Caregiver experiences of developmental screening.

This study explored the experiences and perspectives of Latinx mothers of children younger than 3 years who had participated in a developmental screening initiative provided by 2 Federally Qualified Health Centers in an urban setting, had positive developmental screenings, and were referred to early intervention (EI) services. A 2-phase mixed-methods explanatory design was implemented in English and Spanish. In Phase 1, a telephone survey was conducted with 62 parents. In Phase 2, qualitative semistructured interviews (regarding parental experiences with their child's developmental screening, the process of linking to services, the EI evaluation, and subsequent services received) were conducted with a subset of 13 Phase 1 mothers. Results from the phone survey showed that 91% of children were found eligible for EI and 92% were receiving EI services. More than 90% of mothers reported positive experiences with their children's developmental screening, learning about their child's development, and accessing services. However, results from the semistructured interviews revealed that mothers had mixed experiences with the developmental screening process and linkage to EI services. Findings from this study provide insights into the perceived value of EI services by Latinx families and the need for improved system supports to access and navigate EI services.

In 2004, the American Academy of Pediatrics (AAP) Board of Directors formed the Task Force on Mental Health and charged it with developing strategies to improve the quality of child and adolescent mental health* services in primary care. The task force acknowledged early in its deliberations that enhancing the mental health care that pediatricians and other primary care clinicians† provide to children and adolescents will require systemic interventions at the national, state, and community levels to improve the financing of mental health care and access to mental health specialty resources. Systemic strategies toward achieving these improvements are the subject of other publications of the task force: “ Strategies for System Change in Children's Mental Health: A Chapter Action Kit ” (chapter action kit),1 “Improving Mental Health Services in Primary Care: Reducing Administrative and Financial Barriers to Access and Collaboration,”2 and “Enhancing Pediatric Mental Health Care: Strategies for Preparing a Community.”3 The task force also recognized that enhanced mental health practice will require competencies not currently achieved by many primary care clinicians; in the policy statement “The Future of Pediatrics: Mental Health Competencies for Pediatric Primary Care,”4 the task force collaborated with the AAP Committee on Psychosocial Aspects of Child and Family Health to outline these competencies and propose strategies for achieving them. This report offers strategies for preparing the primary care practice itself for provision of enhanced mental health care services. The task force proposes incrementally applying chronic care principles to the care of children with mental health and substance abuse problems as primary care clinicians apply them to the care of children with chronic medical conditions such as asthma. Most primary care clinicians will find that significant gaps exist between their current practice and the proposed ideal. The task force offers guidance in … Address correspondence to Jane Meschan Foy, MD, Department of Pediatrics, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157. E-mail: jmfoy{at}wfubmc.edu

The purpose of this study was to explore whether a relationship exists between the rates of state-level developmental screening by a health care provider and state-level provision of Individuals with Disabilities Education Act, Part C (IDEA Part C) early intervention services. This is an important first step in determining whether states have the capacity to deal with a potential influx of newly identified children. This analysis compared screening rates from the 2016 National Survey of Children’s Health with service rates from the Department of Education’s 2016 IDEA Part C data. There was no significant relationship between rates of screening by a health care provider and receipt of IDEA Part C services ( r = .13, p = .366). Those who identified as White were screened and provided with IDEA services at a higher percentage than non-White ( r = .80, p < .001). There was a significant relationship between region and receipt of IDEA Part C services, F(3) = 8.14, p < .001, with the Northeast region ( M = 4.95, SD = 1.85) having higher percent served via IDEA Part C services. Results indicate no relationship between state levels of screening by a health care provider and receipt of IDEA Part C services. Efforts to increase developmental screening may require strategies to ensure adequate service access.

