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ABC Unified School District
Tracy High School Cal- SAFE Teen Parent Program

Part I: Program Summary

Sonja Robinson

PPA 696 - Research Methods in Public Policy and Administration

Dr. Michelle Saint-Germain

Thursday 7:00 p.m. - 9:45 p.m.

California State University, Long Beach

May 22, 2010

Table of Contents

Executive Summary 1

Introduction and Background 2

Cal-SAFE Teen Parent Program Description 3

Purpose of the Evaluation 11

A Logic Model for Cal-SAFE Teen Parent Program 12

Literature Review 13

Evaluation Design and Methods 19

References 29

Appendices 30

Executive Summary

This summary provides an overview of the key findings from data and feedback collected during the course of an evaluation design on ABC Unified School District Cal-SAFE Teen Parent Program at Tracy High school. The program supports the academic success of pregnant and parenting teens, increases the availability of support services for enrolled students, and provides child care and developmental services to their children.

The purpose of the comprehensive evaluation is to assess recent and longer-term impacts of the program on its participants. The evaluation requires a multi-phase approach that involved a series of data collection which includes, individual surveys, interviews, program records, pretest and posttest targeted at each comparison group. The scope of the evaluation includes program records of students who receive program services for one or more years and earn a high school diploma or its equivalent. A separate survey and pre and post-test will also be administered teen parents who participated in the program at Tracy High School and who chose to stay at their home school within ABC Unified School District to determine whether the students served will demonstrate effective parenting skills.

In order to compare student success in the Cal-Safe Teen Parent Program, student records will be analyzed to determine the percent of students who improved their parenting skills by receiving a passing grade in the course and comparing the pre and post surveys. A review of each student's record will be made to determine the percent of students who have earned their high school diploma or its equivalent.

In comparison to the Cal-SAFE program two similar programs were analyzed to determine its academic effectiveness. The first is the Teenage Parent Demonstration (TPD) operated in Camden, Newark and the south side of Chicago between late 1987 and mid 1991. All teens who applied for Aid to Families with Dependent Children (AFDC) during the demonstration period in the sites and who were randomly assigned to the demonstration program were required to participate in education, job training, or employment related actives, as appropriate, or be sanctioned until they did participate. The program conducted an experimental design with random assignment on a treatment and control group. For evaluation purposes, half the incoming teens were randomly assigned to receive regular services that non-demonstration teens would have received (the control group) and half received the enhanced services (the treatment group). The study used focus group interviews, personal in-depth interviews, and case conferences with case managers and other program staff to discuss specific cases, probing deeply into areas that are difficult to tap through standard survey procedures.

The second comparison program is the Project Redirection (PR) operates programs in Boston, New York, Phoenix, and Riverside. The Project Redirection was a national research demonstration to test an approach to helping pregnant teens and young mothers. It sought to enhance educational, job-related, parenting and life management skills of young pregnant or parenting women, most of who were on welfare. This program they used a quasi-experimental design on a matched comparison group. Effects were measured through interviews of participants and members of a matched comparison group which are individuals in the matched comparison site who would have been eligible for the program if they were in that site.

Based on the findings from this evaluation, ABC Unified School District Cal-SAFE Teen Parent Program will likely remain a unique and valuable program that will continue to build on its successes, providing lasting academic and parenting skills for future teen parents.
ABC Unified School District
Tracy High School Cal-SAFE Teen Parent Program

