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Developmental Screening and Enhancement Program

DESP team

Aug. 14, 2019 – My travels brought me to the Plaza to visit the Developmental Screening and Enhancement Program team. With 40 members, the DSEP group is one of the largest under the Developmental Services umbrella, and includes two managers, developmental specialists, behavioral specialists, an aide, and dedicated outcomes and administrative teams. Through grant funding and in partnership with the County of San Diego’s Child Welfare Services, DSEP’s staff members accomplish intensive and important work: helping kids from birth to age 6 who have an open CWS case connect with the developmental and behavioral support they need to overcome traumas and live their healthiest possible lives.

Once DSEP Manager Julie McCormack and the team greeted me, Julie provided me with an overview of how DSEP works with CWS. CWS contracts DSEP to perform developmental and behavioral screenings for all kids who are under the agency’s care and within the designated age range — usually covering about 2,000 cases every year. Specialists can visit a family member’s home or screen in a community-based setting with a child’s foster parents, family caregivers or birth parents, depending on each child’s unique situation. “Our screenings provide a snapshot of the child’s strengths and needs or concerns,” Julie explained. Once screening results are in, DSEP’s specialists recommend services and support networks that can help nurture the child’s healthy development, and can also assist in ensuring the child can access those services.

Filling my invisible backpack

To give me an in-depth picture of the trajectory of DSEP evaluation and care, the team had actually assigned me a story to follow during my visit, in which I played the role of a child. Before I set out on my journey, DSEP team members Esmeralda Alva and Erin Howard, who were acting as my caregiver and social worker, respectively, and Developmental Specialist Chelsea Tortona gave me an “invisible backpack” to carry with me. They explained the backpack, which contained a few blocks, symbolized the weight of trauma and stress the kids DSEP sees bear each and every day. I would also have blocks added during my experience to represent additional stressors, or removed when I benefited from the help DSEP and its partners provided. What a powerful statement! That really stuck with me, even after my visit was done.

My first stop was with Chelsea, and I underwent an initial screening with her and my “caregiver” present. Chelsea explained that her assessment would include three tools: a Health and Development Checklist, which would ask my caregiver questions about my medical history, eating and sleeping habits, growth, and their observations of my development and behavior; an Ages and Stages Questionnaire: Social-Emotional 2, or ASQ: SE-2, which would gauge how I related to myself and others; and an Ages and Stages Questionnaire 3, or ASQ-3, which would examine my growth and learning processes through play. After Chelsea worked with my caregiver to complete these evaluations, she explained she would tally scores, identify areas of strength and opportunity, and create an individual care plan. The ICP would be shared with my caregiver at Chelsea’s next visit, as well as with my social worker, and would include my results compared to developmental and behavioral benchmarks and an action plan to help enhance my growth.

Learning about the positive effects of infant massage

A fictional week later, Chelsea paid me and my caregiver a follow-up visit to go over my ICP. Chelsea had pinpointed some areas of concern surrounding my communication, fine and gross motor, problem-solving, and personal-social skills, and had also taken my caregiver’s worries and challenges into consideration. She recommended some activities my caregiver could do with me at home to bolster my development, and also suggested she learn infant massage to help me relax and better bond with her. Infant massage is a tool the DSEP team frequently recommends, and Developmental Specialist Manny Sanchez-Curtis stepped in to demonstrate and explain a bit more about the process.  I learned that infant massage can help build emotional bonds between babies and their caregivers, balance the nervous system, and, in cases where injuries are involved, soothe pain or muscle stiffness. I was pleased to see how the team uses evidence-based tools to form well-thought care plans that include a variety of techniques and approaches — so important to addressing every unique scenario they see.

We then moved on to my Child and Family Team meeting. These two-hour meetings are a part of all CWS cases, and can include many stakeholders, ranging from social workers and developmental specialists to caregivers. One member of the DSEP team said they had been to a CFT meeting with almost 40 attendees. I learned that DSEP facilitates about 50 CFT meetings every week — wow — and that the meetings can take place at caregivers’ homes, DSEP offices or more neutral public spaces. Developmental Specialist Nina Comforti described what typically goes on in these sessions: discussing what is and isn’t working well for the child and their family or caregivers, addressing areas of concern, outlining updated action plans and assigning accountability for various tasks, and setting timelines to ensure the child gets the care they need, right when  they need it. The level of detail is incredible, especially considering the DSEP team tackles about 26,000 each year!

Next, we visited Behavior Specialist Viviana Vasquez, who offered some additional support strategies for my caregiver. Viviana explained that this kind of meeting is common during the DSEP process, and generally includes four to 12 visits, depending on what the caregiver needs to successfully nurture the child’s specific goals. From there, I was connected with a few more key services, as dictated by my ICP, and my case with DSEP was complete — I had access to every recommended support system.

Stamp in and hats on!

I returned to Patrick mode to receive a stamp in my passport and a DSEP team hat, which I proudly donned to match the rest of the group.  My thanks to each and every one of you for the compassion, professionalism and expertise you exhibit in your roles, and for making Rady Children’s a trusted partner in helping kids recover from trauma.