ABCD Activities

ABCD Activities

Research demonstrates that children’s healthy development is essential to school readiness, academic success, and overall well-being. Services that support young children’s healthy development can reduce the prevalence of developmental and behavioral disorders that have high costs and long-term consequences for health, education, child welfare, and juvenile justice systems.

The American Academy of Pediatrics (AAP) recently released a policy statement, Identifying Infants and Young Children with Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening, which recommends that developmental surveillance be performed at every preventive visit and that a screening tool should be administered at 9-,18-, and 24- or 30-month visits and for those children whose surveillance yields concerns about delayed or disordered development. However, as more children are identified as needing further evaluation, diagnostic/assessment or treatment/intervention services, the weakness of the child-serving systems and linkages among providers becomes increasingly apparent.

It is clear that more must be done to assure access to the diagnostic assessment and early intervention services needed as follow-up to developmental screening. Building on current research and best practices from across the country, there are opportunities for states to strengthen linkages among services and thus to promote healthy child development.

This section provides an overview of relevant findings from the science of early childhood development. It includes links to a comprehensive on–line bibliography as well as to a number of reports that draw on current research to develop strategies for state and local programs and policies. It makes the case for involvement of both clinicians and policymakers.

Sources include:

Johnson K and Rosenthal J, Improving Care Coordination, Case Management, and Linkages to Service for Young Children: Opportunities for States. (Portland, ME: The National Academy for State Health Policy, April 2009).

Institute of Medicine, Reducing Risks for Mental Disorders: Frontiers for preventive intervention research (Washington, DC: National Academy of Sciences, 1994); Carnegie Task Force on Meeting the Needs of Young Children. Starting Points: Meeting the Needs of our Youngest Children” (New York, NY: Carnegie Corporation of New York, 1994).

Title	Description	Date Published	Resource	State
Early Intervention for Infants & Toddlers with Disabilities and their Families: Participants, Services, and Outcomes	Kathleen Hebbeler et al. (U.S. Office of Special Education Programs and SRI International, January 2007). Final Report of the National Early Intervention Longitudinal Study (NEILS). This report from the 10-year NEILS summarizes key findings from the study and notes their implications for policy, practice, and additional research. This report finds that children with developmental problems are in poorer health. (From website)	January 2009	Other
All County Letter (ACL) regarding availability of early intervention services	(The California Department of Social Services) This transmittal letter, while initially focused on referring children who have experienced child abuse to the Early Start Program, also expresses California's conclusion that a local coordinated process should identify multiple pathways to provide early intervention services and not be solely dependent on Early Start services, and lists several recommended strategies taken from resources with existing programs and/or experiences with the implementation of the CAPTA amendment.	December 2008	State-specific	California
ABCD Screening Academy Progress Report: Improving the Identification of Young Children At-Risk for Developmental Delay	(Jennifer May, NASHP) Since 2000, the Assuring Better Child Health and Development (ABCD) Initiative has shown that states can take action to facilitate pediatric provider use of a developmental screening tool and that doing so is an important first step in improving the delivery of child development services. The Initiative's partners - NASHP and The Commonwealth Fund - have for the past 18 months conducted the ABCD Screening Academy.	September 2008	NASHP - Commonwealth
Center for Disabilities and Development website	(University of Iowa HealthCare) The website of Iowa's University Center for Disabilities and Development, an ABCD project partner.	December 2007	State-specific	Iowa
An Introduction to Developmental Services for Colorado Health Care Providers	(Colorado ABCD Project) 3-fold color pamphlet for physicians that promotes developmental screening.	January 2007	State-specific	Colorado
EPSDT Resources	(Kay Johnson) PowerPoint presentation for ABCD Screening Academy Learning Session, July 2007. This presentation provides an overview and background information about EPSDT, as well as pediatric issues in managed care.	December 2007	NASHP - Commonwealth
Rationale for using tools other than the Denver II (DDST-II) for screening children	(Minnesota Department of Health) Minnesota does not require any particular instrument in their EPSDT program. However, they have made it clear in policy that in order to bill a 96110 code they expect that a standardized, validated tool is used. Minnesota posted on their Developmental Screening Task Force web site a summary describing for readers why the Denver does not make the list of recommended tools. It is a useful explanation which has helped a lot of providers in Minnesota to understand why they should move on to better instruments.	December 2007	State-specific	Minnesota
EPSDT, Well Child Care and Children's Development	(Edward L. Schor) PowerPoint presentation for ABCD Screening Academy Learning Session, July 2007. This presentation focuses on the role of EPSDT and well child care in children's development.	July 2007	NASHP - Commonwealth
Summary of the Messaging worksheets completed by states during the Learning Session.	(NASHP) This resource is a summary of the Messaging worksheets completed by states during the Learning Session.	July 2007	NASHP - Commonwealth
Healthy Mental Development in the Young Child: The Case for Practice Change newsletter	(Alfred Healy, Kay DeGarmo: Care for Kids Newsletter Vol. 14 No. 1) This newsletter outlines the scientific understandings in child development that highlight the need for health providers to alter their current practices.	March 2007	State-specific	Iowa
Early Intervention for Infants & Toddlers with Disabilities and their Families: Participants, Services, and Outcomes	(Kathleen Hebbeler et al.: U.S. Office of Special Education Programs and SRI International). Final Report of the National Early Intervention Longitudinal Study (NEILS). This report from the 10-year NEILS summarizes key findings from the study and notes their implications for policy, practice, and additional research. This report finds that children with developmental problems are in poorer health. (From website)	January 2007	Other
Healthy Mental Development	(Early Childhood Iowa: Issue Brief No. 1) This issue brief is the first in a series developed by Early Childhood Iowa (ECI) Quality Services and Programs Component Group. This issue brief is intended to help inform policy makers about the importance of Healthy Mental Development for children from birth through five and their families.	December 2006	State-specific	Iowa
HRSA UIC Perinatal Depression Project Information	(University of Illinois at Chicago (UIC), Perinatal Depression Project) This resource outlines information about the UIC Perinatal Depression Project sponsored by HRSA (Health Resources and Services Administration) and The Michael Reese Health Trust. This project, a partner in the ABCD project, was designed to increase understanding and awareness of depression during pregnancy and postpartum (peripartum) among health care providers, affected women and family members in Illinois.	December 2006	State-specific	Illinois
The Timing of Maternal Depressive Symptoms and Mothers' Parenting Practices With Young Children: Implications for Pediatric Practice	(Kathryn Taaffe McLearn, Cynthia S. Minkovitz, Donna M. Strobino, Elisabeth Marks, and William Hou. Pediatrics Vol. 118 No. 1 July 2006, pp. e174-e182 [doi:10.1542/peds.2005-1551]) This study sought to determine whether concurrent maternal depressive symptoms have a greater effect than earlier depressive symptoms on the emergence of maternal parenting practices at 30 to 33 months in 3 important domains of child safety, development, and discipline. (From Objective)	July 2006	Peer-reviewed
Developmental Stages of Developmental Screening: Steps to Implementation of a Successful Program	(Jennifer A. Pinto-Martin et al. Am J Public Health, Nov 2005; 95(11):1928-1932) This article discusses the challenges of instituting universal developmental screening as part of pediatric care and presents two models of existing or planned programs of early screening for autism spectrum disorder and developmental disability. (From abstract).	November 2005	Peer-reviewed
Developmental Screening and Assessment under EPSDT	CMS State Medicaid Manual, Part 5: EPSDT	September 2005	Other
The Role of States in Improving Health and Health Care for Young Children	(Vernon Smith: The Commonwealth Fund) This report highlights how states are uniquely positioned to make significant improvements in the quality of health and heath care for young children, due to their roles as administrators of Medicaid and the State Children's Health Insurance Program, as well as mental health, public health, and education programs. (From Abstract)	July 2005	NASHP - Commonwealth
Pediatricians' reported practices regarding developmental screening: Do guidelines work? Do they help?	(Nina Sand et al. Pediatrics. Jul 2005;116(1):174-179) This article discusses the impact of AAP policy statements on physicians' use of screening for developmental delays.	July 2005	Peer-reviewed
American Academy of Pediatrics--Iowa Chapter Newsletter: Spring 2005	(American Academy of Pediatrics Iowa Chapter. The Heartland Pediatrician Spring 2005 Article p.7) This newsletter article details the Academy's recommendation that practices develop a strategy to provide periodic standardized screening in the context of office-based primary care based on the June 2006 AAP Algorithm. The Academy statement also acknowledges that children and families are best served when provider screening efforts are coordinated with tracking and intervention services available in the community.	June 2005	State-specific	Iowa
Organizational Characteristics and Preventive Service Delivery in Private Practices: A Peek Inside the "Black Box" of Private Practices Caring for Children	(Greg Randolph et al. Pediatrics, Jun 2005. 115(6):1704-1711) Focusing on North Carolina, this article describes selected organizational characteristics and preventive service delivery features that might affect the quality of primary care for children in private practices. The authors find low levels of preventive service performance and substantial variation in performance among practices.	June 2005	Peer-reviewed
Rethinking Well Child Care	(Edward Schor: The Commonwealth Fund) Presentation at Primary Children’s Medical Center, Salt Lake City, Utah, May, 2005	May 2005	State-specific	Utah
Infant/Early Childhood Mental Health: A Concern for All	(Cindy Oser: Zero to Three) Presentation at HRSA/MCHB Grantee Meeting, October 5, 2004.	October 2004	Other
Early Child Development in Social Context: A Chartbook	(Brett Brown and Michael Weitzman. New York, NY: The Commonwealth Fund) This chartbook reviews more than 30 key indicators of development and health for children up to age 6, as well as social factors in families and communities that affect these outcomes. It also offers practical implications for practitioners and parents. (from web overview)	September 2004	NASHP - Commonwealth
Rethinking Well Child Care	(Edward L. Schor. Pediatrics. July 2004; 114(1): 210-216) This article dissusses the need "for major revision of well-child care, taking into account the varying needs of individual children and families, the operation of child health care practices, and the broad issues of access to primary care and payment for services within the US health care system." (From abstract).	July 2004	Peer-reviewed
Measuring the Quality of Preventive and Developmental Services for Young Children: National Estimates and Patterns of Clinicians' Performance	(Christina Bethell. Pediatrics. Jun 2004;113 (6 Suppl):1973-83) Using National Survey on Early Childhood Health data, this article generates a national picture of performance in the area of preventive and developmental services for children aged 4 to 35 months using four composite quality measures in the areas of 1) anticipatory guidance and parental education, 2) screening for family psychosocial risks, 3) screening for smoking and drug and alcohol use in the home, and 4) provision of family-centered care.	June 2004	Peer-reviewed
Quality of Health Care for Children and Adolescents: A Chartbook	(Sheila Leatherman and Douglas McCarthy. New York, NY: The Commonwealth Fund) The authors of this chartbook take a close look at the care provided to children and adolescents, building on their prior study of data for the overall U.S. population. After reviewing more than 500 studies, the authors selected 40 charts and analyses to represent the current state of pediatric health care.	April 2004	NASHP - Commonwealth
First Experiences With Early Intervention: A National Perspective	(Donald B. Bailey et al. Pediatrics, Apr 2004; 113(4): 887-896) This article describes families' experiences interacting with medical providers to determine eligibility and access services in response to concern about a child's development.	April 2004	Peer-reviewed
ABCD: Lessons from a Four-State Consortium	(Helen Pelletier and Melinda Abrams: NASHP) This report summarizes the lessons learned from a four-state collaborative concerned with strengthening the capacity of the health care system to support the early development of children from low-income families. The report details both the significant accomplishments of the four states and the challenges they faced in their efforts to strengthen early childhood development services.	December 2003	NASHP - Commonwealth
How Do Primary Care Physicians Identify Young Children with Developmental Delays? A National Survey	(Laura Sices et al. J Dev Behav Pediatr. Dec 2003;24(6):409-417) This article focuses on the practices of primary care physicians regarding developmental surveillance and screening during pediatric preventive care visits (From abstract).	July 2003	Peer-reviewed
Building a Bridge from Birth to School: Improving Developmental and Behavioral Health Services for Young Children	(Neal Halfon, Michael Regalado, and Kathryn Taaffe McLearn. New York, NY: The Commonwealth Fund) In this report the authors review existing guidelines for developmental care of young children, from birth to their entry to school. They then assess the evidence for the effectiveness of providing such care in primary care settings. (From web briefing note)	May 2003	NASHP - Commonwealth
Children’s Mental Health: An Urgent Priority for Illinois: Final Report of Illinois' Children’s Mental Health Task Force	(Illinois Children’s Mental Health Partnership, ICMHP) This final report by the Illinois Children's Mental Health Task Force presents a cutting-edge approach to the continuum of mental health development, support and treatment that children need from birth to age eighteen. (From Foreword) http://www.isbe.net/spec-ed/pdfs/cmh_priority.pdf	April 2003	State-specific	Illinois
Identification of Children 36 Months at Risk for Developmental Problems and Referral to Early Identification Programs	AAP, Division of Health Policy Research, April 2003. Periodic Survey #53: Executive Summary. This survey was initiated by the American Academy of Pediatrics' Project Advisory Committee-Medical Home Initiatives for Children with Special Needs (National Center) to explore pediatricians' experiences with identifying children <36 months at risk for developmental problems and their perceptions of, involvement with, and referrals to Early Intervention (EI) programs. (From executive summary).	April 2003	Peer-reviewed
Postpartum Depression in Utah	Utah Department of Health. Facts and figures about the prevalence of postpartum depression in Utah.	December 2002	State-specific	Utah
Reasons and Strategies for Strengthening Child Development Services in the Healthcare System	Karen VanLandeghem, Deborah Curtis, Melinda Abrams. (Portland, ME: National Academy for State Health Policy, October 2002). This report summarizes research on early brain development; highlights innovative practices in Washington, Kentucky, North Carolina, and California; and offers concrete steps states can take to strengthen early childhood development services.	October 2002	NASHP-Commonwealth
Primary Care Services: Promoting Optimal Child Development from Birth to Three Years	Michael Regalado, Neal Halfon. (New York, NY: The Commonwealth Fund, September 2002). This report defines and examines the evidence for the effectiveness of health services specifically targeted at promoting optimal development in children from birth to 3 years of age. The services reviewed are provided in general pediatric settings as part of routine well-child care and health supervision. (From the Executive Summary)	September 2002	NASHP-Commonwealth
Profile of referrals for early childhood developmental delay to ambulatory subspecialty clinics	M.I. Shevell et al. J Child Neurol. Sep 2001;16(9):645-650. This article focuses on the profile and pattern of referral to subspecialty clinics of young children with suspected developmental delay, along with the factors prompting their referral. (From abstract).	September 2001	Peer-reviewed
Effectiveness of Compliance With Pediatric Preventive Care Guidelines Among Medicaid Beneficiaries	Rosemarie B. Hakim and Barry V. Bye. Pediatrics, July 2001;108(1): 90-97. This article finds that a series of well-child visits maintained during the first 2 years of life has a positive effect on health outcomes as indicated by a decrease in avoidable hospitalizations among poor and near-poor children, regardless of race, level of poverty, or health status. (From abstract)	July 2001	Peer-reviewed
Improving the Delivery of Health Care that Supports Young Children’s Healthy Mental Development	Neva Kaye. (Portland, ME: National Academy for State Health Policy, February 2008). This report details the results of the 3-year project, Assuring Better Child Health and Development (ABCD II) Consortium. The five states that participated in the second ABCD project were successful in improving child development services, increasing the rate of identification of children in need of developmental services, and improving the likelihood that those identified with a potential need received appropriate follow-up services.	June 2001	NASHP-Commonwealth
Prevalence of Depressive Symptoms in Late Pregnancy and Postpartum	Ann Josefsson et al. Acta Obstet Gynecol Scand, Mar 2001; 80(3): 251-255. This article discusses the prevalence and detection of postnatal depression and depression in late pregnancy.	March 2001	Peer-reviewed
From Neurons to Neighborhoods: The Science of Early Childhood Development	Jack Shonkoff and Deborah Phillips. (Washington, DC: National Research Council and Institute of Medicine, 2000). This book presents important conclusions about nature-versus-nurture, the impact of being born into a working family, the effect of politics on programs for children, the costs and benefits of intervention, and other issues. The committee issues a series of challenges to decision makers regarding the quality of child care, issues of racial and ethnic diversity, the integration of children's cognitive and emotional development, and more. (From overview)	December 2000	Peer-reviewed
Postpartum Depression: It's Not Just the Blues	D. Yvette LaCoursiere. (University of Utah). Presentation about postpartum depression: overview, etiology, screening and treatment.	December 2000	State-specific	Utah
Screening for speech and language delay: A systematic review of the literature	J. Law, J. Boyle, F. Harris, et al. Health Technology Assessment. 1998 2(9): 1-184. This review aims to provide the information needed to help decide whether universal screening for speech and language delays should be implemented. (From executive summary).	December 2000	Peer-reviewed
The feasibility of universal screening for primary speech and language delay: Findings from a systematic review of the literature	James Law et al. Developmental Medicine and Child Neurology. 2000; 2(3):190-200. This paper reports on a systematic review of the literature commissioned to examine the feasibility of universal screening for speech and language delay. This paper discusses the type of data that would be needed to address this issue further and recommendations are made for alternative approaches to early identification. (From abstract).	December 2000	Peer-reviewed
Assuring the Healthy Development of Young Children: Opportunities for States	Peter Budetti, Carolyn Berry, Patricia Butler, et al. (New York, NY: The Commonwealth Fund, February 2000). This issue brief examines opportunities for states to enhance the provision of health-related developmental services to children in low-income families. In particular, it emphasizes the importance of preventive developmental service--formal developmental assessments, assessments of family and social risk factors, and enhanced parent education--in primary, pediatric practices. (From Overview)	February 2000	NASHP-Commonwealth
Early identification of children's special needs: A study in five metropolitan communities	Judith Palfrey et al. J Pediatr. Nov 1987;111(5):651-659. This article focuses on the identification of children's problems and the involvement of the medical system in the diagnosis.	November 1987	Peer-reviewed
Effect of the Pediatrician on the Mother-Infant Relationship	Casey and Whitt. Pediatrics, Apr 1980 65(4), 815-820. This article discusses the positive effect of well child care on mother-infant relationships.	April 1980	Peer-reviewed

