Using Parent-Centered Developmental Screening … ppt and... · The PEDS’ Score Form (showing the concerns raised at prior visits as well) revealed 4 concerns predictive of developmental

Webinar:Parents’ Evaluation of Developmental Status

(PEDS)November 9, 2010

Cynthia Landes, M.P.H., M.A., E.T./P.

Educational TherapistDevelopmental Screening Consultant

Training Provided by:

(310) [email protected]

mailto:[email protected]�



Jane Tabor-BaneResource Center for Family-Focused PracticeThe Center for Human ServicesUC Davis Extension1632 Da Vinci CourtDavis, CA 95616P: 530.757.8636F: 530.754.5104Email: [email protected]: http://humanservices.ucdavis.edu/resource

We would like to acknowledge the generous support of the California Department of Social Services for this webinar.

For additional information of public child welfare department’s responsibility to refer children to early intervention services, please contact:

Adreena C. Lowe, MSW Ed.DCDSS Consultant –Health Care Oversight and CoordinationChild and Youth Permanency BranchCalifornia Department of Social Services(916) 651-9908 [email protected]


http://humanservices.ucdavis.edu/resource�


Features & Materials:Parents’ Evaluation of Developmental Status

(PEDS)

Developed by Frances Page Glascoe, PhD

10 item questionnaire

For children 0 to 8 yearsElicits parents’ concerns (in multiple languages) re: cognitive, language, self-help, personal-social, and motor skillsTakes about 5 minutes for parents to complete, 1-2 minutes to score

Features: PEDS

Sorts children into high, moderate or low risk for developmental and behavioral problems

4th – 5th grade reading level so > 90% can complete independently

Score/Interpretation form used longitudinally

Online application with automated scoring/results

Features: PEDS

Materials: PEDS

• Packets of Response forms and Score & Interpretation forms

• Collaborating With Parents (Users Guide)• Brief Administration & Scoring Guide• Many free, downloadable teaching & support

materials• Available on-line at www.pedstest.com• On-line version available at www.forepath.org

http://www.pedstest.com/�

http://www.forepath.org/�

“Oh, by the way…..”

• Reduces “doorknob concerns”

• Focuses visit and facilitates parent interaction

• Improves parent satisfaction and positive parenting practices

• Increases provider confidence in decision-makingFrances Page Glascoe, Ph.D.

©2006 www.forepath.org

Administration & Scoring:

Parents’ Evaluation of Developmental

Status (PEDS)

Have parents fill out Response Form--either individually or you may ask the screening questions and write down

their answers.Frances Page Glascoe, Ph.D.

©2006 www.forepath.org

If parents complete PEDS on their own and they circle answers but don’t write anything on the form, you cannot be sure of literacy

and should re-administer PEDS as an interview.

CAUTION!

Frances Page Glascoe, Ph.D. ©2006 www.forepath.org

Computing the Child’s Age

Correct for prematurity if the child is < 24 mo. AND was born >3.5 weeks premature,

then subtract 1 week from chronological age for every week born premature.

After Response Form is completed, begin the scoring process by

Administration: PEDS

Correcting for PrematurityChild born on 11/29/09Born 7 weeks premature

Year Month Day

Today’s date: 20102009 109+12=21 24+30=54

Child’s DOB: -2009 -11 -29

Chronological age: 10 mo 23 days- weeks premature -1 21

Corrected age 9 mo 2 daysWould the corrected age change the questionnaire you select?

Find the correct column for the child’s age on the PEDS Score Form

Scoring: PEDS

Read through all comments

Look at the PEDS Brief Guide for examples of how to categorize concerns in the various domains of development

Scoring: PEDS

Scoring Alert !!Parents don’t always answer the question

asked! Be sure to focus on the categories of concern given by the parent, not the answer

they gave.

Scoring: PEDS

Global/Cognitive: Slow and behind; Can’t do what other kids can

Expressive Language: He can’t talk plain

Receptive Language: She doesn’t seem to understand us

Gross Motor: He’s clumsy; falls a lot; awkward; late to walk

Fine Motor: She can’t write well; messy eater

Scoring: PEDSEXAMPLES OF PARENTS’ CONCERNS

Social/Emotional: He’s mean; she’s bossy; doesn’t have friends

Behavior: He won’t mind me; temper tantrums

Academic/pre-academic: trouble in school; doesn’t know ABCs

Self-Help: Can’t get dressed by himself

Other: trouble hearing/seeing; health problems; family issues; I used to be worried but now I think he’s doing OK

Scoring: PEDSEXAMPLES OF PARENTS’ CONCERNS

Mark the box to show the kind of concern

Even if there are several different kinds of issues under the same category, only check the box once (e.g, tantrums, hyperactivity, biting--all just get a single check under behavior)

When parents circle “a little” to indicate the degree of concern, view this as a “yes”

Scoring: PEDS

If you have a concern about a child, you can add checks to the boxes

However, DO NOT remove or ignore the parents concerns

Scoring: PEDS

Total the number of concerns in the shaded boxes into the large shaded box at the bottom

Total the number of concerns in the unshaded boxes into the large unshaded box at the bottom

Scoring: PEDS

Scoring: PEDSIf shaded circle = AND unshaded square = * then PATH A

If shaded circle = AND unshaded square = * then PATH B

If shaded circle = AND unshaded circle = then PATH C

If shaded circle = AND unshaded circle =

AND you have concerns, then PATH D

If shaded circle = AND unshaded circle =

AND you have no concerns, then PATH E

* = Any numberx

>2

0

x

1

0

0

x

>1

0

0

PEDS’ Evidenced Based Decisions

Path A: high risk of developmental disabilities, shows what kinds of referrals are needed.

Path B: moderate risk of disabilities, need for additional screening, developmental promotion, monitoring

Path C: low risk of developmental disabilities but elevated risk for mental health problems, need for parent education, monitoring, and/ or additional behavioral screening

Path D: moderate risk of developmental disabilities, problems with parental communication and need for hands-on screening

Path E: low risk for either type of disability for which reassurance is the best response

PEDS Interpretation Form Description: Path A

Path A is the High Risk path and suggests possible developmental disabilities. Refer for evaluations through EI promptly.

Path A suggests the type of evaluations needed based on the types of concerns

Additional screening with the M-CHAT is wise

Add your clinical judgment about what other kinds of services may be needed (e.g., social

k t l h lth t )

Path B suggests Moderate Risk for developmental disabilities

In response screen further or refer for screening

Offer developmental promotion to those who don’t qualify for special services and provide “watchful waiting”/extra monitoring

Consider referrals to Head Start, after school tutoring, etc.

PEDS Interpretation Form Description: Path B

Path C: Low risk of developmental disability but elevated risk of mental health problems, especially in children 4 yrs and older

For children under 4, give parents advice and written information, and monitor effectiveness

If such counseling is not effective, provide mental health screening or refer for screening (both child and family-focused)

For children 4 and older, give mental health screens or refer for screening (child and family)

PEDS Interpretation Form Description: Path C

Path D is rare but is used for parent-provider communication difficulties (e.g., no language in common, teen parent who doesn’t know much about his child, parents with serious mental health or language problems

Refer these children for hands-on screening (e.g., with the Brigance or ASQ)

PEDS Interpretation Form Description: Path D

Path E: Low risk for problems either in development or social-emotional areas

Offer reassurance unless your clinical judgment suggests a problem

PEDS Interpretation Form Description: Path E

The Interpretation Form has space on the right to record your decisions, referrals, advice, etc. This provides a longitudinal record of services provided—helpful for audits, etc.

Scoring: PEDS

•Pediatric Symptom Checklist (PSC)•Family Psychosocial Screen•Safety Word Inventory & Literacy Screener (SWILS)•Modified Checklist of Autism in Toddlers (MChAT)

are downloadable FOR FREE at

www.pedstest.com/content.php?content=download_resources.html

Additional Follow-up Screening Tools

Review “Roger” Case Example

Talking about Screening Results

with Parents

Information to Guide Referral Decisions

• Biological / Health factors• Environmental factors

• stressful life events • social supports• family / care-giving environment

• Developmental history• Family and cultural context• Parent concerns

Communicating Screening Results

When a concern or problem arises, consider the following culturally sensitive questions:

– Is there a problem?– Why is there a problem?

• What do you think has caused the problem?– What can be done?

• What types of interventions would be appropriate?

– Who can help?

Slide information courtesy of J. Clifford & L. Twombly (Univ of Oregon, Early Intervention Program)

Communicating Screening Results*Prepare for the meeting carefully

• Make notes about behaviors• Note information you need to gather (health

history etc.) from family• Role play conversation with a peer• Select a private, comfortable place• Consider cultural or language issues• Know your community resources• Be calm!

* Adapted from the Hilton/Early Head Start Training Program, CSU Sonoma

Communicating Screening Results

1. Assure the family that the discussion is confidential.

2. Review the purpose of screening.3. Avoid terms such as “test”, “pass” or “fail”. 4. Review screening information and explain

scores.5. Emphasize child and family strengths.6. Provide specific examples of concerns.7. Invite parents to share observations,

concerns.


In Summary• Screening tools can help bridge communication

with families• Screening tools can assist in making referrals to

medical home or community agencies

• Referrals should be based on a variety of considerations-including the culture of the family-in addition to scores

• Developmental issues are very complicated

• Use available resources to make decisions about next steps after screening


Thank you for your participation! Travel safely!

Parents’ Evaluation of Developmental Status (PEDS):

An evidence-based method for detecting and addressing developmental and behavioral

problems in children Case Example

Roger* had regular checkups since birth. During each, his mother had a range of complaints, mostly health-related or behavioral (as shown on both the Score Form and Interpretation Form). These were addressed with medical/nutrition intervention, parent education (including Fer-ber’s sleep techniques), and eventually in-home behavior therapy to address head-banging, pacing, and tantrums. Developmentally, Roger walked and talked on time and had a fairly substantial vocabulary, however unusual, at 18 months of age. His parents were active in playing with and teaching him.

The PEDS’ Response Form (next page) shows what his mother wrote while waiting for Roger’s two-year check-up.

The PEDS’ Score Form (showing the concerns raised at prior visits as well) revealed 4 concerns predictive of developmental problems and 2 non-predictive concerns.

