RUNNING HEAD: PEDS SCREENING IN A LOCAL PUBLIC CHARTER SCHOOL

PEDS SCREENING IN A LOCAL PUBLIC CHARTER SCHOOL: IMPLICATIONS FOR

EARLY CHILDHOOD INTERVENTION
Camille Jones
Houston Baptist University

PEDS as Screening Assessment Instrument

The Parents Evaluation of Developmental Status (PEDS) is a 10item parent completed
standardized questionnaire used to elicit parental concerns around child development for children
less than 8 years old in populations, communities and clinical samples (Glascoe, 2012). The
original PEDS contains 10 questions that include both multiple-choice and open-ended formats
(Glascoe, 2012). The online PEDS test contains template boxes allowing for details for each
(Glascoe, 2012).

Appendix 1 presents PEDS online administration as a virtual screening instrument for

developmental delays (Glascoe, 2013). Costing only $60 for 100 survey forms and score sheets,
PEDS is cost efficient in comparison to other developmental screens (AAP, 2013; Glascoe,
2012). PEDS is also time saving: parents can complete the form in 5 minutes; providers can
score it on average in around 2 minutes (AAP, 2009; Glascoe, 2012). Offered in English,
Spanish, Vietnamese, Hmong, Somali, Chinese, Malaysian, PEDS provides numerous ways to
assure parent feedback and input (Glascoe, 2012). PEDS ranks high in validity measures relative
to other screening instruments--with a sensitivity rating between 74-79% and a specificity rating
between 70-80% (Glascoe, 2013).

PEDS survey outcomes are categorized within one of several paths--estimating a given childs
risk of developmental delay as high, moderate, low or no risk (Glascoe, 2012). These findings
are derived from recorded parental concerns. Based on both categorized and risk-ranked parental

concerns, a clinical pathway is then recommended by the care provider treating the child
(Glascoe, 2012).

Screening and PEDS

Assessment and evaluation in early childhood education are conducted for at least four different
purposes: 1) screening, 2) diagnosis, 3) program planning and 4) evaluation (Heward, 2013, p.
504). Heward (2013) found that while some children have disabilities so significant that no test
is needed, mot children who experience developmental delays re not identifiable by obvious
physical characteristics or behavioral patterns, especially at very young ages. In this scenario,
screening comes into play. Heward (2013) defines screening as an easy to administer test to
identify children who may have a disability and who should receive further testing (Heward,
2013, 504).
More specifically, screening often involves the use of a standardized tool to identify and refine
the risk for developmental delays (AAP, 2010).

Pediatric researchers define developmental

screening as a brief assessment procedure designed to identify children who should receive
more intensive diagnostic assessment (Dworkin, 2009). The Parent Evaluation of
Developmental Stages (PEDS) functions as a developmental screening instrument that helps to
identify those children in need of further evaluation (Glascoe, 2012).

Rules for Administering PEDS

PEDS takes less than 5 minutes for parents to complete and one to two minutes to be scored by
care providers (Glascoe, 2013). Online PEDS versions offer the option of immediate scoring
(upon PayPal Payment of a small fee) (Glascoe, 2013). Once test data for PEDS is calculated,

parents are automatically linked to M-CHAT and to DP-PEDS and PEDS milestones as well to
maximize information analysis through the screening process (Glascoe, 2012).

Subtests for PEDS: PEDS surveys various developmental domains: 1) expressive language, 2)
receptive language, 2) fine motor, 3) gross motor, 4) behavior, 5) socialization and socioemotional development, 6) self-care, and 7) cognition/learning (Glascoe, 2012). An initial step
is to categorize parent responses based on these specific domains. This information is then
downloaded into the PEDS response interpretation form (Glascoe, 2012).

