Delaware’s Efforts to Provide Developmental Screening
When the 2007 National Survey of Children’s Health indicated that only 10.9% of children were screened as part of well-child visits in Delaware, the Delaware State Legislature passed legislation requiring private insurance providers to pay for developmental screening and appropriated funding for the Delaware Division of Public Health (DPH) to increase support for health providers to screen.
The Early Childhood Comprehensive Systems and the Maternal, Infant, and Early Childhood Home Visiting federal grants were partners in this effort and participated on the Help Me Grow Advisory Board.
Operated by United Way, Delaware’s Help Me Grow is a community outreach system for families and caregivers with children from birth to age 8. It includes a 2-1-1 phone line, a statewide centralized intake system, and referral mechanisms to community services. Help Me Grow, all home visiting programs, and early childhood providers are using the Ages and Stages Questionnaires, Third Edition (ASQ-3) and Ages and Stages Questionnaires: Social-Emotional (ASQ:SE2) to screen. Help Me Grow contracted with vendors to provide health ambassadors who link families to services, facilitate referrals and help families improve health outcomes.
In 2012, the DPH, the Delaware Chapter of the American Academy of Pediatrics, Nemours Health and Prevention Services and others launched the PEDS (Parents’ Evaluation of Developmental Status) Online initiative. PEDS Online, ASQ and ASQ-SE are recognized as comparable screening tools; since the PEDS takes less time, it is viewed as preferable for medical providers. Using evidence-based tools, PEDS Online determines children’s risks for various kinds of developmental and behavioral problems and provides an algorithm for the physicians’ referrals. It has automated scoring, generates referral letters and take-home parent summary reports, and identifies the essential billing and procedure codes. The database documents the children screened, the medical practices screening and those in need of training. Delaware’s Academy of Medicine created how-to videos to help medical providers implement screening processes and the Nemours Foundation provided implementation advice and physician champions to encourage other clinicians to embrace the initiative.
Despite progress, some challenges remain, including solidifying buy-in from health providers to use evidence-based screening tools and helping parents to feel comfortable with the online screening version.
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