“Birth to 5: Watch Me Thrive!” has been promoting universal, broad-band developmental and social-emotional screening in children ages 0 to 5 years across the health care, early childhood education and social service sectors. With the U.S. federal government and AAP combining forces to promote periodic developmental-behavioral screening, the next step is for the U.S. to address its capacity crisis for providing high-quality early intervention and learning services.
A new article in Pediatrics proposes that every U.S. state needs: 1) a family-friendly, screening and care coordination entity, 2) comprehensive, tiered, and equitable assessments for “at-risk” or referred children, 3) universal access to high-quality early learning or preschool programs, and 4) continuous accountability for the early detection process from birth to 5 years, and this includes an outcome-based metric for kindergarten readiness. Leaders in health, education, and social service sectors must boldly address our nation’s capacity crisis in a system-wide manner. US early learning (especially IDEA Part C) services must become more equitable, efficient, and effective so that the focus is always on the developmental-behavioral needs of the child.
For more information developmental-behavioral monitoring and training, visit the Learn the Signs. Act Early. Campaign at http://www.cdc.gov/ncbddd/actearly/hcp.
A subcommittee of the Early Childhood Six by’15 workgroup authored this commentary: Kevin P. Marks, MD, Adriane K. Griffen, MPH, MCHES, Patricia Herrera, MS, Michelle M. Macias, MD, Catherine E. Rice, PhD, and Cordelia Robinson, PhD, RN. The authors acknowledge and give special thanks to the other members of the Sixby’15 workgroup: Abigail Alberico, Jeffrey P. Brosco, Shannon Haworth, Andy Imparato, Ben Kaufman, Bergen Nelson and Jamie Perry.
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Gone are the days of “let’s just wait and see if he/she will grow out of it.” The federal-level initiative, Birth to Five: Watch Me Thrive!, is heavily promoting developmental-behavioral screening in children 0 to five 5 of age. Healthcare providers are routinely screening children for developmental delays, autism, behavioral problems and “at-risk conditions.
Politicial candidates in 2016 should know this new “standard of care” has dramatically increased referral rates to early intervention (EI) programs. The next step is to improve our early detection and intervention system for delayed and at-risk/disadvantaged children. For every dollar spent on high-quality early learning, there’s a 7-10 percent annual return rate in cost savings to society—and the younger the child served, the wiser the investment.
Continue reading full article here.
In 2010, a report from the Office of Inspector General (OIG) was released detailing findings of children enrolled in Medicaid who were not receiving all required Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) screenings, nor were they receiving complete medical screening. Based on four recommendations from OIG, the Centers for Medicare and Medicaid Services (CMS) has taken steps towards encouraging children’s participation in these screenings and ensuring proper medical screenings.
Through interviews with the CMS staff, representatives of workgroups relating to EPSDT issues, and reviewing States’ reports on EPSDT participation, CMS found that since 2010, action has been taken to address the recommendations laid out by OIG, but they have not fully addressed each problem area. While children’s participation in EPSDT screenings have increased from 56 percent in 2006 to 63 percent in 2013, these are still below the Secretary’s 80 percent participation goal. Based on these findings, OIG believes all four of the same 2010 recommendations from the report need to stay open.
Read the full report.
Autism Speaks has officially endorsed the Six by ’15 Campaign! Founded in 2005, Autism Speaks is now the world’s largest autism science and advocacy organization.
Their Early Access to Care Initiative seeks to reduce the average age of diagnosis and increase access to high-quality early intervention for all children on the autism spectrum. This initiative will help achieve our goal of increasing the proportion of children who receive recommended developmental screening and improving access to services for children identified by that screening.
According to the CDC, the average age of diagnosis is 4-5 years, but a reliable autism diagnosis can be made as early as 18-24 months. While early detection is critical, research shows that many parents have very little knowledge about autism and its symptoms. Many studies have also documented that racial ethnic minority populations and those of lower socioeconomic status are diagnosed later. The earlier children are identified, the earlier they are able to receive early intervention services. Evidence-based early intervention services have been shown to reduce the core symptoms of autism, improve IQ and daily functioning.
