerns arise: • Is there a problem? • Why is there a problem? • What do you think caused the problem? • What can be done? • What interventions would be appropriate? • Who can help? Recommendations for Practitioners From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 20. Consider the following: • Scores (ASQ-3 & ASQ:SE) • Was an adaptation of ASQ-3/ASQ:SE used? • Overall Responses & Parent Concerns • Additional Factors (e.g., health, setting, stress) -Family culture, home language Cross-Cultural Considerations: Score Interpretation and Referrals From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 21. Recommendations for Practitioners Adapted from Cross-Cultural Lessons: Early Childhood Developmental Screening and Approaches to Research and Practice. CUP Partnership, Alberta, Canada • Consider families’ pre- and post-immigration experiences • Use cultural brokers and interpreters • Ask families about cultural expectations of early development • Clarify language and meaning of each items and reframe questions From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 22. • Incorporate non-standardized methods into the screening process • Interpret screening results with caution and integrate relevant cultural data • Debrief the results with the family, determine appropriate follow-up together • Throughout the process, validate the family’s cultural belief system Recommendations for Practitioners Adapted from Cross-Cultural Lessons: Early Childhood Developmental Screening and Approaches to Research and Practice. CUP Partnership, Alberta, Canada From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 23. • Learn about one’s own cultural framework, world view, power and privilege position • Think about “culture” from your family history, community, training, and work setting • What values, beliefs, or “cultural messages” did you receive about family interactions and childrearing? Recommendations for Practitioners: Self Awareness © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 24. BE AWARE OF YOUR THOUGHTS • Children who come to school dirty are… • Parents who smoke are … • Parents who sleep with their kids … • Children arrive in school in best dress … • Parents who carry their children all the time … • Families who don’t read to their kids … • Parents who talk negatively toward their children are … • Mothers who breastfeed their babies past age of 1 year… • Children who are overweight … • Angry family members who don’t trust helping professionals … Recommendations for Practitioners: Self Awareness © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 25. • Research on Early Childhood Screening in Immigrant and Refugee Families in Canada • Rebecca Gokiert (PI) • Great Resource! • Cross-Cultural Handbook •Downloadable PDF from www.cup.ualberta.ca Community-University Partnership (CUP) for the Study of Children, Youth, and Families (Alberta, Canada) © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 26. Research © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 27. Selected Translations/Adaptations of ASQ-3 and/or ASQ:SE Aboriginal Australian Afrikaans Arabic Bengali Bulgarian Changana Chinese (Simplified) Chuukese Czech Danish Dutch Finnish French Galician Georgian Greek Hmong Hungarian Italian Japanese Kinyarwanda Korean Marshallese Norwegian Portuguese (Brazil) Portuguese (Portugal) Russian Somali Swahili Swedish Tagalog Thai Turkish Ukrainian Urdu Vietnamese For more information about translations, visit http://agesandstages.com/what-is-asq/languages/ © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 28. Functional LinguisticMetric Cultural 28 Factors to Consider in Adaptations (Peña, 2007) © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 29. • National Study • Providers Surveyed: (6) Home visitors, mental health specialist, public health providers • Measured Utility (usefulness) of ASQ:SE • Majority Satisfied • Areas with most diverse expectations or confusion: self-feeding activities, floor time questions Can ASQ:SE be used with families from diverse cultural backgrounds? (D. Lyman, W. Njoroge, D. Willis, 2007) © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 30. Cultural variations found most often in areas of: • Self Regulation • Attachment • Feeding/Toileting Training Can ASQ:SE be used with families from diverse cultural backgrounds? (D. Lyman, W. Njoroge, D. Willis, 2007) From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 31. ASQ-3 Spanish Refined Spanish Translation: • Reflects all changes to ASQ-3 English • Translation reviewed by a panel of experts—focused on issues of dialect, idioms, etc. • Clearer wording to improve utility for Spanish-speaking parents From ASQ-3™ and ASQ:SE Training Materials by