Introduction and Background Adolescent childbearing occurs worldwide, but California rates of teens given birth are between four and 12 times higher than are the rates for France, Spain, Italy, the Netherlands, and Japan. In 2001, more than 53,000 teens - nearly 5 percent of all teens aged fifteen to nineteen years gave birth in California, and many more became pregnant. Although birth rates to teen mothers decreased in the past several years, the California Department of Finance conservatively projects a 23 percent increase in annual teen births in California within five years due to the increase in the teen population. The projected result of this increase is approximately 12,500 more teen births in 2008 than there were in 2003 (Constantine, Norman, Nevarez, 2003). Expectant and parenting teens experience educational, health, economic, and social challenges; they are at higher risk of dropping out of school, their efforts in career preparation are limited, and they might have a repeat pregnancy while in their teens. Teen Pregnancy and Parenting in California provides selected key data from the most recently released documents on teen pregnancy and parenting in California, Teen pregnancy presents challenges not only to teens, their children, and the teens' families; it putss pressure on state and local government resources and society as a whole. The California School Age Families Education (Cal-SAFE) Program, established by Senate Bill1064 (Chapter 1078, Statutes of 1998), began serving expectant and parenting students and their children during the 2000-01 school year. The program became operational July 1, 2000, based on and incorporating many elements of the former Pregnant Minors Program (PMP), School Age Parenting and Infant Development (SAPID) Program, and the Pregnant and Lactating Students (PALS) Program. As of June 2007, the Cal-SAFE Program has served approximately 72,700 students and 42,000 children nationwide. Many teens that become pregnant are not very successful in school. Nationwide, less than half of the women who give birth under age 18 graduated from high school, whereas most of the students who receive the support and services of the Cal-SAFE program do graduate. The Cal-SAFE Teen Parent Program helps students focus on their baby's future and come to school with increased dedication and interest.
Program Description The ABC Unified School District's Cal-SAFE Teen Parent Program (CS-TPP) provides services and specialized classes for school age expectant or parenting students. The Teen Parent Program is open to students who are expecting a child and/or are already parenting. An emphasis is placed on parenting skills, prenatal health, individual and group counseling, academic coursework, and the importance of earning a high school diploma. An infant center is offered to participating students and is staffed by professionals as well as by community and student volunteers. There are two ways to participate. The first is for students who choose to stay at their home school or attend one of another ABCUSD educational program. They will be visited by one Teen Parent staff member and receive information and some services. The second is for students who attend Tracy High School and take prenatal or parenting classes that focus on the unique need of teens, along with their other regular academic classes. Female and male students who are under the age of 18 and who have not graduated from high school may voluntarily enroll in the Cal-SAFE Program if they are an expectant parent, a custodial parent, or a parent taking an active role in the care and supervision of their child. A student with an Individualized Education Plan (IEP) is eligible as long as there is an active IEP. If a student is continuously enrolled in the program and has not graduated before reaching age 19, the student may be enrolled for one additional semester. As long as teen parents are enrolled in the Cal-SAFE Program, their children are eligible for services until age five or entry into kindergarten, whichever comes first. Tracy High School provides: • enrollment at any time during the school year; • flexibility in scheduling classes; • the opportunity to earn more credits for each class; • informative lessons given by Teen Parent Teachers, nurse practitioners, nutritionists, and guest speakers; • on-site private consultations with the nurse, family therapist and case manager; • transportation to WIC each month; • free childcare at the Infant Center located on the campus; • student participation in the Infant Center where the parent can learn quality child care techniques while spending time with their baby and providing their babies with nurturing care; and • specialized guest speakers on issues that meet the needs of teen parents (e.g., meetings with an attorney, ten life skills lessons, health issues, safety for the teen and child, etc.) • Job Training • A toy loan program • Maternity Closet Tracy Infant Center provides developmental care for 33 infants and toddlers. Top priority goes to the teen parents who go to school in the ABC Unified School District. The Cal-SAFE Program allows the parent to bring the baby to school to help the teen with continuing their education. The parent is also allowed to bring the baby to school the first few months after birth while the parent is waiting to get into the Infant Center or to make child care arrangements. When the baby is one month old and weighs at least 8 pounds, the baby may come to Tracy High School with the parent, but there are special rules that need to be followed. Babies need to go to the Infant Center or have other childcare by the time they are 4 months old.
Purpose of Program The Cal-SAFE Program is a comprehensive, integrated, community-linked, school-based program that serves expectant and parenting students and their children. The Cal-SAFE Program is designed to improve the student’s educational experience and increase the availability of support services for enrolled students, and provide child care and development services for their children. The program provides the first opportunity for local educational agencies throughout California to access sufficient resources to support a seamless, cost-effective service delivery system from point of entry into the program until graduation. The goal of the Cal-SAFE Teen Parent Program is to assist expectant and non-expectant teen parents to complete their high school education and receive a high school diploma. The Cal-SAFE Teen Parent Program offers information, education and services that will assist expectant and non-expectant teen parents through the process of parenthood. Services offered by the program include nutrition classes, meals to qualifying students, parenting classes, childcare, counseling services, and transportation. Data indicate substantive progress on the program goals established by the Legislature. Key outcomes include the following: • Over 75 percent of the students left the Cal-SAFE Program having successfully completed their high school education. This graduation rate for teen mothers far exceeds the 20 percent rate cited in the authorizing legislation as a deficit needing action. • Over 65 percent of the exiting students indicated that they would pursue further education or employment. Most planned to enroll in a local community college. • Overwhelmingly, students in the Cal-SAFE Program did not have a repeat birth or father a repeat pregnancy while enrolled in the program. Less than 3 percent of the students were expecting another child when they enrolled or exited the program. Less than 1 percent had a repeat pregnancy while enrolled in the program. • The vast majority of children born while their parents were enrolled in the Cal-SAFE Program were healthy. Only 7.29% weighed less than 2,500 grams at birth. Low-birth-weight is defined as an infant born weighing less than 5.5 pounds (2500 grams) regardless of gestational age. This percentage is lower than the national low birth weight rate of 13.8 percent for mothers under 15 and 9.9 percent for mothers aged 15 to 19. • Over 75 percent of the children of Cal-SAFE students attended a child care center sponsored by the Cal-SAFE Program and received programming and services based on their assessed developmental needs. Furthermore, 94 percent of the children enrolled in childcare sponsored by the Cal-SAFE Program were up-to-date on their immunization schedules. This percentage substantially exceeds the immunization rates for children 19 to 35 months nationally (82 percent) and in California (81 percent).

Clients and Stakeholders

The major stakeholders that are directly impacted by the Cal-SAFE Program, includes the teen parent, the child of teen parent, and the Tracy High School Cal SAFE Teen Parent Program staff. Other stakeholders include the State of California-Legislature funding through taxes, the families of the teens, and society in general.

Teen Parent
Overwhelmingly, the typical student served by the Cal-SAFE Program was a female, single, Hispanic, aged sixteen or seventeen, in the tenth or eleventh grade, still under the guardianship of her parents and living in a highly populated urban area rather than a moderately populated county or rural location. Furthermore, the typical Cal-SAFE Program student did not have a job nor was she seeking a job when she enrolled. Most students (97%) entered the program either pregnant or parenting but not both. If she was pregnant when she enrolled, the typical Cal-SAFE student entered the program during her second trimester. If she was parenting at entry, the typical Cal-SAFE student parented only one child to which she had given birth and/or a child for whom she held custody. If she gave birth to her child while in the Cal-SAFE Program, the typical student delivered a healthy baby 38 weeks after conception, began prenatal care in her first trimester, received prenatal care in a health care clinic, paid for her prenatal care through Medi-Cal, and spent 2.7 days in the hospital at delivery. Table 1 summarizes the characteristics of the typical student enrolled in Cal-SAFE. Table 1: Characteristics of Program Participants
|Characteristics |Typical |Pregnant when enrolled |Gave birth while in |Parenting when enrolled |
| |Student | |Cal-SAFE | |
|Age |16 or 17 |16 or 17 |16 or 17 |16 or 17 |
|Education |10th or 11th grade |10th or 11th grade |10th or 11th grade |10th or 11th grade |
|Gender |Female |Female |Female |Female |
|Ethnicity |Hispanic |Hispanic |Hispanic |Hispanic |
|Number of children |0 to 1 |0 |1 |1 |
|Marital Status |Single |Single |Single |Single |
|Living with |Parents |Parents |Parents |Parents |
|Living in |Urban area |Urban area |Urban area |Urban area |
|Employment |None |None |None |None |
|Trimester |n/a |2nd trimester |n/a |n/a |

Child Enrolled students may voluntarily enroll their children in child care and development services funded by the Cal-SAFE Program. There is no minimum age for enrollment, but infants must have a release from the pediatrician before enrollment. The average age of the infant for initial enrollment is between four to six weeks. Each child must have a health evaluation form signed by a physician, or his or her designee, before the child is allowed on the school campus or is enrolled in the child care and development program (Education Code Section 54746 [c]).

The child of a Cal-SAFE student is eligible for child care funded by the Cal-SAFE Program until the age of five years or until the child is enrolled in kindergarten, whichever occurs first. However, the teen parent must first be enrolled in the Cal-SAFE Program for the child to be enrolled.