The Score Form points to Path A on the PEDS Interpretation Form and the need for audiological/speech-language assessment. Roger’s pediatrician. Dr. Louise Hamilton, also followed the American Academy of Neurology’s recommendations for second-stage screening using an autism-specific measure. Lacking time, she requested that the local Early Intervention (EI) program administer the Modified Checklist of Autism in Toddlers (M-CHAT). Dr. Hamilton also followed the AAN’s recommendation for audiological, vision and lead screening, all of which were negative. (As an aside, PEDS online at www.forepath.org also provides the M-CHAT, offers automated scor-ing, generates a summary for parents and a referral letter for sharing with other professionals).

The early intervention program administered a range of measures and determined that Roger met eligibility crite-ria for enrollment in early intervention because of a receptive and expressive language delay and social deficits. (Note that it is not necessary to have a diagnosis for enrollment in early intervention). The program also inter-viewed Roger’s parents to look at family stressors, mental health issues and other external contributors to Roger’s difficulties but felt the family was healthy and coping well under the circumstances of a challenging child. The developmental specialist at the EI program also administered the M-CHAT which was positive and thus indicated the need to see an autism specialist. The EI program explained these results to Roger’s mother and in a letter back to Dr. Hamilton, suggesting that Roger be placed on the waiting list for the autism specialist at a local university while the program continued to work with him and his family.

*For this case example,no personally identifying information is included. Pseudonyms are used along with stock photography.

© 2010 Glascoe FP. Robertshaw NS. Ellsworth & Vandermeer Press, LLC, 1013 Austin Court, Nolensville, TN 37135 phone: 615-776-4121 facsimile: 615-776-4119 web: www.pedstest.com email: [email protected] Electronic versions: [email protected]

Permission is granted to photocopy these scored forms for training purposes.

PEDS Response Form

Do you have any concerns about how your child talks and makes speech sounds?Circle one: No Yes A little COMMENTS:

Do you have any concerns about how your child understands what you say?Circle one: No Yes A little COMMENTS:

Do you have any concerns about how your child uses his or her hands and fingers to do things?Circle one: No Yes A little COMMENTS:

Do you have any concerns about how your child uses his or her arms and legs?Circle one: No Yes A little COMMENTS:

Do you have any concerns about how your child behaves?Circle one: No Yes A little COMMENTS:

Do you have any concerns about how your child gets along with others?Circle one: No Yes A little COMMENTS:

Do you have any concerns about how your child is learning to do things for himself/herself?Circle one: No Yes A little COMMENTS:

Do you have any concerns about how your child is learning preschool or school skills?Circle one: No Yes A little COMMENTS:

Please list any other concerns.

Please list any concerns about your child’s learning, development, and behavior.

© 2010 Glascoe FP. Robertshaw NS. Ellsworth & Vandermeer Press, LLC, 1013 Austin Court, Nolensville, TN 37135 phone: 615-776-4121 facsimile: 615-776-4119 web: www.pedstest.com email: [email protected] Electronic versions: [email protected]

Permission is granted to photocopy these scored forms for training purposes.

I’m worried about how my child talks and relates to us. He says thingsthat don’t have anything to do with what’s going on. He’s oblivious toanything but what he is doing. He’s not doing as well as other kids inmany ways.

He repeats odd things like “Wheel of Fortune”

I can’t tell if he doesn’t understand, doesn’t hear well or just ignores us

He’s good with manipulatives but does a lot of the same things over andover: spinning wheels on cars, flicking light switches, flipping pages

He’s very coordinated and very fast!

still lots of tantrums but headbanging is almost gone. Behavior therapy has been helpful and his tantrums are less severe and shorter

He doesn’t seem interested in watching other kids, let alone playing with them

He’s very independent

He’s too young for any of that!

We spend lots of time playing with Roger and talking to him. This seems to be helping him be more engaged. I still wonder about his hearing.

Provider

Child’s Name Parent’s Name

Child’s Birthday Child’s Age 2 Today’s Date

Roger J. Malinda J.

8/8/05 8/10/07

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for

M-CHAT and developmental as-

sessment

Roger J

8/8/05

6: Resources for Parent and Professional Education

89

6

from Glascoe FP, Robertshaw NS, Parents’ Evaluation of Developmental Status: Developmental Milestones (PEDS:DM), www.pedstest.com You may reproduce this page.

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el li

ke n

oise

s

~ 3

mon

ths

Pro

ps

on fore

arm

s in

pro

ne

Rolls

to s

ide

Han

ds u

nfist

ed 5

0%

Insp

ects

fing

ers

Bat

s at

obj

ects

Bri

ngs

hand

s to

m

outh

Rea

ches

for

pare

nt’s

face

Follo

ws

obje

cts

mov

ed in

c

ircl

e ( w

hen

in s

upin

e)

Reg

ards

toys

Expr

essi

on o

f dis

-gu

st (s

our

tast

e,

loud

sou

nd)

Vis

ually

follo

ws

pers

on w

ho is

m

ovin

g ac

ross

a

room

Reg

ards

spe

aker

Chu

ckle

s

Voc

aliz

es w

hen

talk

ed to

~ 4

mon

ths

Sit w

ith tru

nk

support

No h

ead lag

when

pulled

to s

it

Pro

ps

on w

rist

s

Rolls

front to

bac

k

Clu

tche

s at

clo

thes

Rea

ches

per

sist

ently

Play

s w

ith r

attle

Hol

ds h

ands

pre

dom

i-na

tely

ope

n

Bri

efly

hold

s on

to

brea

st o

r bo

ttle

Mou

ths

obje

cts

Star

es lo

nger

at n

ovel

face

s th

an

fam

iliar

one

s

Shak

es r

attle

Rea

ches

for

ring

/rat

tle

Smile

s sp

onta

ne-

ousl

y at

ple

asur

-ab

le s

ight

/sou

nd

Stop

s cr

ying

at

pare

nt v

oice

To a

nd f

ro a

lter-

natin

g vo

caliz

a-tio

ns

Ori

ents

hea

d in

dir

ectio

n of

a

voic

e

Stop

s cr

ying

to s

ooth

ing

voic

e

Laug

hs o

ut lo

ud

Voc

aliz

es w

hen

alon

e

~ 5

mon

ths

Sits

with p

elvi

c su

pport

Rolls

bac

k to

fro

nt

Para

chute

sits

with

arm

s su

pport

ing

trunk

(ante

rior

pro

tect

ion)

Gra

sps

cube

usi

ng

who

le h

and

(pal

mer

gr

asp)

Tran

sfer

s ob

ject

s:

hand

-mou

th-h

and

Hol

ds h

ands

toge

ther

Rea

ches

/gra

sps

dan-

glin

g ri

ng

Gum

s/m

outh

s pu

reed

food

Tu

rns

head

to lo

ok fo

rdro

pped

sp

oon

Reg

ards

pel

let o

r sm

all c

rack

er

Rec

ogni

zes

care

-gi

ver

visu

ally

Form

s at

tach

men

t -r

elat

ions

hip

to

care

give

r

Beg

ins

to r

espo

nd to

nam

eSa

ys “

Ah-

goo”

Raz

z, s

quea

l

Expr

esse

s an

ger

with

so

unds

oth

er th

an c

ryin

g

© 2

007 C

hri

s Johnson, M

D, A

AP C

ouncil o

n C

hild

ren w

ith D

isab

ilitie

s. A

dap

ted

with p

erm

issio

n a

nd

by c

ontr

ibutions fro

m F

rances P

age G

lascoe, PhD

and

Nic

hola

s R

ob

ert

shaw

, auth

ors

of

PED

S:D

evelo

pm

enta

l M

ilesto

nes,

Fra

nklin T

rim

m,

MD

, V

ice C

hair

of

Ped

iatr

ics,

USA

/A

PA

Ed

ucation C

om

mitte

e;

the C

ente

r fo

r D

isease C

ontr

ol “A

ct

Earl

y” Initia

tive;

the N

ational In

stitu

te for

Litera

cy/R

each O

ut

and

Read

; and

the Invento

ry o

f Earl

y D

evelo

pm

ent

by A

lbert

Bri

gance p

ub

lished

by C

urr

iculu

m A

ssocia

tes,

Inc.

Perm

issio

n is g

rante

d t

o

rep

rod

uce t

hese p

ages o

n t

he c

ond

itio

n t

hat

they a

re o

nly

used

as g

uid

e t

o a

vera

ge d

evelo

pm

ent

and

not

as a

sub

stitu

te for

sta

nd

ard

ized

valid

ate

d s

cre

enin

g for

develo

pm

enta

l p

rob

lem

s.