Broad stakeholder participation helps improve the design of project models, encourages stakeholders to add resources to the projects, and builds support for program expansion, policy improvement, and practice change. Partnerships with providers and provider associations are crucial to obtaining provider acceptance and support. The creation of a state public/private partnership that explicitly includes pediatric provider leadership and families will improve the quality of care delivered in primary care settings. Additionally, active partnerships with providers and provider associations are crucial to obtaining provider acceptance and support for change. Active participation of state agencies, including Maternal and Child Health bureaus, children’s mental health departments and lead agencies for Early Intervention/Part C, can support the spread of structured screening and improve linkages between primary health care providers and other child and family service providers and community resources, assuring young children and their families receive needed services.

This section includes tools created to help identify and engage a wide range of stakeholders in state efforts to improve the healthy development of young children.

Title	Description	Date Published	Resource	State
Maryland Developmental Screening Tool Selection Subcommittee	(Maryland ABCD Project) PowerPoint presentation describing Maryland's Developmental Screening Tool Selection Committee process.	December 2008	State-specific	Maryland
Notes from California's Early Childhood Development Summit	(California ABCD Screening Academy Project) Notes from California's Early Childhood Development Summit that brought stakeholders together to agree to a direction for the ongoing work of the State Leadership Collaborative on Early Childhood Development including: 1) A preliminary vision for working together; 2) Immediate next steps for producing results and sustaining our work.	December 2008	State-specific	California
Strategic Plan for Building a Comprehensive Children’s Mental Health System in Illinois	Illinois Children’s Mental Health Partnership (ICMHP).	September 2008	State-specific	Illinois
Ohio ABCD Screening Academy stakeholder meeting held June 2008	(Ohio ABCD Screening Academy Project) PowerPoint presentation from Ohio stakeholder meeting held June 19, 2008. Presentation describes: Governor Strickland’s TurnAround Ohio Vision, a NASHP grant overview, subcommittee reports, and Health Disparities & Cultural Competence.	June 2008	State-specific	Ohio
Illinois Healthy Beginnings Advisory Committee	(Illinois Healthy Beginnings) One-page discussion of issues Illinois faced developing their Stakeholder Advisory Committee.	December 2007	State-specific	Illinois
Illinois Healthy Beginnings: Advisory Committee Structure	(Illinois ABCD Project) This document (shared at the June 18, 2007 ABCD TA call) describes how the Illinois ABCD Project (Illinois Healthy Beginnings) engaged stakeholders by creating an Advisory Committee and five subcommittees.	December 2007	State-specific	Illinois
Engaging and Working with Stakeholders	(Scott Allen, Lori Smith, Carrie Fitzgerald) This presentation (shared at the June 18, 2007 ABCD TA call) describes why stakeholder engagement is important and details how three states (Illinois, Utah, and Iowa) reached out to stakeholders and structured their advisory groups.	December 2007	NASHP - Commonwealth
State examples of stakeholder group structure	(Jennifer May: NASHP) This document summarizes critical information about stakeholder groups in three of the ABCD states: Illinois, Iowa, and Utah. The brief describes stakeholder group leadership, membership, subcommittee structure, and frequency of meetings.	December 2007	NASHP - Commonwealth
Engaging and Working with Stakeholders conference call	(NASHP) PowerPoint presentation for ABCD Screening Academy Technical Assistance Call held June 18, 2007: Engaging and Working with Stakeholders.	June 2007	NASHP - Commonwealth
Assuring Better Child Health and Development: A Screening Academy: ABCD Consortia states' stakeholder group structure examples	(Ann Cullen: NASHP)This document provides examples of ABCD Consortium experiences with stakeholder group engagement and summarizes critical information about stakeholder groups in three of the ABCD states: stakeholder group leadership, membership, subcommittee structure, and frequency of meeting.	December 2006	NASHP - Commonwealth
Update on the ABCD Project, Enhancing Utah's Capacity to Support Children Children’s Healthy Mental Development	(Utah ABCD Project) This PowerPoint presentation was used to update stakeholders on Utah's ABCD II project accomplishments and next steps.	December 2006	State-specific	Utah
Minimum Standards and Guidelines	(Iowa's ABCDII Project) This resource consists of the final guidelines developed for Medicaid providers for the identification of developmental and social-emotional problems in young children.	December 2006	State-specific	Iowa
Advisory Board Development	(North Carolina ABCD Project) This document explores key participants, rationale and timing in the development an Advisory Board.	December 2006	State-specific	North Carolina
State Advisory Board Invitation	(North Carolina ABCD Project) This letter was developed to invite key stakeholders to participate in the ABCD project Advisory Board.	December 2006	State-specific	North Carolina
State Advisory Board Work plan	(North Carolina ABCD Project) This work plan was developed as part of the invitation for participation in the Advisory Board. The board’s mission, to address policy, reimbursement, and implementation issues necessary to assure that a model system can be replicated for all Medicaid children, is presented along with members’ responsibilities.	December 2006	State-specific	North Carolina
Supporting Maternal and Infant Mental Health: Beyond the Baby Blues	(Antonia Wilcoxon: Minnesota Department of Human Services) This PowerPoint presentation for the Baby Blue Conference highlights strategies for supporting maternal and infant mental health in primary care.	May 2006	State-specific	Minnesota
Agenda from Leadership Workshop on EPSDT and Title V: Collaboration to Improve Child Health Outcomes: April 27, 2006	(Iowa ABCD Project) Agenda from a Leadership Workshop on improving collaboration between EPSDT and Title V services.	April 2006	State-specific	Iowa
Early Childhood Health Systems Integration: Principles for Consideration	(Iowa Institute for Public Health Practice) This document is a summary of 5 goals participants at the Early Childhood Health Systems Integration conference identified as early childhood health policy priorities within the framework of the Early Childhood Iowa Strategic Plan.	February 2006	State-specific	Iowa
What Doctors Should Know About: The Impact of Poverty on Young Children	(Utah ABCD Project) Informational handout that summarizes issues related to the impact of poverty on young children and suggests options for advocacy, helping families and further information.	December 2005	State-specific	Utah
Building the Foundation for Bright Futures: Final Report of the NGA Task Force on School Readiness	(Washington, DC: National Governor’s Association) This report highlights how states are leading the way in promoting school readiness and shows that there already exists much on which to build. This report presents different options for state action and provides a policy framework for coordinating state decisions across programs and agencies. (From Foreword)	December 2005	Other
The Role of State Public Health in Perinatal Depression	(ASTHO) ASTHO Maternal and Child Heatlh Fact Sheet provides an overview of perinatal depression and describes federal and state roles in addressing this as a public health issue.	December 2005	Other
Assuring Better Child Health and Development (ABCD II): Illinois’ Healthy Beginnings: Overview of ABCD II and the Pilot Project	(Illinois ABCD II Advisory Committee) This resource is an ABCD project update/overview for the Pilot Project Advisory Subcommittee meeting.	October 2005	State-specific	Illinois
ABCD II Healthy Beginnings Lessons Learned #2	(Illinois ABCD Healthy Beginnings) This report details lessons learned from periodic interviews with Healthy Beginnings subcommittee co-chairs.	June 2005	Peer-reviewed	Illinois
Children's’ Mental Health: An Overview and Key Considerations for Health System Stakeholders	(Karen VanLandeghem and Catherine Hess. Washington, DC: National Institute for Health Care Management Foundation) This paper provides an overview of child and adolescent mental health and considerations and resources for health care providers, health plans, and policymakers in addressing the mental health needs of children, youth, and their families. (From Executive Summary)	February 2005	Other
Iowa's ABCD II Healthy Mental Development Panel Prevention and Identification Workgroup	(Iowa's ABCD Project) This resource lists workgroup members, staff, and responsibilities of the Developmental and Early Identification Workgroup under the ABCD Healthy Mental Development panel.	December 2004	State-specific	Iowa
Iowa's EPSDT/ABCD Healthy Mental Development Panel	(Iowa's ABCD Project) This resource lists responsibilities, logistics, and membership for the Healthy Mental Development Panel. The Panel was charged with recommending standards and policies needed to develop an effective, coherent healthy mental development system in Iowa, and monitoring project implementation and recommending changes to standards and delivery systems based on the project evaluation.	December 2004	State-specific	Iowa
Iowa's EPSDT/ABCD II Collaborative Board	(Iowa's ABCD Project) This resource lists the responsibilities, logistics, and membership of the EPSDT Interagency Collaborative Board. The EPSDT Interagency Collaborative Board (a pre-existing group) oversaw the Iowa ABCD project—receiving and acting on recommendations from the Health Mental Development Panel.	December 2004	State-specific	Illinois
ICAAP Membership Needs Assessment	(Illinois Chapter of the American Academy of Pediatrics, ICAAP) This resource includes a cover letter and survey instrument for physician offices regarding child development services procedures.	June 2004	State-specific	Illinois
UPIQ Charter	(UPIQ) Charter of the Utah Pediatric Partnership to Improve Children.	December 2003	State-specific	Utah
UPIQ Steering Committee Members	(UPIQ) List of UPIQ Steering Committee Members.	December 2003	State-specific	Utah
Growing Up Healthy: What Local Governments Can Do to Support Young Children and Their Families	(Parlakian, R., Washington, DC: Zero to Three) This paper examines the key areas in which local officials can have a measurable impact on growth and learning from birth to five.	December 2002	Other
FPs Play Important Role in Early Childhood Development	(Richard Hyer, American Academy of Family Physicians; AAFP News Department. October) This resource examines the importance of family physicians in identifying developmental delays. (From web overview)	October 2002	Peer-reviewed
Report of the Surgeon General	(Office of the Surgeon General. Washington, DC: U.S. Department of Health and Human Services) This report by the Surgeon General's Office introduces a blueprint for addressing children's mental health needs in the United States. According to the report, bridging the gap between research and practice is not the only necessary step. Connecting research and practice to policy is critical to ensuring access to quality mental health care for children and their families. (From Foreword)	December 2000	Other
What Utah has Done to Facilitate an ADHD Partnership	(UPIQ) Flyer on Utah's efforts to facilitate partnerships between Medical and Mental Health Providers, Educators, and Parents to address ADHD.	December 2000	State-specific	Utah

The American Academy of Pediatrics (AAP) policy statement, Identifying Infants and Young Children with Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening, recommends that developmental surveillance be performed at every preventive visit and that a screening tool should be administered at 9-,18-, and 24- or 30-month visits and for those children whose surveillance yields concerns about delayed or disordered development.

Across the country, states, providers, and communities are undertaking efforts to identify young children in need of early interventions by increasing the number who receive appropriate, objective standardized developmental screening. ABCD states have engaged and partnered with providers in education and training activities to improve implementation of structured screening procedures, through learning collaboratives, state conferences, grand rounds, teleconferences, and office-based training. Training topics range from best practices in developmental screening and perinatal depression to improving referral processes and access to follow up services.

Additionally, quality improvement projects across the country are testing strategies for improved developmental care, including linkages and Care Coordination/Case Management. These projects share a quality improvement philosophy and approach that includes bringing practices together for shared learning, engaging providers and other office staff, viewing the practice as a system of care and working through a cycle of change and assessment (e.g., plan, do, study, act, or PDSA).

This section will focus on what is being done to improve quality in practice.

*Johnson K and Rosenthal J, Improving Care Coordination, Case Management, and Linkages to Service for Young Children: Opportunities for States. (Portland, ME: The National Academy for State Health Policy, April 2009).