As the Cal-SAFE Program serves the “school age family,” all eligible children of an enrolled parent must be served if child care is needed. If a child care center is able to serve only infants and toddlers, but child care is needed for a child age three or four years, it is the responsibility of the Cal-SAFE Program to work with the teen parent to locate appropriate child care until that child reaches age five years. Child care for the older child may be subsidized through the Cal-SAFE Program as long as the child is eligible. However, the child care provider serving the older child must meet Cal-SAFE Program requirements. The typical child born while the parent is enrolled in the Cal-SAFE Program: • is a boy • has a mother who lived in a densely populated county • has a normal birth weight • shows no evidence at birth of a serious medical condition or a developmental delay • remains in the hospital for just over one day after his birth • has a mother who planned to have him stay in child care center sponsored by the Cal-SAFE Program when she returned to school
The typical child of a Cal-SAFE Program student: • Is an infant under twelve months of age when the student parent enrolled • Is a boy • Is healthy with no serious medical condition • Is developmentally normal • Is very up-to-date on immunizations shots • Weighs within the normal range at birth • Stays at a child care center sponsored by Cal-SAFE while his parent(s) attends school • Lives in home where the household members spoke English as their primary language • Experiences a high level of involvement with both his parents
The typical child who attends a Cal-SAFE sponsored child care center: • Is an infant under the age of six months • Is a boy • Attends the center five das a week for 6.5 hours per day • Is very up-to-date on his immunizations shots. Program Staff

Tracy High School Cal-SAFE Teen Parent Program has three staff members who administers and/or provides information lessons for the Cal-SAFE Teen Parent Program in the ABC Unified School District. • The Child Development Teacher/Cal-SAFE Teen Parent program director assists expectant/parenting students and their guardians with personal and academic needs, manages the Tracy Infant Toddler Care Center. In addition, she provides support to all expectant teens currently enrolled in school. She provides monthly home visits and prenatal and parenting curriculum to enrolled students. • The Nurse Practitioner/Nutritionist provides service to all expectant students in our district with obtaining a medical home and prenatal care. She also provides Pre and post-natal education, labor and delivery education and support, nutrition education, nutritional supplements for pregnant and lactating teens, and referrals to medical, dental and other health care services • The Resource Teacher provides service to all students enrolled in the Cal SAFE program in ABC Unified school district. She assesses the needs of the students and makes appropriate referrals to supportive agencies. In addition, she monitors all student attendance and academic progress, provides support to all child care classroom staff, assists with transitions into preschool, enrolls children into the child care centers, and supports staff with curriculum. The program outsources to private sectors and consultants to provide additional support services to the students. (e.g., family therapy, case management, life skills, etc)

Funding source In 1995, the Legislature required the California Department of Education (CDE) to make recommendations for improving and expanding state-funded education programs for pregnant and parenting students, taking into considerations increased coordination of existing funding resources and programs. The CDE set forth the framework for the California School Age Families Education (Cal-SAFE) Program in the Pregnant and Parenting Student Program: A Report to the Legislature. Funding for this program is unrestricted pursuant to SBX3 4 (Chapter 12, Statutes of 2009), enacted February 2009. California Education Code (EC) Section 42605, added by SBX3 4, authorizing complete flexibility by a school district, county office of education, and charter school in the use of funds appropriated in the state budget for fiscal years 2008-09 through 2012-13 for numerous budget items, including the funds formerly restricted to the Cal-SAFE Program. School districts, county offices of education, and charter schools may now use the funds formerly restricted to this program for any educational purpose. Because this program is one of the “flexed” programs, the funds may be used for any educational purpose.
Extended family of Cal-SAFE students The extended family is the primary support for teen parents. Young pregnant or parenting unwed adults continue to live with their parents for an average of five years and they most often provide emotional support, housing, transportation, financial and childcare assistance for their child and grandchild (Bunting & McAuley, 2004). Some studies suggest that with good support from families, these young parents have an increased likelihood for positive parenting and child outcomes (Bunting & McAuley, 2004). The reality is, however, that these families are often stressed and unable to support
Purpose of the Evaluation A program evaluation will be conducted to determine the ongoing effectiveness of the Cal-SAFE Teen Parent Program at Tracy High School in increasing the number of teen parents and pregnant teens who receive program services for one or more years and earn a high school diploma or its equivalent. Through this evaluation the other area of outcome that will be addressed will be to determine whether students served will demonstrate effective parenting skills.

Literature Review

Many teen parent programs have implemented services to encourage pregnant teens to continue their education to graduate from high school. Evaluations of teen parent programs at the Teen Parent Demonstration (TPD) and the Project Redirection (PR) were reviewed.

Teen Parent Demonstration

From late 1987 through mid-1991, the States of New Jersey and Illinois conducted demonstrations of innovative approaches to reducing long-term AFDC dependency among teenage parents called the Teenage Parent Demonstration (TPD). With special grant funds from the U.S. Department of Health and Human Services (DHHS), the New Jersey Department of Human Services and the Illinois Department of Public Aid operated demonstration programs in three sites -- Camden and Newark, New Jersey, where the program was known as Teen Progress, and in the south side of Chicago, where it was known as Project Advance. All three programs provided comprehensive services designed to promote self-sufficiency, including education, job training, job readiness preparation and job placement, a variety of life skills workshops, support service payments for child care and transportation expenses, and case management. Thus, the demonstration provided a useful test of the range of services envisioned in the Family Support Act (FSA) of 1988 for custodial adolescent parents served by the Job Opportunities and Basic Skills Training (JOBS) program.
Evaluation Design

The evaluation design that was conducted was an experimental design with random assignment of almost 6,000 teens, split evenly between the treatment and control group. For evaluation purposes, half of the incoming teens were randomly assigned to receive regular services that the non-demonstration teens received (the control group) and the other half received the enhanced services (the treatment group). This in-depth study provided intensive, qualitative information about the experiences, characteristics, and problems of the young mothers in the demonstration and their efforts to deal with program participation requirements. The underlying question was: What is it about these young mothers' lives that drive them toward long-term welfare dependency, and what are the possibilities for diverting them from this path?