Scoring PEDS
High Risk: Path A
Pediatric researchers found that 10% of PEDS screened children landed on Path A; yet more than
50% of these have undetected disabilities (AAP, 2009). Path A indicates whether speech
language evaluations or developmental psychology evaluations are needed (Glascoe, 2012).
Clinical judgment should be used to gauge the need for audiology services, vision screening, and
lead screening (Glascoe, 2012). Public school early intervention evaluations often cannot
proceed without indication that hearing and vision have been tested (Glascoe, 2012).
The American Academy of Pediatrics (AAP) recommends the use of an autism-specific screen
once a child performs poorly on PEDS or other screens (Glascoe, 2008). Autism screens like the
M-CHAT can be sent home with the family or completed online (Glascoe, 2012). If, for
example, the M-CHAT is also failed, the child may need to be referred to an Autism specialist
and possibly---while waiting evaluation--receive an interim form of services (Glascoe, 2012).

Moderate Risk PEDS Path B

Path B suggests Moderate Risk for developmental disabilities (Glascoe, 2012). Path B occurs
about 20% of the time amongst PEDS-screened children (Glascoe, 2012). While including some
children with undetected disabilities, many others scoring well below average and having
numerous psychosocial factors affecting outcomes (Glascoe, 2012). PEDS sensitivity and
specificity gets computed by referring Path B children for diagnostic evaluations (Glascoe,
2012). Specificity (the percentage of children without problems correctly detected) is improved
if a second stage screen is administered (Glascoe, 2012). Since children on Path B remain at
risk, they need ongoing watch while their parents often need advice about promoting child
development (Glascoe, 2012).

Low Risk Developmental Delay; Elevated Risk Mental Problems (Path C)

Path C occurs about 20% of the time and generally focuses on social-emotional and behavioral
issues (Glascoe, 2012). In some cases, particularly with younger children, these concerns reflect
limitations in parenting skills (Glascoe, 2012). Glascoe (2012) found that one optimal response
to behavioral and socio-emotional concerns affecting a Path C child is to give parents advice,
parenting education materials, and then monitor how this works (Glascoe, 2012). The best
response for younger, categorized children is to conduct social-emotional behavioral
problems/mental health screens or refer them for screening (e.g., through the public schools or
mental health clinics) (Glascoe, 2012). PEDS Online links to national resources that track local
services such as parent training classes and child psychologists (Glascoe, 2012). Older children
need more action--if their families have not yet received prior advice, they will need more
intensive services (Glascoe, 2012).

Rationale for Screening Instruments like PEDS: Two key rationales for screening are to
improve the lives of children and families through early intervention and to contribute to societal
savings (AAP, 2009). Screening improves parent satisfaction and can facilitate greater parent
engagement (AAP, 2009). Children who get screened also can be evaluated for services in a
timelier manner (AAP, 2009). While 12 to 18% of surveyed children have a developmental
disorder, fewer than 30% of these children are identified by a clinician before entering school
(AAP, 2009). Developmental screening can boost the identification rate considerably, thereby
opening the door to the benefits of early intervention (AAP, 2009).

Rationales for PEDS Screenings

Several studies show improved economic development and long-term savings for society for
outcomes (AAP, 2009). Researchers affiliated with the Perry Preschool Project longitudinally
correlated early intervention with higher rates of graduation, higher employment rates in learners
(AAP, 2009). Yet fewer than 50% of pediatricians use a screening tool as of 2013 (AAP, 2009;
Glascoe, 2013). Both Title 5 of the Social Security Act and IDEA Legislation reaffirm the need
for more care providers to administer developmental screens (AAP, 2009). The AAP
recommends developmental surveillance at every well-child visit as well as periodic use of a
validated screening instrument (AAP, 2009). These pediatric and medical research findings
suggest an ongoing need for more consistent developmental screening implementation.

Several PEDS Exemplars

Appendix II presentation links set forth exemplars of PEDS Cases and contain a simulation of
Online PEDS administration.

