
Evidence Tools
Developmental Screening
Introduction
This toolkit summarizes content from the Developmental Screening Evidence Accelerator and the MCHbest database. The peer-reviewed literature supporting this work can be found in the Established Evidence database. Use the resources below as you develop effective evidence-based/informed programs and measures.
From the MCH Block Grant Guidance. Early identification of developmental delays and disabilities is critical to provide referrals to services that can promote health and educational success.1 It is an integral function of the primary care medical home. The American Academy of Pediatrics (AAP) recommends developmental screening at the 9, 18, and 24 or 30 month visit.1 Developmental screening is part of the Core Set of Children’s Health Care Quality Measures for Medicaid and CHIP. Systems-level quality improvement efforts that build on the medical home are needed to improve rates of developmental screening and surveillance.2
Goal. To increase the percent of children who receive a developmental screening.
Note. Access other related measures in this Population Domain through the Toolkits page.
Detail Sheet: Start with the MCH Block Grant Guidance
GOAL: To increase the percent of children who receive a developmental screening.
DEFINITION:
Numerators:
Number of children, ages 9 through 35 months (2 years), whose parents reported completing a standardized developmental screening questionnaire from a health care provider in the past year with age-specific content on language development and social behavior
Denominators:
Number of children, ages 9 through 35 months
Units: 100
Text: Percent
HEALTHY PEOPLE 2030 OBJECTIVE: Identical to Maternal, Infant, and Child Health (MICH) Objective 17: Increase the proportion of children who receive a developmental screening. (Baseline: 31.1% in 2016-17, Target: 35.8%)
DATA SOURCES: National Survey of Children's Health (NSCH)
MCH POPULATION DOMAIN: Child Health
MEASURE DOMAIN Clinical Health Systems
1. Accelerate with Evidence—Start with the Science
The first step to accelerate effective, evidence-based/informed programs is ensuring that the strategies we implement are meaningful and have high potential to affect desired change. Read more about using evidence-based/informed programs and then use this section to find strategies that you can adopt or adapt for your needs.
Evidence-based/Informed Strategies: MCHbest Database
The following strategies have emerged from studies in the scientific literature as being effective in advancing the measure. Use the links below to read more about each strategy or access the MCHbest database to find additional strategies.
Evidence-Informed |
Evidence-Based |
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Mixed Evidence |
Emerging Evidence |
Expert Opinion |
Moderate Evidence |
Scientifically Rigorous |
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Field-Based Strategies: Find promising programs from AMCHP’s Innovation Hub
Cutting Edge:
- Community and Healthcare Provider Training (CT; 2021)
- Culturally Relevant Diagnostic Teleaudiology Training (Federated States of Micronesia; 2021)
- Increase Formal Developmental Screening (MO; 2020)
- Screening Tools and Referral Training (TN; 2020)
- Virtual Autism Diagnostic Clinic (PA; 2022)
Emerging:
- Awareness of Screening (GA; 2015)
- Child Service Assessments (RI; 2023)
- Comprehensive Evaluation Services (VA; 2021)
- CYSHCN Inclusive Eligibility Criteria (WV; 2021)
- Early Intervention Partnership Program (MA; 2019)
- Newborn Screening Education (National; 2020)
- Primary Care Education (TN; 2022)
- PRAMS Follow-Up Survey (AK; 2020)
Promising:
- Centralized Electronic Screening Platform (MN; 2018)
- Diaper Incentive (TN; 2021)
- Early Identification and Referral Model (SC; 2019)
- Early Screening/Referral (IA; 2016)
- Individualized Parent Learning Plan (OH; 2023)
- Tele-Diagnostic Evals and Education (TN; 2022)
- Training Components for Providers (TN; 2022)
Best:
- Community Health Workers Program (SC; 2019)
- Community Systems for CYSHCN (NC; 2018)
- Nurse-Family Partnership (National; 2008)
- Pathways Community Hub (National; 2019)
- Promote Child, Family, and Community Well-Being (National; 2021)
2. Think Upstream with Planning Tools—Lead with the Need
The second step in developing effective, evidence-based/informed programs challenges us to plan upstream to ensure that our work addresses issues early and is measurable in “turning the curve” on big issues that face MCH populations. Read more about moving from root causes to responsive programs and then use this section to align your work with the data and needs of your populations.
Move from Need to Strategy
Use Root-Cause Analysis (RCA) and Results-Based Accountability (RBA) tools to build upon the science to determine how to address needs.
Planning Tools: Use these tools to move from data to action
3. Work Together with Implementation Tools—Move from Planning to Practice
The third step in developing effective, evidence-based/informed programs calls us to work together to ensure that programs are implementable and moveable within the realities of Title V programs and lead to improved health outcomes for all people. Read more about implementation tools designed for MCH population change and then use this section to develop responsive strategies to bring about change that is responsive to the needs of your populations.
Additional MCH Evidence Center Resources: Access supplemental materials from the literature
- Find field-based resources focused on increasing developmental screening relevant to Title V programs in the MCH Digital Library.
- Search the Established Evidence database for peer-reviewed research articles related to strategies for increasing developmental screening.
- Request Technical Assistance from the MCH Evidence Center
- MCH Evidence Center Frameworks and Toolkits:
Implementation Resources: Use these field-generated resources to affect change
Practice. The following tools can be used to translate evidence to action to advance this NPM:
- Lessons Learned from the Early Childhood Comprehensive Systems (ECCS) Collaborative Improvement and Innovation Network (CoIIN) (National Institute for Children’s Health Quality). This report describes childhood development screening initiatives across multiple states.
- Milestone Moments (Centers for Disease Control and Prevention (CDC)). This milestone tracker for parents provides guidelines on age-appropriate stages of development.
Partnership. The following organizations focus efforts on supporting developmental screening:
- Zero to Three. Provides early childhood development resources for parents, professionals, and policymakers.
- CDC. Provides developmental tracking tools and free resources for parents and professionals through its Learn the Signs, Act Early initiative.
- AAP. Provides developmental surveillance and screening tools for pediatricians, as well as assessment information and tools for parents.
References
Introductory References: From the MCH Block Grant Guidance
1 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. Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening [published correction appears in Pediatrics. 2006 Oct;118(4):1808-9]. Pediatrics. 2006;118(1):405-420. doi:10.1542/peds.2006-1231
2 Hirai AH, Kogan MD, Kandasamy V, Reuland C, Bethell C. Prevalence and Variation of Developmental Screening and Surveillance in Early Childhood. JAMA Pediatr. 2018 Sep 1;172(9):857-866. doi: 10.1001/jamapediatrics.2018.1524.