eNotes on Developmental Screening
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Developmental Screening and Referral: Early Head Start and the Program for Infants and Toddlers with Disabilities (Part C of IDEA)
This flyer, developed by OSEP, describes ways Early Head Start and the Individuals with Disabilities Education Act (IDEA) Part C early intervention programs can best collaborate to identify, screen, refer, and serve infants and toddlers suspected of having a delay or disability and their families. Federal, local and technical assistance resources are also provided.
CDC's Milestone Tracker App - Now Available in Spanish
The CDC recently made its Milestone Tracker app available in Spanish (October 2018). This free mobile app includes resources made available through the Learn the Signs Act Early program. The app has a user friendly interface and helps parents track their child's developmental progress from ages 2 months through 5 years with milestone checklists, photos, videos and reminders for appointments and developmental screenings.
Children with Heart Conditions Have Special Healthcare Needs
According to a recent study by the CDC (September 2018), children with a heart condition are more likely to have special healthcare needs than those without a heart condition. These include medication needs, physical or speech therapy, and/or treatment for developmental or behavioral challenges. The study also encourages developmental screening, so that children with heart conditions can acquire the necessary services and support.
Parent Participation in Early Intervention
Parent involvement is key for making the necessary decisions about early intervention services for children. This list of resources for parents and early intervention providers recently compiled by CIPR (December 2017) offers information and strategies for supporting parent participation in developmental screening, identifying appropriate services to best meet the child's needs, and staying informed about your (parents') rights.
Developmental/Autism Spectrum Disorder Screening Resources
Developmental screening is an important step in state efforts to ensure effective system-wide programs for screening, referral, care coordination, and access to evidence-based services to meet the needs of children and families. The State Public Health Autism Resource Center (SPHARC) has developed a set of Developmental/Autism Spectrum Disorder Screening Resources, to assist state Title V Maternal and Child Health Programs (MCH) programs in their efforts to bring together stakeholders from many sectors and programs to develop and implement effective system-wide developmental screening services. The set includes resources for Title V action planning, a case study of one state's Title V action plan, a scan of federal and national programs that have a specific objective/measure around developmental screening, and a matrix of which states have had grant or technical assistance programs related to developmental and autism screening.
Child Health USA 2014 Now Online
The MCHB has published its annual report on the health status and service needs of America's children. Child Health USA 2014 provides summaries of data on over 50 health-related indicators and addresses long-term trends. This year's report finds that the proportion of children aged 10-71 months receiving a standardized developmental screening increased from 19.5% in 2007 to 30.8% in 2011-2012. Additionally, among children 6 months-5 years of age, 73.2% were reported to usually or always exhibit 4 age-specific behaviors associated with flourishing (curiosity, resilience, attachment to caregivers, and positive affect). Only 47.7% of school-aged children were reported to usually or always exhibit 3 age-specific flourishing behaviors (curiosity, resilience, and self-regulation). The report allows users to define their own queries and view data by multiple sociodemographic and health-related characteristics.
New Report on Screening for Behavioral and Emotional Problems
The American Academy of Pediatrics (AAP) has published a new report, Promoting Optimal Development: Screening for Behavioral and Emotional Problems (Pediatrics, published online January 26, 2015, doi: 10.1542/peds.2014-3716). The report reviews the prevalence of behavioral and emotional disorders in children and discusses factors affecting the emergence of such problems; the importance of developmental screening and intervention; barriers to screening and strategies to overcome those barriers; and potential changes at the practice and systems level to facilitate successful behavioral and emotional screening. The report includes an appendix highlighting screening instruments that can be used in primary care settings for different age groups, including young children aged 0-5.
When Brain Science Meets Public Policy: Strategies for Building Executive Function Skills in the Early Years
The Institute for Child Success recently published a new brief, When Brain Science Meets Public Policy: Strategies for Building Executive Function Skills in the Early Years (January 2015). The brief discusses the importance of executive function and self-regulatory skills in early childhood, the developmental course of these skills, the critical role of early caregivers, and recommendations to support the development of these important skills. Some of the recommendations include: adopt a two-generation approach to policy and practice; invest in programs and practices that strengthen adult caregiver capacity; use place-based, public-private strategies and tools; and expand early developmental screening, practices, and interventions.