90

6


Ch

ron

olo

gi-

cal A

ge

Gross M

oto

rFin

e M

oto

r/

Writ

ing

Self

-Help

Cognit

ive/A

cadem

icSocia

l/Em

o-

tional

Recepti

ve L

anguage

Expressiv

e L

anguage

~ 6

mon

ths

Sits

mom

enta

rily

pr

oppe

d on

ha

nds

Pivo

ts in

pro

ne (o

n be

lly)

Pron

e--b

ears

wei

ght

on o

ne h

and

Tran

sfer

s ha

nd-h

and

Rak

es p

elle

t

Take

s se

cond

cub

e -

hold

s on

to o

ne

Rea

ches

with

one

ha

nd

Feed

s se

lf cr

acke

rs

Plac

es h

ands

on

bottl

e

Touc

hes

refle

ctio

n an

d vo

caliz

es

Rem

oves

clo

th o

n fa

ce

Ban

gs &

sha

kes

toys

Stra

nger

anx

iety

: re

cogn

izes

fam

il-ia

r vs

. unf

amili

ar

peop

le

Stop

s m

omen

tari

ly to

“no

”

Ges

ture

s fo

r “u

p”

Red

uplic

ate

babb

le w

ith

cons

onan

ts

List

ens

then

voc

aliz

es

whe

n ad

ult s

tops

Smile

s/V

ocal

izes

to m

irro

r

~ 7

mon

ths

Bou

nces

whe

n he

ld

Sits

w/o

sup

port

--

Stea

dy

Puts

arm

s ou

t to

side

s fo

r ba

lanc

e (L

ater

al p

rote

ctio

n)

Gra

sps

usin

g si

de o

f ha

nd (r

adia

l-pa

lmar

gr

asp)

Ref

uses

exc

ess

food

Expl

ores

diff

eren

t asp

ects

of a

toy

Obs

erve

s cu

be in

eac

h ha

nd

Find

s pa

rtia

lly h

idde

n ob

ject

Look

s fr

om

obje

ct to

par

ent

and

back

whe

n w

antin

g he

lp

(e.g

., w

ith a

w

ind-

up to

y)

Look

s to

war

d fa

mili

ar o

bjec

t w

hen

nam

ed

Atte

nds

to m

usic

Incr

easi

ng v

arie

ty o

f syl

-la

bles

~ 8

mon

ths

Get

s in

to s

ittin

g

Com

man

do c

raw

ls

Pulls

to s

ittin

g/kn

eelin

g

Ban

gs s

poon

afte

r a

dem

o

Gra

sps

with

all

four

fin

gers

and

sid

e of

th

umb

(Sci

ssor

gra

sp)

Take

s cu

be o

ut o

f cup

Pulls

larg

e pe

g ou

t

Hol

ds o

wn

bottl

e

Fing

er fe

eds

Che

erio

s or

str

ing

bean

s

Seek

s ob

ject

afte

r it

falls

s

ilent

ly

to th

e flo

or

Lets

par

ents

kn

ow w

hen

ha

ppy

vs. u

pset

Enga

ges

in g

aze

mon

itori

ng:a

dult

look

s aw

ay a

nd

child

follo

ws

adul

t gla

nce

with

ow

n ey

es

Res

pond

s to

“co

me

here

”

Look

s fo

r fa

mily

mem

bers

w

hen

aske

d, “

Whe

re’s

Mam

a?...

etc.

Says

“M

ama”

(no

n-sp

e-ci

fic)

Non

-red

uplic

ate

babb

le

Imita

tes

soun

ds

~ 9

mon

ths

“Sta

nds”

on

feet

an

d ha

nds

Beg

ins

cree

ping

Pulls

to s

tand

Cra

wls

with

all

four

lim

ps s

trai

ghte

nd

(Bea

r w

alks

)

Gra

sps

with

two

finge

r an

d th

umb

belo

w

(Rad

ial-

digi

tal)

Ban

gs 2

cub

es to

-ge

ther

Bite

s, c

hew

s co

okie

Insp

ects

par

ts o

f a b

ell

Rin

gs b

ell a

fter

dem

o

Pulls

str

ing

to o

btai

n an

atta

ched

toy

out o

f rea

ch

Use

s so

unds

to

get a

ttent

ion

Sepa

ratio

n an

xiet

y

Follo

ws

a po

int

“Oh

look

at..

. “

Rec

ogni

zes

fam

iliar

peo

ple

visu

ally

Enjo

ys g

estu

re g

ames

Ori

ents

to n

ame

wel

l

Turn

s he

ad u

pwar

d an

d di

ago-

nally

to v

iew

sou

rce

of s

ound

“Mam

a” (

non-

spec

ific)

Non

-red

uplic

ate

babb

le

Imita

tes

soun

ds

© 2

007

Chri

s Johnson, M

D, A

AP C

ouncil o

n C

hild

ren w

ith D

isab

ilitie

s. A

dap

ted

with p

erm

issio

n a

nd

by c

ontr

ibutions fro

m F

rances P

age G

lascoe, PhD

and

Nic

hola

s R

ob

ert

shaw

, auth

ors

of

PED

S:D

evelo

pm

enta

l M

ilesto

nes,

Fra

nklin T

rim

m,

MD

, V

ice C

hair

of

Ped

iatr

ics,

USA

/A

PA

Ed

ucation C

om

mitte

e;

the C

ente

r fo

r D

isease C

ontr

ol “A

ct

Earl

y” Initia

tive;

the N

ational In

stitu

te for

Litera

cy/R

each O

ut

and

Read

; and

the Invento

ry o

f Earl

y D

evelo

pm

ent

by A

lbert

Bri

gance p

ub

lished

by C

urr

iculu

m A

ssocia

tes,

Inc.

Perm

issio

n is g

rante

d t

o

rep

rod

uce t

hese p

ages o

n t

he c

ond

itio

n t

hat

they a

re o

nly

used

as g

uid

e t

o a

vera

ge d

evelo

pm

ent

and

not

as a

sub

stitu

te for

sta

nd

ard

ized

valid

ate

d s

cre

enin

g for

develo

pm

enta

l p

rob

lem

s.


91

6


Ch

ron

olo

gi-

cal A

ge

Gross M

oto

rFin

e M

oto

r/

Writ

ing

Self

-Help

Cognit

ive/A

cadem

icSocia

l/Em

o-

tional

Recepti

ve L

anguage

Expressiv

e L

anguage

~ 1

0 m

onth

sC

reep

s w

ell

Cru

ises

aro

und

furn

iture

- tw

o ha

nds

Stan

ds--

one

hand

he

ld

Wal

ks--

two

hand

s he

ld

Clu

msy

rel

ease

of

cube

Gra

sps

pelle

t with

sid

e of

inde

x fin

ger

and

thum

b (in

feri

or p

ince

r gr

asp)

Isol

ates

inde

x fin

ger

and

poke

s

Dri

nks

(not

suc

ks)

from

cup

hel

d fo

r hi

m/h

er

Unc

over

s to

y un

der

clot

h

Poke

s at

pel

let i

n bo

ttle

Trie

s to

put

cub

e in

cup

, but

may

no

t be

able

to le

t go

Expe

rien

ces

fear

Look

s pr

efer

en-

tially

whe

n na

me

is c

alle

d

Enjo

ys P

eek-

A-B

oo

Wav

es “

bye-

bye”

bac

k

Says

“D

ada”

(spe

cific

)

Wav

es b

ye-b

ye

~ 1

1 m

onth

sW

alks

--on

e ha

nd

held

Pivo

ts in

sitt

ing

Cru

ises

furn

iture

ho

ldin

g on

with

on

e ha

nd

Stan

ds fo

r a

few

se

cond

s

Thro

ws

obje

cts

Stir

s w

ith s

poon

Coo

pera

tes

in

dres

sing

Find

s to

y un

der

cup

Look

s at

pic

ture

s in

boo

k

Giv

es o

bjec

ts to

ad

ult f

or a

ctio

n af

ter

dem

onst

ra-

tion

(lets

adu

lt kn

ow h

e ne

eds

help

)

Stop

s ac

tivity

whe

n to

ld “

no”

Bou

nces

to m

usic

Says

firs

t wor

d

Voc

aliz

es to

son

gs

~ 1

2 m

onth

sSt

ands

wel

l with

ar

ms

high

and

legs

sp

laye

d (P

oste

rior

pr

otec

tion)

Inde

pend

ent s

teps

Scri

bble

s af

ter

dem

o

Fine

pin

cer

gras

p of

pe

llet

Hol

ds c

rayo

n

Atte

mpt

s to

wer

of t

wo

cube

s

Coo

pera

tes

in

dres

sing

Fing

er fe

eds

part

of

mea

l

Take

s ha

t off

Rat

tles

spoo

n in

cup

Lifts

box

lid

to fi

nd to

y

Show

s ob

ject

s to

pa

rent

to s

hare

in

tere

st

Poin

ts in

ord

er to

ge

t des

ired

obj

ect

(Pro

to-i

mpe

rativ

e po

intin

g)

Follo

ws

1-st

ep c

omm

and

with

ge

stur

e

Rec

ogni

zes

nam

es o

f tw

o

obje

cts–

look

s w

hen

nam

ed

Poin

ts in

ord

er to

get

de-

sire

d ob

ject

(Pro

to-i

mpe

ra-

tive

poin

ting)

Use

s se

vera

l ges

ture

s w

ith

voca

lizin

g (w

avin

g, r

each

-in

g, e

tc.)

~ 1

3 m

onth

sW

alks

with

arm

s hi

gh a

nd o

ut (h

igh

guar

d)

Atte

mpt

s to

rel

ease

pe

llet i

n bo

ttle

Dri

nks

from

cup

w

tih s

ome

spill

ing

Dan

gles

rin

g by

str

ing

Rea

ches

aro

und

clea

r ba

rrie

r to

ob

tain

obj

ect

Unw

raps

toy

in c

loth

Show

s de

sire

to

plea

se c

areg

iver

Solit

ary

play

Func

tiona

l pla

y

Look

s ap

prop

riat

ely

whe

n as

ked

“W

here

’s th

e ba

ll?”,

etc

.

Use

s th

ree

wor

ds

Imm

atur

e ja

rgon

ing

(Infle

c-tio

ns w

ithou

t rea

l wor

ds)

~ 1

4 m

onth

sSt

ands

with

out p

ull-

ing

up

Falls

by

colla

pse

Wal

ks w

ell

Atte

mpt

s to

rel

ease

pe

llet i

n bo

ttle

Imita

tes

back

--fo

rth

scri

bble

Add

s th

ird

cube

to a

tw

o cu

be to

wer

Puts

rou

nd p

eg in

&

out o

f hol

e

Rem

oves

soc

ks/

shoe

s

Che

ws

wel

l

Puts

spo

on in

m

outh

typi

cally

tu

rnin

g it

over

Dum

ps p

elle

t out

of b

ottle

afte

r de

mo

Poin

ts a

t obj

ect

to e

xpre

ss in

ter-

est (

e.g.