PEDS Administration Demonstrated

Appendix II contains the actual questions of the PEDS as simulated. Steps for traditional PEDS
administration are:
1) Ask parents whether they would like to complete the Response Form on their own or
have someone go through it with them (Glascoe, PEDS Online, 2013); If the parents
only circle answers and without writing on the form, their PEDS should be readministered as an interview, since the provider and scorer cannot be sure of literacy
skills (Glascoe, 2012).
2) Compute the childs age, correcting for prematurity if less than 24 months old.
3) Find the Age Column--Find the correct column for the childs age on the PEDS Score
Form (Glascoe, 2012)
4) Categorize ConcernsReading through all comments--Look at the PEDS Brief Guide for
categorizing examples by domains of development (Glascoe, 2012)
5) Mark the Score Form--Mark the box to show the kind of concern--if several different
issues fall under the same category, only check the box once (e.g., tantrums,
hyperactivity, biting etc. are a single check under behavior). A little as response is
marked as yes. (Glascoe, 2012). Add care provider concerns, never removing or
ignoring the parents concerns (Glascoe, 2012).

6) Summarize the total number of concerns in shaded boxes into the large shaded box at the
bottom; Total the concerns in unshaded boxes into the large unshaded box at the bottom
(Glascoe, 2012).
7) Score and Find the Correct Path by following directions below the large shaded box. If
the number is 2 or more, follow Path A (Glascoe, 2012). If the number is 1, follow Path
B (Glascoe, 2012).
PEDS Use in Amigos Por Vida School District Possibilities and Implications
Given that the PEDS Screening process is usually administered in a clinic and/or care provider
setting independent from classroom Special Education and/or PPCD practice, access to
previously completed PEDS survey outcomes could significantly impact the planning and
differentiation practices in use in Pre-K-3, Pre-K-4 and early childhood classrooms (Glascoe,
2013). Parents could avail themselves of the multiple levels of resources accessible through
PEDS online and other pediatric sites to aide their understanding of child developmental
milestones and clarify how to develop an individual learners skills by starting with his/her
strengths (Glascoe, 2012). The efficiency of the PEDS screening instrument, along with its
availability in Spanish (the home language of 99.7% of all Amigos Por Vida students), and its
relevance to 8 domains critical to affective and cognitive success, make it an interesting
screening instrument to draw from for purposes of differentiating responses to intervention [RTI]
and enrichment strategies in early childhood classrooms (Glascoe, 2012). Using PEDS-type
screening processes to inform ECI and RTI efforts at Amigos Por Vida might further enhance the
common objectives amongst parents, professionals and pupilsin socio-educational and
multilingual ways which, in turn, could further develop all.

REFERENCES

Glascoe, F. (2013). Collaborating with Parents: Using Parents' Evaluation of Developmental

Status (PEDS) to Detect and Address Developmental and Behavioral Problems (2nd Edition).
Nolensville, TN: PEDSTest.com, LLC.
Hooper, S. and Umansky, W. (2009). Young Children with Special Needs (5th ed.).Upper Saddle
River, New Jersey: Pearson.
Wortham, S. (2012). Assessment in Early Childhood Education (6th ed.). New Jersey: Pearson.
Glascoe, F. (2008). PEDS: Developmental Milestones (PEDS: DM): A tool for Surveillance and
Screening, Professionals' Manual. Nolensville, TN: PEDSTest.com,LLC. 2008.
Heward, W. (2013). Exceptional Children: An Introduction to Special Education (10th ed.).
Upper Saddle River, New Jersey: Pearson.
Dworkin, P. (1992). Developmental Screening: (Still) Expecting the Impossible? Pediatrics. Jun
89:1253-5.
American Academy of Pediatrics (AAP) (2009). Section on Developmental and Behavioral
Pediatrics, Developmental Check Ups, Retrieved 11.24.2014 from
https://www2.aap.org/sections/dbpeds/pdf/PDFNewContent/ImplementScreenTools/Developme
ntalCheckUps.pdf
Glascoe, F. (2012). Welcome to PEDS Online. PEDS Test Online, Retrieved November 27,
2014 at http://pedstestonline.com

Appendix I. The 10 'PEDS' Questions

(Glascoe, 2013)
PLEASE REVIEW YOUR RESPONSES BELOW
You're almost done...
Your responses to the test questions are shown below. Please review your responses and
make changes if necessary. When finished, please click on the "Continue..." button at
the bottom of the page to move to the next test measure.