To the Editor .— In their article regarding early-intervention services provided through Part C of the Individuals With Disabilities Education Act, Bailey et al1 express concern that the length of time is excessive between the identification of a child with a possible disability and referral for intervention services. However, whether this delay in referral for intervention is harmful totally depends on whether the interventions available are effective. The Part C program serves a large number of children with a variety of disabilities or risk factors, and the effectiveness of the interventions differs with the disability involved. For example, for children diagnosed early with hearing loss, the effectiveness of early intervention is well-supported by existing data, and a delay in referral for intervention may have a substantial negative impact on the future development of the child with hearing loss. Depending on how risk is defined, varying numbers of children, perhaps a majority, who might be referred for early-intervention services because they have been deemed at risk, will develop normally even if early-intervention services are not provided. For such children, it can be argued that immediate referral for intervention …

Congenital hearing loss affects one to three of every 1,000 live born infants and negatively impacts children through delayed speech, language, social, and emotional development when undetected. To address this public health issue, jurisdiction-based Early Hearing Detection and Intervention (EHDI) programs are working to ensure all newborns are screened for hearing loss, receive follow-up diagnostic testing (DX) if they do not pass the screening, and are enrolled in early intervention (EI) services if diagnosed with a permanent hearing loss. Although substantial progress has been made in the provision and documentation of services, challenges remain because, unlike screening results, diagnostic test results and enrollment in EI are not consistently reported to the EHDI programs. Therefore, it is difficult for states and territories to know if infants received recommended follow-up services (diagnostic testing and/or EI services), often resulting in infants being classified at either stage as lost to follow-up (LFU)/lost to documentation (LTD). To assess progress toward identifying children with hearing loss and reducing LFU/LTD for DX (LFU/LTD-DX) and EI enrollment (LFU/LTD-EI), CDC analyzed EHDI surveillance data for 2006-2012. Results indicated that the number of jurisdictions reporting data increased from 49 to 57, rates of screening increased from 95.2% to 96.6%, rates of referral from screening decreased from 2.3% to 1.6%, rates of diagnosis among infants not passing their final screening increased from 4.8% to 10.3%, and enrollment in EI among children diagnosed with hearing loss increased from 55.4% to 61.7%, whereas rates for both LFU/LTD-DX and LFU/LTD-EI declined. These findings show sustained progress toward screening, identification, and enrollment in EI as well as highlighting the need for continued improvements in the provision and documentation of EHDI services.

Currently more than 15% of children have an emotional, behavioral, or developmental concern. In spite of recommendations by the American Academy of Pediatrics and the Centers for Disease Control and Prevention to conduct universal developmental surveillance and screening with children at 9, 18, and 24 months of age, fewer than 30% of children under 6 years of age ever receive a developmental screening. Children in low-income and diverse communities are even less likely to be screened by a medical provider and/or referred for further diagnostic evaluation when predictive concerns are identified. As part of a cross-agency collaborative effort involving a family resource center, a child care resource and referral agency, a regional center for developmental disabilities, and a master's degree program in early childhood education, the Mobile Developmental Screening Van Project conducted outreach to provide free developmental screening with families of children 0-8 years of age in diverse and low-income communities within the greater Los Angeles County. Using the Parent Evaluation of Developmental Status (PEDS) screening tool, 94 children were screened over the course of 6 months, with 33% showing 2 or more predictive concerns that resulted in referrals for further diagnostic evaluation. The feasibility of reaching families in hard to reach communities using a mobile screening van, as well as study limitations and recommendations for next steps, are discussed.

Developmental Screening in the Primary Care Setting: A Qualitative Integrative Review for Nurses