, to

get

pare

nt to

nam

e it)

(P

roto

-dec

lara

tive

poin

ting)

Purp

osef

ul e

x-pl

orat

ion

of to

ys

thro

ugh

tria

l and

er

ror

Follo

ws

one-

step

com

man

d w

ithou

t ges

ture

(e.g

., “g

ive

it”)

Nam

es o

ne o

bjec

t

Poin

ts a

t obj

ect t

o ex

pres

s in

tere

st (e

.g.,

to g

et p

aren

t to

nam

e it)

(Pro

to-d

ecla

ra-

tive

poin

ting)

© 2

007 C

hri

s Johnson, M

D, A

AP C

ouncil o

n C

hild

ren w

ith D

isab

ilitie

s. A

dap

ted

with p

erm

issio

n a

nd

by c

ontr

ibutions fro

m F

rances P

age G

lascoe, PhD

and

Nic

hola

s R

ob

ert

shaw

, auth

ors

of

PED

S:D

evelo

pm

enta

l M

ilesto

nes,

Fra

nklin T

rim

m,

MD

, V

ice C

hair

of

Ped

iatr

ics,

USA

/A

PA

Ed

ucation C

om

mitte

e;

the C

ente

r fo

r D

isease C

ontr

ol “A

ct

Earl

y” Initia

tive;

the N

ational In

stitu

te for

Litera

cy/R

each O

ut

and

Read

; and

the Invento

ry o

f Earl

y D

evelo

pm

ent

by A

lbert

Bri

gance p

ub

lished

by C

urr

iculu

m A

ssocia

tes,

Inc.

Perm

issio

n is g

rante

d t

o

rep

rod

uce t

hese p

ages o

n t

he c

ond

itio

n t

hat

they a

re o

nly

used

as g

uid

e t

o a

vera

ge d

evelo

pm

ent

and

not

as a

sub

stitu

te for

sta

nd

ard

ized

valid

ate

d s

cre

enin

g for

develo

pm

enta

l p

rob

lem

s.


92

6


Ch

ron

olo

gi-

cal A

ge

Gross M

oto

rFin

e M

oto

r/

Writ

ing

Self

-Help

Cognit

ive/A

cadem

icSocia

l/Em

o-

tional

Recepti

ve L

anguage

Expressiv

e L

anguage

~15

mon

ths

Stoo

ps to

pic

k up

to

y

Cre

eps

up s

tair

s

Run

s st

iff-l

egge

d

Wal

ks c

arry

ing

toy

Clim

bs o

n fu

rnitu

re

build

ds 3

-4 c

ube

tow

er

Plac

e 10

cub

es in

cup

Rel

ease

s pe

llet i

nto

bottl

e

Use

s sp

oon-

-som

e sp

ill

Atte

mpt

s to

bru

sh

own

hair

Fuss

es to

be

chan

ged

Turn

s pa

ges

in b

ook

Plac

es c

ircl

e in

sin

gle

shap

e p

uzzl

e

Show

s em

path

y (s

omeo

ne e

lse

crie

s ch

ild lo

oks

sad)

Hug

s ad

ult i

n re

cipr

ocat

ion

Rec

ogni

zes

with

-ou

t a d

emo

that

a

toy

requ

ires

act

i-va

tion

and

hand

s it

to a

n ad

ult i

f ca

n’t

oper

ate

Poin

ts to

1 b

ody

part

Poin

ts to

1 o

bjec

t of 3

Get

s ob

ject

from

ano

ther

roo

m

upon

dem

and

Use

s 3

- 5

wor

ds

Mat

ure

jarg

onin

g w

ith r

eal

wor

ds

~ 1

6 m

onth

sSt

ands

on

one

foot

w

ith s

light

sup

port

Wal

ks b

ackw

ards

Wal

ks u

p st

airs

-

one

hand

hel

d

Puts

sev

eral

rou

nd

pegs

in b

oard

(with

ur

ging

)

Scri

bble

s sp

onta

ne-

ousl

y

Pick

s up

and

dr

inks

from

cup

Fetc

hes

and

carr

ies

obje

cts

(sam

e ro

om)

Dum

ps p

elle

t out

with

out d

emo

Plac

es c

ircl

e in

form

boar

d

Find

s to

y ob

serv

ed to

be

hidd

en

unde

r la

yers

of c

over

s

Kis

ses

by to

uch-

ing

lips

to s

kin

Peri

odic

ally

vis

u-al

ly r

eloc

ates

ca

regi

ver

Self-

cons

ciou

s:

emba

rras

sed

whe

n aw

are

of

peop

le o

bser

ving

Und

erst

ands

sim

ple

com

-m

ands

“B

ring

to m

omm

y”

Poin

ts to

one

pic

ture

whe

n na

med

Use

s 5-

10 w

ords

~18

mon

ths

Cre

eps

dow

n st

airs

Run

s w

ell

Seat

s se

lf in

sm

all

chai

r

Thro

ws

ball—

stan

d-in

g

Mak

es 4

cub

e to

wer

Cru

dely

imita

tes

vert

i-ca

l str

oke

Rem

oves

gar

men

t

Get

s on

to a

dult

chai

r un

aide

d

Mov

es a

bout

ho

use

with

out

adul

t

Mat

ches

pai

rs o

f obj

ects

Re-

plac

es c

ircl

e in

form

boar

d af

ter

it ha

s be

en tu

rned

aro

und

(usu

ally

w

ith tr

ial a

nd e

rror

)

Pass

es M

-CH

AT

Enga

ges

in

pret

end

play

with

ot

her

peop

le

(e.g

. tea

par

ty,

birt

hday

par

ty

Beg

ins

to s

how

sh

ame

(whe

n do

es w

rong

) &

poss

essi

vene

ss

Poin

ts to

2 o

f 3 o

bjec

ts w

hen

nam

ed

Poin

ts to

3 b

ody

part

s

Poin

ts to

sel

f

Und

erst

ands

“m

ine”

Poin

ts to

fam

iliar

peo

ple

whe

nnam

ed

Use

s 10

-25

wor

ds

Use

s gi

ant w

ords

(all

gone

, st

op th

at)

Imita

tes

envi

ronm

enta

l so

unds

(e.g

., an

imal

s(

Nam

es o

ne p

ictu

re o

n de

man

d

~ 2

0 m

onth

sSq

uats

in p

lay

Car

ries

larg

e ob

ject

Goe

s up

sta

irs

held

by

one

han

d

Com

plet

es r

ound

peg

bo

ard

with

out

urgi

ng

Mak

es 5

-6 c

ube

tow

er

Com

plet

es s

quar

e pe

g bo

ard

Plac

es o

nly

edib

les

in m

outh

Feed

s se

lf w

ith

spoo

n --

entir

e m

eal

Ret

urns

to s

earc

h fo

r ob

ject

hid

den

unde

r cl

oth

afte

r no

t find

ing

it an

ad

ult’s

clo

sed

fists

Plac

es s

quar

e in

form

boa

rd

Beg

ins

to h

ave

thou

ghts

abo

ut

feel

ings

Enga

ges

in te

a pa

rty

with

stu

ffed

anim

als

Kis

ses

with

pu

cker

Poin

ts to

thre

e pi

ctur

es

Beg

ins

to u

nder

stan

d he

r / h

im

/ me

Hol

ophr

ases

(“

Mom

my?

”and

poi

nts

at

keys

, mea

ning

“Th

ese

are

Mom

my’

s ke

ys”)

Two-

wor

d co

mbi

natio

ns

Ans

wer

s re

ques

ts w

tih “

no”

© 2

007 C

hri

s Johnson, M

D, A

AP C

ouncil o

n C

hild

ren w

ith D

isab

ilitie

s. A

dap

ted

with p

erm

issio

n a

nd

by c

ontr

ibutions fro

m F

rances P

age G

lascoe, PhD

and

Nic

hola

s R

ob

ert

shaw

, au

thors

of

PED

S:D

evelo

pm

enta

l M

ilesto

nes,

Fra

nklin T

rim

m,

MD

, V

ice C

hair

of

Ped

iatr

ics,

USA

/A

PA

Ed

ucation C

om

mitte

e;

the C

ente

r fo

r D

isease C

ontr

ol “A

ct

Earl

y” Initia

tive;

the N

ational In

stitu

te for

Litera

cy/R

each O

ut

and

Read

; and

the Invento

ry o

f Earl

y D

evelo

pm

ent

by A

lbert

Bri

gance p

ub

lished

by C

urr

iculu

m A

ssocia

tes,

Inc.

Perm

issio

n is g

rante

d t

o

rep

rod

uce t

hese p

ages o

n t

he c

ond

itio

n t

hat

they a

re o

nly

used

as g

uid

e t

o a

vera

ge d

evelo

pm

ent

and

not

as a

sub

stitu

te for

sta

nd

ard

ized

valid

ate

d s

cre

enin

g for

develo

pm

enta

l p

rob

lem

s.


93

6


Ch

ron

olo

gi-

cal A

ge

Gross M

oto

rFin

e M

oto

r/

Writ

ing

Self

-Help

Cognit

ive/A

cadem

icSocia

l/Em

o-

tional

Recepti

ve L

anguage

Expressiv

e L

anguage

~22

mon

ths

Goe

s up

sta

irs

hold

ing

rail,

put

ting

both

feet

on

each

st

ep

Kic

ks b

all w

tih

dem

o

Wal

ks w

ith o

ne fo

ot

on w

alki

ng b

oard

Clo

ses

box

with

lid

Imita

tes

vert

ical

line

Imita

tes

circ

ular

sc

ribb

le

Use

s sp

oon

wel

l

Dri

nks

from

cup

w

ell

Unz

ips

zipp

ers

Puts

sho

es o

n pa

rtw

ay

Com

plet

es fo

rmbo

ard

with

thre

e sh

apes

W

atch

es

othe

r ch

ildre

n in

tens

ely

Beg

ins

to s

how

de

fiant

beh

avio

r

Poin

ts to

4 –

5 p

ictu

res

whe

n-na

med

Poin

ts to

5 –

6 b

ody

part

s

Poin

ts to

4 p

iece

s of

clo

thin

g w

henn

amed

Use

s 25

-50

wor

ds

Ask

s fo

r m

ore

Add

s 1-

2 w

ords

per

wee

k

~ 2

4 m

onth

sW

alks

dow

n st

airs

ho

ldin

g ra

il, b

oth

feet

on

each

ste

p

Kic

ks b

all w

ithou

t de

mo

Thro

ws

over

hand

Mak

es a

sin

gle-

line

“tra

in”

of c

ubes

Imita

tes

circ

le

Imita

tes

hori

zont

al

line

Ope

ns d

oor

usin

g

knob

Suck

s th

roug

h st

raw

Take

s of

f clo

thes

w

ithou

t but

tons

Pulls

off

pant

s

Sort

s ob

ject

s

Mat

ches

obj

ects

to p

ictu

res

Show

s us

e of

fam

iliar

obj

ects

Para

llel p

lay

Beg

ins

to m

ask

emot

ions

for

soci

al e

tique

tte

Follo

ws

two-

step

com

man

d

Und

erst

ands

me

/ you

Poin

ts to

5-1

0 pi

ctur

es

2 w

ord

sent

ence

s

(n

oun+

verb

)

