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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Medical Home: Referrals.

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Strategy. Early Intervention

Approach. Provide caregivers with screening and treatment options for preschool aged children to improved developmental outcomes

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Overview. Early intervention for preschool aged children can lead to improved developmental outcomes for children at risk for ASD. Referrals to early intervention services result in increased timely evaluations and decreased refusal rates.[1] Models like the Get SET Early led to a significant decrease in the age of autism spectrum disorder. (ASD) diagnosis, with improved screening and referral behaviors among pediatric healthcare providers.[2] Early identification and referral of infants with social and environmental risks leads to increased participation in early intervention services.[3] A multi-stage screening process found strong associations between screening scores, provider concerns, and completion of screening stages.[4]

Evidence. Moderate Evidence. Strategies based on moderate evidence show a clear trend toward positive results. While these approaches are likely to be effective, further research is needed to confirm their impact. Implement with evaluation to better understand specific local effects.

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

Potential Data Sources. Data to support this strategy can be accessed through:

  • Caregiver treatment engagement and completion data
  • Home visitor activity logs
  • Provider screening logs

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. Individual/Family-Focused

Examples from the Field. There are currently no ESMs that use this strategy. Search similar intervention components in the ESM database.

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 children screened for developmental delays using validated tools identified by Title V. (Assesses early detection efforts)
  • Number of children identified with delays connected to early intervention services supported by Title V. (Shows linkage to intervention services)

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

  • Percent of early intervention process that are family-centered. (Measures quality of intervention practices)
  • Percent of caregivers actively engaged in planning their child's intervention services. (Shows family engagement in intervention)

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

  • Number of cross-sector partners engaged in coordinating early intervention services that report high levels of engagement. (Measures system collaboration for intervention)
  • Number of policies supported by Title V established to support access to early intervention. (Assesses enabling conditions for intervention)
  • Number of communities demonstrating reductions in developmental differences through comprehensive intervention strategies. (Measures population-level impact of intervention)
  • Number of early intervention policies informed by family voices and scientific evidence. (Shows policy impact of intervention field-building)

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

  • Percent of intervention initiatives prioritizing families facing the greatest challenges to developmental support. (Measures impact of intervention efforts)
  • Percent of intervention resources allocated to building capacity across communities. (Assesses orientation of intervention investments)
  • Percent of early detections and developmental outcomes across multiple populations. (Measures intervention impact)
  • Percent of early childhood and family-serving systems and sectors that are fundamentally transformed to uphold early intervention policies and practices. (Shows longer-term, structural impact of early intervention in driving systems change)

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] Conroy, K., Rea, C., Kovacikova, G. I., Sprecher, E., Reisinger, E., Durant, H., Starmer, A., Cox, J., & Toomey, S. L. (2018). Ensuring Timely Connection to Early Intervention for Young Children With Developmental Delays. Pediatrics, 142(1), e20174017. https://doi.org/10.1542/peds.2017-4017

[2] Smith, C. J., James, S., Skepnek, E., Leuthe, E., Outhier, L. E., Avelar, D., Barnes, C. C., Bacon, E., & Pierce, K. (2022). Implementing the Get SET Early Model in a Community Setting to Lower the Age of ASD Diagnosis. Journal of developmental and behavioral pediatrics : JDBP, 43(9), 494–502. https://doi.org/10.1097/DBP.0000000000001130

[3] Fauth, R. C., Kotake, C., Manning, S. E., Goldberg, J. L., Easterbrooks, M. A., Buxton, B., & Downs, K. (2023). Timeliness of Early Identification and Referral of Infants with Social and Environmental Risks. Prevention science : the official journal of the Society for Prevention Research, 24(1), 126–136. https://doi.org/10.1007/s11121-022-01453-6

[4] Sheldrick, R. C., Frenette, E., Vera, J. D., Mackie, T. I., Martinez-Pedraza, F., Hoch, N., Eisenhower, A., Fettig, A., & Carter, A. S. (2019). What Drives Detection and Diagnosis of Autism Spectrum Disorder? Looking Under the Hood of a Multi-stage Screening Process in Early Intervention. Journal of autism and developmental disorders, 49(6), 2304–2319. https://doi.org/10.1007/s10803-019-03913-5

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.