State Strategies to Support Developmental Screening in Early Childhood Settings
A new brief from the Center for Law and Social Policy (CLASP), First Steps for Early Success: State Strategies to Support Developmental Screening in Early Childhood Settings (October 2014) explores the role of child care and early education programs in connecting children to developmental screening, as well as national efforts and funding streams to support developmental screening and its relationship to early childhood. The brief includes state policy examples and recommendations stakeholders can draw on when considering how to expand access to developmental screening in early childhood settings.
New CDC Reports on Developmental Screening of Young Children in the U.S.
A new supplement of the Morbidity and Mortality Weekly Report (MMWR) from the Centers for Disease Control and Prevention (CDC) focuses on Use of Selected Clinical Preventive Services to Improve the Health of Infants, Children, and Adolescents - United States, 1999-2011. The supplement includes a number of reports on developmental screening of young children in the United States, including for example:
- Early Hearing Detection and Intervention Among Infants - Hearing Screening and Follow-up Survey, United States, 2005-2006 and 2009-2010
MMWR, September 12, 2014, 63 (No. Suppl 2); 20-26
- Screening for Developmental Delays Among Young Children - National Survey of Children's Health, United States, 2007
MMWR, September 12, 2014, 63 (No. Suppl 2); 27-35
- Lead Screening and Prevalence of Blood Lead Levels in Children Aged 1-2 Years - Child Blood Lead Surveillance System, United States, 2002-2010 and National Health and Nutrition Examination Survey, United States, 1999-2010
MMWR, September 12, 2014, 63 (No. Suppl 2); 36-42
- Vision Screening Among Children Aged <6 Years - Medical Expenditure Panel Survey, United States, 2009-2010
MMWR, September 12, 2014, 63 (No. Suppl 2); 43-46
Six by '15 Campaign Invites Contributions from the Field
The Association of University Centers on Disabilities (AUCD) recently announced a new Six by '15 Campaign, which celebrates 25 years of the Americans with Disabilities Act (ADA) and 40 years of Individuals with Disabilities Education Act (IDEA). The campaign has six overarching goals that its founding partners and endorsers hope to achieve by the end of 2015 to directly improve the lives of people with disabilities across the country. The early childhood goals of the campaign are:
- At least six states increase by 15 percent the proportion of children ages 0-3 who receive recommended developmental screening.
- At least six states commit to improving cross-system information exchange that supports access to services for children identified by screening.
The AUCD invites contributions to the content of the Sixby15 Campaign website with updates on efforts that are being made at the state and regional level toward these goals. Everyone is invited to contribute! Updates can be sent to Adriane Griffen at email@example.com
The Health and Well-Being of Children, NSCH 2011-2012 Chartbook
The Maternal and Child Health Bureau recently published its latest chartbook of findings from the National Survey of Children's Health (NSCH). The Health and Well-Being of Children: A Portrait of States and the Nation 2011-2012 (June 2014) reports that overall 73.2% of young children (aged 6 months-5 years) met all of the survey's criteria for flourishing. The parents of 30.8% of children aged 10 months-5 years reported that they received a standardized developmental screening. Children with low household incomes were most likely to receive early intervention and special education services. Of children from age 1 until 3 years, 3.1% received early intervention services, while 6.6% of children from age 3 until age 6 received special education services. Boys were more likely to receive special education services than girls (8.3% versus 4.8% for preschool-aged children). The concerns of the parents of 26.2% of children aged 4 months to 5 years indicated that their child is at moderate or high risk of developmental delay.
New Initiative - Birth to 5: Watch Me Thrive!
The Departments of Health and Human Services (HHS) and Education (ED) have launched a new collaborative initiative, Birth to 5: Watch Me Thrive!. The initiative will help families look for and celebrate milestones; promote universal screenings; identify delays as early as possible; and improve the support available to help children succeed in school and thrive along side their peers. Birth to 5: Watch Me Thrive! resources include:
- A list of research-based developmental screening tools appropriate for use across a wide range of settings;
- Guides on how to use the screeners for a variety of audiences, from early learning teachers to doctors, social workers, and families;
- Toolkits with resources and tip sheets;
- Guidance on finding help at the local level; and
- A screening passport that allows families to track a child's screening history and results.