Tele

grap

hic

spee

ch

50%

inte

lligi

bilit

y

Ref

ers

to s

elf b

y na

me

Nam

es 3

pic

ture

s

Use

s tw

o-w

ord

sent

ence

s (n

oun+

verb

)

Tele

grap

hic

spee

ch

50 +

wor

ds in

voc

abul

ary

50%

inte

lligi

bilit

y

Ref

ers

to s

elf b

y na

me

Nam

es 3

pic

ture

s

~ 2

yea

rs, 4

mon

ths

Jum

ps fr

om b

ot-

tom

ste

p, o

ne fo

ot

lead

ing

Wal

ks o

n to

es a

fter

dem

o

Wal

ks b

ackw

ard

10

step

s

Stri

ngs

larg

e be

ads

(aw

kwar

dly)

Uns

crew

s ja

r lid

Turn

s pa

per

page

s (o

ften

seve

ral a

t onc

e)

Hol

ds s

elfa

nd/o

r ve

rbal

izes

toile

t ne

eds

Pulls

pan

ts u

p w

ith

assi

stan

ce

Mat

ches

sha

pes

Mat

ches

col

ors

Red

uctio

n in

se

para

tion

anxi

ety

Und

erst

ands

“ju

st o

ne”

Rep

eats

2 d

igits

Beg

ins

to u

se p

rono

uns

(I,

me,

you

)

Nam

es 1

0-15

pic

ture

s

~ 2

yea

rs, 6

mon

ths

Goe

s up

sta

irs

with

ra

il, a

ltern

atin

g fe

et

Jum

ps in

pla

ce

Stan

ds w

ith b

oth

feet

on

bala

nce

beam

Wal

ks w

ith o

ne fo

ot

on b

alan

ce b

eam

Mak

es a

n 8

cube

to

wer

Mak

es “

a tr

ain”

of

cube

s an

d in

clud

es a

st

ack

Was

hes

hand

s

Puts

thin

gs a

way

Bru

sh te

eth

with

as

sist

ance

Re-

plac

es c

ircl

e in

form

boar

d af

ter

it ha

s be

en tu

rned

aro

und

(littl

e or

no

tria

l and

err

or)

Poin

ts to

sm

all d

etai

ls in

pi

ctur

es

Imita

tes

adul

t ac

tiviti

es (e

.g.,

swee

ping

, tal

king

on

pho

ne, p

re-

tend

ing

to h

unt

anim

als)

Follo

ws

2 pr

epos

ition

s: “

Put

bloc

k in

. . .

on b

ox”

Poin

ts to

obj

ects

by

use:

“ri

de

in”

... “

put o

n fe

et”

. . .”

wri

te

with

”

Echo

lalia

and

jarg

onin

g go

ne

Nam

es o

bjec

ts b

y us

e

Ref

ers

to s

elf w

ith c

orre

ct

pron

oun

Rec

ites

part

s of

wel

l-kn

own

stor

y/fil

ls in

wor

ds

© 2

007 C

hri

s Johnson, M

D, A

AP C

ouncil o

n C

hild

ren w

ith D

isab

ilitie

s. A

dap

ted

with p

erm

issio

n a

nd

by c

ontr

ibutions fro

m F

rances P

age G

lascoe, PhD

and

Nic

hola

s R

ob

ert

shaw

, au

thors

of

PED

S:D

evelo

pm

enta

l M

ilesto

nes,

Fra

nklin T

rim

m,

MD

, V

ice C

hair

of

Ped

iatr

ics,

USA

/A

PA

Ed

ucation C

om

mitte

e;

the C

ente

r fo

r D

isease C

ontr

ol “A

ct

Earl

y” Initia

tive;

the N

ational In

stitu

te for

Litera

cy/R

each O

ut

and

Read

; and

the Invento

ry o

f Earl

y D

evelo

pm

en

t b

y A

lbert

Bri

gance p

ub

lished

by C

urr

iculu

m A

ssocia

tes,

Inc.

Perm

issio

n is g

rante

d t

o

rep

rod

uce t

hese p

ages o

n t

he c

ond

itio

n t

hat

they a

re o

nly

used

as g

uid

e t

o a

vera

ge d

evelo

pm

ent

and

not

as a

sub

stitu

te for

sta

nd

ard

ized

valid

ate

d s

cre

enin

g for

develo

pm

enta

l p

rob

lem

s.


94

6


Ch

ron

olo

gi-

cal A

ge

Gross M

oto

rFin

e M

oto

r/

Writ

ing

Self

-Help

Cognit

ive/A

cadem

icSocia

l/Em

o-

tional

Recepti

ve L

anguage

Expressiv

e L

anguage

~ 2

yea

rs, 9

mon

ths

Wal

ks s

win

ging

ar

ms

oppo

site

of

legs

(syn

chro

nous

ga

it)

Mak

es 9

-10

cube

to

wer

Puts

6 s

quar

e pe

gs in

pe

gboa

rd

Imita

tes

cros

s

Toile

t tra

ined

Puts

on

coat

una

s-si

sted

Poin

ts to

sel

f in

phot

os

Poin

ts to

bod

y pa

rts

acco

rdin

g to

func

tion

(“w

hat d

o yo

u he

ar

with

...?”

)

Beg

ins

to ta

ke

turn

s

Trie

s to

hel

p w

ith

hous

ehol

d ta

sks

Und

erst

ands

thre

e pr

epos

ition

s

Und

erst

ands

dir

ty, w

et

Giv

es fi

rst a

nd la

st n

ame

Cou

nts

to 3

Beg

ins

to u

se p

ast t

ense

Enjo

ys b

eing

rea

d to

(sho

rt

book

s)

~ 3

yea

rs, 0

m

onth

s

~3

year

s, 6

m

onth

s

Bal

ance

s on

one

fo

ot fo

r 3

sec

onds

Goe

s up

sta

irs,

al

tern

atin

g fe

et,

no r

ail

Peda

ls tr

icyc

le

Wal

ks h

eel t

o to

e

Cat

ches

bal

l—ar

ms

stif

Cop

ies

circ

le

Cut

s w

ith s

ciss

ors:

si

de to

sid

e (a

wk-

war

dly)

Imita

tes

brid

ge o

f cu

bes

Stri

ngs

smal

l bea

ds

wel

l

Eats

inde

pend

ently

Pour

s liq

uid

Puts

on

shoe

s w

ithou

t lac

es

Spre

ads

with

kni

fe

Unb

utto

ns

Dra

ws

a 2

– 3

part

per

son

Und

erst

ands

big

/sm

all,

mor

e/le

ss

Kno

ws

own

gend

er

Kno

ws

own

age

Mat

ches

lette

rs/n

umer

als

Star

ts to

sha

re

with

/with

out

prom

pt

Fear

s im

agin

ary

thin

gs

Imag

inat

ive

play

Use

s w

ords

to

desc

ribe

wha

t

som

eone

els

e is

th

inki

ng (“

Mom

th

ough

t I w

as

asle

ep”)

Poin

ts to

par

ts o

f pic

ture

s (n

ose

of c

ow, d

oor

of c

ar)

Und

erst

ands

act

ion

wor

ds:“

play

ing.

..was

hing

...bl

owin

g”

Nam

es b

ody

part

s w

hen

func

-tio

nIs

desc

ribe

d

Und

erst

ands

neg

ativ

es

Gro

ups

obje

cts

(food

s, to

ys)

Und

erst

ands

long

/ sh

ort

Use

s 20

0+ w

ords

3 w

ord

sent

ence

s

Use

s pr

onou

ns c

orre

ctly

75%

inte

lligi

bilit

y

Use

s pl

ural

s

Nam

es b

ody

part

s by

use

Ask

s to

be

read

to

~ 4

yea

rs, 0

m

onth

s

~ 4

yea

rs, 6

mon

ths

Bal

ance

s on

one

fo

ot 4

-8 s

ec

Hop

s on

one

foor

2-

3 tim

es

Stan

ding

bro

ad

jum

p:1-

2 ft

Gal

lops

Thro

ws

ball

over

-ha

nd 1

0 ft

Cat

ches

bou

nced

ba

ll

Cop

ies

squa

re

Imita

tes

mak

ing

a co

mpl

ex g

ate

with

cu

bes

Ties

sin

gle

knot

Cut

s 5

inch

cir

cle

Use

s to

ngs

to tr

ansf

er

Wri

tes

part

of fi

rst-

nam

e

Wor

ks fr

om le

ft to

ri

ght,

top

to b

otto

m

Goe

s to

toile

t al

one

Wip

es a

fter

BM

Was

hes

face

/ ha

nds

Bru

shes

teet

h al

one

But

tons

Use

s fo

rk w

ell

Dra

ws

a 4

– 6

part

per

son

Can

giv

e am

ount

s (u

sual

ly le

ss th

an

5) c

orre

ctly

Com

plet

es s

impl

e an

alog

ies:

(e.g

., da

d /b

oy: m

othe

r/ ?

??, I

ce /c

old:

fire

/ ?

??, C

eilin

g /u

p: fl

oor/

???

Poin

ts to

5 -

6 c

olor

s

Poin

ts to

lette

rs/n

umer

als

whe

n na

med

Rot

e co

unts

to 4

“Rea

ds”

seve

ral c

omm

on s

igns

/sto

re

nam

es

Dec

eptio

n –

inte

rest

ed in

“t

rick

ing”

oth

ers,

an

d co

ncer

ned

ab

out b

eing

tr

icke

d by

oth

ers

Has

a p

refe

rred

fr

iend

Labe

ls h

appi

ness

, sa

dnes

s, fe

ar a

nd

ange

r in

sel

f

Gro

up p

lay

Follo

ws

thre

e st

ep c

omm

ands

Poin

ts to

thin

gs th

at a

re th

e sa

me

vers

us d

iffer

ent

Nam

es th

ings

whe

n ac

tions

ar

e de

scri

be (e

.g.,

it sw

ims

in w

ater

, you

cut

with

it, i

t’s

som

ethi

ng y

ou r

ead,

it te

lls

time.

