ࡱ> mol @ ?bjbjPP 7F::'|||8<\ZX , , , , > J YYYYYYY$W\R^|Z] , , Z, , qZ=#=#=# (, , Y=# Y=#=#2ZTY, L p˃|'!@U.YdZ0ZV%_g!%_\Y4,h%_YpR "t =#  _R R R ZZd-# Beneficiary:  FORMTEXT       General Infant Development INTERVENTION LEVEL BASED ON RISK IDENTIFIER RISK INFORMATION  INTERVENTION EXPECTED OUTCOME (check all that apply)  FORMCHECKBOX  MODERATE  FORMCHECKBOX  HIGH  Age appropriate Bright Futures questions answered (BF2-BF15) and score is positive or ASQ-3 or ASQ:SE score suggests providing learning activities and monitoring ASQ-3 or ASQ:SE score indicates further assessment with a professional may be needed In addition to providing educational material as outlined in Part 1 of the Plan of Care and in addition to the completion of the ASQ-3 and ASQ:SE Questionnaires corresponding to the infants age: MODERATE: 1. Discuss: importance of attachment comfort level and confidence with caring for infant 2. Review the hallmarks of physical development of infants 3. Review the hallmarks of social/emotional development of infants: Cry, coo, smile Looks at faces Seeks comfort Shows excitement Turns to parent or caregiver when scared or unsure Calms down when hurt or upset when comforted by a familiar adult Is curious about new people and things around him Actively explores new places Likes to discover new things 4. Discuss what parents can do to support their infants social/ emotional development: Gently hold and cuddle infant often Respond to infants effort to communicate (eye contact, etc) Enrich infants routine (meal, bath and nap times) with stories, songs, etc. Take time to follow infants lead (join in floor time) Gently guide through social interactions Be sure expectations match what infant is socially/emotionally ready to do When infant is fussy or crying try to uncover real reason for behavior (e.g. scared, hungry, thirsty, cold, hot, etc.) Dont let infant witness family violence; dont allow anyone to physically abuse or use words to hurt infant Take care of own social-emotional health 5. Administer the ASQ-3 and ASQ:SE Questionnaires corresponding to the infants age (see age administration chart) HIGH: In addition to moderate interventions: 1. Assess for any increase in developmental risk: Resists holding Difficult to comfort Lack of vocalizations Dysregulation in sleep Poor weight gain Physical dysregulation (vomiting, diarrhea) Rarely seeks or maintains eye contact Lack of response to attempts to engage Extremely low activity level or tone 2. Arrange referral to additional supports (e.g.. Early On, Childrens Special Health Care Services, Infant Mental Health Specialist, etc.) 3. Advise regarding the importance of making all care appointments and following provider recommendations 4. Follow up with beneficiary to assure appointments are scheduled and kept 5. Assist with addressing barriers to access services  Screened using :  FORMCHECKBOX ASQ-3 at age appropriate intervals Date Outcome Achieved:  FORMTEXT        FORMCHECKBOX ASQ-SE at age appropriate intervals Date Outcome Achieved:  FORMTEXT       Information received and discussed:  FORMCHECKBOX  Social/emotional development Date Outcome Achieved:  FORMTEXT        FORMCHECKBOX  Physical development milestones Date Outcome Achieved:  FORMTEXT        FORMCHECKBOX  Received referral to appropriate community resources to assist with additional developmental testing Date Outc "68:DFL      2 @ B D r t    Ķxfxx#jh?OMh?OMCJUaJhC=,CJaJjhC=,CJUaJhIhC=,5CJ\aJhC=,5CJ\aJ hC=,5\hIhC=,5\h!GdhC=,5CJ\aJhC=,5CJ\aJjh?OMUmHnHujh!Ujh!Uhhh!5h!hC=,'JL   D t :::::PjPjsppsTTsTs $Ifgd= $$Ifa$gd=gd! !N<?t v x z | /)P)P)P$Ifkdt$$Ifl\*;(H,  t(0|;44 lap(| ~ PPPPsPPPPPPPPPPPPPPPPPPPPPPPPP$If         ! 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