2013 State of States' Early Childhood Data Systems
The Early Childhood Data Collaborative recently released The 2013 State of States' Early Childhood Data Systems (February 2014), a new report of findings based on a survey of 50 states and the District of Columbia, assessing the coordination of their early childhood data systems. The survey was completed by state education, health, and social services program staff. It focused on these three key aspects of state data systems:
- Do states have the ability to securely link child level data across early care and education (ECE) programs and to other state data systems, including K-12, health, and social services?
- Do states collect developmental screening, assessment, and kindergarten entry data to examine children's developmental status and service needs?
- Do states have an ECE data governance structure designated to support the development and use of a coordinated longitudinal ECE data system?
Findings show that although federal and state agencies do collect data on an array of ECE programs, Pennsylvania is the only state that links child-level data across all programs and to the state's K-12 data system. Twenty-six states can link child-level data between at least two publicly funded early care and education programs. To learn more, see the full report.
New Policy Brief on Improving Access to Early Identification and Intervention
The ZERO TO THREE Western Office recently published a new policy brief, Improving Access to Early Identification and Intervention: 211 LA County Developmental Screening and Care Coordination (2013). The brief describes the 211 LA County telephone-based developmental screening and care coordination program and provides policy recommendations for expanding and replicating the model. A discussion of the research supporting universal developmental screening is also included.
Resource List for 2013 Early Childhood Comprehensive Systems (ECCS) Grant Opportunity
The ZERO TO THREE Policy Center has created a resource list to help states think through some strategies they could pursue through the 2013 Early Childhood Comprehensive Systems (ECCS) grant opportunity. The ECCS grant program helps states build early childhood service systems that better meet the needs of children and families. This year's grant provides states with an opportunity to make improvements that will specifically benefit infants and toddlers through one of three strategies:
- Mitigation of toxic stress and trauma in infancy and early childhood across multiple systems; or
- Coordination of the expansion of developmental screening activities in early care and education settings statewide; or
- Improvement of state infant-toddler child care quality initiatives by incorporating Caring for Our Children, 3rd ed. standards into state licensing standards, QRIS, and/or professional development.
The 2013 ECCS grant application was posted on March 1, 2013. Applications are due on April 26, 2013.
2011-2012 Data from the National Survey of Children's Health (NSCH) Now Available
New 2011-2012 data from the National Survey of Children's Health (NSCH) are now accessible on the Data Resource Center for Child and Adolescent Health (DRC) Web site. Browse the data here (to view state specific data, select a state in the far right column). See also, fast facts about the survey. Some nationwide highlights include:
- Premature Birth: Nearly 12% of US children have parents who report they were born premature, ranging from 8.5% to 15.7% across the states.
- Developmental Screening: Nearly 31% of young US children are reported to have received standardized developmental screening. Ranging from 17.5% to 58.0% across the states.
- Developmental Risk for Young Children: Over 1 in 4 US children under age 6 meet criteria for risk for developmental problems or delays. This ranges from 18.0% to 33.2% across the states.
Effectiveness of Developmental Screening for the Identification of Developmental Delays
PolicyLab at The Children's Hospital of Philadelphia recently published data from the Translating Evidence-based Developmental Screening (TEDS) study, the largest study to date to confirm the feasibility and effectiveness of standardized developmental screening in urban primary care settings. See Effectiveness of Developmental Screening in an Urban Setting, Pediatrics, published online December 17, 2012, doi: 10.1542/peds.2012-0765. Some key findings include:
- Standardized developmental screening is feasible in a busy, urban primary care practice and effective in identifying developmental delay.
- Children were almost twice as likely to be identified with delay if screened using a standardized tool; however standardized developmental screening was not sufficient to ensure that children received needed services.
- Only 58% of children identified with delay were given a referral for Early Intervention services and only 50% of referred children completed a multi-disciplinary evaluation, required to determine eligibility for services.