Data Collection Methods The study used various forms of data collection: focus group interviews; personal in-depth semi-structured interviews with program staff; program data; state records data; and case conferences with case managers and other program staff to discuss specific cases, probing deeply into areas that are difficult to tap through standard survey procedures. These areas included the motivations these young women have to become self-sufficient; their attitudes toward work, welfare, marriage, and child rearing; their expectations and goals for the future; the barriers they encounter in attempting to achieve those goals; and their patterns of response to the program obligations and services. The case reviews with program staff, and the two follow-up surveys of the teens were conducted. One conducted 2.5 years after the teens enrolled in the demonstration and the other 6.5 years after enrollment. The evaluator performed special studies on child care use and supply, in-home assessments of the parenting skills of the young mothers and the well-being of their oldest child, surveys of the case managers and site staff, and regular site monitoring visits.
Findings
The prospects for these young mothers were not promising without some form of intervention, judging by the experiences of those in the regular-services group. Two years after starting to receive welfare for themselves and their first child, 75 to 80 percent was still on welfare; 80 to 90 percent lived in poverty; over 50% had another child; only 10 to 25 percent had a job; fewer than 10 percent lived with a spouse or a male partner; and only 25% had regular contact with the fathers of their children. Poverty rates exceed 90 percent for those who did manage to get jobs. The benefits of participation in the demonstration programs included increased rates of school attendance, job training, and employment. The program-induced increases in employment was accompanied by earnings gains that, in combination with program sanctions, resulted in lower rates of dependence on public assistance. There was little or no measurable change in economic welfare, however, except for those who became employed. The hoped-for improvements in social and demographic outcomes generally were not observed. Also, the possible impacts on the children of these young mothers were not examined
Strengths of Evaluation Design

The strength of the design is that it was a properly designed and executed experiment which is the most effective way of testing for the effects of one variable upon another. Two powerful strengths of this method of research are: conditions other than the experimental variable that could affect the dependent variable are minimized, if not eliminated completely; and the experimental variable can be manipulated or controlled by the experimenter. Together, these conditions allow rigorous testing of causal hypotheses. These are hypotheses stating a cause and effect relationship. Experimental research also has other positive features. It can also be used to test the practical value of a new program, such as teaching techniques of family planning or for improving knowledge of nutrition.

Weaknesses of Evaluation Design

Since this was random assignment to experimental and control groups, this study was designed to generalize to the larger population. One of the main limitations of the experimental method used in this evaluation was the difficulty of meeting the requirements for both internal and external validity. Because this was a carefully controlled experiment, which is often high in terms of internal validity, it may have lower external validity. Another limitations is that a population of 6,000 is a very large size for an experimental and control group.

Project Redirection

The Project Redirection (PR) operates programs in Boston, New York, Phoenix, and Riverside. The Project Redirection was a national research demonstration to test an approach to helping pregnant teens and young mothers. It sought to enhance educational, job-related, parenting and life management skills of young pregnant or parenting women, most of who were on welfare. Features of the Project Redirection included: • the "Community Women Component" trained women from the community who served, for a small stipend, as mentors to 1 to 5 teenagers, for at least 5 hours per week for each teen • individual counseling • peer group sessions • on-site life management and employability components • referrals to other services, including health services and education • child care, transportation and recreational services; and • stipends for participation ($30 /month with deductions for unsatisfactory attendance) Participants in PR were adolescent girls age 17 or under who were: pregnant for the first time or mothers of young children; receiving or eligible to receive welfare and without a high school diploma or GED. In the main demonstration period, 1980 to 1982, four sites served 805 teenagers, 90 percent of whom were "ethnic minorities."

Evaluation Design

For the evaluation of this program they used a quasi-experimental design on a matched comparison group. Effects were measured through interviews of participants and members of a matched comparison group which are individuals in the matched comparison site who would have been eligible for the program if they were in that site. Interviews were conducted as one and two years using a sample size of 675 and five years using a sample size of 277 after participant enrollment. The five-year interview also examined outcomes for the children of the young women.

Data Collection Methods

For this particular program the data collection method used was interview and focus groups. The interview were conducted in person and questions posed in the interviews open-ended and responses were documented in full, through detailed note-taking. The purpose of the interviews is to gather detailed descriptions, from the sample group, of the program processes and the stakeholder’s opinions of the processes.

Findings

The Manpower Demonstration Research Corporation evaluation measured effects of PR on participants relative to a matched comparison group using responses to interviews conducted at one, two and five years. Evaluators found that: • One year after program completion, PR participants had better outcomes than comparison women. • At the two-year point, no gains were found for the average participant. However, more participants than comparison group members who were school dropouts at enrollment had obtained a diploma or GED (20 percent vs. 11 percent) and more program teens than comparison group members who were receiving AFDC payments at enrollment were employed (16 percent vs. 10 percent). Several positive outcomes were found for all participants five years after program enrollment. At the five-year point, relative to the comparison group, PR participants: • were more likely to be employed (34 percent vs. 28 percent) • were working more hours per week on average (13 hours vs. 9 hours) • had higher weekly earnings on average ($68 vs. $45) even when they had more than one child ($80 vs. $54 for 2 children, $46 vs. $24 for 3 children) • were less likely to be living in an AFDC household (49 vs. 59 percent), even though they were more likely to be in AFDC households at the two-year point • were providing their children with a more positive home environment, as measured on the HOME scale (means score of 44 vs. 40) • were more likely to enroll their children in Head Start (47 vs. 34 percent) • showed no difference in educational outcomes (percent in school/completed, percent with diploma/GED), overall household income, or birth control usage. • had higher weekly earnings ($76 vs. $37) • were less likely to be in AFDC households (57 vs. 71 percent)
Strengths of Evaluation Design

The strengths of utilizing quasi-experimental designs minimize threats to external validity as natural environments do not suffer the same problems of artificiality as compared to a well-controlled laboratory setting. Evaluations using these kinds of comparison groups can effectively test for the effects of program participation on outcomes under certain conditions. Since quasi-experiments are natural experiments, findings in one may be applied to other subjects and settings, allowing for some generalizations to be made about population. The main advantage of evaluations using matching methods are that they can draw on existing data sources and thus often quicker and cheaper to implement. Also, this experimentation method is efficient in longitudinal research that involves longer time periods which can be followed up in different environments.

Weaknesses of Evaluation Design

The main threat to internal validity of matching is the bias due to unobservable. Inference can only be made to a larger population (external validity) for which the treatment group is representative. Another threat to external validity is the fact that units with extreme values are discarded, in order to ensure common support which increases internal validity. This may further limit the possibility to generalize to a wider population. The principle disadvantages are that the reliability of the results is oftened reduced as the methodology may not completely solve the problem of selection biase; and the matching methods can be statistically complex, thus requiring considerable expertise is the design of the evaluation and in analysis and interpretation of the results.

