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Developmental Surveillance and Screening
Provider Information
Surveillance |Screening | Tools | Resources | Educational Initiatives
Did you know?
- 20% of all visits to the pediatrician's office are developmental or behavioral in nature.1
- 80% of parental concerns are correct
and accurate.1
One of the primary goals of routine preventive health care
is to ensure that a child is developing normally.2
The American Academy of Pediatrics recommends developmental surveillance at every well-child visit and developmental screening using formal, validated tools at 9, 18, and 30* months or whenever a parent or provider concern is expressed. Surveillance and screening activities should be performed within the medical home and coordinated with tracking and intervention services available in the community.3
Developmental Surveillance
Surveillance is the process of recognizing children who may be at risk of developmental delays. Developmental surveillance is a flexible, longitudinal, continuous, and cumulative process whereby knowledgeable health care professionals identify children who may have developmental problems. There are 5 components of developmental surveillance:3
- Eliciting and attending to the parents’ concerns about their child’s development
- Documenting and maintaining a developmental history
- Making accurate observations of the child
- Identifying the risk and protective factors
- Maintaining an accurate record and documenting the process and findings
Developmental Screening
Developmental screening is the administration of a brief standardized tool aiding the identification of children at risk of a developmental disorder. Developmental screening that targets the area of concern is indicated whenever a problem is identified during developmental surveillance.3
Tools
 Piloting
the AAP Algorithm: Lessons Learned
This Webcast, co-sponsored by the American Academy
of Pediatrics and hosted by the National Academy for
State Health Policy Screening Academy, offers
an in-depth examination of the AAP algorithm by Paul
Lipkin, MD, FAAP—particularly as it relates to
implementing the algorithm in a practice. It
also features the experience of Amy Gibson, MS, RN,
from Boys Town Pediatrics (NE) and Thomas Sullivan,
MD, FAAP of Alexandria-Lake Ridge Pediatrics (VA)
both of whom participated in the Developmental Surveillance
and Screening Policy Implementation Project (D-PIP)
which piloted the algorithm. Visit http://www.medicalhomeinfo.org/screening/DPIP.html for
more details. Tracy King, MD, MPH, FAAP, Assistant
Professor of Pediatrics at the Johns Hopkins School
of Medicine also presented on preliminary qualitative
outcomes of the D-PIP. The Webcast is available at: https://cc.readytalk.com/play?id=0kb2hx3w.
The NASHP Screening Academy is a selection of 19 states
who are implementing policies and practices to standardize
developmental screening within the Medicaid program.
The jurisdictions selected for the Screening Academy
are: Alaska, Alabama, Arkansas, California, Connecticut,
Delaware, the District of Columbia, Kansas, Maryland,
Maine, Michigan, Minnesota, Montana, New Jersey, Ohio,
Oregon, Puerto Rico, Virginia, and Wisconsin. Each of
these states is working with at least 2 practices to
implement the AAP algorithm. More information about the
NASHP Screening Academy is available at www.nashp.org.
- Developmental Surveillance and Screening Policy Implementation Project (D-PIP)
Seventeen pediatric practices are implementing the AAP policy statement on developmental surveillance and screening to examine whether it can be implemented into pediatric practice, strategies used for implementation, and outcomes of implementation.
A Web site has been developed that provides materials
from the D-PIP training workshop, including resources
to help practices implement the policy statement. The
Web site is continually updated with new information.
- Resource Guide for Developmental Screening in Primary Care Practices
New on the NASHP Web site is an office resource guide designed to help primary care practices integrate developmental screening into their workflow. The guide was developed by the Office of Research, Demonstrations, and Rural Health, North Carolina Department of Health and Human Services, as the result of two demonstration programs in integrating developmental screening and surveillance. The programs were conducted under NASHP's Assuring Better Child Health and Development (ABCD) project, supported by The Commonwealth Fund.
To tap into these materials, visit the office resource guide.
- A Practical Guide for Healthy Development - A New Manual
Developed by the Healthy Development Learning Collaborative, a 12-month quality improvement initiative, to give offices step-by-step guidance on how to revise their office systems. The initiative was designed to help primary care practices in Vermont and North Carolina engage families in a partnership to promote positive developmental outcomes for the families' children.
The Guide offers a number of newly tested and established
resources including checklists, surveys, bibliographies,
and helpful links.
Adopting the strategies and tools described in the manual can help practices of all kinds offer improved developmental services to their patients and their families.
