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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. NPM 6: Developmental Screening

MCHbest Logo toddler and doctor playing with their noses

Strategy. Women Infants and Children (WIC) Nutrition Programs

Approach. Utilize WIC clinics to provide developmental monitoring and referral.

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Overview. Based on Centers for Disease Control and Prevention’s Learn the Signs. Act Early. campaign, the program was developed and replicated in two phases at 20 demographically diverse WIC clinics in eastern Missouri. Parents were asked to complete developmental milestone checklists for their children, ages 2 months to 4 years, during WIC eligibility recertification visits; WIC staff referred children with potential concerns to their healthcare providers for developmental screening. WIC staff surveys and focus groups were used to assess initial implementation outcomes.1

Evidence. Emerging. There is growing evidence for the utilization of WIC clinics increase parent-reported developmental screening. More research is needed for conclusive results. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Children from families with low incomes, like those served by WIC.

Outcomes. Increase in number of children screened and referred to services.

Examples from the Field. Access descriptions of ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the approach “WIC clinics to provide developmental monitoring and referral,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

QUADRANT 1:
Measuring Quantity of Effort ("What/how much did we do?")

  • Number of children receiving a developmental screen.

QUADRANT 2:
Measuring Quality of Effort ("How well did we do it?")

  • Percent of children receiving a developmental screen.

QUADRANT 3:
Measuring Quantity of Effect ("Is anyone better off?")

  • Number of children referred to services.

QUADRANT 4:
Measuring Quality of Effect ("How are they better off?")

  • Percent of children referred to services.

Note. When looking at your ESMs, SPMs, or other strategies: (1) move from measuring quantity to quality; (2) move from measuring effort to effect; (3) Quadrant 1 strategies should be used sparingly, when no other data exists; and (4) the most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

Reference:

1 Farmer, J.E., Falk, L.W., Clark, M.J. et al. Developmental Monitoring and Referral for Low-Income Children Served by WIC: Program Development and Implementation Outcomes. Materal Child Health J 26, 230–241 (2022). https://doi.org/10.1007/s10995-021-03319-9.