Evaluation Design & Data Collection Method

Reason to Conduct a Program Evaluation

A program evaluation will be conducted to determine the effectiveness of the ABC Unified School District (ABCUSD) Cal-SAFE Teen Parent Program (CSTPP) at Tracy High School. The evaluation will measure two outcomes:
1) number of teen parents and pregnant teens receiving services for one or more years who earn a high school diploma or its equivalent; and
2) whether students served will demonstrate effective parenting skills

One independent variable in this evaluation is the participation in the Cal-SAFE Teen Parent Program and the dependent variable is the graduation rates. The other independent variable will be the method of instruction and the experimenter may manipulate this and the dependent variable will be the grades earned in the class.

There will be a statistically significant difference in graduation rates of teen parents who participate in the Cal-SAFE Teen Parent Program at Tracy High School as opposed to teen parents who do not participate in the Cal-SAFE Teen Parent Program at Tracy High School.

Evaluation Design

The design used to evaluate the ABC Unified School District Cal-SAFE Teen Parent Program at Tracy High School is a quasi-experimental study. The quasi-experimental design will use a pre and post test project to determine whether students served will demonstrate effective parenting skills. It will measure the information on parenting practices at the time the student entered into the program at Tracy High School and at completion of the program, and the same information from a similar group who did not participate in the program at Tracy High School. The program is implemented district wide and the comparison group will be on students who choose to stay at their home school.

This study will gather information pertaining to the number of students who earn their high school diploma or its equivalents using program records and surveys. With this research methodology, the evaluation would have control over the teen parents participating. Participants are assigned to focus groups through random assignment. Although the students volunteer for participation in the program most students are attending with the purpose of getting a high school diploma. Program staff at Tracy High School CSTPP collects data repeatedly, through surveys, on each participating student. Outcomes will be measured through the success in earning a high school diploma or its equivalent.

This quasi-experimental design has a relatively high degree of validity. Participants will be assigned randomly to the group that will receive intervention or to the group that will not receive intervention. The random assignment will ensure that the students of the intervention and comparison group are the same in terms of vital characteristics, such as age, race, characteristics, attitudes and any other factors that influence the outcomes of the Cal-SAFE Teen Parent Program.

The strength of the pretest-posttest is that it will allow measurements both before and after the intervention, and all comparisons between the impact on the program (experimental) group and the impact on the comparison group. The weakness of the pretest-posttest design with a comparison group is that it is not always feasible to randomly assign subjects to the experimental and/or control group. The evaluator will need to be able to maintain experimental conditions by minimizing the number of other programs introduced to the control group (minimize the effects of history and of design contamination).

As in experimental evaluation, plans for quasi-experimental evaluations need to pay close attention to the problem of collecting comparable information on comparison group members and developing procedures for tracking them. However, the need for close collaboration with program staff is reduced, since the staff is generally neither involved in selecting participants nor in daily contact with comparison group members.

Sample Selection

The target population of interest in this evaluation is Cal-SAFE teen parents who attend Tracy High School from the 2009-2011 school years. A school year typically begins in September and ends June of the following year. Being that the program is voluntary, students are able to enroll into the program anytime throughout the year and earn their high school diploma anytime throughout the school year.

The participants, ages 16 to 17, ranged in grade from tenth to eleventh. They are all either pregnant or had at least one child. The young women are involved in daily Cal-SAFE classes embedded within the Tracy alternative high school program or the student's home school in the ABC Unified School District. The classes are designed to provide support and information on a variety of topics that relate specifically to female teen parents.

Data Collection Method

Students will be randomly selected to participate in various classes of the program. The different classes in the program are a prenatal health class, a prepared childbirth class, a parenting I course and a parenting II course. The students also attend their regular general education required courses on the campus. Services begin at the time student enters the program which is usually during pregnancy.

The randomly selected group of teen mothers will be divided into two groups designed to be similar in age and other characteristics. Each group will be evenly divided among black, Hispanic, and white participants. One group attends an alternative school with child development and parenting classes and a nursery school featuring a parenting-child development curriculum. The comparison group attends their home school and receives information and services through one Teen Parent staff member who visits their school.

In order to compare student success in the Cal-Safe Teen Parent Program, student records will be analyzed to determine the percent of students who improved their parenting skills by receiving a passing grade in the course and comparing the pre and post surveys. A review of each student's record will be made to determine the percent of students who have earned their high school diploma or its equivalent.

Mixed methods of data collection from the GradStar Management Information System (MIS) will be used to gather quantitative and qualitative data. The first step of data collection will be to obtain a list of students who are enrolled in Cal-SAFE Teen Parent Program at Tracy High School. The program staff collects information via survey on each participating student. The major sources of data shared in the MIS are:

• Student Enrollment Form • Pregnancy Outcome Form • Prenatal Information • Child Care Enrollment Form • Student Entrance and Exit/Withdrawal Information • School Site Information • Demographic Information • School History • Information about student's partner (baby's/child's other parent) • Connections with other agencies • Support Services Received

The sample size is not more than 60 students in each group (program group and comparison group) because each of the four classes has a maximum of 30 students. It will be difficult to track the comparison group because students tend to exit the program at any given time. Reasons that students exit the program range from the positive such as graduation, to the negative, such as dropping out or miscarriage.

Evaluators will conduct a pretest on the students at the time of enrollment and posttest at the time of exiting the program. The pretest/posttest questions will focus on the level of support teens received in the program, the difficulties of having and raising children, and the relationship participants had with their parents. Examples of the questions include the following: What do you think the most challenging thing is or will be about having a baby? What do you think the best thing is or will be about having a baby?

The instrument used in the survey portion of the study will be a questionnaire that includes demographic information and information on the participants' educational goals. For the last part of the questionnaire, focus group interviews will be held during the day in a private room at the alternative high school and the home schools. All focus group sessions will be conducted by an evaluator trained in qualitative data gathering techniques. Each focus group will be approximately 45 minutes in length and will be audio taped. Specifically, participants will be asked to assess how good of a student they want to be, how much education they plan to attain, and what their education goals are.

The second part of the survey will be a quantitative data gathering and will ask participants to rate types and sources of support according to how helpful they were in helping them achieve their educational and career goals, which is adapted from a measure developed by Trivette, Dunst, and Deal (1994). A five-point Likert scale with response options ranging from (1) not very helpful to (5) very helpful will be used.