J. Squires, J. Farrell, J. Clifford, S. Yockelson, E. Twombly, and L. Potter © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 32. Item Functioning DIF analyses • 27 out of 90 items functioned differently across groups • Older age intervals—24, 30 months • Difficulty of items represented evenly across language versions • Minor revisions to a few items recommended 32 ASQ-3 Spanish: Research © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 33. ASQ-3 Scores • MANOVA: For each of the 3 intervals (9, 18, and 30 months) • Language was statistically related to the weighted multivariate combination of DV measures in each age interval • ANOVA showed statistically significant mean differences between groups • 9 m: version on communication and personal-social • 18 m: version on personal-social • 30 m: version on fine motor ASQ-3 Spanish: Scores © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 34. • Items easy to understand • Clear, easy to respond • ASQ-3 interesting, helped think about children’s development • 87% indicated would not introduce any changes • Pomes & Squires, under review 34 ASQ-3 Spanish: Readability and Utility © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 35. • Developed cutoff points based on national sample • Adaptations to some items (e.g., chopsticks) • In general, mean scores similar to U.S. (only 10% of means had > 5 point difference) • Differences found in communication, problem-solving, personal-social • Fine motor skills means lower in younger children, then surpassed U.S. sample at 36 - 60 months ASQ Research: Korea Heo, Squires, & Yovanoff (2008) © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 36. • French-Canadian (Quebec) • High validity and reliability • Used in child care centers, pediatric offices • ASQ, 2nd Edition, French • Dionne and colleagues (2004, 2006) • Netherlands (Dutch) • Translation and adaptation of 48 months • High validity and utility • Completing remainder of 3rd edition (ASQ-3) • Kerstjens, Bos, and ten Vergert (2009) ASQ Research: Canada and Netherlands © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 37. ASQ Research: China Chinese (Shanghai; complex characters) • In general, minor differences in means • Most differences in Fine Motor • Lower mean scores between 4 and 27 months, higher after 27 months • Children born in winter walked later than children born in spring/summer © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 38. Equador • Flower growing region • ASQ administered to children as well as growth measurement, blood test • Children 24-61 months residing in high- exposure communities scored significantly lower on gross motor skills compared to low exposure group 38 ASQ Research: Ecuador Handal, Lozoff, Breilh, & Harlow (2007) © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 39. % of Children Displaying Developmental Delay Related to Proximity to Flower Fields 0 5 10 15 20 25 30 35 40 45 50 Community C Communities A and B Percentdelay © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 40. • Minnesota--statewide • ASQ:SE on small PDAs, paper www.patienttools.org • Screened 10,000 children • Adapted scoring options for Hmong (4 point scale) • Extremely low cost—start up was most costly part • High satisfaction by programs and parents • Identified between 5-28% of children • Foundationforsuccess.org ASQ:SE Research: USA on Hmong, Somali populations © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 41. • ASQ-3 and ASQ:SE have been used successfully with families from diverse cultural backgrounds • Important to consider the family’s culture in the process of screening • Research supports the use of these tools with families from diverse cultural backgrounds In Summary © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 42. ASQ-3™ & ASQ:SE Training Institute June 5-7, 2013 Hyatt Regency Grand Cypress Orlando, Florida Register: www.brookespublishing.com/asq-institute/ 1-800-638-3775 Would you like to learn more? Attend the
  • 43. On-Site Training • Training seminars at your location provided by ASQ experts • Introductory seminars and Training of Trainers • 1 – 3 days • 10 – 30 attendees • Learn more at www.brookesonlocation.com © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 44. Thanks for joining us! To order: www.brookespublishing.com 1-800-638-3775 To learn more: http://www.brookespublishing.com/ resource-center/screening-and- assessment/asq/ © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.
  • 45. For More Information, Please Contact: Jane Squires, Ph.D., Liz Twombly, M.S., or Jantina Clifford, Ph.D. University of Oregon 541-346-0807 eip.uoregon.edu www.agesandstages.com © 2013 Paul H. Brookes Publishing Co., Inc. All rights reserved.