Last summer, eNotes highlighted PolicyLab's Evidence to Action brief, SERIES: An Integrated Approach to Supporting Child Development (2012), which discusses the need to promote a more coordinated approach to ensuring that children with identified developmental needs are linked to appropriate services.
An Integrated Approach to Supporting Child Development
PolicyLab at the Children's Hospital of Philadelphia has published a new Evidence to Action brief, SERIES: An Integrated Approach to Supporting Child Development (Summer 2012), which discusses the need to promote a more coordinated approach to ensuring that children with identified developmental needs are linked to appropriate services. The brief proposes the adoption of the SERIES paradigm of developmental screening, in which each step - Screening, Early identification, Referral, Intake, Evaluation, and Services - is viewed not as an isolated activity, but rather as an integral component of a single process.
Promote Access to Early, Regular and Comprehensive Screenings
CLASP has released a new resource that highlights research supporting the importance of early and regular health, mental health, and developmental screening for infants and toddlers. It includes policy recommendations to help states improve their screening rates. Promote Access to Early, Regular and Comprehensive Screenings (February 2012) is part of the "Charting Progress for Babies in Child Care" project at CLASP.
Trends in the Use of Standardized Tools for Developmental Screening in Early Childhood: 2002-2009
Findings from a new study show that pediatricians' use of standardized screening tools increased from 23% to 48% between 2002 and 2009, which is good news considering the importance of developmental screening in early identification, evaluation, and intervention. However, the percentage remains less than half of respondents who work with children under the age of 3, suggesting that additional research needs to be done to identify barriers to the use of standardized screening tools in practice. An abstract is available at http://pediatrics.aappublications.org/content/early/2011/06/23/peds.2010-2180.abstract
Full citation: Radecki, L., Sand-Loud, N., O'Connor, K. G., Sharp, S., Olson, L. M. (2011). Trends in the Use of Standardized Tools for Developmental Screening in Early Childhood: 2002-2009. Pediatrics. Published online June 27, 2011. doi: 10.1542/peds.2010-2180
State Early Care and Education Public Policy Developments for Fiscal Year 2011
The National Association for the Education of Young Children (NAEYC) has published a report that provides a recap of public policy developments in states for Fiscal Year 2011 in a number of early childhood areas, including for example: State Early Childhood Advisory Councils, Governance, Professional Development, Data Systems, Quality Rating and Improvement Systems, Child Care Subsidies and Regulations, Developmental Screenings, Early Intervention, Autism, Early Childhood Mental Health, Home Visiting and more. It is available online at http://www.naeyc.org/files/naeyc/file/policy/state/State%20ECE%20Public%20Policy%20Developments%202_11_2.pdf
Improving the Lives of Young Children: The Role of Developmental Screenings in Medicaid and CHIP
The Urban Institute recently published a brief entitled Improving the Lives of Young Children: The Role of Developmental Screenings in Medicaid and CHIP (December 2010), by Genevieve M. Kenney and Jennifer Pelletier. The brief looks at how increased developmental surveillance and screening of young children eligible for Medicaid and CHIP could facilitate early identification of health, developmental and behavioral problems and increase referrals to early intervention. Some steps states can take to address the problem are included. It is available at http://www.urban.org/publications/412275.html
Implementing Developmental Screening and Referrals: Lessons Learned From a National Project
In 2006, the American Academy of Pediatrics (AAP) released a policy statement on developmental surveillance and screening that included an algorithm to help pediatric practices implement the new recommendations. Recent findings from a pilot project show that although doctors screened more children for developmental delays after the policy statement was issued, they did not consistently refer children suspected of having delays to early intervention programs and had difficulty tracking the referrals they did make. Additionally, many families did not follow through with recommended referrals. To learn more, go to http://pediatrics.aappublications.org/cgi/content/abstract/peds.2009-0388v1