A strength in using surveys is that they are relatively inexpensive, especially if they are self-administered. Surveys are useful in describing the characteristics of a large population. There is flexibility at the creation phase in deciding how the question will be administered; face-to-face surveys or group administered surveys allow the evaluator to administer the survey either in person or from remote locations. Many questions can be asked about a given topic, giving considerable flexibility to the analysis. Lastly, instrument standardization ensures that similar data can be collected from both program and control groups, and then interpreted comparatively. A weakness of surveys is that they are inflexible in that they require the initial study design (the tool and administration of the tool) to remain unchanged throughout the data collection. The evaluator must ensure that a large number of the selected sample will reply. Also, it may be hard for participants to recall information or to tell the truth about controversial questions. As opposed to direct observation, survey research (excluding some interview approaches) can seldom deal with "context." Another challenge is that students may not want to fill out the surveys. If the student does not complete the survey and returned it, evaluators will not be able to analyze the opinions, attitudes and behaviors students have towards the program. Perhaps evaluators can contact students by phone and complete the surveys for them.

Analysis

Assessments of educational progress, knowledge, and child development will be based on pretests/posttests, surveys, and focus group interviews. In order to get a good analysis of the qualitative data the evaluator must understand the data by listening to the tape recordings and reading the text several times. The data gathered through the pretest/posttest must be organized in two approaches. One way will be by question to look across all respondents and their answers in order to identify consistencies and differences. The other way will be analyzed by focus groups and then analyzed as a whole.

After categorizing the data, the information will be coded based on themes or patterns and organized into coherent categories and subcategories. This will help in providing a descriptive name for each category. This may be labor-intensive because of the amount of data being collected. Table 1 shows examples of how categories and subcategories are identified to sort responses to the questions.

TABLE 1*
|Question |Categories |
| |Responses to the question are sorted into: |
|1. What makes a quality teen parent program? |Quality of Staff (Stf) |
| |Relevance to my life (Rel), participation (Part), |
| |timeliness (Time), |
| |Resources (Res), |
| |Support Services (SupSer), |
| |Content (Con) |

*Source: Evaluation in Social Work: The Art and Science of Practice, By Yvonne A. Unrau, Peter A. Gabor, Richard M. Grinnell: New York: Oxford University Press, 2007.

Table 2 describes a question about the benefits of parenting classes, data within the category benefits to teens might be broken into a number of subcategories.

TABLE 2*
|Question |Categories |
|What is the benefit of parenting classes in the Cal-SAFE Teen |Benefits to teen parents (TP) |
|Parent Program? |School performance (TP-SP) |
| |Knowledge (TP-K) Subcategories |
| |Self-concept (TP-SC) |
| |Role-modeling (TP-RM) |
| |Benefits to child (CH) |
| |Benefits to staff (S) |
| |Benefits to mentor (M) |
| |Benefits to family (F) |
| |Benefits to community (CO) |

*Source: Evaluation in Social Work: The Art and Science of Practice, By Yvonne A. Unrau, Peter A. Gabor, Richard M. Grinnell: New York: Oxford University Press, 2007.

Table 2 shows labeling of one open-ended question on an end-of session posttest. In this example, all responses are numbered and given a label to capture the idea(s) in each comment. Later, the data will be sorted and organized into their categories to identify patters and bring meaning to the responses.

There are numerous ways to analyze the data that will be collected. The main question to answer is: By participating in the Cal-SAFE Teen Parent Program did the program help teen parents graduate from high school? For this question, the independent variable is the program. The responses on the survey will indicate if the student had any experience with the program. The dependent variable is whether or not a student graduated from high school. The answers in the survey will indicate if the student had any exposure to the program and if the program caused them to graduate from high school. The data will be presented in a contingency table as shown in Table 3.
TABLE 3

|Participated in the |Graduated because of participation in the program |
|Cal-SAFE Teen Parent | |
|Program | |
| | |Yes |No |Total |
| |Yes | | | |
| |No | | | |
| |Total | | | |

The data from the five-point Likert scale will be analyzed based on the students expressing their opinions, attitudes and behaviors towards the program. Table 4 shows an example of a question for this evaluation. The Variable will be measured using a number of different scales. These scales help to generate quantitative data for the analysis.
TABLE 4
How helpful was the Cal-SAFE Teen Parent Program towards you earning a high school diploma?
|1 |2 |3 |4 |5 |
|Very helpful |Somewhat helpful |Neutral/ |Somewhat unhelpful |Not helpful |
| | |No opinion | | |

Limitations of Evaluation

The evaluation has limitations that program evaluators should be aware of. The lack of pretest data and access to the comparison group make it difficult to see if the program was a success. Pretest data could have shown if the Cal-SAFE Teen Parent Program played a factor in students becoming effective parents by comparing it to the posttest data gathered at completion of the program.

Having a comparison group can help to demonstrate if attending the Cal-SAFE TPP on Tracy High School campus or attending the home school has an impact on the student’s educational success.
Recommendations

While it is possible to identify strategies to assist teen mothers, a strategy to delay teenage childbearing is likely to have better overall outcomes. Such a strategy should involve many of the same elements as those aimed at teen parents: it should provide early assessments with appropriate treatments; it would emphasize education and training; and it would provide supportive services, delivered in the context of a long-term relationship. One successful program, the Teen Outreach Program, suggests the importance of preventative efforts focused on late childhood and early adolescence (Allen et al., 1994, 1997). Franklin and colleagues, (1997), in their meta-analysis of adolescent pregnancy programs, indicate that some programs are successful in increasing contraceptive use and decreasing pregnancy. However, the quality of the research showing the largest effects was generally judged to be poor, reducing confidence in the findings. It is important that states and localities create more effective incentives for educational investments among youth at risk for teen pregnancy and parenting. Programs, such as the Teen Outreach Program targeting middle school children can be effective in preventing both school dropout and teenage pregnancy.

References

Trivette, Dunst, Deal, Hamby, & Sexton. “5 Point Likert Scale.” (1994). http://www.friendsnrc.org/download/outcomeresources/toolkit/annot/frs.pdf

Maynard, R. and Rangarajan, A. "Contraceptive Use and Repeat Pregnancies Among Welfare-dependent Teenage Mothers." Family Planning Perspectives, 26(5): 198-205, 1994.

Constantine, N. A., & Nevarez, C. R. (2003). No time for complacency: Teen births in California. Berkeley, CA: Public Health Institute. Retrieved July 20, 2006, from http://teenbirths.phi.org/

Bender, K. (2004). California: Birth rate for teens in Berkeley a state low. Oakland Tribune, September 23, 2004, p. B1.