**Fine A and Mayer R, Beyond Referral: Pediatric care linkages to improve developmental health, (New York, NY: The Commonwealth Fund December, 2006.) (Pub.No. 976).

Title	Description	Date Published	Resource	State
SoonerStart Early Intervention Referral	(Oklahoma ABCD Project) This referral form is to be used to refer a potentially eligible infant or toddler (birth to 36 months) to the SoonerStart Early Intervention Program, and it includes a Child Referral Status Information form to return to the referring practitioner. If a provider has concerns that a child has one or more of the conditions listed, they should consider referring the child to the SoonerStart program.	February 2009	State-specific	Oklahoma
ASQ Age Administration Calculator	(California ABCD Screening Academy Project) Excel-based tool used to help providers determine which ASQ tool to use with a client. Enter client data and Excel will automatically calculate the age of the child in days and recommend the best ASQ tool to use.	December 2008	State-specific	California
Minnesota's letter to Healthy Development Collaborators introducing parent surveys of well-child visits	(Minnesota ABCD Screening Academy Project) Letter to participating practices introducing the surveys for parents of newborn up to 6-year-old child brought in for a well-child visit. This letter is included in a well-child survey packet sent to providers.	December 2008	State-specific	Minnesota
Ideas for ways to introduce the Promoting Health Development Parental Surveys of well-child visits	(Minnesota ABCD Screening Academy Project) Informational list of suggested descriptive phrases to prompt providers to promote participation in parent survey of well-child visits. Included in well-child survey packet sent to providers.	December 2008	State-specific	Minnesota
Well-Child Visit Survey for Infants 10 to 18 Months of Age	(Minnesota ABCD Screening Academy Project) Parent well-child visit survey for infants 10 to 18 months of age. Included in well-child survey packet sent to providers.	December 2008	State-specific	Minnesota
Letter announcing referral tracking card	(Minnesota ABCD Screening Academy Project) Letter to providers describing options for using Minnesota's referral tracking card: a small card attached to each screening tool that provides a space to mark if the child (or caregiver) was referred for developmental and/or mental health screening or maternal depression screening.	December 2008	State-specific	Minnesota
Sample Referral Tracking Cards	(Minnesota ABCD Screening Academy Project) Minnesota developed two sample cards for tracking referrals: one for ASQ and ASQ:SE, the other for maternal depression screening with the Edinburgh tool.	December 2008	State-specific	Minnesota
Oklahoma's Developmental Screening Initiative Screening Tools Flyer: Back page	(Ohlahoma Department of Health) Flyer announcing that evidence-based developmental screening tools are available FREE through the Oklahoma State Department of Health.	December 2008	State-specific	Oklahoma
Kansas Provider Survey of EPSDT services	Kansas Provider Survey of EPSDT services: Summary of responses	July 2008	State-specific	Kansas
Ohio's Child Health Improvement Partnership/OCHIP	(Karen Hughes, Debbie Wright) PowerPoint presentation describing Ohio's Child Health Improvement Partnership/OCHIP	June 2008	State-specific	Ohio
District of Columbia Medicaid Referral Form	District of Columbia (2008) This referral form is designed to allow participating providers to specify the reasons for a referral. The form contains a disclosure form for parents to sign to authorize a developemntal screening for their child. Parental permission is reported to Early Intervention and the Infants and Toddlers with Disabilities Division so the outcome can be tracked.	May 2008	NASHP-Commonwealth	District of Columbia
Oklahoma's Developmental Screening Initiative Screening Tools Flyer	Oklahoma Department of Health. (2008). Flyer announcing that evidence-based developmental screening tools are available FREE through the Oklahoma State Department of Health.	January 2008	State-specific	Oklahoma
Ordering Screening Tools	Oklahoma Department of Health (2008) To facilitate providers ordering developmental screening tools, the Oklahoma Department of Health set up a page on their website on which Primary Care Providers may order materials and request consultative services online, by phone or click a link to complete the online order information form.	January 2008	State-specific	Oklahoma
Primary Care Provider Developmental Screening Survey	Virginia ABCD Project (2007) Two-page survey of Virginia health care providers designed to gather information to better understand the needs of health care providers in meeting the developmental needs of young patients.	December 2007	State-specific	Virginia
Using QI Methods to Spread Improvements in Developmental Services and Well Child Care	Peter Margolis. (2007). PowerPoint presentation for ABCD Screening Academy Learning Session, July 2007. This presentation discusses the evidence supporting QI approaches to improving preventive and developmental care; describes Quality Improvement Science; outlines three models for supporting practice-based improvement; and explains the transition from pilot testing to large scale spread.	December 2007	NASHP-Commonwealth
The VHA New England Medication Error Prevention Initiative as a model for long-term improvement collaboratives	Lesar TS et al. Jt Comm J Qual Patient Saf. 2007;33:73-82. This article compares various quality improvement collaboratives to gain insight into the elements important for their success. (From abstract).	December 2007	Peer-reviewed
Child Development Review Parent Questionnaire (CDR-PQ)	Minnesota Department of Health (2007) Profile of and relevant information on the Child Development Review Parent Questionnaire.	December 2007	State-specific
Mom, are you feeling blue?	Utah ABCD project (2007) Utah created posters focusing on screening mothers for postpartum depression. The posters have the PHQ-2 questions and are available in English and Spanish. They have been distributed widely and were well received. English version.	December 2007	State-specific	Utah
When mom suffers from postpartum depression	Utah ABCD project (2007) Utah created posters focusing on screening mothers for post partum depression. The posters had the PHQ-2 questions and were available in English and Spanish. They have been distributed widely and were well received. English version directed toward families.	December 2007	State-specific	Utah
Cuando la mam	Utah ABCD project (2007) Utah created posters focusing on screening mothers for postpartum depression. The posters had the PHQ-2 questions and were available in English and Spanish. They have been distributed widely and were well received. Spanish version directed toward families.	December 2007	State-specific	Utah
CDC-AAP GrowthChart	AAP/CDC (2007) The AAP and CDC have developed a poster that outlines developmental milestones on one side and height on the other (it is a developmental growth chart). The poster includes the new AAP recommendations for screening (9, 18, 24/30 months for general developmental and 18 and 24 months for autism-specific). Spanish and English language versions are included. Link to Growth Chart	December 2007	Other
Piloting the AAP Algorithm: Lessons Learned - presentation	NASHP (2007) PowerPoint presentation for ABCD Screening Academy Piloting the AAP Algorithm: Lessons Learned Webcast held October 18, 2007.	October 2007	NASHP-Commonwealth
Developmental and Mental Health Screening	Glenace Edwall. (2007). PowerPoint presentation for ABCD Screening Academy Learning Session, July 2007. Based on the Minnesota experience, this presentation provides an overview of developmental and socio-emotional screening tools, including how to address barriers to screening.	July 2007	NASHP-Commonwealth	Utah
Utah Pediatric Partnership to Improve Healthcare Quality	Chuck Norlin. (2007). PowerPoint presentation for ABCD Screening Academy Learning Session, July 2007. This presentation examines how Utah utilized learning collaboratives to help physician practices incorporate standardized screening into well child care.	July 2007	NASHP-Commonwealth
Parental Depression Screening for Pediatric Clinicians: An Implementation Manual	Ardis Olson, M.D. and Cecelia Gaffney, M.Ed. (The Commonwealth Fund, April 18, 2007). This manual guides health providers in conducting routine screening for parental depression and referring parents to counseling services. The manual is based on the findings of the Dartmouth Parental Well-Being Project, which tested practical approaches over a six-month period with more than 9,000 parents.	April 2007	NASHP-Commonwealth
Implementation Guide for Depression Screening: Part 1 “Prepare Your Practice”	Utah ABCD Project (2006) This chart outlines steps to be taken by all office staff prior to implementing and integrating depression screening into office flow. This list of tasks to consider includes what, who, and how.	December 2006	State-specific	Utah
Objectives for UPIQ’s Learning Collaborative on Screening for Maternal Depression	Utah ABCD Project (2006) This document outlines objectives for the Maternal Depression Screening Learning Collaborative participants.	December 2006	State-specific	Utah
Performance Improvement Project Workplan with CME Incentive	Utah ABCD Project (2006) This workplan template serves to guide providers as they undertake performance improvement projects as one part of the Maternal Depression Learning Collaborative. Participating providers earn an additional CME credit.	December 2006	State-specific	Utah
Building Strong Foundations: Promoting the Social-Emotional Development of Infants and Toddlers within a Cultural Context	Antonia Wilcoxon. (Minnesota Department of Human Services, 2006). This PowerPoint presentation outlines the value of communication across cultures to promote the healthy social-emotional development of infants and toddlers within a cultural context.	December 2006	State-specific	Minnesota
Central Pediatrics, St. Paul, Mental Health Screening for Primary Care Flowchart	Central Pediatrics, St. Paul, Minnesota. (April 12, 2006). This flowchart provides a visual model for practice redesign to support incorporating mental health screening into clinic processes.	December 2006	State-specific	Minnesota
Instructions for using the North Carolina ASQ access database	North Carolina ABCD Project. (2006). Instructions for using the North Carolina ASQ access database.	December 2006	State-specific	North Carolina
Screening for Maternal Depression Monthly Audit Form	Utah ABCD Project (2006) This resource is a practice-completed chart audit form designed to collect data on screenings for maternal depression during well child visits.	December 2006	State-specific	Utah
Parenting During Depression: A Guide for Clinicians	Utah ABCD Project (2006) This pamphlet provides counseling tips for clinicians who work with parents exhibiting symptoms of or diagnosed with depression.	December 2006	State-specific	Utah
Implementation Guide for Depression Screening: Part 2	Utah ABCD Project (2006) This chart outlines steps to be taken to integrate a depression screening into an office visit, including information on interacting with the patient and referrals. This resource includes information on each step taken: when, by whom, and how.	December 2006	State-specific	Utah
Aim, Measure, and Changes Worksheet	Utah ABCD Project (2006) This worksheet was provided to Learning Collaborative participants to structure and evaluate implementation of standardized screening for maternal depression.	December 2006	State-specific	Utah
Users Tip Sheet: Measure of Whether a Parent-Completed Standardized Developmental and Behavioral Screening Tool was Administered	North Carolina ABCD Project. (2006). Child and Adolescent Mental Health Initiative. This resource was developed to provide technical assistance to Setting the Stage sites implementing standardized screening processes.	December 2006	State-specific	North Carolina
Screening and Referral Tracking Sheet	North Carolina ABCD Project. (2006). This worksheet was used by North Carolina pilot sites to track screening and referral outcomes.	December 2006	State-specific	North Carolina
Getting Started Worksheet for Social Emotional Screening	North Carolina ABCD Project. (2006). This resource is a form designed to help practices better identify available system supports and partners in an effort to improve follow-up services.	December 2006	State-specific	North Carolina
Getting Started Worksheet	North Carolina ABCD Project. (2006). This resource is designed to help practices begin to integrate and implement standardized screening into office flow.	December 2006	State-specific	North Carolina
Setting the Stage for Success training materials	North Carolina ABCD Project. (2006). This resource provides background information on the importance of integrating standardized screening into primary care. It also provides worksheets to be used by pilot sites to implement screening processes.	December 2006	State-specific	North Carolina
Measuring and Reporting Performance	North Carolina ABCD Project. (2006). This resource was developed to assist Setting the Stage projects in measuring performance. It includes in-depth instruction for using the ABCD database (developed under NC ABCD I) to evaluate implementation.	December 2006	State-specific	North Carolina
The Parent Evaluation of Developmental Status (PEDS) and Electronic Medical Records	North Carolina ABCD Project. (2006). This resource outlines the use of the PEDS instrument for screening, how it interfaces with electronic medial records, and explores additional copyright issues.	December 2006	State-specific	North Carolina
The Logistics of Sponsoring a Training	North Carolina ABCD Project. (2006). This resource outlines the critical steps that must be considered in order to sponsor successful quality improvement training.	December 2006	State-specific	North Carolina
Keeping it Tops with Practices	North Carolina ABCD Project. (2006). When there are many competing initiatives for a practice, it is important to explore what mechanisms you will use for connecting with them. This resource lists the strategies that were successful in North Carolina.	December 2006	State-specific	North Carolina
Quality Improvement Meeting Agenda	North Carolina ABCD Project. (2006). This agenda highlights how North Carolina used its stakeholder groups to continually engage leaders and further project success even beyond the life of the ABCD grant.	December 2006	State-specific	North Carolina
PEDS Access database (mdb file)	North Carolina ABCD Project (2006) North Carolina has developed databases for primary care providers who use the Parents Evaluation of Developmental Status (PEDS) as part of a well-child visit to conduct standardized screening.	December 2006	State-specific	North Carolina
Instructions for using the North Carolina PEDS Access database	North Carolina ABCD Project (2006) Instructions for using the North Carolina PEDS access database.	December 2006	State-specific	North Carolina
ASQ Access database	North Carolina ABCD Project (2006) North Carolina has developed databases for primary care providers who use the Ages and Stages Questionnaire (ASQ) as part of a well-child visit to conduct standardized screening. This database allows providers to capture and record outcomes for referral and tracking purposes, as well as for practice level quality improvement efforts. As this file is nearly 7MB, please contact Larry Hinkle to arrange a method of delivering it to you.	December 2006	State-specific	North Carolina
Statewide quality improvement outreach improves preventive services for young children	Judith S. Shaw et al. Pediatrics. Oct 2006;118(4); e1039-e1047. This article, which focuses on Vermont, provides the evidence for an effective statewide pediatric quality improvement outreach program to improve preventive services for children who are younger than 5 years.	October 2006	Peer-reviewed
Screening for Maternal Depression Learning Collaborative Agenda	Utah ABCD Project Learning Collaborative. (September 15, 2006) This resource is the agenda for the Maternal Depression Learning Collaborative held at the University of Utah in September 2006.	September 2006	State-specific
Parental Depression: The Elephant in the Room with Us, Powerpoint presentation	Ardis Olsen (Utah ABCD Project, September 15, 2006) This PowerPoint presentation from the Maternal Depression Learning Collaborative provides a comprehensive clinical overview of parental depression, highlights primary care providers' roles in identification and treatment, and strategies for integrating screening into practice flow.	September 2006	State-specific	Utah
Evaluation of a learning collaborative to improve the delivery of preventive services by pediatric practice	Paul C. Young et al. Pediatrics. May 2006; 117(5):1469-1476. This article demonstrates that learning collaboratives are a potentially effective method of improving the quality of care delivered by pediatric practices. (From abstract).	May 2006	Peer-reviewed
A Practical Guide for Improving Child Developmental Services	The Commonwealth Fund. (May 8, 2006). This guide helps pediatric practices redesign their office systems to improve the quality of preventive and developmental services. The resources (checklists, surveys, bibliographies, and more) were developed and tested in a year-long quality improvement initiative in which primary care practices in Vermont and North Carolina used improved office systems to engage families in efforts to promote positive developmental outcomes.	May 2006	NASHP-Commonwealth
Information for Physicians on Prescription Products to Treat Perinatal Depression	Utah ABCD Project (February 2006) This chart provides a list of available medications for treating perinatal depression, including information on risks, teratogenicity and recommended dosage. This list was provided to Learning Collaborative participants.	February 2006	State-specific	Utah
ABCD Healthy Beginnings Pediatric Practice Social/Emotional (S/E) & Maternal Depression Questionnaire	Illinois ABCD Healthy Beginnings. (2005). This survey was designed to evaluate the existing processes in pediatric practices for identifying social/emotional (S/E) and maternal depression issues in patients.	December 2005	State-specific	Illinois
UPIQ Social-Emotional Screening Learning Collaborative Pre-Collaborative Assessment Audit	UPIQ. (2005). Form for participants to complete prior to the UPIQ Social Emotional Learning Collaborative held in Lehi, Utah, May 20, 2005. Information used to establish a baseline to measure quality improvement efforts during UPIQ.	December 2005	State-specific	Utah
Practice Information Sheet	UPIQ. (2005). Form for UPIQ Social Emotional Learning Collaborative participants to complete detailing team leader and team membership.	December 2005	State-specific	Utah
Team Time- Screening Tool Selection	UPIQ. Before you decide what direction you want to take with Social Emotional Screening, it is best to look at what your group is currently doing. This tool will assist providers in selecting the best developmental screening tool for their practice.	December 2005	State-specific	Utah
Screening Implementation Worksheet - Practice Questions and Answers	UPIQ. (2005). Form for practices to complete to organize office workflow. Adapted from North Carolina's ABCD project materials and Ploof D, Hamel SC: Developmental screening is an important part of well care: How can we really make it happen? Basic principles for practice change in the real world. Newsletter of the American Academy of Pediatrics' Section on Developmental and Behavioral Pediatrics, June 2002	December 2005	State-specific	Utah
BCAP Toolkit: Enhancing Child Development Services in Medicaid Managed Care	Purvi Kobawala Smith. (Hamilton, NJ: Center for Health Care Strategies. October 2005). This toolkit reflects the experiences of the Enhancing Child Development Services in Medicaid Managed Care workgroup - 10 health plans and a primary care case management program - that collaborated to develop best practices for enhancing child development services. (From web Summary)	October 2005	Other
So, What Now?	Jenifer Lloyd. (Utah Department of Health, May 20, 2005). A presentation by Jenifer Lloyd at the UPIQ Social Emotional Learning Collaborative held in Lehi, Utah, May 20, 2005	May 2005	State-specific	Utah
Implementing the ASQ: From Keys to Success to Biting Off Too Much: The Only Way to Find Out What Is Right for Your Practice	Harper Randall (Granger Medical Clinic, May 20, 2005). Presentation outline for the UPIQ Social Emotional Learning Collaborative held in Lehi, Utah, May 20, 2005	May 2005	State-specific	Utah
Monthly Audit Form	UPIQ. Form for practices completing monthly chart audits. Participating practices are asked to review 10 charts and respond to short questions on referrals and their Plan-Do-Study-Act (PDSA) cycles.	May 2005	State-specific	Utah
UPIQ Learning Collaborative Agenda Focusing on Social Emotional Screening of Toddlers 12 to 36 months	UPIQ (2005). Agenda for Collaborative meeting focusing on Social Emotional Screening of Toddlers 12 to 36 months, Friday May 20, 2005 7:30-4:30, Thanksgiving Point.	May 2005	State-specific	Utah
The paths from research to improved health outcomes	Paul Glasziou and Brian Haynes. ACP Journal Club. Mar/Apr 2005; 142(2): A8-A10. This article discusses the role of evidence based medicine in improved health outcomes.	March 2005	Other
PSDA Cycles	UPIQ. PDSA stands for Plan, Do, Study, Act. It is a model for testing ideas that you think may create an improvement.	January 2005	State-specific	Utah
ABCD II Prevention and Identification Workgroup Report June 14, 2004	Iowa ABCD II Prevention and Identification Workgroup (2004). This resource summarizes the Prevention and Identification Workgroup efforts around detailing minimum clinical standards for providers in the identification of developmental, social-emotional, and behavioral problems in children birth to three years.	December 2004	State-specific	Iowa
The Basics of Quality Improvement	Paul Young. (UPIQ, 2004). PowerPoint presentation on models for improvement for Social-Emotional Screening Learning Collaborative October 15, 2004.	December 2004	State-specific	Utah
UPIQ Presentation at Thanksgiving Point Learning Collaborative, October 2004	UPIQ. (October 15, 2004). Presentation at Thanksgiving Point Collaborative meeting, October, 2004. Describes UPIQ Learning Collaborative approach: identify need, apply evidence by changing system, measure what you do.	October 2004	State-specific	Utah
Screening: A Quality Improvement Initiative in Primary Care Practice	Marian Earls. (October 2004). Presentation on Screening, developed by Dr. Marian Earls, Developmental & Behavioral Pediatrician, for UPIQ.	October 2004	State-specific	North Carolina
Practice based education to improve delivery systems for prevention in primary care: randomised trial	Peter A Margolis et al. BMJ 2004 328: 388. This article demonstrates that combining continuing education with process improvement methods is an effective method of increasing rates of delivery of preventive care to children. (From abstract).	February 2004	Peer-reviewed
CME Curriculum Outline: Setting the Stage for Success: A Study of the Physician's Role in Early Intervention	North Carolina ABCD I Project This agenda outlines the Developmental Screening CME training conducted under the NC ABCD project.	December 2003	State-specific	North Carolina
Developmental screening checklist for children ages 0-5	North Carolina ABCD I Project. This resource is a checklist of talking points for providers to consider as they implement standardized developmental screening for children ages 0-5.	December 2003	State-specific
The Breakthrough Series: IHI's collaborative model for achieving breakthrough improvement	IHI Innovation Series white paper. (Boston: Institute for Healthcare Improvement, 2003). IHI’s Innovation Series white papers were developed to further the mission of improving the quality and value of health care. The findings and tools in these reports provide you with an opportunity to understand and evaluate the issues, and begin testing changes that can help your organization make breakthrough improvements. (From website)	December 2003	Other
Principles to Guide Iowa's System of Developmental Services for Children and their Families	Iowa's Developmental Services Workgroup. (September 2002). This resource outlines principles to guide Medicaid provider interactions with children, families, and communities. It was developed by the Developmental Services Workgroup under the Healthy Mental Development Panel.	September 2002	State-specific	Iowa
Ready to Enter: What Research Tells Policymakers About Strategies to Promote Social and Emotional School Readiness Among Three- and Four-year-old Children	(C. Cybele Raver and Jane Knitzer. New York, NY: National Center for Children in Poverty) This resource is policy paper number three in the series "Promoting the Emotional Well-Being of Children and Families" and was designed for policymakers. The paper focuses on reasons why it is important to intervene to help young children at risk for poor social, emotional, and behavioral development and what kinds of research-based interventions seem most effective. (From Executive Summary)"	July 2002	Other
Developmental Screening Is An Important Part Of Well Care: How Can We Really Make It Happen? Basic Principles For Practice Change In The Real World	Dianna Ploof and Sara C. Hamel. American Academy of Pediatrics’ Section on Developmental and Behavioral Pediatrics’ Newsletter, June 2002. This article describes the necessary components for creating lasting change when initiating developmental screening in primary care.	June 2002
Improving preventive service delivery through office systems	W. Clayton Bordley, et al. Pediatrics Sept 2001; 108 (3): e41. This article focuses on determining the effectiveness of office systems implemented to improve the delivery of preventive care in pediatric practices. (From abstract).	September 2001	Peer-reviewed
Early childhood mental health services: A policy and systems development perspective	Jane Knitzer. in Shonkoff J, Meisels S (eds): Handbook of Early Childhood Intervention, ed 2. (New York, NY: Cambridge University Press, 2000).	December 2000	Peer-reviewed
Principles of educational outreach ('academic detailing') to improve physician decision making	S.B. Soumerai and J. Avorn. JAMA. Jan 26, 1990; 263(4):549-556. This article defines the theory and practice of methods to improve physicians' clinical decision making to enhance the quality and cost-effectiveness of care. (From abstract)	January 1990	Peer-reviewed