.)

Rep

eats

4 –

6 s

ylla

ble

sent

ence

Use

s 30

0-10

00 w

ords

Tells

sto

ries

100%

inte

lligi

bilit

y w

ith

few

art

icul

atio

n er

rors

Use

s “f

eelin

g” w

ords

Use

s w

ords

that

tell

abou

t tim

e

© 2

007 C

hri

s Johnson, M

D, A

AP C

ouncil o

n C

hild

ren w

ith D

isab

ilitie

s. A

dap

ted

with p

erm

issio

n a

nd

by c

ontr

ibutions fro

m F

rances P

age G

lascoe, PhD

and

Nic

hola

s R

ob

ert

shaw

, auth

ors

of

PED

S:D

evelo

pm

enta

l M

ilesto

nes,

Fra

nklin T

rim

m,

MD

, V

ice C

hair

of

Ped

iatr

ics,

USA

/A

PA

Ed

ucation C

om

mitte

e;

the C

ente

r fo

r D

isease C

ontr

ol “A

ct

Earl

y” Initia

tive;

the N

ational In

stitu

te for

Litera

cy/R

each O

ut

and

Read

; and

the Invento

ry o

f Earl

y D

evelo

pm

ent

by A

lbert

Bri

gance p

ub

lished

by C

urr

iculu

m A

ssocia

tes,

Inc.

Perm

issio

n is g

rante

d t

o

rep

rod

uce t

hese p

ages o

n t

he c

ond

itio

n t

hat

they a

re o

nly

used

as g

uid

e t

o a

vera

ge d

evelo

pm

ent

and

not

as a

sub

stitu

te for

sta

nd

ard

ized

valid

ate

d s

cre

enin

g for

develo

pm

enta

l p

rob

lem

s.


95

6


Ch

ron

olo

gi-

cal A

ge

Gross M

oto

rFin

e M

oto

r/

Writ

ing

Self

-Help

Cognit

ive/A

cadem

icSocia

l/Em

o-

tional

Recepti

ve L

anguage

Expressiv

e L

anguage

~ 5

yea

rs, 0

m

onth

s

~ 5

yea

rs, 6

m

onth

s

Wal

ks d

own

stai

rs,

alte

rnat

ing

feet

, w

ithou

t usi

ng r

ail

Bal

ance

s on

one

fo

ot fo

r >

8 se

c

Hop

s on

one

foot

15

feet

Skip

s

Run

ning

bro

ad

jum

p 2-

3 ft

Wal

ks b

ackw

ard

heel

-toe

Jum

ps b

ackw

ard

Cop

ies

tria

ngle

Bui

lds

stai

rs fr

om-

mod

el

Puts

pap

er c

lip o

n pa

per

Can

use

clo

thes

pins

to

tran

sfer

sm

all o

bjec

ts

Cut

s w

ith s

ciss

ors

Wri

tes

first

nam

e

Spre

ads

with

kni

fe

Inde

pend

ent d

ress

-in

g

Bat

hes

inde

pen-

dent

ly

Dra

ws

an 8

– 1

0 pa

rt p

erso

n

Giv

es a

mou

nts

(< 1

0)

Iden

tifies

coi

ns

Nam

es le

tters

/num

eral

s ou

t of o

rder

Rot

e co

unts

to 1

0

Nam

es 1

0 co

lors

Use

s le

tter

nam

es a

s so

unds

to

inve

nt s

pelli

ng (e

.g. N

DN

)

By

end

of k

inde

rgar

ten:

Kno

ws

soun

ds o

f lco

nson

ants

and

“sh

ort

vow

els”

Rea

ds 2

5 w

ords

Has

a g

roup

of

frie

nds

Apo

logi

zes

for

mis

take

s

Res

pond

s ve

rbal

ly to

goo

d fo

rtun

e of

oth

ers

Kno

ws

righ

t and

left

on s

elf

Poin

ts to

diff

eren

t one

in a

se

ries

Und

erst

ands

“er

” en

ding

s,

(e.g

.,(ba

tter,

skat

er).

Und

erst

ands

adj

ectiv

es:b

ushy

, lo

ng, t

hin,

poi

nted

Enjo

ys r

hym

ing

wor

ds a

nd

allit

erat

ions

Prod

uces

wor

ds th

at r

hym

e

Poin

ts c

orre

ctly

to “

side

”,

“mid

dle”

, “co

rner

”

Rep

eats

6 –

8 s

ylla

ble

sent

ence

Defi

nes

sim

ple

wor

ds

2000

wor

ds

Kno

ws

tele

phon

e nu

mbe

r

Res

pond

s to

why

que

stio

ns

Ret

ells

sto

ries

with

cle

ar

begi

nnin

g, m

iddl

e, e

nd

~ 6

yea

rs, 0

mon

ths

~6

year

s, 6

mon

ths

Tand

em w

alks

Skip

s

Bui

lds

stai

rs fr

om

mem

ory

Dra

ws

dia

mon

d

Cop

ies

flag

Wri

te fi

rst a

nd la

st

nam

e

Cre

ates

and

wri

tes

shor

t sen

tenc

es

Form

s le

tters

with

do

wn-

goin

g an

d co

unte

rclo

ckw

ise

stro

kes

Ties

sho

es

Com

bs h

air

Look

s bo

th w

ays

at

stre

et

Rem

embe

rs to

br

ing

belo

ngin

gs

Dra

ws

a 12

-14

part

per

son

Num

ber

conc

epts

to

20

Sim

ple

addi

tion/

subt

ract

ion

Und

erst

ands

sea

sons

Soun

ds o

ut r

egul

arly

spe

lled

wor

ds

Rea

ds (b

y en

d of

firs

t gra

de) 2

50

wor

ds

Has

bes

t fri

end

of

sam

e se

x

Play

s bo

ard

gam

es

Dis

tingu

ishe

s fa

ntas

y fr

om

real

ity

Wan

ts to

be

like

frie

nds

and

plea

se th

em

Enjo

ys s

choo

l

Ask

s w

hat u

nfam

iliar

wor

ds

mea

n

Can

tell

whi

ch w

ords

do

not

belo

ng in

a g

roup

Rep

eats

8 –

10

wor

d

S

ente

nces

Des

crib

es e

vent

s in

an

o

rder

ly w

ay

Kno

ws

days

of t

he w

eek

10,0

00 w

ord

voca

bula

ry

~ 7

- 8

yea

rsR

ides

bic

ycle

inde

-pe

nden

tly

Bat

s ba

ll pl

aced

on

cone

Doe

s so

mer

saul

ts

Wri

ting

rate

incr

ease

s

Stay

s on

line

whe

n w

ritin

g

Spac

es b

etw

een

wor

ds

Size

of l

ette

rs b

e-co

mes

uni

form

Lette

r re

vers

als

disa

p-pe

ar

Stic

ks w

ith ta

sks

(with

TV

off)

for

up

to 2

0 m

inut

es

Pays

atte

ntio

n to

te

ache

r w

hen

in a

gr

oup

Com

plet

e ho

me-

wor

k on

ow

n

Ans

wer

s an

d de

liver

s ph

one

mes

sage

s

Com

plet

e ho

use-

hold

cho

res

(with

re

min

ders

)

Kno

ws

soun

ds o

f con

sona

nt d

i-gr

aphs

(e.g

., “c

h”, “

sh”)

Kno

ws

soun

ds o

f vow

eldi

ptho

ngs

(e.g

., “o

o”, “

ou”)

Rea

ds w

ords

with

-r-c

ontr

olle

d vo

w-

els

(e.g

., “b

ird”

, “bu

rn”

Star

ts “

read

ing

to le

arn”

not

just

“l

earn

ing

to r

ead”

Two-

plac

e ad

ditio

n an

d su

btra

ctio

n

Enjo

ys r

eadi

ng in

depe

nden

tly

Rem

embe

rs s

pelli

ng w

ords

Avo

ids

hurt

ing

othe

rs in

pla

y

Lear

ns fr

om

mis

take

s

Hel

ps y

oung

er

child

ren

Stro

ng n

otio

ns

abou

t wha

t is

fair

Take

s tu

rns

in

conv

ersa

tions

Del

ays

grat

ifica

-tio

n an

d w

aits

to

take

turn

Inte

rest

ed in

the

opin

ions

of p

eers

Und

erst

ands

“op

posi

tes”

and

w

ord

anal

ogie

s

Ans

wer

s “w

ho”,

“w

hy”,

“w

hen’

,“w

here

” an

d “h

ow”

ques

tions

Kno

ws

righ

t fro

m le

ft on

oth

ers

Und

erst

ands

day

s an

d m

onth

s

Mas

ters

“r”

sou

nd in

sp

eech

Tells

tim

e

Use

s co

mpl

ex a

nd c

om-

poun

d se

nten

ces

Talk

s ab

out a

ran

ge o

f to

pics

© 2

007 C

hri

s Johnson, M

D, A

AP C

ouncil o

n C

hild

ren w

ith D

isab

ilitie

s. A

dap

ted

with p

erm

issio

n a

nd

by c

ontr

ibutions fro

m F

rances P

age G

lascoe, PhD

and

Nic

hola

s R

ob

ert

shaw

, au

thors

of

PED

S:D

evelo

pm

enta

l M

ilesto

nes,

Fra

nklin T

rim

m,

MD

, V

ice C

hair

of

Ped

iatr

ics,

USA

/A

PA

Ed

ucation C

om

mitte

e;

the C

ente

r fo

r D

isease C

ontr

ol “A

ct

Earl

y” Initia

tive;

the N

ational In

stitu

te for

Litera

cy/R

each O

ut

and

Read

; and

the Invento

ry o

f Earl

y D

evelo

pm

en

t b

y A

lbert

Bri

gance p

ub

lished

by C

urr

iculu

m A

ssocia

tes,

Inc.

