In the previous module you learned about the foundations of the screening process; this is central knowledge to ensure you are administering and scoring the measures in a way that preserves the fidelity of the instrument. Having an understanding of the purpose and materials is an important first step toward reliable and valid screening; however, there is additional clinical skill that screeners will need to become aware of and practice in order to effectively administer communication screening measures. The following are tips to review: 

Setting up for Screening and Managing Materials (REVIEW)

• Bring a pencil (or a few) 

• Keep materials organized and generally to the side of your dominant hand (e.g., if you're right handed keep extra materials to your right side) 

• Seat the child to your non-dominant side (e.g., if you're right handed have the child seated to your left)

• Consider setting up a seating arrangement at the corner of a table 

• Before starting the screening test complete ALL demographic information at the TOP of the screening record form (i.e., age, name, site) 

• Double check the child's chronological age; it's critical that you choose the age range record form consistent with the child's age. If you need to double check chronological age Pearson has a quick "chronological age calculator" that you can easily access from your phone. 

SUGGESTED: Watch the administration of the PLS-5 Screening Test to a child

Understanding the materials and using the materials in an effective way helps with the flow and management of screening; however, screeners must also be prepared to be responsive to the child (and the family) being screened. All moments of screening are an opportunity to observe development and understand the child (access, strengths, etc). There are times when the screening process is ideal; materials are all at hand, ease of transition (for child), attentive and interactive conversation and play between the screener and child, no outside distractions, etc. There are other times when the environment or interactions require screening to be responsive to the circumstance(s). This section will address TWO concepts that promote responsive and individualized developmental screening that maintains the fidelity of the screening protocol.

Responding to Children's Answers and Responses (REVIEW)

• Do not provide ANY specific feedback on the child's performance; you can give general feedback and praise for hard work. 

• State the prompt exactly as written in the Picture Book and/or Record Form; for the screening test to remain reliable and valid you can NOT adjust the wording or the order of the test items.

• Administer the test items in the EXACT order on the record form. 

• You can provide reasonable wait time after giving the stimulus, you can encourage a response, but you can NOT prompt a correct answer. Do not emphasize any particular words in the test items or point in the direction of the correct answer. 

• Sometimes other aspects of developmental screening are more engaging for children. If you find that the communication portion of the screening is less preferred, consider doing another aspect (e.g., motor) and then returning to the communication screening.  

• Take data on the child's responses for EACH item as you go along; under no circumstances should you try to remember the child's responses. Never plan to record their responses after they have completed all the items. It is suggested that you 'keep up' with scoring each item and set of items while the child is working through the screening test. 

Engaging the Harder to Engage Child: Remember when children are engaged, there is less need to manage behaviors

• Give child manipulatives to hold (e.g., ladybug from the DIAL test, banana from the hearing screening monkey)

• Make sure child can clearly see the materials

• Offer a supported and comfortable in seat; or offer alternate seating (e.g., poly spot on the floor)

• Provide child with more frequent encouragement and feedback for sitting

• Offer choice (e.g., would you like to listen to the headphones (i.e., hearing screening) or take a look at my cool camera with party lights (e.g., vision screening)

• Build in play-based breaks

• Invite a trusted/familiar adult to join the screening process (but be sure that adult does not lead the child to answers) 

• Reduce distractions in the screening environment; remove extra items from the table/floor where the child will be working

SUGGESTED: Watch the interview with a Get Ready to Grow SLP screener

Get Ready to Grow follows all HIPPA compliant regulations when handling child data; please refer to the overall guidance and apply it to all communication screening materials as well. Recall the following central information about protected information: 

• Do not discuss child information at home or outside of work, including who you saw for screening.

• Avoid discussing child-specific information in public areas, including talking on a cell phone where others may overhear.

• Lower your voice when you must share child-specific information in areas where others might overhear (e.g., main office at a child care center).

• If possible, close the door when consulting with consented providers and/or family members or when discussing a case.

• Only share results with those consented to receive the information. 

• Email using an encrypted platform OR without identifying information. 

• Check to make sure that you are giving the correct paperwork to the right provider-partner or family (right results to right person) 

• Keep paper records/protocols out-of-sight, and in locked storage areas. If you are screening in a common area of a site consider placing your results in a folder or on a clipboard with a cover sheet. 

• Cover, put away, or turn over paperwork with PHI.

ASHA (2023) advises speech-language pathologists that counseling is a critical component of clinical practice. Read the following excerpt that defines counseling and also explains the relevance to working with clients (and their families) with communication disorders: 

"Counseling is a broad term that refers to assistance provided in an interactive manner to individuals (i.e., clients, patients, and/or students) and their families/caregivers dealing with challenging emotions and life situations in an effort to facilitate realistic and clearly understood goals and improve quality of life (Flasher & Fogle, 2012; Tellis & Barone, 2018).

Counseling can fall into varied categories, two of which are informational and personal adjustment counseling, both of which fall within the purview of audiologists and speech-language pathologists (Flasher & Fogle, 2012). Informational counseling, also referred to as client and family/caregiver education, involves discussing with individuals and their families/caregivers the nature of a disorder or situation, intervention considerations and techniques, prognosis, and material and community resources. Personal adjustment counseling addresses feelings, emotions, thoughts, and beliefs expressed by individuals and their families/caregivers (e.g., realization of the pervasive impact of a communication disorder on day-to-day life).

Counseling is an important clinical skill that helps individuals and families/caregivers adjust to and cope with feelings about a disorder or situation (Flasher & Fogle, 2012). Counseling can empower individuals and families, encouraging them to self-advocate in their efforts to adjust, strive, and grow.