In the National Survey of Early Childhood Health, less than half of parents of young children reported that their pediatric primary care provider offered thorough “anticipatory guidance” related to their child’s health and development, and only 57 percent reported their child’s development had ever been assessed at a pediatric primary care visit.* Additionally, because patient and family education to build self-management skills is considered a critical characteristic of high performance pediatric care coordination** providing adequate resources and education to families is critical to improving the health and development of young children. Ultimately, families that understand the components of and have expectations of quality well child care will result in a greater demand for services and has the potential to improve the delivery of these services for all children.

ABCD states recognized that by providing useful information and tools to families to promote health physical, mental, social and emotional development, children will be able to better reach their full potential. States used various approaches to provide education to families regarding expectations of their child’s health and development, including pamphlets, brochures, web-based resources, and surveys. Additionally, states developed resources and materials to support providers in their efforts to effectively identify children at-risk for developmental delay thus improving the delivery and quality of anticipatory guidance.

This section includes tools created to educate families and promote the healthy development of young children.

______________________________________________________________________________________________________________________________________

*Halfon N, Olson L, Inkelas M, et al., ”Summary statistics from the National Survey of Early Childhood Health, 2000,” National Center for Health Statistics. Vital Health Stat; 15, No. 3 (2002).

**Antonelli RC, McAllister JW, and Popp J, Developing Care Coordination as a Critical Component of a High Performance Pediatric Health Care System: Forging a Multidisciplinary Framework for Pediatric Care Coordination. (New York, NY: The Commonwealth Fund, Forthcoming 2009).

Title	Description	Date Published	Resource	State
2011 ABCD III PIP Q & A's	(Oregon ABCD III Project) This is a series of answers to questions that those tasked with implementing the ABCD III Performance Improvement Project may have. Questions deal with topics such as collaboration and External Quality Review Organizations (EQROs).	January 2011	State-specific	Oregon
Parent Partnerships to Support Early Child Health and Development	This webinar was based on an issue brief written by Nilofer Ahsan and Jill Rosenthal. It focused on a three-part framework for building parent engagement, why each level of engagement is critical to efforts to improve care coordination and services for young children, and how states engaged in these initiatives can incorporate parent partnerships into their work. This recording features a presentation by Nilofer Ahsan of the Center of the Study of Social Policy, as well as examples of these partnerships in action from representatives from Rhode Island and Colorado.	May 2010	NASHP - Commonwealth
Engaging Parents as Partners to Support Early Child Health and Development	(Nilofer Ahsan and Jill Rosenthal) This brief puts forth a three-part framework for engaging parents in supporting health child development: parents engaging with: 1) their child, 2) the services and programs they receive, and 3) the larger systems and policies that govern those services.	May 2010	NASHP - Commonweath
Developmental Screening in Early Childhood Systems: Summary Report	(American Academy of Pediatrics: Healthy Child Care America) This is a summary report of a meeting hosted by the American Academy of Pediatrics, Healthy Child Care America, and Child Care and Health Partnership. The goal was: "To strategize new ways to reach out to children and families in the community and child care settings to promote high-quality developmental screening in the context of the medical home."	March 2009	Other
Utah Medical Home Portal	(Utah Medical Home Portal: Tab for Parents and Families) This page of the website provides information to help parents and other family members learn about caring for children with chronic and complex conditions and to help them become effective partners - with physicians and other health care professionals - in their child's healthcare. (From website) Subsections focus on various aspects of assuring the best outcomes for your child.	January 2009	State-specific	Utah
Infant & Toddler Connection of Virginia	(Virginia ABCD Project) The Infant Toddler Connection of Virginia assists families of children with delays and/or disabilities help their children learn and develop through everyday activities and routines so that they can participate fully in family and community activities. In order to take advantage of the services and supports available, families need to know about the system and how to access these resources, so this guide was developed to help providers inform families of the available resources.	December 2008	State-specific	Virginia
Family panel screening card - Spanish	(Colorado ABCD Project) Proof copy of informational card promoting developmental screening. Answers three most common questions about screening. Spanish version.	December 2007	State-specific	Colorado
A Gift for Your Child! Give your child the gift of regular checkups.	(Colorado ABCD Project) Color poster promoting developmental screening to families. English version.	December 2007	State-specific	Colorado
Family panel screening card - English	(Colorado ABCD Project) Proof copy of informational card promoting developmental screening. Answers three most common questions about screening. English version.	December 2007	State-specific	Colorado
Find Your Child's Developmental Age	(Utah Registry of Autism and Developmental Disabilities (URADD)) Chart showing child's age in relation to social-emotional needs, nutritional needs, motor skills, and understanding and talking.	January 2007	State-specific	Utah
Give your Child the Gift of Good Health: CHEC is Medicaid for Kids!	(Utah ABCD Project) This comprehensive resource for parents of Medicaid children outlines Utah's EPSDT services, describes what parents should expect of their health care visits as well as what roles they can play to keep children healthy.	December 2006	State-specific	Utah
Guide for parents when times are tough	(Utah ABCD Project) This brochure provides parenting advice for parents of children ages 0-18.	December 2006	State-specific	Utah
Tips on healthy parenting for mothers with depression	(Utah ABCD Project: National Mental Health Association) Strengthening Families Fact Sheet on parenting for parents with depression.	December 2006	State-specific	Utah
Child Abuse Prevention Bookmark	(UPIQ) Child abuse prevention tips, services, websites, and phone numbers in bookmark form.	December 2005	State-specific	Utah
ABCD Glossary: Selected Terms Related to the Healthy Mental Development of Young Children	(NASHP) This document provides definitions of selected terms related to the healthy mental development of young children.	September 2005	NASHP - Commonwealth
Michigan ABCD Project Parent Survey Results	IHCS, in collaboration with MDCH and the ABCD Workgroup, developed a brief 4-question (8-item) parent survey.	Undated	State-specific	Michigan

Early identification is essential for three reasons. First, in terms of brain development, quality early relationships and experiences can positively affect gene function, neural connections, and the organization of the mind, having lifelong positive effects.* Second, once established, social and emotional problems are highly resistant to change.** It is not surprising that a strong relationship exists between childhood social and emotional problems, delinquency, and later criminality.*** Third, the costs associated with antisocial and criminal behavior are staggering. Targeted interventions may improve outcomes and save subsequent social costs, such as those incurred in juvenile justice programs.****

To improve the accuracy and efficiency of developmental surveillance, it is important to use formal screening measures in addition to observation and interview. Screening tests also need to be repeated over time to improve the effectiveness of the screening process. Having parents complete a simple questionnaire may improve the accuracy of the screening process while empowering them and conserving valuable professional resources. Parents may provide information that they would not otherwise share and may provide more complete information with a small investment of professional time.