Please list any concerns about your child's learning, development, and behavior.
Comments:

Do you have any concerns about how your child talks and makes speech sounds?
Choose one:
Comments:

No

Yes

A Little

Do you have any concerns about how your child understands what you say?
Choose one:
Comments:

No

Yes

A Little

Do you have any concerns about how your child uses his or her hands and fingers to do
things?

Choose one:
Comments:

No

Yes

A Little

Do you have any concerns about how your child uses his or her arms and legs?
Choose one:
Comments:

No

Yes

A Little

Do you have any concerns about how your child behaves?

Choose one:
Comments:

No

Yes

A Little

Do you have any concerns about how your child gets along with others?
Choose one:
Comments:

No

Yes

A Little

Do you have any concerns about how your child is learning to do things for
himself/herself?
Choose one:
Comments:

No

Yes

A Little

Do you have any concerns about how your child is learning preschool or school skills?

Choose one:
Comments:

No

Yes

Please list any other concerns.

Comments:

A Little

Appendix II. Modified Checklist of Autism in Toddlers (M-CHAT) & Site Link
(Glascoe, 2013)
M-CHAT (second level psycho-social screen)
Modified Checklist of Autism in Toddlers (M-CHAT) is a 23 item yes-no screen
for children 16 to 60 months focused on detecting possible autism-spectrum disorder.
Please fill out the following about how your child usually is.
If the behavior is rare (e.g. Youve seen it only once or twice), please answer as if the child
does not do it.

1. Does your child enjoy being swung, bounced on your knee, etc.?
2. Does your child take an interest in other children?
3. Does your child like climbing on things, such as upstairs?
4. Does your child enjoy playing peek-a-boo/hide-and-seek?

Yes
Yes
Yes
Yes

5. Does your child ever pretend, for example, to talk on the phone or take care of dolls, or pretend other
things?
Yes
6. Does your child ever use his/her index finger to point, to ask for something?
7. Does your child ever use his/her index finger to point, to indicate interest in something?
8. Can your child play properly with small toys (e.g. cars or bricks) without just mouthing, fiddling, or
dropping them?
9. Does your child ever bring objects over to you (parent) to show you something?
10. Does your child look you in the eye for more than a second or two?
11. Does your child ever seem oversensitive to noise? (e.g., plugging ears)
12. Does your child smile in response to your face or your smile?
13. Does your child imitate you? (e.g., you make a face-will your child imitate it?)

Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes

14. Does your child respond to his/her name when you call?
15. If you point at a toy across the room, does your child look at it?
16. Does your child walk?

Yes

18. Does your child make unusual finger movements near his/her face?
19. Does your child try to attract your attention to his/her own activity?
20. Have you ever wondered if your child is deaf?

Yes
Yes
Yes

21. Does your child understand what people say?

Yes

22. Does your child sometimes stare at nothing or wander with no purpose?
23. Does your child look at your face to check your reaction when faced with something unfamiliar?
continue...

Child's Name: Rosalba Amable

Birth Date: 12-10-2011
Test Date: 11-27-2014
Child's Age: 3 years

Yes
Yes

17. Does your child look at things you are looking at?

APPENDIX III. PEDS:DM - DEVELOPMENTAL MILESTONES

Yes

Yes
Yes

Prematurity: No

Please complete the test form below and submit your answers at the bottom of the page.
PEDS:DM Questions (Test Form M) (6 questions)
No
Can your child scribble with a crayon or marker without going off the page
much?

Sometimes
Yes

Point to the pictures of the cats and balls and say "Show me something big.
Now show me something little." What does your child know?

Neither big nor

little
Knows big or little,
not both
Knows both

None
When your child talks to other people, how much do they understand of what
he or she says?

Not much
About half
Most
No

Can your child stand on each foot for a second?

Only one foot

Yes
No

Can your child slip his or her shoes on?

Yes, mostly on the

wrong feet
Yes, mostly on the
right feet

No, or less than 5

minutes
Can your child play well with a group of children? If so, for how long?

5-10 minutes
15-20 minutes

Submit for Scoring

Link to

Link to Site for Simulation: http://e-ppcd.weebly.com/assessment-project---pedsscreener.html