Notes de l'éditeur

  1. Describe purpose of training for specific audience.
  2. Parent/Caregiver completed. All of the research on the ASQ was conducted with a primary caregiver completing the form, so we know little about how accurate results are if, for example, a childcare provider completes the tool. (For the ASQ:SE, caregivers need to have at least 20 hours of contact with the child during the week). Optional Activity: Ask Participants, "Why is it important to include parents in the screening process?”Possible answers include:Parents know children best, so are good sources of informationParents can learn about child developmentParents are seen as the expert, which can be empoweringIncludes parents as part of the teamFacilitates communication between provider and parent regarding child’s development
  3. Parent/Caregiver completed. All of the research on the ASQ was conducted with a primary caregiver completing the form, so we know little about how accurate results are if, for example, a childcare provider completes the tool. (For the ASQ:SE, caregivers need to have at least 20 hours of contact with the child during the week). Optional Activity: Ask Participants, "Why is it important to include parents in the screening process?”Possible answers include:Parents know children best, so are good sources of informationParents can learn about child developmentParents are seen as the expert, which can be empoweringIncludes parents as part of the teamFacilitates communication between provider and parent regarding child’s development
  4. Review slide.ASQ-3 covers 5 Domains of Development. Explain that ASQ:SE was developed as a companion tool toASQ in order to address the need for age-appropriate tools to monitor very young children’s behavior and address parental concerns.
  5. Exercise: Materials: Overhead projector w/transparency paper & marker or flipchart pad & markers1) Ask participants to identify what types of screening tools they have used in their agencies.2) Ask participants to identify 1 word that typifies screening. Write these words down and discuss screening using those words. (Examples: funnel, sand sifter, snapshot)Also, remind participants (see slide "ASQ and ASQ:SE Development") that ASQ and ASQ:SE items are not to be used as targets for intervention or for goals/objectives. The results can let you know, however, what development domain or behavioral area to focus interventions efforts on. Examples of Screening tools:The Ages & Stages Questionnaires® (ASQ) , DIAL-3, Early Screening Inventory (ESI), Revised Developmental Screening Inventory (RDSI), Parent’s Evaluation of Developmental Status (PEDS).Examples of SE Screening Tools: Temperament and Behavior Scales (TABS), BITSEA (Brief Infant/Toddler Social-Emotional Assessment), Devereux Early Childhood Assessment (DECA)Developmental screening similar in theory to health screenings such as a quick hearing or vision screen.
  6. Culture can affect the developmental expectations of parents as well as the type and quantity of opportunities that children are provided to practice certain skills. It is important to take this into consideration when interpreting questionable results. The normative sample was used to establish cut-off scores and will be mentioned later in the presentation in the Research section, but you could also mention it here. It is important to understand that while the normative sample includes children across races, the majority of children in the sample were Caucasian. Since culture is sometimes related to race, this could be a consideration when working with children who are not Caucasian.
  7. Culture can affect the developmental expectations of parents as well as the type and quantity of opportunities that children are provided to practice certain skills. It is important to take this into consideration when interpreting questionable results. The normative sample was used to establish cut-off scores and will be mentioned later in the presentation in the Research section, but you could also mention it here. It is important to understand that while the normative sample includes children across races, the majority of children in the sample were Caucasian. Since culture is sometimes related to race, this could be a consideration when working with children who are not Caucasian.