To date, 27 ABCD states have engaged in efforts to improve the performance of health care practices through the adoption of structured developmental screening of young children. A short list of tools the ABCD states recommended/required includes:

Developmental screening:
Ages and Stages Questionnaire (ASQ)
Ages and Stages Questionnaire – Social Emotional (ASQ-SE)
Parents’ Evaluation of Developmental Status (PEDS)
Pediatric Symptom Checklist

Perinatal depression screening:
Edinburgh Postnatal Depression Scale
The Patient Health Questionnaire (PHQ-2)
The Patient Health Questionnaire (PHQ-9)

This section includes resources that summarize current guidelines and recommendations and that offer suggestions for improving developmental and behavioral health services for young children. It will include suggestions for identifying and selecting screening tools. It will also provide information on engaging and working with primary care practices to implement developmental screening, including establishing learning collaboratives of practice-based teams, developing training modules for individual pilots and practices, identifying “provder champions” to serve as mentors to primary care providers, and partnering with provider organizations that provide direct support to practices.

Sources:
*Shonkoff J, Phillips D (eds): From Neurons to Neighborhoods: The Science of Early Childhood Development. Washington, D.C., National Academy Press, 2000

**Walker HM, Sprague JR: The path to school failure, delinquency, and violence: Causal factors and some potential solutions. Intervention in School and Clinic 2000;35(2):67

***Dishion T, French D, Patterson G: The development and ecology of antisocial behavior, in Cicchetti D, Cohen D (eds): Developmental Psychopathology, Vol. 2: Risk, Disorder, and Adaptation. New York, John Wiley and Sons, 1995, pp 388–394

****Wildman B, Kizilbush A, Smucker W: Physicians' attention to parents' concerns about the psychosocial functioning of their children. Arch Fam Med 1999;8(5):440

Title	Description	Date Published	Resource	State
SoonerStart and Child Guidance Flow Chart	(Oklahoma ABCD III Project) This is a flow chart outlining the referral process. It details each activity and responsible parties.	January 2011	State-specific	Oklahoma
Screening Implementation Worksheet - Practice Questions and Answers	(Oklahoma ABCD III Project) This is a questionnaire that Oklahoma sent to its pilot practices to inquire about screening, documentation of results, and follow-up.	January 2011	State-specific	Oklahoma
Identifying and Treating Maternal Depression: Strategies and Considerations for Health Plans	(National Institute for Health Care Management) This paper is about identifying and treating maternal depression. From NIHCM, "Between 10 and 20 percent of women experience maternal depression, which can lead to serious and costly health complications for both the mother and baby. Given the investments in prevention and the estimated 12 million women of reproductive age who will gain insurance as a result of health care reform, health plans are well suited to support screening and treatment among their members."	June 2010	Peer-reviewed
State Strategies that Support Effective Identification of Children At-Risk for Developmental Delay	(Neva Kaye, Jennifer May: NASHP) In 2007, 19 states, Puerto Rico and the District of Columbia came together to form the Assuring Better Child Health and Development (ABCD) Screening Academy. They worked, with the support of NASHP, to improve identification of children with or at risk for or with developmental delays.	March 2009	NASHP - Commonwealth
Developmental Screening in Early Childhood Systems: Summary Report	(American Academy of Pediatrics: Healthy Child Care America) This is a summary report of a meeting hosted by the American Academy of Pediatrics, Healthy Child Care America, and Child Care and Health Partnership. The goal was: "To strategize new ways to reach out to children and families in the community and child care settings to promote high-quality developmental screening in the context of the medical home."	March 2009	Other
Pediatric Clinicians Guide: Steps to Parental Depression Screening	(Utah ABCD Project) This flowchart describes steps for clinicians to use during Parental Depression Screening.	January 2009	State-specific	Utah
Pediatric Developmental Screening: Understanding and Selecting Screening Instruments	(Dennis Drotar, Ph.D., Terry Stancin, Ph.D., and Paul Dworkin, M.D.) This manual helps providers choose and apply the structured screening method that is most appropriate for their practice setting. The manual is based on an extensive review of scientific research on available developmental screening instruments. Part I of the manual is designed to help practitioners define their screening needs. Part II includes a series of guides that compare screening instruments with respect to clinical utility, and sensitivity and specificity in different populations and at various ages.	December 2008	NASHP - Commonwealth
Maryland's Screening Tool Selection Criteria	(Maryland ABCD Project) Criteria agreed upon by the Maryland Screening Tool Selection Committee for the purpose of choosing a list of approved tools for general developmental screening for use in the Maryland Healthy Kids Program (EPSDT). This resource also lists tools selected for review based on those criteria.	December 2008	State-specific	Maryland
Developmental Screening Tools: Choices for Practices and Providers	Margaret Dunkle (August 2008). California developed a table designed to help select high-quality and practical tools to screen children from birth to 8 years of age for developmental delays or disabilities. All tools listed have at least 70% accuracy – that is, sensitivity and specificity, correctly identifying at least 70% of children with and without disabilities, delays or problems.	December 2008	State-specific	Colorado
Comparative Information on ASQ, PEDS and PEDS:DM	Margaret Dunkle (2008). The California ABCD Screening Academy Project developed this table of comparative information on ASQ, PEDS and PEDS:DM, including a description of the tool, developmental domains covered, accuracy, age range, administration time, scoring, psychometric properties, available languages and reading level, costs, and purchasing and additional information.	December 2008	State-specific	California
Comparative Information on Other Developmental Screening Tools	California ABCD Screening Academy Project (2008). Table of comparative information on additional screening tools for: social & emotional issues, autism, language and cognitive skills, motor skills, and specialized screening tools covering multiple but not all developmental domains.	December 2008	State-specific	California
Screening Tool Guidelines For Primary Care Pediatric Providers, November, 2007	Oregon ABCD Project (2007) The Steering Committee of Oregon Assuring Better Child Development (ABCD) Early Childhood Screening Initiative reviewed the American Academy of Pediatrics policy statement and created guidelines to help implement standardized developmental, behavioral and psychosocial screening in a primary care setting.	December 2007	State-specific	Oregon
Protocol for the Administration of ASQ Questionnaire in Puerto Rico	Puerto Rico ABCD Project (2007) A Comprehensive Guide for using the ASQ Questionnaire in the demonstration Sites participating in the Puerto Rico ABCD “Creciendo Juntos” Project	December 2007	State-specific	Puerto Rico
Developmental and Social-Emotional Screening of Young Children in Minnesota	Minnesota Department of Health (2007) The Minnesota Developmental Screening Task Force developed criteria for selecting standardized developmental screening tools in primary care practices. This is a link to the description of the criteria the task force developed.	December 2007	State-specific	Minnesota
Tools for Clinicians	Jill Rosenthal, NASHP (2007) PowerPoint presentation for ABCD Screening Academy Tools for Clinicians Technical Assistance Call or Webcast October 9, 2007.	October 2007	NASHP-Commonwealth
Choosing Screening Tools to Recommend/Promote: Process and Considerations	Julie Olson and Chuck Norlin. (2007). PowerPoint presentation for ABCD Screening Academy Learning Session, July 2007. Drawing from the Utah ABCD experience, this presentation focuses on the process for selecting screening tools.	July 2007	NASHP-Commonwealth
Choosing developmental screening instruments: Scientific and pragmatic considerations	Dennis Drotar. (2007). PowerPoint presentation for ABCD Screening Academy Learning Session, July 2007. This presentation describes relevant scientific and pragmatic considerations in choosing developmental screening instruments. It aims to facilitate the discussion of implications for state level developmental screening.	July 2007	NASHP-Commonwealth
Developmental Screening of Young Children in Minnesota	Minnesota Department of Health. (2006). This resource, Minnesota’s multi-agency Developmental Screening website, was funded and developed by collaborating state agencies in Minnesota in an effort to support and spread standardized developmental screening in Minnesota.	December 2006	State-specific	Minnesota
Menu of Recommended Parental/Caregiver Depression Screening Tools	Utah ABCD Project (2006) This resource provides descriptions and a review of each of the Utah Department of Health recommended Parental/Caregiver Depression screening tools.	December 2006	State-specific	Utah
Screening for Post-Partum or Maternal Depression Learning Collaborative Initial Assessment	Utah ABCD Project (2006) This self-administered survey for providers who participated in the Maternal Depression Learning Collaborative was designed to evaluate providers' readiness to implement and integrate parental depression screening into their practice flow. The form also provides an opportunity to access follow-up technical assistance from ABCD staff.	December 2006	State-specific	Utah
Developmental Services Schedule	North Carolina ABCD Project. (2006). This resource outlines the recommended developmental and social-emotional screening schedule for well-child visits.	December 2006	State-specific	North Carolina
The ASQ and Electronic Medical Records—A question for Brooks Publishing	North Carolina ABCD Project. (2006). This resource answers the question, ‘What does Brookes Publishing say about using the ASQ with electronic medial records?’ and explores other copyright issues.	December 2006	State-specific	North Carolina
Overview of Social Emotional Screening Tools	North Carolina ABCD Project. (2006). This summary reviews available recommended social emotional screening tools.	December 2006	State-specific	North Carolina
Parent Handouts in Spanish on Well-Child Visits and Developmental Milestones	Utah ABCD Project. Handouts for parents in Spanish on each well-child visit and appropriate developmental milestones for children from 2 weeks to 5 years old.	December 2006	State-specific	Utah
Screening for developmental delay: reliable, easy-to-use tools	Sutton Hamilton. Posted with permission from the Journal of Family Practice. 2006. 55(5): 415-421.The author discusses practical, reliable screening tools to use to improve the likelihood of identifying children who need help.	December 2006	Peer-reviewed
Screening for speech and language delay in preschool children: Systematic evidence review for the US Preventive Services Task Force	H.D Nelson, P. Nygren, M. Walker, et al. Pediatrics. 2006; 117(2): e298-319. This article evaluates the strengths and limits of evidence about the effectiveness of screening and interventions for speech and language delay in preschool-aged children to determine the balance of benefits and adverse effects of routine screening in primary care. This evidence was used by the US Preventive Services Task Force for the development of routine screening guidelines. (From abstract).	December 2006	Peer-reviewed
Autism spectrum disorder screening and management practices among general pediatric providers	Susan Dosreis, et al. Developmental and Behavioral Pediatrics. Apr 2006; 27(2) Supplement 2: S88-S94. This study examines (1) the factors influencing the use of general developmental and autism-specific screening tools in primary care pediatric practice, (2) the barriers to providing these assessments, and (3) pediatricians' beliefs regarding ASD (autism spectrum disorder) prevalence. (From abstract).	April 2006	Peer-reviewed
Illinois Healthy Beginnings Provider Knowledge Survey	Illinois ABCD Healthy Beginnings. (2005). This resource is a brief 10 question survey for providers about social/emotional and maternal depression issues for children and families.	December 2005	State-specific	Illinois
Screening Tool Selection	UPIQ. (2005). Worksheet to assist practice teams when determining appropriate screening tools for their practice.	December 2006	State-specific	Utah
Screening for developmental and behavioral problems	Frances P. Glascoe. Mental Retardation and Developmental Disabilities Research Reviews. 2005;11(3): 173-179. This article describes methods to identify accurate measures (of developmental and behavioral/mental health problems) and presents standards for screening tests.(From abstract)	December 2005	Peer-reviewed
Psychometric properties and standardization samples of four screening tests for infants and young children: A review	L.L.S. Lee and S.R. Harris. Pediatric Physical Therapy. 2005; 17(2): 140-147. This article compares traditional psychometric properties (interrater and test-retest reliability, concurrent and predictive validity), clinical epidemiological characteristics (sensitivity, specificity, and positive predictive values), and standardization samples of four tests useful to pediatric therapists in screening infants and young children for developmental delays. (From abstract).	December 2005	Peer-reviewed
Screening Tools	Lori Smith and Jenifer Lloyd. (Utah Department of Health, May 20, 2007). A presentation by Lori Smith and Jenifer Lloyd at the UPIQ Social Emotional Learning Collaborative held in Lehi, Utah, May 20, 2005	May 2005	State-specific	Utah
An Introduction to Quality Improvement & Human Factors – Design for Use by Humans	Thomas Jackson. (HealthInsight, May 20, 2005). A presentation by Thomas Jackson, HealthInsight, at the UPIQ Social Emotional Learning Collaborative held in Lehi, Utah, May 20, 2005	May 2005	State-specific	Utah
Community Based Resources	Julie Olson. (Utah Department of Health, May 20, 2005). A presentation by Julie Olson at the UPIQ Social Emotional Learning Collaborative held in Lehi, Utah, May 20, 2005	May 2005	State-specific	Utah
Laminated Pocket Guide to Developmental Screening for Children Ages 0-5	UPIQ. Pocket Guide to Developmental Screening for Children Ages 0-5	May 2005	State-specific	Utah
Importance of Social Emotional Screening for Utah	Matt Denhalter. (Southwest Behavioral Health Center, May 20, 2005). A presentation by Matt Denhalter at the UPIQ Social Emotional Learning Collaborative held in Lehi, Utah, May 20, 2005	March 2005	State-specific	Utah
Identifying Children at risk	Glascoe FP. (2004). This summary developed by Frances Glascoe provides an overview of screening and surveillance terms, reviews available recommended screening tools and provides a comparison chart.	December 2004	State-specific	North Carolina
Developmental and Behavioral Screening: The Longitudinal Relationship with Children and Families	Marian Earls. (Guilford Child Health, Inc, 2004). Schedule of appropriate screen to use at each well-child visit, with description of pertinent issues and potential parental concerns that might be generated at each visit/screen.	December 2004	State-specific	North Carolina
Screening for Behavioral Developmental Problems: Issues, Obstacles, and Opportunities for Change	David Bergman (Portland, ME: National Academy for State Health Policy, August 2004) This paper examines issues related to screening children for developmental disabilities and problems. It examines the ways in which screening tools differ from one another and the opportunities and challenges that are often faced by those working to integrate screening tools into medical practices. The paper also includes summary information on 17 different tools.	August 2004	NASHP-Commonwealth
North Carolina primary care screening and referral practice flowchart	North Carolina ABCD I Project.(2003). This resource is a sample flow chart outlining steps for implementation of screening and referral processes in primary care offices.	December 2003	State-specific	North Carolina
Targeted Case Management: Early Childhood Development for Medicaid Eligible Children	Utah ABCD Project. (Utah Case Management Provider Manual, 2001). This resource outlines the rules and regulations of Utah's Targeted Case Management program.	December 2001	State-specific	Utah
Developmental Surveillance and Screening of Infants and Young Children	Committee on Children with Disabilities. Pediatrics 2001;108 (1);pp 192-195. This statement provides recommendations for screening infants and young children and intervening with families to identify developmental delays and disabilities. (From abstract)	December 2001	Peer-reviewed
Child Development and Medicaid: Attitudes of Mothers with Young Children Enrolled in Medicaid	Susan Kannel, Michael Perry. (New York, NY: The Commonwealth Fund, March 2001). This report is based on findings from eight focus groups of mothers with young children enrolled in Medicaid in the four ABCD I states (NC, UT, VT, WA). For policymakers, the report includes recommendations about how to notify mothers about services and provide them with information. Focus group findings also suggest specific areas where state Medicaid programs can play an active role in supporting early child development. (From Preface)	March 2001	NASHP - Commonwealth
A comparative review of developmental screening tests	Frances P. Glascoe, Elaine D. Martin, and Steven Humphrey. Pediatrics. Oct 1990. 86(4): 547-554. To help physicians select from the array of developmental screening instruments, 19 different screening tests were administered by a pediatrician and rated by a panel of pediatricians and a special educator. (From abstract)	October 1990	Peer-reviewed
Can developmental screening tests identify children who are developmentally at risk?	Samuel .J. Meisels. Pediatrics. Apr 1989; 83(4): 578-585.; This article discusses findings suggesting that the Denver Developmental Screening Test (DDST) underrefers children. The author presents other screening tests with more optimal psychometric properties. (From abstract).	April 1989	Peer-reviewed

As providers conduct more screening and identify more children in need of follow-up services, the weakness of the U.S. child-serving systems and inadequacy of linkages among providers becomes increasingly apparent.* It is clear that more must be done to improve referrals and assure access to services essential as follow up to screening. Promising approaches for improving follow up and strengthening linkages are underway at the practice, community, and state levels. Many such projects and initiatives aim to help families benefit from screening and surveillance in pediatric primary care by connecting them and their children to services and supports they needs.