- A new web page for pediatric health care providers
has been added to the CDC
Child Development Web site. The new page provides
tips for primary care practitioners on integrating developmental
screening into their practices efficiently, at low cost,
and while ensuring coordination of care. A sample flowchart
of clinical screening activities and an example of how
physician and non-physician staff roles may be delineated
to make routine screening feasible are provided as well
(these can be printed from the web site).
- The First Signs Screening Kit
The
First Signs Screening Kit provides quick, accurate,
and affordable developmental and autism screening tools.
Featuring a 24-minute award-winning educational
video, On the Spectrum: Children and Autism,
this innovative kit arms you with best practice guidelines
to ensure accurate, efficient use of screening procedures.
It also includes a practitioner’s referral guide
to Early Intervention and a convenient wall
chart, Key Milestones for Social, Emotional, and
Communication Development.
You can purchase the video and wall chart separately,
in addition to First
Signs Parent Brochures. As a practicing professional,
you know that early detection of developmental delays
has never been more important. For more information, visit www.firstsigns.org
- Developmental Screening/Testing Coding Fact
Sheet
Developmental screening, surveillance, and assessment
are often complemented by the use of special tests, which
vary in length. This Coding Fact Sheet provides guidance
on how pediatricians can appropriately report limited
and extended developmental screening and testing services.
- Screening Implementation Worksheet
A worksheet developed by the Common Wealth Fund that
generates questions about staff responsibilities for
developmental screening.
- Enhancing Child Development Services in Medicaid
Managed Care: A Best Clinical and Administrative Practices Toolkit
Author: Purview Koala Smith, MS, MPH
Published: October 2005
This toolkit reflects the experiences of the Enhancing
Child Development Services in Medicaid Managed Care workgroup
- 10 health plans and a primary care case management program
- that collaborated to develop best practices for enhancing
child development services. Health plans using this toolkit
will learn how the BCAP Quality Framework can be applied
to design and evaluate pilot projects to improve developmental
services for children from 0-3 years old.
- The Promoting Healthy Development Survey-PLUS (PHDS-PLUS)
Implementation Guidelines manual present the steps necessary
to implement a telephone-administered parent survey that
assesses whether young children (ages 3-48 months) receive
nationally recommended preventive and developmental services.
The manual, produced by the Child and Adolescent Health
Measurement Initiative with support from the Commonwealth
Fund, is organized according to six implementation steps
and their respective subcomponents.
The steps include the following: (1) learning about the survey, (2) specifying
the implementation strategy, (3) preparing
for and conducting the survey, (4) monitoring
survey administration and preparing for data and analysis, (5) constructing quality measures and
analytic variables, and (6) reporting
findings. The manual is intended for use by researchers
and others in implementing the PHDS-PLUS in Medicaid and
other settings.
Resources
- (NASHP)
Unveils Electronic Resource Center Devoted to Early
Childhood Health and Development
National Academy for State Health Policy (NASHP)
recently opened the ABCD Electronic Resource Center,
providing easy access to research and resources on early
childhood health and development. This new Web resource
is the latest development of the Assuring Better Child
Health and Development initiative, which NASHP has conducted
for more than seven years. The Center provides resources
and information that states and childrens primary
care providers can use to promote and support effective
identification of children with health and development
needs
- Developmental Toolkit for Primary Care Providers Tookit
Contains resources including videos of practitioners talking about their reluctance initially and then how they changed their minds and came to understand the importance of standardized screening. It is for primary care providers considering or planning to start screening children for developmental needs using a validated tool. Whether you know you should change but don’t know where to start, or are still thinking about how this change could work in your setting, this web site will help.
- CDC’s
Child Development Web site
Learn about the Child Development Studies Team’s
major projects and activities, public health issues
in child development, child development milestones,
and down-load Positive Parenting Tips sheets free
of charge. You will also find links to more information,
resources, and their partners in promoting child
development.
- CDC's
Learn the Signs, Act Early Campaign
The Centers for Disease Control and Prevention (CDC) has launched an awareness campaign to educate parents, health care professionals, and child care providers about childhood development, including early warning signs of developmental disorders.
To help prepare the health care community for the anticipated
increase in questions and requests for information
from parents, CDC has developed a Provider Resource
Kit. This kit contains materials designed to help you
communicate with parents about child development, including
a series of fact sheets on child development and developmental
screening and informational cards for parents listing
developmental milestones by age. Materials in this
kit are printed in Spanish on the reverse side.