  8. What are cultural considerations for each step in the screening process?
  9. Meeting with parents. What language does the family speak? Who should be at the meeting? What is appropriate in terms of meeting and greeting? What is appropriate dress? What are the possible customs of the family? Do you have an interpreter and a cultural broker to assist if necessary?Evidence-based practice indicates that support for the family’s home language is:Is crucial to the development of social, emotional, cognitive and language skills and academic successIs crucial to the developing self-esteem of the child.Leads to greater success in acquiring other languages and academic successPromotes more complex thought, conceptual development and critical thinking skills.What are cultural considerations for each step in the screening process?Either debrief this slide with entire group or can do in small groups (see Activity below).Examples of issues or considerations include:Meeting with parents. What language does the family speak? Who should be at the meeting? What is appropriate in terms of meeting and greeting? What is appropriate dress? What are the possible customs of the family? Do you have an interpreter and a cultural broker to assist if necessary?Administering the Screening Tool. Is there a translated version of the screening tool? Is an interpreter or cultural broker available? Are certain materials or activities not encouraged or valued in this culture?Communicating Results/Follow-up suggestions in the home. What are appropriate follow-up suggestions? In some cultures, a mother "playing" with her child may not seem appropriate. One on one time with his/her child may not reflect their parenting practice. Making community referrals. Is the receiving agency ready for the family (i.e., Do they have interpreters, cultural brokers, etc?). Is the family in agreement that a referral is necessary? Activity: Provide Handout "Cultural Considerations in Screening" and break into small groups. Have groups brainstorm what issues may arise, what information or questions you may need to ask (of the caregivers or community agencies) in order to ensure as high a level of cultural sensitivity in the screening process as possible.
  10. Either debrief this slide with entire group or can do in small groups (see Activity below).Administering the Screening Tool. Is there a translated or adapted version of the screening tool? Is an interpreter or cultural broker available? Are certain materials or activities not encouraged or valued in this culture?These are all activities/materials you will find on the ASQ. Discuss how cultural values and parenting practices may impact a child’s performance on these different activities.Examples of issues that may arise:Feeding/Dressing: Some cultures feed and dress their babies much longer than "western" cultures and do not encourage self-feeding or children dressing themselves.Reading/Writing: Some cultures have strong oral traditions; writing may not be emphasized, especially at very young ages...may also be considered a safety issue.Playing with Toys: Some cultures place a high value on socializing and may not encourage solitary play with toys.Sports: Some cultures may have strong gender roles and not allow or encourage girls to participate in sport-type activities.Excerpts from: Cross-Cultural Lessons: Early Childhood Developmental Screening and Approaches to Research and Practice. Community-University Partnership for the Study of Children, Youth, and Families. Edmonton, Alberta, Canada.
  11. Communicating Results/Follow-up suggestions in the home. What are appropriate follow-up suggestions? In some cultures, a mother "playing" with her child may not seem appropriate. One on one time with his/her child may not reflect their parenting practice.
  12. Possible questions may be: How is the family feeling about the child’s development at this point in time?Do they have concerns?What are the next steps they would like to take, and how can the provider support them?Make sure to build from child and family strengths and explore concerns in areas where there are low scores.
  13. Handout: "Comfort Levels with Parenting Practices"Activity: Have participants complete independently, then compare with another participant or in small groups. Have participants discuss different viewpoints. This activity is a good example of coming to some personal awareness about feelings participants have, and how they may differ from person to person or across different cultural groups.This can be an interesting exercise to have participants examine their preconceived view of what behaviors are socially appropriate, what parenting practices are appropriate, and what interventions are appropriate, and how our personal "culture" impacts those views.
  14. Instruct participants to form small groups and together discuss Andrew’s ASQ-3. Participants should generate ideas and questions regarding:Further information they would like to have regarding Andrew and VickyIdeas for possible activities that can be done in a home environment as well as potential referral sources available in their communityDebrief the activity focusing on:CommunicationFine Motor and Problem SolvingSee: "16-Month ASQ Scoring Exercise for Andrew" in Trainer’s Materials
  15. Instruct participants to form small groups and together discuss Andrew’s ASQ-3. Participants should generate ideas and questions regarding:Further information they would like to have regarding Andrew and VickyIdeas for possible activities that can be done in a home environment as well as potential referral sources available in their communityDebrief the activity focusing on:CommunicationFine Motor and Problem SolvingSee: "16-Month ASQ Scoring Exercise for Andrew" in Trainer’s Materials
  16. See notes on slide 10.
  17. Korean Study:Heo, K., Squires, J., & Yovanoff, P. (2008) French-Canadian Study: Dionne, C., Squires, J., & Leclerc, D. (2004)Chinese Study:Bian, et al. (in preparation)Chilean Study: Cordero, M. (in preparation)Norwegian Study:Janson, H., & Squires, J. (2004)
  18. Not only is caregiving environment important but also health of environment—exposure to toxins