Counseling is an integral part of clinical work, and counseling skills are used intentionally or spontaneously in every clinical encounter (Luterman, 2008). Counseling services provided by audiologists and speech-language pathologists should occur in the context of comprehensive service delivery. It is important for audiologists and speech-language pathologists to recognize when referral to a related professional is warranted to best meet any additional counseling needs." 

As a Get Ready to Grow screener it is critical that you are prepared to: RELATE, SPEAK, LISTEN and GAIN TRUST of the families and providers of the children you are screening. Active listening is a key skill in establishing a relationship in order to share results. 

SUGGESTED: Watch the "Active Listening" video [LINK HERE] and reflect on your strengths as a listener as well as your opportunity for growth. 

Within clinical practice counseling strategies and techniques are used (1) to share sensitive information, (2) as part of the education process, and (3) within treatment to address roadblocks toward the client's goals/progress. For the purposes of Get Ready to Grow screenings it is important to think about the concept of counseling as related to sharing results and discussing options/recommendations. Remember, counseling is not something we DO TO clients, but a process we engage in WITH clients; counseling is relationships based and reciprocal. For the purposes of screening consider the following points (Stein-Rubin & Fabus, 2018):

• PROCESS: Recognize that sharing results, discussing recommendations, and making a plan for the next steps might be a familiar and straightforward process for you (the screener), but is likely new and uncertain for the family; it is your role as the screener to meet the family (or provider) where they are. It is important to remain open to the process and not simply tied to the outcome (that you may think is best/preferred). As we recognize this as a process we can better provide space and opportunity for questions and discussions that in the best interest of the child and family. 

• PRESENCE: Working in child care settings and out in the community is complex and multi-faceted; child-serving professionals are often juggling many factors beyond completing the screening (e.g., communication with site-based partners, completion of paperwork, tracking of data, materials management, environmental distractions, malfunctioning equipment). As we work through these realities, we must find the time to be present with the child/family and/or providers as we share results and discuss recommendations.  

• PERSPECTIVE: Children are full of potential and those conducting the Get Ready to Grow screenings are caring individuals that want to see every child reach their fullest potential. Those are important points to remember as results and recommendations are shared and discussed; however, it is important that we remain objective in discussing results. Consider the following quote about the importance of perspective, we must trust "both ourselves and the process of human interaction. To empower our clients, we must develop the capacity to create non-judgemental space for their normal human emotions, including pain, grief, fear and guilt." As you engage in dialogue with parents and providers remain objective, use examples from the screening to illustrate your main points, asking questions, and avoiding jargon. 

• PRAISE/FEEDBACK: Social and psychological research tells us that people thrive on positive reinforcement and feedback; this is an important factor to keep in mind as you share results and engage in the process of discussing recommendations.  Consider the following points: (a) begin your conversation with the family/provider with a positive, (b) remain objective and non-judgemental as you present results, (c) do not take a deficit perspective or suggest short or long-term limitations based on the results of the screening, and (d) do not suggest a disability label (e.g., Autism, intellectual disability) or link a disability label to a child's potential. 

In addition to key elements of the PROCESS, it is important to think about the words (terms) we use when engaging with clients and families; all Get Ready to Grow screeners should avoid 'word traps' that are deficit-based, disrespectful, or disability first. 

SUGGESTED: Review the NIH's 'person-first' resource [LINK HERE] and consider the concepts/terms you will likely need to be conscious of as you discuss results and recommendations with families and providers. 

Review the following "tips for success" as you consider your role in building relationships with families/caregivers and providers in order to support a child reaching their fullest potential:

• Introduce yourself and state the purpose of your interaction (i.e., "Hi, I'm XX and I'm one of the screeners with the GROW screenings. I had the pleasure of meeting [child] today and I wanted to share the results. I have some materials that I will send home with you, and we can talk about the possible next steps.")

• Start with a positive.

• Avoid jargon or acronyms. 

• Provide opportunities for questions (in fact, prompt questions).

• Check for understanding and clarity.

• Use examples to support your main points (e.g., the child made speech sound errors that impacts the amount of speech I understood; for example, I noticed the child had difficulty with the 'k, l, r, f, s' sounds. 

• Monitor your speech rate; remember this information is very familiar to you, but may be less familiar to the family/caregiver/provider. 

SUGGESTED: Engage in self-reflection about self and family that may impact your relationship-building and interaction. Read the following quotes and the journal about the associated questions: 

• Beliefs, attitudes and fears about may hinder true family partnerships and engagement. It is critical that professionals establish core beliefs about the importance of family engagement. 

  •  WHAT ARE SOME BELIEFS, ATTITUDES OR FEARS THAT MAY HINDER FAMILY PARTNERSHIPS? 

• When professionals “reach out with the goal of building partnerships based on mutual respect and common purpose, families will respond” (Henderson et al, 2007, p.28). 

  • IF YOU’RE STARTING FROM A POSITIVE AND RESPECTFUL PLACE TO FOSTER FAMILY PARTNERSHIPS (CONCEPTUALLY), WHAT DO YOU LITERALLY DO (TANGIBLY)? WHAT ARE YOUR ACTIONS AND STEPS?   

• Adopt the Core Belief that power should be shared in parent-provider- school relationships and establish practices that value the contributions of all. 

  • HOW DO YOU BUILD IN POSITIVE TWO-WAY (RECIPROCAL) PRACTICES TO ENHANCE EQUALITY IN PARENT-PROVIDER PARTNERSHIPS?

CONGRATULATIONS! You have completed the last section of the last module of this competency-based training. You have ONE MORE competency quiz to complete. If you are preparing to conduct communication screenings you will want to take some time to review your notes from this training and begin to make a plan with your Get Ready to Grow contact to practice in the field/at sites. 

It is suggested that you review the final section/module as you begin the field practice. There are a number of curated resources and quick references that will be useful as you begin applying the content from this training to Get Ready to Grow screenings. 

QUIZ 6