Coding for Developmental and Behavioral Disorders

You have accessThe ASHA LeaderPolicy Analysis1 Jul 2009State Laws Improve Hearing Screening Follow-Up Rend Al-MondhiryJD Rend Al-Mondhiry Google Scholar More articles by this author , JD https://doi.org/10.1044/leader.PA2.14092009.9 SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In Recently enacted state legislation in Kentucky and Iowa will increase the number of infants who receive follow-up diagnostic assessments and early intervention services after failing a newborn hearing screening. The new laws reflect a growing nationwide trend to implement Phase II initiatives in early hearing detection and intervention (EHDI). The successful Phase I effort to mandate newborn hearing screening in all hospitals and birthing centers raised the number of newborns screened from 38% in 2000 to 96% in 2009. Phase II extends that effort with initiatives that improve tracking and surveillance to reduce the number of cases lost to follow-up; address privacy concerns associated with the exchange of health-related information; provide comprehensive coverage of early intervention and amplification devices; and promote an unbiased, family-centered approach to help parents make the best early intervention choice for their child. Nationally, 46% of the infants born in 2006 did not complete follow-up after a failed newborn hearing screening and are considered “lost to follow-up” or “lost to documentation.” The new laws will help ensure that newborns and infants with hearing loss receive needed audiological and early intervention services and will help reduce the number of infants lost to follow-up by strengthening the requirements for reporting hearing screening results and diagnostic assessments. Kentucky The Kentucky law requires the Kentucky Commission for Children with Special Health Care Needs to establish standards for infant audiological assessment and diagnostic centers based on national standards, including those established by ASHA and the Joint Committee on Infant Hearing (JCIH). The law includes new reporting requirements: Diagnostic centers must provide data to the commission within 48 hours regarding children ages birth to 3 who are newly identified with permanent hearing loss and also must refer those children to the state’s early intervention system. In addition, if a newborn fails a hearing screening, the hospital or birthing center must forward the screening report to the child’s primary care provider, the child’s parent(s), the commission, and an audiological assessment and diagnostic center, if follow-up is needed. (Previously the law did not require the report to be sent to a diagnostic center.) Finally, the law also expands the definition of “infant at risk for late-onset, progressive hearing loss, or both”; the expanded definition will help identify more infants who have a higher-than-normal risk of becoming deaf or hard of hearing, and who should therefore be monitored for hearing loss. Iowa In Iowa, the new law requires a hospital, birthing center, or person performing a hearing screening to report the results or screening status to the primary care provider of the infant upon discharge from a hospital or birthing facility, not to just the infant’s parents, as previously required. The information must now include, in addition to existing reporting requirements, information about the primary care provider, any known risk indicators for hearing loss, and other information specified by the Iowa Department of Public Health. An audiologist who conducts diagnostic audiological assessments of newborns and infants will now be required to do so in accordance with the department’s standards; the audiologist’s report to the department must now include the assessment results and any known risk indicators. Strengthened Requirements With mandates to report hearing screening and diagnostic assessment data, states are helping to ensure that all newborn infants are screened and that those with hearing loss—or at risk for later-onset hearing loss—are identified as early as possible and receive appropriate follow-up services. The new laws in Kentucky and Iowa reflect a growing trend to strengthen reporting and documentation requirements and improve all aspects of EHDI, such as enrollment in early intervention services and mandated coverage of hearing aids by insurance providers. Other aspects of EHDI, however, remain in need of improvement, such as the availability of culturally competent family resources, information for parents of children with hearing loss, and use of computerized data management systems to record, track, and monitor hearing health throughout childhood. ASHA is continuing to work with state associations and EHDI professionals nationwide to advance and implement Phase II objectives. ASHA plans to update the model bill in the near future to incorporate the next phase of its EHDI campaign: promoting lifetime screening. ASHA will focus on the importance of continued hearing screening at 12–18 months, pre-kindergarten, and elementary school. For more information on EHDI, including Phase II state model legislation and talking points, state laws, and federal information, go to ASHA’s Early Hearing Detection & Intervention Action Center. Author Notes Rend Al-Mondhiry, JD, director of state legislative and regulatory advocacy, can be reached at [email protected] or 800-498-2071, ext. 5665. Advertising Disclaimer | Advertise With Us Advertising Disclaimer | Advertise With Us Additional Resources FiguresSourcesRelatedDetails Volume 14Issue 9July 2009 Get Permissions Add to your Mendeley library History Published in print: Jul 1, 2009 Metrics Downloaded 70 times Topicsasha-topicsleader_do_tagleader-topicsasha-article-typesCopyright & Permissions© 2009 American Speech-Language-Hearing AssociationLoading ...

The author reflects on the importance of early psychosis intervention services. She says health decision-makers are planning to include the results of health economic analyses within resource allocation decisions. She refers to a study which showed that early intervention services may save about 14,000 British pounds per patient to the mental health sector. She notes that economic evaluations of early intervention for other mental health problems are also found to be cost-effective.