Perm

issio

n is g

rante

d t

o

rep

rod

uce t

hese p

ages o

n t

he c

ond

itio

n t

hat

they a

re o

nly

used

as g

uid

e t

o a

vera

ge d

evelo

pm

ent

and

not

as a

sub

stitu

te for

sta

nd

ard

ized

valid

ate

d s

cre

enin

g for

develo

pm

enta

l p

rob

lem

s.

Before giving parents the PEDS Response Form, let them know that addressing behavioral and developmental issues is an important part of the services you provide.

Then ask, “Would you like to complete the form on your own or have someone go through it with you?” In Spanish this statement is:

¿Les gustaría completar el formulario solos o prefieren que alguien lo responda con ustedes?(phonetically): Lays goos-tár-ee-ah comb-play-tár el for-myu-lár-ee-o solos oh pray-fee-aír-ayn kay all-gée-en loh raysb-pohn-dah cone oo-stéhd-ays?

Usually, parents with reading problems or language barriers will ask for help. In Spanish they will say something like “Prefiera alguien que ayudarme.” If you are unsure of parental literacy, interview the parent verbally. If there are no Spanish-speakers available to help, send PEDS home with parents in preparation for a subse-quent visit or give them a stamped and addressed envelope so that they can return PEDS by mail, saying to them:

Por favor, toma ésta forma con usted y busque alguien que le ayude a comple-tarla y vuelva la proxima semana.(phonetically): Pore fah-vóhr, tóe-mah és-tah fórm-ah cone oo-stéhd ee boós-key all-gée-en kay lay I-yóu-day ah comb-play-tár-la ee buell-vah la pró-ksee-mah say-máhn-ah

If parents only circle “No” (No), ”Yes” (Sí), or “A little” (Un poco) and don’t write comments on the Response Form, assume that illiteracy is a problem and interview the parent verbally. Please add your concerns, if any.

Brief Administration and Scoring Guide (with directions for use with English- and Spanish-speaking parents )

PE

DS

Parents’ Evaluation of Developmental Status

An evidence-based method for detecting and addressing

developmental and behavioral problems in children

To use PEDS you will need this brief guide plus two different pads of forms. The PEDS Response Form is used to gather information from parents. The PEDS Score Form and PEDS Interpretation Form (printed front and back on the same pad) are used by professionals to track decisions and performance over time.

Health care professionals should use PEDS at each well visit in order to comply with recommendations for developmental/behavioral detection and surveillance from the American Academy of Pediatrics, the American Nurses’ Association, the Bright Futures Guidelines, the Australian College of Paediatrics, the American Academy of

Neurology, the Royal College of Paediatrics and Community Child Health, etc. For children who rarely attend well-visits, PEDS can be used at sick- or return-visits.

Early childhood professionals may wish to use PEDS annually or semi-annually as suggested by the National Association for Education of Young Children and other education organizations.

In all settings, PEDS promotes parent-professional collaboration and cultural competence in early detection. PEDS also serves as an intake and triage tool that indicates the kind of evaluations needed or whether parents simply need guidance, training or reassurance.

Step 1: Prepare Parents.

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PEDS Response Form

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#700PEDSv1-2008

PEDS: Formulario para Respuestas(Spanish)

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© 2009 Frances Page Glascoe, Ellsworth & Vandermeer Press, LLC, 1013 Austin Court, Nolensville, TN 37135, phone: 615-776-4121, fax: 615-776-4119, web: www.pedstest.com. For electronic applications contact: [email protected]. This Guide may not be reproduced.

#300-PEDS Guide V8-04/08

Page 2 #300-PEDS Guide V9-10/08

Once parents have completed the PEDS Response Form and returned it to you, take a PEDS Score Form and locate the appropriate column for the child’s age.

Don’t forget to correct for prematurity for children under 2 years old and more than 3 weeks premature.

Step 2: Locate Correct Column on the PEDS Score Form for the child’s age.

Read through parents’ responses to all questions on the PEDS Response Form. Then view the table on the next page to decide which boxes and/or circles to mark on the PEDS Score Form.

Peds Score Form

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spoiled(mimado)

still wants bottle(quiere su biberón)

walks funny(andar raro)

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Janie Smith Jane Smith2/21/05 3 yrs 3/13/08

Janie is spoiled. she still wants a bottle. She walks funny, too.PEDS: Formulario para Respuestas

(Spanish)

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Maria Rodriguez Consuela Rodriguez3/12/05 3 años 3/18/08

Maria es mimado. Tadoria quiere su biberón y andar raro.If parents make statements such as “I was worried but now I think she’s doing bet-ter” (Antes me preocupaba, pero ahora me parece que está mejor), mark this as a con-cern in the developmental area mentioned. Similarly, when parents report that they are only “a little” (un poco) concerned, this too should be marked as a concern.

Peds Score Form

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Peds Score Form

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Step 3: Mark boxes on the Score Form for each concern raised on the Response Form.

When categorizing con-cerns, remember that parents’ answers don’t always apply to the question at hand. If a parent answers the expressive language question with “He’s whiny” (quejumbroso) score it under “Social-Emotional.”

If parents do not write any-thing on the PEDS Response Form except to circle an occa-sional “Yes” (Sí) or “A little” (Un poco) on Questions 2–10, illiteracy may be a problem. Double check responses by re-administering the PEDS Response Form by interview.

Categorizing parents’ concerns

#300-PEDS Guide V9-10/08 Page 3

TYPICAL RESPONSES(English)

TYPE OF CONCERN

Seems behind; can’t do what other kids can; slow and behind other kids; immature; learns slowly; late to learn to do things; learns but takes a long time; problems with learning everything

Global/Cognitive

Not talking like he should; uses short sentences; can’t always say what she means; doesn’t always make sense; can’t talk plain. Nobody understands what he is saying but me

Expressive Language and Articulation

Doesn’t understand what you say; doesn’t listen well Receptive Language

Can’t stay in the lines when colors; can’t write name; can’t draw shapes, can’t hold a pencil right; can’t get food to mouth with a spoon yet and so is a messy eater

Fine-Motor

Clumsy; walks funny; can’t ride a bike yet; falls a lot; limps, poor balance; hates soccer

Gross Motor

Stubborn; over-active; short attention span; spoiled; aggra-vating; throws fits; only does what she wants

Behavior

Wants to be left alone; mood swings, clingy; whiny; both-ered by changes; angry, disinterested in usual things; easily led; acts mean; easily frustrated; bossy; shy; class clown; is angry; mean; hates me

Social-emotional

Won’t do things for herself; won’t tell me when he’s wet; not toilet trained yet; still wants a bottle; can’t get dressed by herself

Self-help

Can’t write his name [scored also with fine motor]; doesn’t know colors or numbers; just not learning to read; can’t remember letter sounds; knows spelling words one day but not the next

School

Ear infections; asthma; small for age; sick a lot; I don’t think he hears well; She gets up too close to the TV and I worry about her sight

Other/Health

If no concerns are raised, leave boxes empty and proceed to step 4

No concernsTypical child; development is normal; he’s coming along just fine; she’s advanced

If present, mark the box in the age-appropriate column on the PEDS Score Form for:


TYPICAL RESPONSES(Spanish)

TYPE OF CONCERN

Parece estar atrasado, no puede hacer lo que hacen otros niños, es lento y está atrasado con respecto a otros niños, es inmaduro, aprende despacio, aprende tarde a hacer las cosas, aprende pero le toma mucho tiempo, problemas aprendiendo todo

No habla como debería, usa oraciones cortas, no siempre puede decir lo que quiere, no siempre tiene sentido, no puede hablar sencillo. Nadie entiende lo que está diciendo, excepto yo

Expressive Language and Articulation

No entiende lo que usted dice, no escucha bien Receptive Language

No se mantiene dentro de la línea al colorear, no puede escribir su nombre, no puede dibujar figuras, no puede sostener bien el lápiz, todavía no puede llevarse la comida a la boca con una cuchara y por lo tanto se ensucia mucho al comer

Fine-Motor

Torpe, camina extraño, todavía no puede montar bicicleta, se cae mucho, cojea, balance deficiente, no le gusta el football Gross Motor

Terco, muy activo, lapsos cortos de atención, malcriado, desesperante, impulsivo, solamente hace lo que él/ella quiere Behavior

Le gusta estar a solas, humor variable, apegado, quejumbroso, le molestan los cambios, enojado, desinteresado en cosas comunes, influenciable, actúa con mala intención, se frustra fácilmente, mandón, tímido, es el gracioso de la clase, está enojado,malintencionado, me odia

Social-emotional

No hace las cosas por sí mismo, no me dice cuándo está mojado, todavía no va al baño, todavía quiere biberón, no se puede vestir solo

Self-help

No puede escribir su nombre [scored also with fine motor]; no sabe los colores o lo números, simplemente no aprende a leer, no puede recordar los sonidos de las letras, sabe las palabras del vocabu-lario un día y se le olvidan al siguiente

School

Infecciones de oído, asma, pequeño para su edad, se enferma mucho, creo que no escucha bien, se pone muy cerca de la tele-visión y me preocupa su vista

Other

If no concerns are raised, leave boxes empty and proceed to step 4

No concernsNiño típico, desarrollo normal, está creciendo bien, está avanzado

If present, mark the box in the age-appropriate column on the PEDS Score Form for:

Global/Cognitive

The small colored circles on the PEDS Score Form show the concerns predictive of developmental problems. Count the number of checks in the small colored circles in the column above and write the total in the large colored circle near the bottom of the PEDS Score Form.

The small boxes on the PEDS Score Form show the non-predictive concerns (those not predictive of disabilities). Count the checks in the small boxes and write the total in the large box at the very bottom of the PEDS Score Form.

Step 4: Summarize Concerns on the PEDS Score Form.

Peds Score Form

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Step 5: Determine the Appropriate Path to follow on the PEDS Interpretation Form.

