Policy Resource

Delaware’s Efforts to Provide Developmental Screening

Jul 9, 2017

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 the Department of Public Health (DPH), Delaware’s Help Me Grow is a central access point for families and caregivers with children from birth to age 8. It includes a 2-1-1 phone line, an intake system, and referral and follow-up 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. DPH contracted with vendors to provide health ambassadors who link families to services, facilitate referrals and help families improve health outcomes.

In 2012, 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 milestone domains passed or failed. In partnership with DPH, Delaware Academy of Medicine created how-to videos to help medical providers implement screening processes DPH, in partnership with American Academy of Pediatrics also provides training and technical assistance to pediatricians on how to use the screening tools. For the 2018 calendar year, pediatric practices that signed up to implement the PEDS tool administered 28,231 screens, averaging about 2,353 screens per month. Of the 28,231 screens, 20,126 were of unique children. About 8 percent of the screens were also considered potential high risk for delays.

ASQ screening data received through the Office of Early Learning from August 1 2017 to July 31, 2018 shows a total of 4,923 screens administered by child care providers.

Despite progress, some challenges remain, including securing buy-in from health providers to use evidence-based screening tools and building parent knowledge of developmental milestones and the importance of screening

Updated July 2019

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