Early childhood represents an important and vulnerable developmental period shaped by the intersection of socio-structural factors (1).Timely intervention is crucial for children's future well-being (2); however, children from marginalized backgrounds, including migrant families, encounter barriers to developmental delay detection and intervention.Addressing disparities before the transition into the school system can impact a child's developmental trajectory (3).Leveraging existing community infrastructure for preschool developmental delay detection can help to support timely intervention for underserved communities.Governments and clinical associations globally, including in Canada, have developed guidelines and programs to promote healthy development and intervene early when development is delayed (4,5).Despite cost-free initiatives like the Agir Tt program in Quebec, which aims to identify children from 0 to 5 years of age with developmental difficulties and quickly link them to services (4), significant barriers exist for families in accessing the services, particularly among recently arrived migrant families to Canada, including asylum seekers, resettled refugees, immigrants and others.Community-based interventions, such as community health fairs, have been used to help bridge cultural and linguistic barriers and provide health resources and information to recently arrived migrants in the Global North (6).Here, we describe a model that integrates developmental screening into community health fairs to reach children of recently arrived migrant families and help reduce obstacles to early intervention.On September 30, 2023, in collaboration with a community organization, a non-profit organization and the government-run local integrated health and social services centre, a developmental screening intervention was held at a community health fair organized by members of the predominantly Haitian community of Montreal-Nord, a borough in Montreal, Canada (7).

During the 1990s, requirements for child care for children with special needs will increase substantially. Parents of children with special needs face particular challenges in finding suitable child care for their children. A major factor influencing future directions in child care for children with special needs is PL 99-457, the Early Intervention Amendments to the Education for All Handicapped Children Act.1 The component for 0- to 3-year-olds is Part H of the Individuals with Disabilities Education Act (IDEA).2 Almost all states have indicated their intent to provide early intervention services for children with disabilities and developmental delays. As each state moves toward implementation of its plan for 0- to 3-year-olds, federal fiscal incentives to expand such services will grow. The IDEA encourages integrated or inclusionary services for children with disabilities, as does the Americans with Disabilities Act (ADA).3 As a result of this stream of legislation, there will be growing pressure to serve children with special needs in generic child-care settings. Less certain is whether children with identifiable biological or social risks will have a similar entitlement under Part H, because only 10 states have, thus far, included an "at risk" group in their legislative mandate for early intervention. WHO ARE CHILDREN WITH SPECIAL NEEDS AND HOW MANY ARE THERE? The Technical Panel on Children with Special Needs of the American Public Health Association's and American Academy of Pediatrics' (APHA/AAP) National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care Programs4 defined the population with special needs as those children with developmental disabilities, mental retardation, emotional disturbance, and chronic illness, as well as those with sensory or motor impairments.

