Prepare before you share ASQ screening results

Tips and resources for more productive parent meetings

The ASQ-3 or ASQ:SE-2 questionnaire is complete. You’ve reviewed the answers and calculated the score. Now it’s time to discuss results with parents.

Many providers report that this last part—discussing results with families—is often difficult, particularly if the child’s score is in the monitoring zone or indicates that the child requires a referral (below the cutoff for ASQ-3, or above the cutoff for ASQ:SE-2). It can be difficult for parents or caregivers to hear that their child may need a referral or intervention, and they may have concerns. Even when a child’s results are typical, parents are likely to have questions.

There’s plenty you can do to make your meetings productive

To make these meetings go smoothly, the best thing you can do is come fully prepared to be the calming, supportive, resourceful presence all parents need.

Before the meeting

• Follow up quickly
  Be timely. Review and score the completed ASQ-3 or ASQ:SE-2 questionnaire shortly after it’s completed, then follow up with the family as soon as possible to arrange a parent meeting.

• Refresh your skills
  It can be helpful to occasionally revisit ASQ training materials.

• Suggest a private, comfortable place to meet, and tell the family that the child’s results, and your discussion, will remain confidential.

• Consider cultural or language issues
  Depending on the family’s home language, you may want to involve an interpreter.

Q&A

• Parent: But he’s so young!
  You: Yes, he is still very young—but one thing that research has shown is that these first five years are when the brain develops the majority of neurons (pathways in the brain) and is most open to learning. It is one of the very best times to support your child’s development!

• Try practicing with team members by acting out provider and parent/caregiver roles (http://bit.ly/DiscussingResults). Prepare for common parent questions with the Q&As listed throughout the article.
• Revisit your User’s Guide for additional information on communicating results with families (p. 103 of the ASQ:SE-2 User’s Guide (http://bit.ly/ASQSE2UG), and p. 77 of the ASQ-3 User’s Guide (http://bit.ly/ASQ3UG)).
• Refer to this quick tip sheet: Sharing Screening Results with Families (http://bit.ly/SharingASQResults)

Know your referral options

Make sure you’re well versed on what kinds of follow-up or referrals you’ll need to make in different scenarios. The type of support you’ll offer will depend on scores; parents’ specific concerns; and environmental, health, and cultural factors that may have influenced the results. Know the contact information for your local Early Intervention and Early Childhood Special Education programs; have brochures or printed handouts available to share with parents who have concerns.

During the meeting

Review the completed questionnaire and be positive

Start with strengths and speak positively, considering the whole child.

Take notes on a parent conference sheet

To help focus the conversation and keep track of goals, strengths, concerns, and follow-up actions, a parent conference sheet (http://bit.ly/ParentConference) can be helpful. English and Spanish versions for both ASQ-3 and ASQ:SE-2 are available.

Q&A

• Make sure parents know that screening is a service you offer to all families, that it’s a quick look to see if development is on schedule, and that the results inform you and them about their child’s strengths, as well as areas that may benefit from follow-up in school or at home.

You**: It’s good to know his doctor feels he is healthy and doing well. One thing to keep in mind is that doctors do not spend much time with your child. It is hard for them to closely look at a child’s development. You know your child best and have shared your observations on the ASQ. What about making an appointment to share these ASQ results with your doctor?

Parent**: I’m not worried. His doctor said he was doing fine and said he would catch up.

Q&A

• You: I understand your concern. This decision is completely up to you. I’d like you to know early intervention often prevents children from needing special education in school. But, we really don’t know what is going on yet. Your child may have a health issue that is making it hard for him in this area. The next step is only to get more information from developmental specialists and your child’s doctor. Would that be okay?

• Parent: I’m not sending my child to special education.

ASQ-3

• Review and celebrate skills marked "Yes."
• Notice skills that were marked "Sometimes." Remind parents that "sometimes" means the child is just beginning to demonstrate a skill and delight with them at their child’s new attempts.
• Review items marked "Not Yet" and discuss any parent concerns. Gather more information from the parent about what they may have tried or observed.
• If relevant, discuss factors that may have impacted the child’s performance: opportunity to practice skills, the child’s health (e.g., hearing, vision), the family home, culture or language.

ASQ:SE-2

• Review skills marked with a "Z." These are social-emotional strengths.
• Review 10 or 15-point items and discuss items of concern.
• If scores are high or there are concerns, discuss factors that may be affecting the child’s behavior: setting/time, health, development, family/culture variables, stress, or trauma.

Review results together, and be clear with language

As you share the Information Summary Page, avoid terms such as pass, fail or test. When reviewing the bar graph, use terms such as on-schedule, monitor, and below or above the cutoff.

Listen to the parent’s concerns, share your own specific concerns, and encourage discussion.

Approach the situation with curiosity and a desire to help the parent make informed decisions.

Q&A

• Restate factors to consider. “There are a lot of factors that might impact your child’s development. For example, if a child is not hearing well, his communication skills (and behavior) may not develop as we would expect. What these results suggest is that it would be good to get more information to understand what might be going on.”
• Think about where the parent is in this process. If they are expressing concerns, they may be ready to refer. If they are not concerned or if this is all new information, parents may need more time.

Parent**: I’m not worried. His doctor said he was doing fine and said he would catch up.

Provide information and address parent questions, if necessary

Help parents take next steps. Be ready with referral contacts to local programs such as early intervention, early childhood special education, parenting education, parenting support, and behavioral health programs. If referrals aren’t needed, discuss whether and when a follow-up screening should be performed.

Remember, follow the parent’s lead

If parents are not ready to discuss referral as a next step, stay calm. Even if parents express big feelings or no feelings at all, your role is to support, guide, and inform parents about resources. Follow the parent’s lead. If they aren’t ready, you can continue to aid the development or positive behavior of the child by supporting parents in the home, or the child in a caregiving setting.

Share learning activities parents and children can do at home

Whether a child’s scores are typical, or in monitoring or referral zones, you can offer support by sharing activities that families can do on their own. Two great resources to try:

• ASQ-3 Learning Activities (http://bit.ly/ASQ3LearningAct) encourage progress in the same five developmental areas screened using the tool.
• ASQ:SE-2 Learning Activities & More (http://bit.ly/ASQSE2LearningAct) complements the screener with more than 90 activities that promote adult–child interaction and key social-emotional skills.

For more in-depth guidance on preparing for parent meetings and sharing results during the meetings, check out the article “Success after screening” (http://bit.ly/SuccessScreening) and refer to p. 103 of the ASQ:SE-2 User’s Guide (http://bit.ly/ASQSE2UG), and p. 77 of the ASQ-3 User’s Guide (http://bit.ly/ASQ3UG).

Q&A

Additional information

You: It’s a family-friendly organization. After you call, they’ll schedule a time to meet. They have specialists who can discuss your concerns and take a more in-depth look at her development. If they identify an area where your child can use more support, you’ll work together to create a plan and set goals. They offer free services, such as speech therapy.

Parent**: What are they (Early Intervention) going to do?

Q&A

Parent**: Have you got any ideas for things I can do to help my child at home?

You: Yes, let’s look at the ASQ learning activities together and see which ones would be fun for you to try.