Get Real About Teen Pregnancy, California Adolescent Health Collaborative (2004). Teen birth rate declines, but challenges loom for California cities. 55 cities get “Reality Check.” Retrieved November 25, 2006, from http://www.letsgetreal.org/nr_RealityCheckCities_2004.htm

Bunting, L., & McAuley, C. (2004). Research Review: teenage pregnancy and motherhood: the contribution of support. Child and Family Social Work, 9, 207-215.

Unrau, Yvonne A., Gabor, Peter A. and Grinnell, Richard M. Jr. (2007). Evaluation in social work: The art and science of practice, 4th ed. New York: Oxford University Press.

Allen, J.P., Philliber, S., Herrling, S., & Kupermine, G.P. (1997). Preventing teen pregnancy and academic failure: Experimental evaluation of a developmentally based approach. Child Development, 68, 729-742.

Corcoran, J., Franklin. C., & Bell, H. (1997). Pregnancy prevention from the teen perspective. Child and Adolescent Social Work Journal, 14(5), 365-382.

Appendices
Table 1 shows examples of how categories and subcategories are identified to sort responses to the questions.
TABLE 1*
|Question |Categories |
| |Responses to the question are sorted into: |
|1. What makes a quality teen parent program? |Quality of Staff (Stf) |
| |Relevance to my life (Rel), participation (Part), |
| |timeliness (Time), |
| |Resources (Res), |
| |Support Services (SupSer), |
| |Content (Con) |
|2. What is the benefit of parenting classes in the Cal-SAFE Teen |Benefits to teen parent (TP), |
|Parent Program? |benefits to child (CH), |
| |benefits to staff (S), |
| |benefits to mentor (M), |
| |benefits to family (F), |
| |benefits to community (CO) |
|3. What do you need to continue your learning about early |Practice (P), |
|childhood development? |additional training (TRG), |
| |time (T), |
| |resources (R), |
| |feedback (Fdbk), |
| |mentor (M), |
| |uncertain (U) |

*Source: Evaluation in Social Work: The Art and Science of Practice, By Yvonne A. Unrau, Peter A. Gabor, Richard M. Grinnell: New York: Oxford University Press, 2007.

Table 2 describes a question about the benefits of parenting classes, data within the category benefits to teens might be broken into a number of subcategories.
TABLE 2*
|Question |Categories |
|What is the benefit of parenting classes in the Cal-SAFE Teen |Benefits to teen parents (TP) |
|Parent Program? |School performance (TP-SP) |
| |Knowledge (TP-K) Subcategories |
| |Self-concept (TP-SC) |
| |Role-modeling (TP-RM) |
| |Benefits to child (CH) |
| |Benefits to staff (S) |
| |Benefits to mentor (M) |
| |Benefits to family (F) |
| |Benefits to community (CO) |

*Source: Evaluation in Social Work: The Art and Science of Practice, By Yvonne A. Unrau, Peter A. Gabor, Richard M. Grinnell: New York: Oxford University Press, 2007.

The data will be presented in a contingency table as shown in Table 3.
TABLE 3
|Participated in the |Graduated because of participation in the program |
|Cal-SAFE Teen Parent | |
|Program | |
| | |Yes |No |Total |
| |Yes | | | |
| |No | | | |
| |Total | | | |

Table 4 shows an example of a question for this evaluation
How helpful was the Cal-SAFE Teen Parent Program towards you earning a high school diploma?
TABLE 4
|1 |2 |3 |4 |5 |
|Very helpful |Somewhat helpful |Neutral/ |Somewhat unhelpful |Not helpful |
| | |No opinion | | |

Findings

Demographics:
Just over 70% of the study group were females, 30% males. The majority (76%) were teens aged 14-17 years, and most of the remainder (24%) were aged 18 or older. The full age range was 18-19 years. The study group was very diverse: 37% Hispanic or Latino, 25% White, 17% African-American and 16% multi-racial.
(Tables 1a and 1b).

Table 1a: Demographic Characteristics of Participants FY 2009-2010 (N=65)

| |Number of Participants |Percent of Participants |
|Age Group |n=65 |p=100% |
|14-17 | | 76% |
|18-19 | | 24% |
| | | |
|Gender |n=65 |p=100% |
|Male | |70% |
|Female | |30% |
| | | |
|Race/Ethnicity |n=65 |p=100% |
|Hispanic | | |
|Black/African American | | |
|White | | |
|Other single race | | |
|Multiracial | | |

Table 1b: Overall Age-by-Gender
(percents are percent of total respondents (n= )

|Age Group |Males |Females |
|14-17 years | | |
|18-19 years | | |

Demographics within programs did vary somewhat (Table 1c). Tracy High School enrolled the highest percentage of Hispanic/Latinos. The home school programs enrolled the highest percentage of older-aged teens. Tracy High School had the highest enrollments of younger teens.

Table 1c: Demographics by Program Type

| |Tracy HS |Gahr HS |Cerritos HS |Artesia HS |
|#participants | | | | |
| | | | | |
|Male | | | | |
|Female | | | | |
| | | | | |
|14-17 | | | | |
|18-19 | | | | |
| | | | | |
|Hispanic | | | | |
|Black/African American | | | | |
|White | | | | |
|Other single race | | | | |
|Multiracial | | | | |

Table 2 presents the demographic characteristics of the youth who also completed the post-test survey (based on the linked subgroup). The percentage of females (%) and teens aged 14-17 years (%) and whites (%) were somewhat higher than for the entire pre-test group, however, the results were comparable (Table 1a vs. Table 2). This indicates that the relatively low follow-up rate of (%) was likely due to logistical issues at sites rather than biased follow-up. We assume, therefore, the post-test responses are representative of the responses we would have gotten had there been 100% completion of the post-tests. The average length of time between pre- and post-test was 65 days.

Table 2: Demographics of the linked pre/post test data set

|Age Group |Gender |Race/Ethnicity |
|14-17 years: % |Male |Hispanic/Latino |
|18-19 years: % |Female |Black/Af-Am |
| | |White |
| | |Other single race |
| | |Multiracial |

58 respondents (%) indicated they were "very satisfied" with the services they've received through the program thus far. An additional three respondents (%) indicated they were "somewhat satisfied" with the services received. Four respondents (%) indicated they were not satisfied with the program and provided the following explanations: "we need programs that help with cash", "driver's training money is needed", "we need help with child care services", "when Ms. C don't come, Ms. M does". and "treated like I'm/we're nothing".