Follow Path A if the number listed in the large colored circle of the PEDS Score Form is 2 or more (multiple predictive concerns). These children have a high risk of problems (11 times that of children whose parents do not have concerns)—50% have disabilities or substantial delays. They need prompt referrals for early intervention and developmental diagnostic testing. Additional screenings will only result in under-detection. The PEDS Interpretation Form suggests the kinds of referrals that should be most helpful. Those children not found to have disabilities are

still likely to have below-average performance. Private speech therapy, early stimulation programs (e.g., Head Start or day care) and other services should be marshaled. Expect to follow Path A with about 1 out of every 10 patients.

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Directions for interpretation


Follow Path B if the number listed in the large colored circle is exactly 1 (a single significantly predictive concern). These children have a moderate risk of serious difficulties (7 times that of children whose parents do not have concerns)—30% have disabilities. Additional screening (e.g. PEDS:Developmental Milestones, see www.pedstest.com) is needed to determine which children need referrals and which do not. When health concerns are raised, screening

should focus on health and sensory issues; otherwise on developmental screening. Those who fail additional screening should be referred for intervention and further testing. Those who pass screening need developmental promotion, patient education and vigilant follow-up, since they may have emerging disabilities or below-average intelligence, language, or school skills. Where facilities, time, or tools are limited, children can be referred for

screening through the public schools or early intervention programs (see www.nectac.org for local programs). Expect to follow Path B with about 2 out of every 10 patients.

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Referral to an autism specialist is warranted if, at 0 – 35 months, there are 3 or more concerns about behavior, fine or gross motor, receptive language, or social-emotional; or at 3 – 5 years about school, social-emotional, expressive or receptive language.


Follow Path C if the number in the large unshaded box is 1 or more (nonsignificantly predictive concerns) and the number in the large colored circle is 0 (no significantly predictive concerns). These children have only a low risk of developmental disabilities (1.3 times that of children whose parents have no concerns). Only about 5% of these children have developmental disabilities, although about 25% have emotional and behavioral difficulties, and the frequency is higher still when children are 4 years of age and older. The best response is to first counsel parents about their concerns (most are about children’s behavior) and to monitor their progress closely. If such counseling is unsuccessful (it is advisable to check on progress after several

weeks), professionals should screen further for mental health problems and refer children who fail for mental health services (e.g., family counseling, child psychiatry or psychology, social work, mental health centers, etc.). When children pass a behavioral/emotional screen, somewhat less intensive services can be recommended, such as parent-training or behavioral intervention programs. Expect to follow Path C with about 2 in 10 children. Second-stage emotional/behavioral screens can be found in PEDS: Developmental Milestones.

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Barton Schmitt, Instructions for Patient Education www.barnesandnoble.com

Discipline Without Shouting or Spanking, Wyckoff & Unell www.amazon.com

American Academy of Child and Adolescent Psychiatry: These include many fact sheets writ-ten in multiple languages on a range of issues. (www.aacap.org)

PEDS customizable information handouts in English and Spanish, summary reports and refer-ral letters (www.pedstest.com)

The American Academy of Pediatrics section on Developmental and Behavioral Pediatrics has anewsletter and website (www.dbpeds.org) with substantial information for educating families on parenting, medication management, disabilities, etc.

SOURCES FOR INFORMATION HANDOUTS

Follow Path D if there are zeros in both large boxes (no concerns of either type) but parents have difficulty com-municating due to language barriers, lack of familiarity with the child (e.g., another family member provides most of the care), parental mental health problems, etc. These children (about 3 out of 100) have a moderate risk of disabilities (4

times that of children whose parents have no concerns and no communication difficulties). Almost 20% have disabilities while 35% have delays (i.e. perform well below average). Additional screening is needed, preferably through the schools or early intervention/stimulation programs, since interpreters or social work services may be required for obtaining quality information from these parents. Those who pass screening remain at risk for difficulties. These children also need careful health and sensory assessments and often social work/family assessment.

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If parents have no concerns or nonpredictive con-cerns, but clinical judgment suggests the presence of a problem, follow Path A or B or add your con-cerns to those of the parents before you score. Do not remove any of the parents’ concerns..

Follow Path E if there are zeros in both large boxes (no concerns) and parents are able to communicate well. These children are at low risk and only 5% have delays or disabili-ties. This group requires only reassurance and routine moni-toring by re-administering PEDS at the next expected check point (e.g., annual re-screening, well visit, or sick/return visit when families do not keep well-visit appointments). Expect to follow Path E with about 5 out of 10 children.

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On the far right of the PEDS Interpretation Form is space to list specific decisions, referrals, additional screening test results, counseling topics, plans for future encounters, etc. This form can be used across multiple encounters to follow children over time.

Because PEDS’ questions are similar to those asked by many professionals, it may be tempting to reword or rein-terpret PEDS in a manner different from that presented here. However, research shows that altering questions leads to substantial under-identification of children with problems.

Step 6: Complete the Interpretation Form.

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• Can be used from birth to 8 years of age

• Takes about 5 minutes to administer if conducted as an interview, and about 2 minutes to score. Less time is need-ed if parents complete the brief Response Form in the wait-ing or exam rooms or at home prior to an encounter.

• Can be self-administered by parents in waiting areas, exam rooms, or at home prior to a visit.

• Can be used by parents with differing levels of education, socioeconomic status, etc.

• Is written at the 4th-5th-grade reading level, which ensures that almost all parents can read and respond independently to the items.

• Has a longitudinal recording form for summarizing surveil-lance and promotion activities. This facilitates optimal long-term management of children’s psychosocial needs.

• Promotes parent satisfaction with services and increases positive parenting practices.

• Increases parents’ willingness to return for well-child visits.

• Reduces “oh by the way” concerns and helps manage visit length.

• Offers a platform for meaningful communication and enhances “teachable moments.”

• Helps less educated parents express concerns and recog-nize that primary care includes developmental-behavioral topics.

• Helps identify parents who are overly concerned and sim-ply need reassurance and parent education.

• Promotes clinician confidence and accurate decision-mak-ing about developmental and behavioral issues.

• Requires minimal training. New users need only read this brief scoring and administration guide.

• Has presentation materials including slide shows with case studies and scored examples of PEDS at www.pedstest.com.

• The pedstest.com website also houses parent information handouts in Spanish and English along with links to foreign language handouts and services.

• www.pedstest.com also offers an extensive list of questions and answers on use of PEDS and an early detection discus-sion list.

Other Benefits and Features of PEDS

• Has English, Spanish, and Vietnamese versions in print.

• Other translations are licensed and are available in a wide array of languages (contact: [email protected]).

• Standardized on a national sample of 2,800 children from various backgrounds, with varying ethnicity and levels of socioeconomic status.

• Validated on more than 1229 children across the US in various settings, pediatric offices, outpatient clinics, day care centers, and schools.

• Has high sensitivity and identifies 74% to 80% of children with disabilities—in keeping with standards for develop-mental screening tests and unsurpassed by any other mea-sure, even those that take much longer to administer.

• Has high specificity. 70% to 80% of children without dis-abilities are identified as typically developing—also in keeping with standards for screening tests.

• Proven to accurately identify children with language delays, intellectual disabilities, learning disabilities, behav-ioral/mental health problems, and those with autism spec-trum disorder.

• Over-referrals, while minimal, identify children at risk for school difficulties.

• Has been extensively peer-reviewed (see www.pedstest.com) to view abstracts and papers.

• Is widely used in various research projects including Computer Assisted Telephone Interviews.

• Is highly reliable and can be administered by a range of professionals and paraprofessionals including office staff.

• Complies with AAP policy to elicit and address parents’ concerns at each well-visit.

• When used together with PEDS:Developmental Milestones, offers evidence-based compliance with AAP policy on screening and surveillance.

• Has a total per-encounter cost of $0.30 or less.

• Confers reimbursement under 96110 screening procedure-code.

• Is available electronically. The online version has virtually instantaneous, automated scoring and generates summary reports and referral letters. See www.pedstest.com for more information.

Electronic PEDS

PEDS is available electronically. Please contact us at [email protected] for more infrmation and guidance on

working effectively with families.

Research on PEDS

See www.pedstest.com for abstracts and references or the PEDS Comprehensive Manual

8 PEDS Guide

PEDS Printed Forms and Guides:Ellsworth & Vandermeer Press, LLC1013 Austin Court, Nolensville, TN 37135phone: 615.776.4121 fax: 615.776-4119 www.pedstest.com [email protected]

Now Available:PEDS:Developmental Milestones! A brief, accurate way to monitor progess and outcomes (see www.pedstest.com for details)

ORDERING INFORMATION - PEDS FORMS AND GUIDES

Item Description705-PEDS Complete Set: 1 Brief Administration & Scoring Guide, 1 pad of 50 PEDS Response Forms, 1 pad of 50 PEDS Score & Interpretation Forms

300-Brief Administration & Scoring Guide (for English- and Spanish-speaking families) Volume discount (e.g., large clinics, teaching hospitals) orders of 20+

700-PEDS Response Forms for English-speaking parents (pad of 50)

720-PEDS Score & Interpretation Forms (pad of 50)

710-PEDS Response Forms for Spanish-speaking parents (pad of 50)

730-PEDS Response Forms for Vietnamese-speaking parents (pad of 50)

740-Discounted Bulk Order Package: 1000 Response Forms, 1000 Score & Interpretation Forms, 20 Brief Administration & Scoring Guides (substitutions available on request)

500-Comprehensive PEDS Manual, “Collaborating with Parents”

PEDS Forms are designed for ease of scanning completed Forms into image-based electronic records.For information on using PEDS in electronic health records contact: [email protected]. For ordering enough material to screen 50,000 children during a single year con-tact: [email protected]. 50% prepayment required.For versions in other languages, and research issues contact:[email protected]. Examples, downloadable training slide shows and research information are also available at www.pedstest.com.

Cost Quantity Total

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**There is a 30 day limit for credit for a returned order. Returned orders, ifdamaged, will not be credited. Shipping costs plus a 10% restocking fee will be deducted from undamaged returned orders. Ifunsure what to order please read through this ordering guide carefully. Also helpful is the Q & A on www.pedstest.com.Please join our Early Detection Discussion List. Sign up at www.pedstest.com and post questions to other PEDS users.

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Documents

Using Parent-Centered Developmental Screening … ppt and... · The PEDS’ Score Form (showing the concerns raised at prior visits as well) revealed 4 concerns predictive of developmental