Back to table of contents Previous article Next article Clinical & Research NewsFull AccessSimple Screening Tool Identifies Kids With Development DelaysJun YanJun YanSearch for more papers by this authorPublished Online:21 Sep 2007https://doi.org/10.1176/pn.42.18.0017aEarly intervention improves outcomes for children with developmental delays, but performing routine, formal developmental screening as recommended by the American Academy of Pediatrics can be a challenge for busy pediatricians. The experience of pediatric staff at a large medical practice in Eugene, Ore., however, has demonstrated that a systematic screening program in which parents fill out a validated assessment questionnaire can dramatically increase the number of children identified with potential problems that required further evaluation.The program is described and its effects are analyzed in an article in the August Pediatrics by Hollie Hix-Small, Ph.D., and colleagues.In the period between April 1, 2005, and March 1, 2006, a simple process was incorporated in routine well-child visits at 12 or 24 months. At each visit, a parent or caregiver was given the Ages and Stages Questionnaire (ASQ), a 30-item, screening tool for monitoring child development, which has been shown to be valid and reliable for children between 4 months and 5 years old. Participants in the program had the option to complete the questionnaire at home and mail it in or complete the questionnaire at the medical office.The research staff reviewed the completed questionnaires and referred children with suspected developmental problems to the Program for Infants and Toddlers (part C of the Individuals with Disabilities Education Act [IDEA], a federal grant program) based on predetermined criteria for ASQ scores. Meanwhile, pediatricians at the practice independently saw these children as a part of standard care, documented their ratings of each child's developmental status and determined whether the child needed a referral to the same part C agency evaluation. The pediatricians were unaware of the children's ASQ scores.The result was impressive: out of 1,428 children who were seen at the practice, 107 children were referred to an IDEA part C agency for further developmental evaluations. That represented a 224-percent increase over the period April 2003 to March 2004, when only 33 referrals were made. On the basis of their clinical impression alone, physicians referred 45 children, while researchers identified and referred 82 children on the basis of ASQ scores. Only 20 were cases overlapping from both processes.Of all the referrals, 25 children were screened out by the state's part C agency as “no concern,” 38 met the eligibility criteria for IDEA part C special-education services immediately, and 44 were scheduled for future screening because of suspected developmental delays.Once a child is referred to a part C agency, the agency contacts the parents or caregiver and conducts further evaluations to determine whether the child is eligible for state-provided care.The authors cited the importance of early intervention, which requires early detection of signs or symptoms, to achieve optimal outcomes for children with developmental delays. Although the American Academy of Pediatrics has published guidelines for identifying infants and young children with developmental disorders, busy pediatricians may find it challenging to use these algorithms during routine visits. In contrast, the ASQ can be completed by parents or caregivers at home and potentially teach them possible signs to look for in children.“One anecdotal observation in the clinic was that often the act of filling out the ASQ increased the parent's observational skills for child development,” Hix-Small told Psychiatric News.The authors estimated that the cost of incorporating the screening program, including distributing the ASQ to parents or caregivers upon check-in and collecting the forms at the clinic or by postage-paid mail, was only $1.61 to $2.43 per patient. Kevin Marks, M.D., one of the study authors and a physician at the medical practice group, noted that “the ASQ screening system was found to be feasible [and] low cost and did not impede office flow.”An abstract of “Impact of Implementing Developmental Screening at 12 and 24 Months in a Pediatric Practice” is posted at<http://pediatrics.aappublications.org/cgi/content/abstract/120/2/381>.▪ ISSUES NewArchived

Developmental and behavioral screenings are crucial in pediatric care for the detection and intervention of developmental and behavioral issues in early years. American Academy of Pediatrics (AAP) offers guidelines for healthcare providers to screen and evaluate children, stressing the integration of developmental and behavioral surveillance into routine pediatric care. When screenings indicate potential risks, children should immediately undergo comprehensive developmental and medical assessments and be enrolled in early intervention programs without waiting for the results. By early diagnosis and intervention, children at risk will reach their developmental potential and healthcare costs will be reduced.

In 2006, the American Academy of Pediatrics recommended developmental screening of young children with a standardized screening tool as a routine component of well-child care. To assess the national and state prevalence of standardized, parent-completed developmental screening (DS-PC) in the previous 12 months and evaluate associations between screening and receipt of an early-intervention plan or mental health services for children at higher risk. Data from the 2007 National Survey of Children's Health were used. Nested t tests were used to compare each state to national prevalence. Logistic and multilevel regression models evaluated variations and associations with DS-PC. Nationally, 19.5% of children received a DS-PC in the previous 12 months, although the figure varied from 10.7% to 47% across the United States. Prevalence did not rise above 26.7% for any socioeconomic subgroup of children and was highest for younger, black, and publicly insured children and lowest for uninsured children and children with gaps in insurance coverage. Equally high-risk children varied twofold in their probability of receiving early intervention or needed mental health services according to whether they had received a DS-PC. There is a significant gap between the developmental screening that is recommended and what is reported nationally. When children are not screened consistently, opportunities for early identification, intervention, and treatment may be delayed. Gaps in screening and wide variations across states present considerable opportunities for cross-state learning to improve quality on this critical component of preventive pediatric care. Measurement systems for assessing prevalence and impact of screening require continued evaluation and development.