ABCD states found that improving linkages between primary care providers and other child and family and service providers is critical to promoting healthy development for children. The ABCD III initiative is focusing attention on models that will improve linkages to promote child development as the result of screenings. The collaborative will help state agencies, especially Medicaid agencies, in developing more effective referral pathways between pediatric primary care practices and community intervention and support agencies to promote the healthy development of young children.

Building on previous ABCD efforts, these projects will seek to identify existing assessment and treatment resources, remove policy barriers to accessing those services, and facilitate referrals to these resources. States play an important role in removing barriers and providing support as communities move toward more integrated services. This section focuses on resources designed to assist states working to address the health and developmental needs of children and families. _______________________________________________________________________________________________________________________________
*Johnson K and Rosenthal J, Improving Care Coordination, Case Management, and Linkages to Service for Young Children: Opportunities for States. (Portland, ME: The National Academy for State Health Policy, April 2009).

Title	Description	Date Published	Resource	State
Tracking Linkages: A Closer Look at Data Tools in Minnesota and Oklahoma	(NASHP/CMWF: June 2011) This is a recording of two state presentations from an ABCD III Evaluation Workgroup Webcast. This recording features presentations from Minnesota on its Access Database and from Oklahoma on its Web Portal. The speakers described how these data tools 1) track information for the common outcome (and additional measures), 2) fit into clinic or organization office flows, 3) interact with EHRs, 4) change over time, and 5) inform (or might potentially inform) other state projects.	June 2011	NASHP - Commonwealth
Illinois Early Intervention Referral Form	(Illinois ABCD III Project) This is Illinois' most recent iteration of its form to refer children to EI for eligibility determination.	April 2011	State-specific	Illinois
Illinois Early Intervention Program, Child and Family Connections Referral Follow-up Form	(Illinois ABCD III Project) This form is used to provide a summary on the status of a referral to the EI system point of entry (Child and Family Connections).	April 2011	State-specific	Illinois
SoonerStart and Child Guidance Flow Chart	(Oklahoma ABCD III Project) This is a flow chart outlining the referral process. It details each activity and responsible parties.	January 2011	State-specific	Oklahoma
Early Childhood Services Request ABCD III	(Oklahoma ABCD III Project) This PowerPoint presentation is a user's guide of the web portal that Oklahoma designed as a part of its ABCD III project. The guide demonstrates several pages on the web portal and includes screenshots.	January 2011	State-specific	Oklahoma
ABCD III Community Site Monthly Report	(Oklahoma ABCD III Project) This is the monthly form that Oklahoma's pilot sites are using to report progress as a part of its ABCD III project.	January 2011	State-specific	Oklahoma
Screening Implementation Worksheet - Practice Questions and Answers	(Oklahoma ABCD III Project) This is a questionnaire that Oklahoma sent to its pilot practices to inquire about screening, documentation of results, and follow-up.	January 2011	State-specific	Oklahoma
2011 ABCD III PIP Q & A's	(Oregon ABCD III Project) This is a series of answers to questions that those tasked with implementing the ABCD III Performance Improvement Project may have. Questions deal with topics such as collaboration and External Quality Review Organizations (EQROs).	January 2011	State-specific	Oregon
Oregon Intergovernmental Agreement	(Oregon Department of Human Services) This is an agreement between the Oregon Department of Human Services and the Oregon Health & Science University. It concerns the tasks and scope of work for the ABCD III performance improvement projects conducted by participating managed care organizations. Because of the size of the document it is not currently available on the Resource Center. If you would like a copy please e-mail Larry Hinkle.	November 2010	State-specific	Oregon
Linking Children to Services: Building on Community Assets to Pilot Test Improvement Strategies	(Carrie Hanlon: NASHP) This issue brief describes: 1) how the five ABCD III states are building on existing local partnerships and assets to organize community pilots, and 2) preliminary lessons that have emerged from these states, including new federal opportunities to bolster community partnerships that will improve service linkages for children.	December 2010	NASHP - Commonwealth
Improving the Lives of Young Children: Opportunities for Care Coordination and Case Management for Children Receiving Services for Developmental Delay	(Carrie Hanlon, NASHP: produced by Urban Institute) This brief examines states' Medicaid and CHIP policy choices and new opportunities under health reform and other federal legislation to develop a well-coordinated system of care for children receiving Early Intervention and other ongoing services. State examples in the paper draw significantly from ABCD III.	December 2010	Peer-reviewed
Improving the Quality of Care and Coordination of Services for Young Children -- ABCD, CHIPRA and Beyond!	(NASHP) This webinar highlighted how Illinois, Oregon, South Carolina, and Vermont are using ABCD III and/or CHIPRA quality grants to build on and align current efforts, such as medical home initiatives, health information technology or exchange, performance measurement, and health reform, to transform the delivery of care to children covered by Medicaid and CHIP. This event was sponsored by The Commonwealth Fund and built on a session held during the 2010 NASHP Annual Conference.	December 2010	NASHP - Commonwealth
United Way of Connecticut 2-1-1 Community Resource Inventory	(United Way of CT: 2010) This is the United Way of Connecticut's 2-1-1 resource inventory. It provides a number of resources broken down by Service Categories	October 2010	State-specific	Connecticut
United Way of Connecticut 2-1-1 e-Library	(United Way of CT: 2010) The e-Library offers substantive information on a number of topics and then links to resources related to those topics.	October 2010	State-specific	Connecticut
Overcoming Barriers to Referral and Care Coordination for Children Eligible for Early Intervention Services: An ABCD Alumni Webinar	(NASHP: February 2010) This webinar recording contains a presentation done by Scott Allen of the Illinois Chapter of the American Academy of Pediatrics. Mr. Allen discussed lessons learned from a Commonwealth Fund grant to the Illinois Chapter of the American Academy of Pediatrics, overcoming barriers to referral, and care coordination for children eligible for early intervention services.	February 2010	NASHP - Commonwealth
Improving Care Coordination, Case Management, and Linkages to Service for Young Children: Opportunities for States	(Kay Johnson and Jill Rosenthal: NASHP) States can use primary care practice-based strategies, service provider linkage strategies, and systems change and cross-system strategies to improve linkages to services for young children. This paper uses a framework that illustrates the various roles that states can play to facilitate and support improved linkages: 1) maximizing the use of personnel; 2) undertaking quality improvement initiatives; 3) supporting data, information and technology; and 4) supporting individualized care plans and cross systems planning.	April 2009	NASHP - Commonwealth
Enhancing Developmental Outcomes for Children: Help Me Grow Connecticut	(Joanna Bogin) PowerPoint presentation describing the structure and development of Connecticut's Help Me Grow program, a coordinated, statewide referral system that links young children and their families to existing services and support.	December 2008	State-specific	Connecticut
Developmental services contact information for California counties with 2-1-1- programs	(California ABCD Screening Academy Project) Spreadsheet on 2-1-1 service agencies by county, including contact information for the developmental services persons for each county, when available.	December 2008	State-specific	California
Alaska's Referral Process for Pilot Sites	(Alaska ABCD Project) Flow chart of referral process for pilot sites	December 2007	State-specific	Alaska
Referral, Evaluation, and Release Form	(Colorado Early Childhood Connections) Parental release form for infants and toddlers - birth through two years of age - who may need early intervention services.	December 2007	State-specific	Colorado
Early Intervention Referral Process for Children Birth to 36 Months	(Colorado Early Childhood Connections) Flow chart for Early Intervention Referral Process showing responsibilities of health care provider's office, Part C Early Childhood Connections, and where responsibilities overlap.	December 2007	State-specific	Colorado
Colorado Referral Form	Colorado Early Childhood Connections (2007) Provider-completed form for recording status and progress of referrals.	December 2007	State-specific	Colorado
Barriers to the Identification and Management of Psychosocial Issues in Children and Maternal Depression	(Sarah McCue Hurwitz, Kelly Kelleher, Ruth Stein, et al. Pediatrics 2007; 119; 208-218) The purpose of this work was to determine whether (1) perceived barriers to care for children's psychosocial issues and maternal depression aggregate into patient, physician, and organizational domains, (2) barrier domains are distinct for mothers and children, and (3) physician, patient, and practice/organizational characteristics are associated with different barrier domains for children and mothers. (From Introduction)	December 2007	Peer-reviewed
Community Resources Inventory	(Paula Duncan: Alabama) The purpose of this tool is to structure an approach to identifying community resources that might enhance a practice’s ability to serve their patients. This tool allows practitioners to evaluate which organizations they would like to develop or improve links with.	December 2007	State-specific	Alabama
Community Resource Data Form	(Alabama ABCD Project) The purpose of this tool is to provide a structured approach to collecting information about services in the community that might benefit patients.	December 2007	State-specific	Alabama
Locating Community-Based Services for Children and Families	(Alabama ABCD Project) PowerPoint presentation created to provide stakeholders with information about Alabama’s participation in the ABCD Screening Academy. Presentation provides information on identifying generic and specialized community resources for families and children, birth to five years, and identifying roles for participant involvement in the local ABCD Demonstration Project.	September 2007	State-specific	Alabama
Agenda for meeting: Locating Community-Based Services to Support Children (Birth to Five) and Families	(Alabama ABCD Project) Agenda for meeting held September 26, 2007 to introduce stakeholders to the Alabama ABCD project.	September 2007	State-specific	Alabama
Linking Children to Developmental Services and Supports: An Overview	Amy Fine. (2007). PowerPoint presentation for ABCD Screening Academy Learning Session, July 2007. This presentation focuses on models to improve provider access to follow-up care for families.	July 2007	NASHP - Commonwealth
Access to Follow Up Services: Iowa's Healthy Mental Development Initiative	(M. Jane Borst) PowerPoint presentation for ABCD Screening Academy Learning Session, July 2007. This presentation describes Iowa's model for improving provider access to follow-up care to families: creating designated state-funded staff called EPSDT coordinators.	July 2007	NASHP - Commonwealth
Enhancing Developmental Outcomes for Children: Help Me Grow Connecticut	Joanna Bogin. (2007). PowerPoint presentation for ABCD Screening Academy Learning Session, July 2007. This presentation describes Connecticut's model of telephone-based care coordination to improve provider access to follow-up care to families.	July 2007	NASHP - Commonwealth
Access to Follow-up Services: Bringing Community and Health Care Providers Together	Julie Olson. (2007). PowerPoint presentation for ABCD Screening Academy Learning Session, July 2007. This presentation describes Utah's model for improving provider access to follow-up care to families: fostering referral pathway development.	July 2007	NASHP - Commonwealth
Healthy Babies Kids and Families, Perinatal Communication Tool	Vermont ABCD I Project. This form was designed to promote improved care coordination between MCH coordinators, Medicaid providers, and home visiting programs--allowing for a more streamlined approach to improve access to quality services for pregnant women.	April 2007	State-specific	Vermont
Enhancing Utah’s Capacity to Support Children’s Healthy Mental Development	Lori Smith (Salt Lake City, UT: Utah Department of Health, March 2007) This report summarizes findings related to system capacity in Utah. Completed yearly, this assessment consists of a survey tool designed to review and determine the number of professionals qualified to provide services to infants and toddlers from birth to age three.	March 2007	State-specific	Utah
Beyond Referral: Pediatric Care Linkages to Improve Developmental Health	Amy Fine and Rochelle Mayer. (New York, NY: The Commonwealth Fund, December 2006). This report provides a first step in reviewing the current state of pediatric primary care linkage to developmental services, identifying key strategies, developing a linkage typology, and providing recommendations to improve linkage for developmental care. (From web overview)	December 2006	NASHP - Commonwealth
How to Develop a Statewide System to Link Families with Community Resources: A Manual Based on Help Me Grow	Paul Dworkin, Joanna Bogin, Marijane Carey, et al. (New York, NY: The Connecticut Children's Trust and the Commonwealth Fund, 2006). The material in this manual is based on Connecticut's Help Me Grow Initiative, a program of Connecticut's Children's Health Fund. This online tool offers guidance for exploring, creating, and/or enhancing a single-point-of-access system to connect children at risk for developmental or behavioral problems with community resources. (From Table of Contents)	December 2006	NASHP - Commonwealth
ABCDII Gaps/Barriers to Interventions at the Demonstration Sites	Iowa ABCD Project (2006) This resource summarizes results from Iowa's Care Coordinators survey regarding barriers faced when referring families for services. Particularly, they were asked to document when a needed or recommended service was not available, and why.	December 2006	State-specific	Iowa
Guiding Principles of Iowa's System of Developmental Services for Children and their Families	Iowa ABCD Project (2006) This resource outlines principles for provider interactions with children, families, and communities developed by the ABCD project and disseminated to providers statewide.	December 2006	State-specific	Iowa
ABCD II Great Start Minnesota Project	Glenace Edwall, Antonia Wilcoxon, Susan Castellano. (Minnesota Department of Human Services, 2006). This presentation provides background information on the Minnesota ABCD II Project.	December 2006	State-specific	Minnesota
Patient Information and Referral Sheet	Minnesota ABCD project. (2006). This document is a standardized patient information and referral sheet used by Minnesota pilot sites and designed to capture referral needs and available services.	December 2006	State-specific	Minnesota
Identifying Infants and Young Children With Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening	Council on Children With Disabilities et al. Pediatrics 118 (1): 405. (2006) This statement provides an algorithm as a strategy to support health care professionals in developing a pattern and practice for addressing developmental concerns in children from birth through 3 years of age. The authors recommend that developmental surveillance be incorporated at every well-child preventive care visit. (From Abstract)	December 2006	Peer-reviewed
Maternal Depression Resources, Salt Lake County	Utah ABCD Project (2006) This resource is a sample matrix of the maternal depression resources available in Salt Lake County during the Maternal Depression Learning Collaborative.	December 2006	State-specific	Utah
North Carolina Early Childhood Resource List	North Carolina ABCD Project. (2006). This document lists current resources relevant to early childhood development service providers and policymakers.	December 2006	State-specific	North Carolina
Survey of Primary Care Providers: Developmental Screening and Referral for Early Intervention Services	North Carolina ABCD Project. (2006). This survey was designed to enable North Carolina staff who were conducting Quality Improvement trainings to gain an understanding of health care providers’ views on, and experience with, developmental screening and referral services.	December 2006	State-specific	North Carolina
Community Based Resources by County	Julie Olson. (UPIQ). A list of community based resources in Utah by county.	December 2006	State-specific	Utah
Brief Maternal Depression Screening at Well-Child Visits	Ardis L. Olson, Allen J. Dietrich, Greg Prazar, et al. Pediatrics Vol. 118 No. 1 July 2006, pp. 207-216. This study examines how routine, brief maternal depression screening conducted during well-child visits was feasible and detects mothers who are willing to discuss depression and stress issues with their pediatrician. (From web overview)	July 2006	Peer-reviewed
ABCD Healthy Beginnings Social/Emotional Consultant Consultation Satisfaction Survey	Illinois ABCD Healthy Beginnings (2005) This resource is a satisfaction survey given to providers who recently used a Social/Emotional Consultant to access follow-up services for a patient.	December 2005	State-specific	Illinois
Advanced Training -- DC: 0-3R™: Developmentally- Based Diagnosis of the Mental Health and Developmental Disorders of Infancy and Early Childhood	Zero to Three. (2005). This document outlines training for diagnosing developmentally-based mental health and developmental disorders of infancy and early childhood. This seminar is designed for mental health clinicians who have 1) participated in a full-day Introductory Training on use of DC: 0-3R™, and 2) have been using DC: 0-3R clinically for at least 6 months.	December 2005	State-specific	Minnesota
What Doctors Should Know About: Early Head Start	Utah ABCD Project. (2005) Informational handout summarizing issues related to Early Head Start and suggesting options for advocacy, helping families and further information.	December 2005	State-specific	Utah
What Doctors Should Know About: Part C Early Intervention Programs	Utah ABCD Project. (2005) Informational handout summarizing issues related to Part C Early Intervention Programs and suggesting options for advocacy, helping families and further information.	December 2005	State-specific	Utah
Developmental Stages of Developmental Screening: Steps to Implementation of a Successful Program	Pinto-Martin, Dunkle, Earls, Fliedner, Landes. American Journal of Public Health, 95(November 2005):1928 - 1932. This report explores the challenges of instituting universal developmental screening as part of pediatric care and presents 2 models of existing or planned programs for early screening for autism spectrum disorder and developmental disability (1 in a community-based setting and 1 in a pediatric setting), and discusses the pros and cons of the different strategies. (From Abstract)	November 2005	Peer-reviewed
Assuring Better Child Development: Improving Services in Communities	Edward Schor. (The Commonwealth Fund, May 20, 2005). A presentation by Edward Schor at the UPIQ Social Emotional Learning Collaborative held in Lehi, Utah, May 20, 2005 that provides information on the consequences of early childhood developmental problems and the value of early intervention.	May 2005	State-specific	Utah
Introduction to the DC: 0-3™ Diagnosing Mental Health and Developmental Disorders in Very Young Children	Molly Romer Witten. (Minnesota ABCD Project, Tuesday, April 26, 2005). This resource is a flyer for an interactive training session that introduces mental health practitioners and other interested professionals to the DC:0-3R, a system for diagnosing the mental health and developmental disorders of very young children.	April 2005	State-specific	Minnesota
Introduction to the DC: 0-3™ - Diagnosing Mental Health and Developmental Disorders in Very Young Children	Minnesota ABCD Project. (April 26, 2005). This interactive workshop introduces mental health practitioners and other interested professionals to a cutting edge system for diagnosing emotional and developmental disorders of very young children. This system, developed by ZERO TO THREE with the help of a diverse task force of infant mental health clinicians and researchers, takes into account the unique sensory, developmental, and relational needs of very young children.	April 2005	State-specific	Minnesota
Developmental Screening Tools: Web Resources	UPIQ. List of web resources: screening tools and related web sites that providers can use to learn more about developmental screening.	December 2005	State-specific	Utah
Perinatal Depression: Prevalence, Screening, Accuracy, and Screening Outcomes: Summary	BN Gaynes et al. AHRQ Evidence Report/Technology Assessment Number 119, February 2005. A systematic review of the evidence on the prevalence and incidence of perinatal depression, the accuracy of screening instruments for perinatal depression, and the effectiveness of interventions for women screened as high risk for developing perinatal depression. (From introduction)	December 2005	State-specific	Illinois
Addressing Social-Emotional Development and Infant Mental Health in Early Childhood Systems	Paula Zeanah, Brian Stafford, Geoffrey Nagle, et al.(Los Angeles, CA: National Center for Infant and Early Childhood Health Policy, January 2005). This report presents an overview of infant mental health (IMH) and the principles that need to be considered when building systems to meet the social and emotional needs of young children. The authors present a number of suggestions about the organization and delivery of IMH services at the state level, as well as some of the problems that are likely to be encountered. (From Introduction)	January 2005	Other
California Matrix of Services and Populations	California ABCD Project, Screening Matrix (2004) A spreadsheet detailing available Medicaid services and populations receiving services.	December 2004	State-specific	California
Parents as Primary Partners in Their Child’s Development and School Readiness	Kathy Seitzinger Hepburn. (Baltimore, MD: Annie E. Casey Foundation, December 2004). This toolkit has been created for the Annie E. Casey Foundation to help promote early childhood development and school readiness. The purpose of the tool kit is to provide guidance, resource materials, and references that will assist communities in working with families as primary partners in their child’s development and school readiness. (From Introduction)	December 2004	Other
Dialing For Help: State Telephone Hotlines as Vital Resources for Parents of Young Children	Meg Booth, Treeby Brown, and Malia Richmond-Crumb. (New York, NY: The Commonwealth Fund. November 2004). This brief examines the use of toll-free telephone hotlines by families to obtain advice on their children's health and well-being.	November 2004	NASHP-Commonwealth
Screening Children for Behavioral Developmental Problems	NASHP. (Portland, ME: National Academy for State Health Policy, September 2004). News from the Assuring Better Child Health and Development Program: This brief discusses screening, assessment, and developmental surveillance.	September 2004	NASHP-Commonwealth
Bright Futures: Guidelines for health supervision of infants, children, and adolescents	M Green and J Palfrey (Eds.) (2nd ed.). (Arlington, VA: National Center for Education in Maternal and Child Health, 2nd ed., rev.1994; 2000; 2002). 338 pp., 1 CD-ROM. These Bright Futures guidelines present a detailed framework for health professionals, in partnership with families, to promote the developmental health and well-being of children from birth to young adulthood. (From web overview)	December 2002	Peer-reviewed
Early Childhood Assessment Clinic	Washington ABCD I Project. (Whatcom County Health Department) This letter was provided to parents whose children had been screened at the Early Childhood Assessment Clinic using the Ages and Stages Questionnaire. It outlines relevant results and referral resource options.	August 2002	State-specific	Washington
Parents' Concerns about Their Children's Development: Prescreening Technique or Screening Test?	Glascoe FP, Pediatrics Vol. 99 No. 4 April 1997, pp. 522-528 The purpose of this study was to assess whether parents' concerns could: (1) serve instead as a screening measure; (2) aid in making focused referral decisions; and (3) help pediatricians target families for developmental promotion and in-office counseling. An additional goal was to determine why most parents' concerns are accurate although some are not. (From Abstract)	April 1997	Peer-reviewed
Improving Care Coordination, Case Management, and Linkages to Service for Young Children: Opportunities for States			NASHP-Commonwealth
Improving the Delivery Health Care that Supports Young Children's Healthy Mental Development: Update on Accomplishments and Lessons from a Five-State Consortium	The five states that participated in the second Assuring Better Child Health and Development (ABCD II) Consortium were successful in improving child development services, increasing the rate of identification of children in need of developmental services, and improving the likelihood that those identified with a potential need received appropriate follow-up services.		NASHP-Commonwealth

