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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Developmental Screening.

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Strategy. Provider Training

Approach. Train medical, social service, childcare providers, and home visitors on the importance of utilizing validated developmental screening tools

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Overview. Although pediatricians' use of standardized screening tools for identifying developmental delays has increased, only 63% of pediatricians report performing standardized screening as recommended.[3] There is growing evidence that professional training may increase developmental screening rates for a range of healthcare professionals.[1,2] Practice-based improvements such as in-person meetings, webinars, multi-session trainings, and individualized feedback have been used to improve developmental monitoring, screening, and referral for general developmental concerns and autism spectrum disorder by pediatricians.[4,5,6,7]

Evidence. Moderate Evidence. Strategies with this rating are likely to work...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Access to/Receipt of Care. This strategy increases the ability for individuals to obtain healthcare services when needed, including preventive, diagnostic, and treatment services.
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.
  • Timeliness of Care. This strategy promotes delivery of healthcare services in a timely manner to optimize benefits and prevent complications.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Screening (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. Access descriptions of ESMs that use this strategy or aligned components.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of medical, social service, childcare providers, and home visitors who complete training on using validated developmental screening tools. (Measures the reach and scale of training efforts) Number of organizations for practice settings represented by providers participating in developmental screening training. (Measures the breadth of cross-sector engagement in training)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of developmental screening training sessions that include hands-on practice with validated screening tools. (Assesses the use of active learning and skill-building strategies in training) Percent of providers who receive follow-up support and coaching after initial developmental screening training. (Measures the availability of ongoing technical assistance to reinforce training)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Number of communities for regions that implement a coordinated, cross-sector developmental screening training initiative for providers. (Measures the spread and alignment of training efforts at a population level) Number of state for local policies and funding streams that incentivize for require developmental screening training for providers. (Measures the level of systemic support and accountability for training participation) Number of provider organizations that demonstrate sustained improvements in developmental screening rates and quality after staff training. (Assesses the long-term practice change outcomes of training) Number of early intervention and special education programs that report increases in appropriate referrals from trained providers conducting developmental screening. (Shows the system-wide benefits of improved screening and referral practices)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of developmental screening training participants who serve communities experiencing socioeconomic challenges. (Assesses the focus and reach of training efforts) Percent of developmental screening training content and materials that are adapted for various provider and family populations. (Measures the responsiveness and usability of training resources) Percent reduction in gaps in developmental screening and referral rates between different groups after provider training initiatives. (Measures the training's impact on screening access and utilization) Percent of all children in the community who receive recommended developmental screening from a trained provider. (Assesses the reach and universality of screening access as a result of widespread provider training)

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.
  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.

References

1 Garcia S, Brown E, Strobino D, & Minkovitz C. National Performance Measure 6 Developmental Screening Evidence Review. Strengthen the Evidence Base for Maternal and Child Health Programs. 2018. Women's and Children's Health Policy Center, John Hopkins University, Baltimore, MD.

2 Alen SG, Berry AD, Brewster JA, Chalasani RK,& Mack PK. Enhancing developmentally oriented primary care: an Illinois initiative to increase developmental screening in medical homes. Pediatrics. 2010: 126 Suppl 3, S160-S164.

3 Bright, M. A., Zubler, J., Boothby, C., & Whitaker, T. M. (2019). Improving developmental screening, discussion, and referral in pediatric practice. Clinical pediatrics, 58(9), 941-948.

4 Steinman, K. J., Stone, W. L., Ibañez, L. V., & Attar, S. M. (2021). Reducing Barriers to Autism Screening in Community Primary Care: A Pragmatic Trial Using Web-Based Screening. Academic Pediatrics.

5 McNally Keehn, R., Ciccarelli, M., Szczepaniak, D., Tomlin, A., Lock, T., & Swigonski, N. (2020). A statewide tiered system for screening and diagnosis of autism spectrum disorder. Pediatrics, 146(2).

6 Mazurek, M. O., Curran, A., Burnette, C., & Sohl, K. (2019). ECHO autism STAT: accelerating early access to autism diagnosis. Journal of Autism and Developmental Disorders, 49(1), 127-137.

7 Zuckerman, K. E., Chavez, A. E., Wilson, L., Unger, K., Reuland, C., Ramsey, K., ... & Fombonne, E. (2021). Improving autism and developmental screening and referral in US primary care practices serving Latinos. Autism, 25(1), 288-299.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.