Additional information stemming from the survey includes the following:
Length of time in program: % had been in the program less than one month, % had been in the program one to six months, % had been in the program seven to twelve months, % had been in the program more than one year, and % had been in the program more than two years.

Frequencies of meetings with nutritionist: % reported they meet (face-to-face) with the nutritionist more than once a week, % once every two weeks, % once every three weeks, and % once a month.
Enough contact with nutritionist: When asked if thy felt this was enough contact with the nutritionist, % indicated that it was, while % indicated it was, while % indicated it was NOT. In addition, % indicated it was too much and % "didn't know".

In addition, respondents were asked to indicate how helpful the Teen Parent Program has been in seven broad areas of service. The results appear in the table below:

|The Teen Parent Program helps |Helped me a lot |Helped me a little |I did not need |Did not help as |No Response |
|me with the following: | | |help |much as I needed | |
|find the community resources I|26 |20 |11 |3 |5 |
|need | | | | | |
|follow through with my |19 |11 | | | |
|employment goals | | | | | |
|follow through with my |23 |17 | | | |
|education goals | | | | | |
|learn about parenting and |27 | | | | |
|child development | | | | | |
|make responsible reproductive |18 | | | | |
|health decisions through | | | | | |
|information including | | | | | |
|sexuality and AIDS | | | | | |
|maintain well baby |21 | | | | |
|care/immunizations | | | | | |
|provides information about |11 | | | | |
|life options including | | | | | |
|marriage and adoption | | | | | |

Data collected by the Cal-SAFE Teen Parent Program revealed that, overall, % of participants, who were successfully located and contacted for data collection purposes, were involved in educational and parenting skills training. Two individuals had earned their GED certificate some time during the school year. Meanwhile, two individuals, who were working during the school year, were no longer in school, having earned a high school diploma or GED sometime during the school year.

|Month enrolled |Number successfully contacted |Involved in Education, Parent Skills Training, |
| | |and/or Employment Activities |
| |n |% |n |% |
|September 2009 | | | | |
|October 2009 | | | | |
|November 2009 | | | | |
|December 2009 | | | | |
|January 2010 | | | | |
|February 2010 | | | | |
|March 2010 | | | | |
|Overall Totals | | | | |

Ninety percent (90%) of the teen mothers who are pregnant at the time of program entry participated in prenatal care.

|Report Month/Year |Number Eligible for Child |Participation in Prenatal Care |
| |Development Education | |
| | |N |% |
| | | | |

Eighty-five percent (85%) of the teen parents and/or their children ages 0-3 years will be referred and/or receive child development and parenting education within three months of program entry.

1. Child Development Education:

|Report Month/Year |Number of pregnant at |Referral and/or receipt of service at|Referral and/or receipt of service |
| |program entry |intake within three months of program|beyond three months of program entry |
| | |entry | |
| | |N |% |N |% |
| | | | | | |

2. Parenting Education

|Report Month/Year |Number of pregnant at |Referral and/or receipt of service at|Referral and/or receipt of service |
| |program entry |intake within three months of program|beyond three months of program entry |
| | |entry | |
| | |N |% |N |% |
| | | | | | |

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-----------------------
-Students served will demonstrate effective parenting skills
-Students served who receive program services for one or more years will earn a high school diploma or equivalents
-Students in need of targeted supportive services related to school success will be served
-Children of enrolled teen parents will receive child care and development services based upon the assessed developmental and health needs of each child

Participation
-Babies in classroom

-Tasting of healthy foods

-Discussions with nurse practitioner

-Specialized Classes
Prepared Childbirth and Prenatal Health
Parenting I – Infants
Parenting II – Infants

-Independent Study

-Home visits by staff as needed

Activities
-Health Lessons
-Individual Consultations
-Group and Individual Therapy
-On campus care for infant
-Nutrition Demonstrations
-Ten life skill lessons
-Job Training
-Informative lessons given by Teen Parent Teacher, nurse practitioner, nutritionist, and guest speakers
-On-site private consultations with the nurse, family therapist and case manager

Program Resources
-Full-time teacher
-WIC
-Infant Center
-Nutritionist
-Case Manager
-Therapist
-Nurse Practitioner
-Guest Speakers
-Toy Loan
-Maternity Closet
-Helpline

Outcomes

Inputs

Processes

ABC Unified School District
Tracy High School Cal-SAFE Teen Pregnant Program

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...Infancy and Early Childhood Development Terrence O. Roberts PSY/375 March 30, 2015 11:59 pm Linda O'Connor Infancy and Early Childhood Development One’s early childhood and infancy are some of the most advanced periods of their lives. This development is beneficial to the child’s productive abilities in life. These developmental stages form a foundation for the child’s future learning and well-being. Elements that effect a child during their infancy and early childhood can hinder a child’s development. Particular elements such as one’s family as well as their parenting styles. Some parent’s style of raising children are more effective than other parents’ methods. There are also certain programs that have been developed to influence cognitive development. Family’s effect on Development One’s family and their influences affect them during infancy and early childhood more than any other period in their lives. If a child’s family is attentive, sensitive and responsive the child tends to develop better. Family’s show this during the child’s infancy and early childhood in manners such as a gentle reassuring touch, overheard conversation, and facial expressions which improves the speech of young children (Berger, 2011). Families are the first teachers for infants and young children. It’s this relationship between young children and their families that determine how they development. “Early relationships help infants developing...

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...the United Kingdom 3% of school aged children are identified as having a special education need associated with either a learning difficulty or an autistic spectrum disorder (National Statistics, 2012). Early detection by professionals is deemed to be of great importance as recognised in a recent government drive with health visiting (DoH, 2011). It is also important because studies have highlighted the substantial benefits that early intervention can offer to children with varying needs (Camilli et al, 2010; Anderson et al, 2003). Therefore despite the implementation of child health surveillance services (Mackrides & Ryherd, 2011; Hamilton, 2006), in clinical practice, children are not being detected before they start school. In the UK and in the student’s own area of clinical practice developmental screening is undertaken by health visitors as part of the Healthy Child Programme (HCP). It is viewed as the core health service for protecting, promoting and improving the health and well-being of children (Department of Health, 2009). A review of the literature shows two screening tools used in the UK, the Denver Developmental Screening Tool (DDST) and in the student’s practice area the Schedule of Growing Skills II which will be discussed further. The Schedule of Growing Skill toolkit is: • A researched based screening procedure to assess developmental milestones on children. The individual assessment can be used at any time...

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