The ABCD experience has demonstrated that Medicaid and other state agencies can play an important role in promoting system and practice level change to improve routine identification of young children with developmental problems. Policy improvements most often occurred when they were an integral part of the work from the start rather than added on later in the project. Projects were most successful when senior officials within state government supported them and there was a defined line of communication between project staff and these decision-makers.

The success of the ABCD Initiative provides lessons for states and other entities wishing to improve the quality of health care while controlling costs and improving efficiency. ABCD states changed state statutes, state regulations, contracts, provider manuals, Web sites, and other documents that define state policies designed to improve the delivery of child development services. They also changed eligibility and claims processing systems to implement the policies described in the documents, conducted quality improvement projects designed to assess performance and foster change, and helped providers better understand new and existing policies through workshops, letters to providers and other means. These states made changes not only to Medicaid policies, but also to those governing related programs, such as early intervention and maternal and child health programs.*

Additionally, a background paper written for the ABCD III initiative, Improving Care Coordination, Case Management, and Linkages to Service for Young Children: Opportunities for States, highlights areas where states policies can affect and improve care coordination, case management, and linkages. Specifically, states can:

Maximize use of personnel in assuring effective linkages and CC/CM;
Assure and monitor quality of referrals, linkages, and CC/CM;
Support data, information, and technology that facilitates linkages and communication among families and providers;
Support individualized care plans and cross systems planning. This section focuses on resources designed to assist states workign to address the health and developmental needs of children and families.

This section includes resources highlighting state activities in identifying and implementing key processes to improve policy around preventive services.

______________________________________________________________________________________________________________________________________

*Neva Kaye and Jennifer May, State Policy Improvements that Support Effective Identification of Children At-Risk for Developmental Delay: Findings from the ABCD Screening Academy, (Portland, ME: National Academy for State Health Policy).