Citation: King, Tracy M., Tandon, S. Darius, Macias, Michelle M., Healy, Jill A., Duncan, Paula M., Swigonski, Nancy L., Skipper, Stephanie M., & Lipkin, Paul H. (2010). Implementing Developmental Screening and Referrals: Lessons Learned From a National Project. Pediatrics, Published online January 25, 2010. (doi:10.1542/peds.2009-0388)
Using Community Care Networks to Improve the Childhood Developmental Screening Delivery and Referral Services
A new Commonwealth Fund brief examines the key elements of North Carolina's Assuring Better Child Health and Development (ABCD) program that have resulted in fewer children entering school with unrecognized or untreated developmental problems. Some of these include: identifying standardized screening tools and teaching physicians to implement them without disrupting the workflow of their practices; building providers' knowledge of referral agencies; helping providers develop processes for tracking cases; and enhancing providers' relationships with community agencies. The brief, North Carolina's ABCD Program: Using Community Care Networks to Improve the Delivery of Childhood Developmental Screening and Referral to Early Intervention Services (2009), is available online at http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2009/Aug/1312_Klein_North_Carolina_ABCD_using_community_care_ib.pdf
Newly Released National Survey of Children's Health
The Child and Adolescent Health Measurement Initiative (CAHMI) has just published the results of its 2007 National Survey of Children's Health (NSCH). The survey provides state-level data on over 100 child health indicators, including a number of questions related to early childhood, risk for developmental delays, children with an IFSP/IEP (0-5 years) and more. See Survey Section 6. The survey results can be searched in a variety of ways at http://www.childhealthdata.org/content/Default.aspx. Some quick links of interest include:
- State Ranking Map: Risk of Developmental or Behavioral Problems - http://nschdata.org/Rankings/RankingMap.aspx?item=07_ind2_2chbk
- State Ranking Map: Developmental Screening - http://nschdata.org/Rankings/RankingMap.aspx?item=07_ind4_16.
- State Ranking Map: Reading to Young Children - http://nschdata.org/Rankings/RankingMap.aspx?item=07_ind6_7chbk
- State Ranking Map: Safety of Child in Neighborhood - http://nschdata.org/Rankings/RankingMap.aspx?item=07_ind7_2chbk
Findings from the Assuring Better Child Health and Development (ABCD) Screening Academy
In 2007, 19 states, Puerto Rico and the District of Columbia formed the Assuring Better Child Health and Development (ABCD) Screening Academy, with support from the National Academy for State Health Policy (NASHP). Their aim is to improve the identification of children with or at risk for developmental delays. NASHP has recently released the following new policy briefs, which examine some of the findings from the ABCD Screening Academy. They were produced with the support of the Commonwealth Fund.
- State Policy Improvements that Support Effective Identification of Children At-Risk for Developmental Delay (March 2009)
Summarizes strategies used by ABCD Screening Academy members to improve state policies designed to support primary care providers' use of a validated developmental screening tool as part of well-child care. Examples include changing state statutes, regulations, contracts and provider manuals, and changing eligibility and claims processing systems.
State Strategies to Support Practice Changes that Improve Identification of Children at Risk for or with Developmental Delays (March 2009)
Describes approaches used by ABCD Screening Academy members to support providers as they worked to improve developmental screening in primary care. Examples include serving as a trusted source of information, providing funding and direct support, and facilitating access to follow-up services.
- Measurement to Support Effective Identification of Children at Risk for Developmental Delay (April 2009)
Examines the efforts of ABCD Screening Academy members to collect and use meaningful data in order to make the case for change, develop and refine training targeted to primary care provider needs, and assess whether changes had the intended effect.