Improving this unacceptable situation will take the combined efforts of families, healthcare professionals, educators and autism advocates in every community.
Resources of the initiative include:
- First Concern Action Tool Kit
- Resources for Parents
- Engaging Professionals
- Engaging Community Partners
- Research and Progress in Early Intervention
Information En Espanol: Acceso Temprano A Servicios – Autism Speaks
When is your toddler’s difficult behavior cause for concern? Learn more in this post, originally from the Urban Child Institute.
Partnerships between health care providers and community organizations could have a significant impact on health and developmental outcomes by assisting with early identification, supporting parents, and coordinating needed services in a timely manner. One successful example of such a partnership is led by 211 LA County.
Learn more about how LA County is improving developmental screening:
The Six by ’15 campaign aims to raise visibility of ways that states are improving the lives of people with disabilities and achieving the Six by ’15 goals. To that end, we will be posting examples of innovative state leaders on each of our goals, in a new series we’re calling Do This in Your State!
Oregon is leading in innovative approaches to increasing early childhood screening rates. Here’s how Judy Newman, Co-Director of Early Childhood CARES at the University of Oregon UCEDD describes their work:
The developmental screening was originally focused on the START training in doctors offices around the state. The START program is still providing many trainings around the state in addition to other screening efforts focused on medical professionals, childcare providers, and agency staff. Developmental screening is very much a statewide priority. One of the main objectives of the developmental screening initiative is to identify children needing help as early as possible and linking them with needed services and supports in their community. The early learning system, through the newly formed Early Learning Hubs are working to make sure this happens. A very important aspect of ensuring that referrals are made to appropriate services as soon as possible, is having up-to-date and easily accessible information about local services and supports. This is currently being done through our 211 info and 211 info Family a line specifically for parents of young children, Calls and texts are free, live and confidential. The line is staffed by master’s level professionals who also have the benefit of leveraging the 211info network database with thousands of community resources. They respond to inquiries about child development and behavioral strategies, school readiness and success, family stress and anxiety, parent support groups, playgroups, basic family resources.
This brief shares their experiences in working in these areas of screening and services – from building baseline data to tracking through to services. Developmental Screening in Oregon- 2014
Learn how parts of Help Me Grow were incorporated into Oregon’s early detection system (the ABCD & ABCD III projects, the START project, the “211 info” line): Oregon Help Me Grow Replication
This week’s Morbidity and Mortality Weekly Report published a supplement that examined the use of selected clinical preventive services among infants, children, and adolescents in the United States. This supplement indicates that millions of U.S. infants, children, and adolescents did not receive key clinical preventive services, such as screening for child development. In 2007, parents of almost eight in ten (79%) children aged 10–47 months were not asked by healthcare providers to complete a formal screen for developmental delays in the past year.
Increased use of clinical preventive services could improve the health of infants, children, and adolescents and promote healthy lifestyles that will enable them to achieve their full potential. Read the full Morbidity and Mortality Weekly Report article: Use of Selected Clinical Preventive Services to Improve Health of Infants, Children, and Adolescents – United States, 1999-2011
The Six by ’15 Campaign wants to see more children receive recommended developmental screening so that they can access the services they need as early as possible. Here on the blog, we invite contributions from partners in the disability community. Here are some new resources from the American Academy of Pediatrics and American Academy of Child and Adolescent Psychiatry on ways to enhance and strengthen early detection and intervention system.
Learn where your state stands and what they can do better to promote early childhood development with these tools:
See how your state is doing in the area of early childhood by looking at data available from the Early Childhood Data Collaborative (ECDC). The ECDC’s 2013 Early Childhood Data Systems Survey revealed states’ capacity to link child-level data, collect child development data, and governance of coordinated early childhood data systems varied. Observing the ECDC data is another way to assess changes in your state.
To promote a more coordinated approach to meeting the developmental needs of children, the Screening, Early Identification, Referral, Intake, Evaluation, and Services (SERIES) model was developed as a way to promote shared responsibility for helping each child successfully completes the entire pathway from screening to services. Check out the SERIES model as an example of how states can approach supporting child development.