- Developmental Behavioral Pediatrics
Online
The American Academy of Pediatrics' Section on
Developmental and Behavioral Pediatrics Web site. With
a grant from the Commonwealth Fund, the site offers
extensive information on developmental and behavioral
screening including information about various tests,
how to use them in practice, and how to get reimbursed.
There are several discussion lists on the site for assisting
providers in the nuts and bolts issues of using measures.
In addition, dbpeds.org house information on various
kinds of disabilities and conditions and how to treat
them.
-
Irving B. Harris Training Center
for Infant and Toddler Development
The
Training Center is an educational non-profit center
dedicated to the training and continuing education of
individuals working in the field of infant and toddler
development. Housed at the Institute of Child Development
at the University of Minnesota, the Harris Center is
a University/community partnership with a twofold mission:
to serve as an information resource for the University
and to maximize the ability of professionals and organizations
to better serve infant and toddler populations.
- University Centers for Excellence in Developmental
Disabilities Education, Research, and Service (UCEDD) Directory
Sixty-one Centers in every state and territory, are located
in a university setting. Centers are in a unique position
to facilitate the flow of disability-related information
between community and university. Centers work with people
with disabilities, members of their families, state and
local government agencies and community providers in projects
that provide training, technical assistance, service,
research and information sharing, with a focus on building
the capacity of communities to sustain all their citizens.
Centers have played key roles in every major disability
initiative over the past four decades. Many issues, such
as early intervention, health care, community-based services,
inclusive and meaningful education, transition from school
to work, employment, housing, assistive technology and
transportation have been directly benefited by the services,
research and training provided by UCEDDs.
Educational Initiatives
-
Child Development: The Science and Practice
of Catching Problems Early (Web Conference)
Presenters: Edward L. Schor, MD; Paul H. Dworkin,
MD; Marian F. Earls, MD
This Web conference discusses
barriers to screening, the role of the child health provider
in the early detection of children at risk for poor developmental
outcomes, differences between screening and assessment,
and much more! Visit the Commonwealth
Fund Web site to download the presentations.
- Developmental
Surveillance and Screening in the Medical Home Teleconference
On January 19th, 2005, Paul Dworkin, MD, FAAP
and Lina Salazar, a parent partner, discussed the importance
of ongoing surveillance, proper methods of screening,
appropriate follow up, and available resources to assist
you with integrating developmental screening into the
medical home you provide. Listen to the audio of the teleconference
as well as view the presentations and related materials
by clicking
here.
- Developmental/Behavioral
Screening: How to do it Efficiently and Cost Effectively
and Why
A presentation done by Frances Glascoe at the May, 2003
Institute for Leaders in CSHCN Programs Workshop.
- Developmental
Screens in the Office Setting
A presentation specifically developed for residents and
primary care physicians by Dr Nathaniel Beers, Assistant
Professor of Pediatrics - Children's National Medical
Center George Washington University.
- Early
Detection of Developmental Delays - How Do You "Measure
Up?"
A presentation by Paul H. Dworkin, MD; Pfizer Visiting
Professor in Pediatrics Wright State University School
of Medicine/ The Children's Medical Center
- Pediatric
Evaluation of the Child at Risk for Potential Developmental
Disabilities
A presentation by Dr Genoveva C. Prieto, Miami Children's
Hospital
- STEPPS
The STEPPs program and the Power Point presentation are
from the Illinois Chapter of the American Academy of Pediatrics
and to contact the Chapter at 312-733-6207 or email info@illinoisaap.com
with any questions, for more information, or for permission
to use the slides.
Contact Us
If you have additional questions related to the Medical
Home Screening & Surveillance Program, please send your
question or comment by e-mail to mhscreening@aap.org.
1. Olson AC. How to establish family
professional partnerships. Presented at: International Family
Centered Care Conference; September 5, 2003; Boston, MA
2. American Academy of Pediatrics. The
Medical Home and Early Intervention Brochure. Elk Grove
Village, IL: American Academy of Pediatrics; 2004
3. American Academy of Pediatrics; Council on Children With Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee and Medical Home Initiatives for Children With Special Needs Project Advisory Committee. Identifying Infants and Young Children With Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening. Pediatrics. 2006;118(1):405-420
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The mission of the National
Center on Birth Defects and Developmental Disabilities
within the Centers for Disease Control and Prevention
is to promote the health of babies, children, and adults,
and enhances the potential for full, productive living.
NCBDDD's work includes identifying the causes of birth
defects and developmental disabilities, helping children
to develop and reach their full potential, and promoting
health and well-being among people of all ages with
disabilities. |
Last Updated
August 6, 2008
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