Guidance in Choosing Developmental Screening Instruments
The Commonwealth Fund has released a new manual entitled Pediatric Developmental Screening: Understanding and Selecting Screening Instruments, by Dennis Drotar, Terry Stancin, and Paul Dworkin. It is based on a comprehensive review of scientific research and is meant to assist providers in selecting and using screening instruments that are appropriate for their practice settings. It is available online at http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=614864
Research Report on Developmental Surveillance and Screening in Primary Care
The Commonwealth Fund has published a report entitled Developmental Screening in Primary Care: The Effectiveness of Current Practice and Recommendations for Improvement, which finds that developmental delays in early childhood are significantly under-identified by primary care providers. The author suggests that financial, educational, and other barriers to physicians' use of developmental screening tools need to be addressed. The report is available at http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=605625
Applications Available - Improvement Partnerships, Phase Two
The mission of the Improvement Partnerships Initiative, supported by the Commonwealth Fund and the Vermont Department of Health, is to build state and regional capacity for the improvement of health care for all children, with a focus on developmental screening and surveillance for young children. To date, five states/regions (RI, NY, WA, AZ, DC) selected during Phase I have successfully launched Improvement Partnership programs. Complete information and applications for Phase II are now available online at http://www.nichq.org/NICHQ/Programs/CollaborativeLearning/ImprovementPartnership.htm [Note: Link checked on 11/26/2007 - this document is no longer available online]
Intent to Apply due: March 8, 2007
Application due: March 27, 2007
Recent Grant Notices Related to Early Childhood / Special Needs
The following grant notices were recently published online at http://www.grants.gov:
Agency: Social Security Administration
Title: Early Identification and Intervention
Posted Date: February 01, 2007
Summary: This funding will support projects that design and implement effective, replicable, and sustainable models which will increase the number of children (birth to age 5) who receive developmental screening and improve the early identification of children with developmental delays and/or disabilities.
Application Receipt/Submission Deadline: March 14, 2007.
Additional information: http://www.ssa.gov/oag/grants/current/opdr-07-1/
Agency: Administration for Children and Families (ACF)
Title: Head Start Graduate Student Research Grants
Summary: These funds are provided to support dissertation research by advanced graduate students who are working in partnership with Head Start programs.
Application Receipt/Submission Deadline: May 01, 2007
Additional Information: http://www.acf.hhs.gov/grants/open/HHS-2007-ACF-OPRE-YR-0068.html [Note: Link checked on 11/26/2007 - this document is no longer available online. For other ACF grant opportunities go to http://www.acf.hhs.gov/grants/ ].
Agency: Administration for Children and Families (ACF)
Title: Head Start University Partnership Research Grants: English Language Learners (ELLs) in Head Start and Early Head Start Programs
Summary: These grants will provide funding for research that either develops and/or rigorously evaluates interventions and assessments for ELLs or gathers information about associations between school readiness, culture, and language that will directly inform Head Start policy and practice.
Application Receipt/Submission Deadline: May 3, 2007
Additional Information: http://www.acf.hhs.gov/grants/open/HHS-2007-ACF-OPRE-YF-0070.html [Note: Link checked on 11/26/2007 - this document is no longer available online. For other ACF grant opportunities go to http://www.acf.hhs.gov/grants/ ].
Revised AAP Policy Statement - Identifying Infants and Young Children With Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening
This revised policy statement, published in the July issue of Pediatrics, provides an algorithm as a strategy to support health care professionals in developing a pattern and practice for addressing developmental concerns in children from birth through 3 years of age. The authors recommend that developmental surveillance be incorporated at every well-child preventive care visit. Any concerns raised during surveillance should be promptly addressed with standardized developmental screening tests. In addition, screening tests should be administered regularly at the 9-, 18-, and 30-month visits. For more information go to http://pediatrics.aappublications.org/cgi/content/full/118/1/405
Council on Children with Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee, & Medical Home Initiatives for Children with Special Needs Project Advisory Committee. (2006). Identifying infants and young children with developmental disorders in the medical home: An algorithm for developmental surveillance and screening. Pediatrics, 118(1), 405-420.
Setting the Stage for Success: Implementation of Developmental and Behavioral Screening and Surveillance in Primary Care Practice
This article, published in the July issue of Pediatrics, presents strategies for integrating developmental screening into pediatric offices. The strategies are drawn from lessons learned in North Carolina, which has developed a comprehensive system to significantly increase screening rates. For more information go to http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=381569
Earls, M. R., & Hay, S. S. (2006). Setting the stage for success: Implementation of developmental and behavioral screening and surveillance in primary care practice. Pediatrics, 118(1):e183-e188.
New Bibliography on Child Developmental Screening
The MCH Library has produced a new online bibliography on Child Developmental Screening. It contains 26 items taken from the MCH Library online catalog. Materials were selected in collaboration with The Commonwealth Fund's research project "Linking Pediatric Developmental Care to Community Resources." The bibliography includes selected materials published primarily in 1996 or later. Go to http://188.8.131.52/MCH_library/AZresources.html#D and scan down to Developmental Screening.