Title	Description	Date Published	Resource	State
Oregon Intergovernmental Agreement	(Oregon Department of Human Services) This is an agreement between the Oregon Department of Human Services and the Oregon Health & Science University. It concerns the tasks and scope of work for the ABCD III performance improvement projects conducted by participating managed care organizations. Because of the size of the document it is not currently available on the Resource Center. If you would like a copy please e-mail Larry Hinkle.	November 2010	State-specific	Oregon
Opportunities and Challenges in Health Reform for Young Children's Health and Development	Health care reform legislation presents many opportunities to support young children's health and development, as well as implementation challenges for states. This webinar recording features a presentation by NASHP Senior Program Director Catherine Hess on these issues, as well as a response from representatives from two states.	May 2010	NASHP - Commonwealth
Improving Care Coordination, Case Management, and Linkages to Service for Young Children: Opportunities for States	(Kay Johnson and Jill Rosenthal) States can use primary care practice-based strategies, service provider linkage strategies, and systems change and cross-system strategies to improve linkages to services for young children. This paper uses a framework that illustrates the various roles that states can play to facilitate and support improved linkages: 1) maximizing the use of personnel; 2) undertaking quality improvement initiatives; 3) supporting data, information and technology; and 4) supporting individualized care plans and cross systems planning.	April 2009	NASHP - Commonwealth
State Policy Improvements that Support Effective Identification of Children At-Risk for Developmental Delay	The success of the ABCD Initiative provides lessons for states and other entities wishing to improve the quality of health care while controlling costs and improving efficiency. Identifying and implementing key processes to improve state policies affecting screening in primary care are the focus of this brief. ABCD states changed state statutes, state regulations, contracts, provider manuals, Web sites, and other documents that define state policies designed to improve the delivery of child development services.	March 2009	NASHP - Commonwealth
2009 Families and Children Contract Final Model	(Minnesota Department of Human Service) 2009 Families and Children Contract Final Model. Sample contract used by the Minnesota Department of Human Services to contract with Managed Care Organizations (MCO)	January 2009	State-specific	Minnesota
Child and Family Policy Center Website	Iowa's Child and Family Policy Center designed this website to link research and policy on issues vital to children and families and to advocate for evidence-based strategies to improve child outcomes. Here you'll find research and policy information to help you promote strong children and families. You'll also find updates on our work to advance outcome-based policies that improve children's well-being. (from Website)	April 2009	State-specific	Iowa
Screening and Prevention Web Page	Utah Medical Home Portal: Tab for Physicians and Professionals. This website provides clinicians with information and resources about best practices in screening and treatment for developmental delays. It explains that the use of an objective screening tool is encouraged for EPSDT screens.	January 2009	State-specific	Utah
Prioritized list of health services billing codes	Oregon ABCD Project (2008) List of IDC-9, CPT and HCPCS codes for prioritized diagnoses and treatments in Oregon. Includes pregnancy, birth, preventive services, substance dependency, and reproductive services.	December 2008	State-specific	Oregon
Interventions considered and recommended for the periodic health examination	Oregon ABCD Project (2008) List of interventions considered and recommended for the Periodic Health Examination for children from birth to 10 years in the general population. Interventions are arranged by screening area and counseling topic. Also includes leading causes of death. Information from Oregon Health Plan Prevention Tables.	December 2008	State-specifc	Oregon
Virginia EPSDT Supplement 2007	Virginia ABCD Project. (2008). Supplement to Virginia Medicaid manual for providers updating information on EPSDT services.	December 2008	State-specifc	Virginia
Infant & Toddler Connection of Virginia Referral Form	Virginia ABCD Project (2008) Link to Virginia's uniform referral/consent form for referring a child to early intervention. Also indicates the feedback that a physician wants to receive from the early intervention program in response to the referral.	December 2008	State-specifc	Virginia
Maryland Infants and Toddlers Program Referral and Feedback Form	Maryland ABCD Project (2008) Maryland's referral form for referring a child (Birth to 3) to Early Intervention (Part C) and informing referral source of actions that the Early Intervention program has taken.	December 2008	State-specifc	Maryland
Alabama's Early Intervention System: Dear Doctor letter	Alabama ABCD Project (2008) Alabama Early Intervention System's 'Dear Doctor' letter, a check-off form letter used by Alabama's Early Intervention System (AIES) service coordinators to communicate back with physicians and other members of the multidisciplinary service team about their patients' Individualized Service Plan (ISP).	December 2008	State-specifc	Alabama
Alabama's ECCS Organization	Alabama ABCD Screening Academy Project (2008). Two PowerPoint slides for Alabama's Early Childhood Comprehensive Systems Initiative (ECCS), the first is an organizational chart for ECCS, the second is a flow chart of their progress from 2002 to 2008.	December 2008	State-specifc	Alabama
Healthy Babies, Kids and Families Web Page	Child Development Division, Vermont Department for Children and Families. Available online at: http://dcf.vermont.gov/cdd. This website provides information about Vermont's Healthy Babies, Kids and Families program, a project of the Child Development Division. The division brings together three child development programs to support the delivery of integrated services; this website communicates the division's expectations and services.	December 2008	State-specifc	Vermont
Principles and recommendations for developmental screening	State of California—Health and Human Services Agency, California Department of Public Health (2008). This document summarizes the California Maternal, Child and Adolescent Health Program, Center for Family Health's recommendations for developmental screening and early intervention, including identifying available resources and improving language.	December 2008	NASHP- Commonwealth	California
Developmental Screening Program Consent Form	California ABCD Screening Academy Project (2008). Developmental Screening Program's consent form for parents to permit use, disclosure, and/or release of their child's personal and health information.	December 2008	State-specifc	California
California's ABCD Strategy Implementation Matrix - System level (policy)	California ABCD Screening Academy Project (2008). California identified system-level (policy) approaches to promote healthy development for all children. Table includes information on drivers, strategies, implementation, timeframe, action steps, update on the action steps, and lead/support agencies.	December 2008	State-specifc	California
Medicaid: Health Promotion and Disease Prevention for School Readiness	Edward Schor, Melinda Abrams, Katherine Shea. Health Affairs, 26, no. 2 (2007): 420-429 March/April 2007. This article provides a timely reminder that health care services for children, including preventive and developmental services, are a smart investment for society. (From Overview)	December 2007	Peer-reviewed
Minnesota Department of Human Services Managed Care Contract	This resource outlines policy improvements made during the ABCD project to Managed Care Contracts. Section 7.10.6 of the contract sets down financial incentives for implementation of standardized developmental and mental health screening with use of appropriate CPT code by participating MCO providers.	November 2007	State-specifc	Minnesota
MCO Contract language	Virginia ABCD Project (2007) Language incorporated into Virginia Medallion II managed care contracts July 1, 2007 to promote the use of a standardized developmental screening tool.	July 2007	State-specifc	Virginia
Policy Improvement in the ABCD Collaborative States:What and How	M. Jane Borst, Deborah Saunders, Susan Castellano, and Neva Kaye. (2007). PowerPoint presentation for ABCD Screening Academy Learning Session, July 2007. This presentation examines some state options for improving policy to better support developmental screening, based on options actually implemented in ABCD consortia states. It also identifies the structures and processes ABCD consortia states used to encourage and facilitate policy change.	July 2007	NASHP- Commonwealth
Developmental and Behavioral Screening: A Quality Improvement Initiative in Primary Care Practice	Marian Earls. (2007). PowerPoint presentation for ABCD Screening Academy Learning Session, July 2007. This presentation describes how North Carolina utilized CME workshops to help physician practices incorporate standardized screening into well child care.	July 2007	NASHP- Commonwealth
Assuring Better Child Health and Development Initiative	NASHP (2007) PowerPoint presentation for ABCD Screening Academy Welcome call.	July 2007	NASHP- Commonwealth
Informational Letter No. 564: Services Provided to Young Children	Iowa Department of Human Services, Iowa Medicaid Enterprise (January 10, 2007). This resource is an informational release for Community Mental Health Centers on issues of Medicaid coverage and billing for services to young children who do not meet the criteria for a DSM IV diagnosis. This notice also contains information on provider training for the DC:0-3R.	January 2007	State-specifc	Iowa
ABCD II Findings and Recommendations to Iowa Medicaid to Support the Healthy Mental Development of Iowa's Young Children	Iowa ABCD Project (2006). This report to Iowa Medicaid details findings and recommendations from ABCD pilot sites and the Medicaid Barriers workgroup in an effort to improve EPSDT services and add to the Medicaid Reform Child Health Plan.	December 2006	State-specifc	Iowa
State Policy Options to Improve Delivery of Child Development Services: Strategies from the Eight ABCD States	Neva Kaye, Jennifer May, Melinda Abrams. (Portland, ME: National Academy for State Health Policy, December 2006) The work of the eight ABCD states has shown that state policies, especially Medicaid policies, can effectively promote improvements in the quality of preventive and developmental services provided to young children. This paper provides a starting point for states seeking to identify and implement policy improvements that support the healthy development of young children.	December 2006	NASHP- Commonwealth
Iowa Medicaid Standards to Promote the Healthy Mental Development of Children	Iowa Medicaid. (2006). This document outlines the minimum guidelines for the identification of developmental and social-emotional problems in young children--a summary of the three-tiered system of care developed under the ABCD project.	December 2006	State-specifc	Iowa
Iowa Medicaid: Opportunities to Support the Healthy Mental Development of Iowa's Young Children	Iowa ABCD Project. (2006). This report from the clinical workgroup of the Healthy Mental Development Panel I to the Iowa EPSDT Interagency Collaborative Board outlines recommendations to improve the healthy mental development of young children.	December 2006	State-specifc	Iowa
Recommendations to Implement the Iowa Medicaid Guidelines for Identification of Young Children with Developmental and Behavioral Problems	Iowa ABCD Project. (2006). This document outlines recommended protocols and tools for levels 1-3 of developmental and behavioral surveillance developed under the ABCD project.	December 2006	State-specifc	Iowa
Child Health Evaluation and Care (CHEC) Medicaid Provider Manual Maternal Depression Screening Update	Utah ABCD Project (Utah Medicaid, July 2006) This resource is a page in the Utah CHEC Medicaid provider manual that was updated to reflect policy improvements related to Maternal Depression Screening.	December 2006	State-specifc	Utah
Flowchart for the use of the Edinburgh screening tool	Joe Cramer (Utah ABCD Project, 2006) This flowchart details the appropriate process for implementation of the Edinburgh screening tool within a well-child visit.	December 2006	State-specifc	Utah
State of Illinois Department of Healthcare and Family Services Contract for Furnishing Health Services by a Managed Care Organization	This resource outlines policy improvements made during the ABCD project to Managed Care Contracts in Illinois. Please see highlighted sections of contract for specific improvements requiring use of standardized developmental and social emotional screening during EPSDT visits, risk assessment or perinatal depression screening during maternity care, as well as related quality improvement and performance payment projects.	December 2006	State-specifc	Illinois
Conference Call Guidelines for UPIQ Collaborative members	UPIQ. Guidelines for collaborative conference calls with UPIQ Learning Collaborative members.	December 2006	State-specifc	Utah
Partners and Providers Page, MHCP Provider Manual, Children's Therapeutic Services and Supports (CTSS)	This section of the Minnesota Health Care Programs Manual details the CTSS program, including eligibility requirements and covered services. Minnesota improved program coverage by creating CTSS, which provides mental health services to children with an emotional disturbance.	December 2006	State-specifc	Minnesota
Generic Consent Form	First Five Marin County (2006). Generic consent form that can be personalized by each project or organization using it. Includes a positive check option for respondent to select the specific agencies that can access health information.	December 2006	State-specifc	California
Medicaid Opportunities to Support the Healthy Mental Development of Iowa’s Young Children	Iowa ABCD Project (July 22, 2006) This final report from the ABCD II Clinical Panel to the Iowa EPSDT Healthy Mental Development Collaborative Board details findings and recommendations to further the intent of the federal EPSDT mandate and add to the Medicaid Reform child health plan to improve preventive health care for Iowa children.	July 2006	State-specifc	Iowa
Utah Medicaid Provider Manual, CHEC Services	Utah Department of Health. (July 2006). This section of the Medicaid Provider Manual describes Utah's Child Health Evaluation and Care (CHEC) program.	July 2006	State-specifc	Utah
Health Check Billing Guide 2006	North Carolina Department of Health and Human Services. (April 2006). This Medicaid Special Bulletin describes billing procedures for North Carolina's Health Check program. It clarifies that the use of an objective screening tool is encouraged for EPSDT screens (see page 5).	April 2006	State-specifc	North Carolina
Medicaid Barriers to Interventions Workgroup--Conference Call Minutes	Iowa ABCD Project. (2005). This resource details a conversation between workgroup members discussing perceived and real Medicaid barriers and opportunities--an insightful look into cooperative problem solving and interagency collaboration.	December 2005	State-specifc	Iowa
Medicaid Barriers to Implementation of the Three Level Identification System	Iowa's ABCD Project. (2005). This resource is a draft version of the guiding principles, recommendations, and billing codes for Levels 1-3 of Iowa's developmental and behavioral surveillance.	December 2005	State-specifc	Iowa
Medicaid Barriers to Interventions Work Group Roster	Iowa's ABCD Project. (2005). This resource lists workgroup members, staff, and responsibilities of the Medicaid Barriers to Interventions workgroup under the ABCD Healthy Mental Development panel.	December 2005	State-specifc	Iowa
Quality of Preventive Health Care for Young Children: Strategies for Improvement	Neal Halfon, Moira Inkelas, Melinda Abrams, and Gregory Stevens. (New York, NY: The Commonwealth Fund. May 2005). Even as policymakers increasingly understand the importance of children's early years for promoting health, learning, and school readiness and for identifying and mediating risk that can compromise later functioning, not all parents receive the services needed to identify developmental and behavioral issues in early childhood.	May 2005	NASHP- Commonwealth
Promoting Young Children's Healthy Mental Development	NASHP. (Portland, ME: National Academy for State Health Policy, November 2004). News from the Assuring Better Child Health and Development Program: This brief summarizes presentations made at NASHP’s 17th annual state health policy conference during a session on “Promoting Young Children’s Healthy Mental Development.” The session focused on the evidence base, state program highlights, a discussion of the ABCD program, and ways to use the Medicaid program to better support early childhood social and emotional development.	November 2004	NASHP- Commonwealth
Collaboration Between Title V and Medicaid Programs	NASHP (Portland, ME: National Academy for State Health Policy, August 2004). This news brief addresses the value of collaboration and partnership between agencies addressing children's healthy development, and is one in a series designed to address issues of interest and concern to states seeking to improve services and systems that support young children’s healthy mental development.	August 2004	NASHP- Commonwealth
Access to Children's Mental Health Services under Medicaid and SCHIP	Embry Howell (Washington, DC: The Urban Institute, August 2004). This brief fills some of the knowledge gaps about the unique roles of Medicaid— the dominant payer for mental health services for poor children—and SCHIP, a newer program whose role is still evolving. The brief first reviews coverage policy for mental health services for Medicaid and SCHIP. It then provides new information on the prevalence of mental health problems for Medicaid and SCHIP children, and their use of mental health services.	August 2004	Other
Up and Running: A Compendium of Multi-Site Early Childhood Initiatives Second Edition.	Sheri Floyd and CFPC Staff. (Des Moines, IA: State Early Childhood Policy Technical Assistance Network, July 2004). This compendium provides a brief description of a number of multi-site initiatives and programs that have a strong focus on early childhood and at least some emphasis on state or community policy development to improve school readiness. (From Overview)	July 2004	Other
Informational Notice to Providers	Illinois Department of Public Aid. (February 10, 2004). The purpose of this notice is to provide clarification on the billing of objective screenings and assessments under the departments Healthy Kids program and to advise providers of the Department's acceptance of the Guidelines for Adolescent Preventive Services (GAPS) Adolescent Screening Tool.	February 2004	State-specifc	Illinois
Using Medicaid to Support Young Children's Healthy Mental Development	Kay Johnson, Neva Kaye. (Portland, ME: National Academy for State Health Policy, September 2003). This report examines both why and how state Medicaid programs can support children's healthy mental development and includes a discussion of how states can use Medicaid to better support young children's social/emotional development. It includes specific strategies Medicaid agencies can use (and have used) to support young children's healthy mental development.	September 2003	NASHP- Commonwealth
Handbook For Healthy Kids Services: Appendix 1: Anticipatory Guidance Topics	Illinois Department of Public Aid. (April 2002). This handbook section provides information about well child visits and screening for providers.	April 2002	State-specifc	Illinois
Child Development Programs in Community Health Centers	Sarah Rosenbaum, Michelle Proser, Peter Shin, et.al. (New York, NY: The Commonwealth Fund, Jan. 2002). This report, the third in a series that reviews federal health policy related to child development, examines the role of community health centers in providing child development programs for children age 3 and younger. (From Executive Summary)	January 2002	NASHP- Commonwealth
Building Services and Systems to Support the Healthy Emotional Development of Young Children	Jane Knitzer. (New York, NY: National Center for Children in Poverty, January 2002). This guide is for policymakers and community leaders who want to improve policies and practices that promote healthy emotional development in children. It highlights why policymakers should invest in such services; describes emerging principles and strategies for what are often called early childhood mental health services; and offers concrete tips from early leaders in these efforts. (From Introduction)	January 2002	Other
Room to Grow: Promoting Child Development Through Medicaid and CHIP	Sara Rosenbaum, Michelle Proser, Andy Schneider, et al., (New York, NY:The Commonwealth Fund, 2001). The report begins with an overview of Medicaid and CHIP and then examines opportunities available to states to use these programs.	December 2001	NASHP- Commonwealth
Health Policy and Early Childhood Development: An Overview	Sara Rosenbaum, Michelle Proser, Colleen Sonosky. (New York, NY: The Commonwealth Fund, July 2001). This report explores federal and state health policy in the area of early childhood development and provides an overview of the evolution of federal health policy related to the financing and provision of preventive health services for young children. (From Overview)	July 2001	NASHP- Commonwealth
Using mental health strategies to move the early childhood agenda and promote school readiness.	Jane Knitzer. (New York, NY: Carnegie Corporation of New York, and National Center for Children in Poverty, Columbia University 2000). Part of the series Promoting the Emotional Well-Being of Children and Families, this report highlights emerging strategies to promote the emotional wellness of young children and their families, enhance caregiver skills, and ensure appropriate use of specialized services. The report describes mental health initiatives in child care, early learning and home visiting programs, early health care, and statewide approaches. (From Overview)	December 2000	Other
Behavioral and emotional problems among preschool children in pediatric primary care: Prevalence and pediatricians' recognition	John Lavigne, Helen Binns, Katherine Christoffel, et al: Pediatric Practice Research Group. Pediatrics 1993;91(3):649 This study examines how well private-practice pediatricians can identify emotional/behavioral problems among preschool children. (From web overview)	December 1993	Peer-reviewed

The ABCD collaborative experience confirms the importance of being able to show results for improving, sustaining, and spreading innovation and provides valuable information for others seeking to use data to support policy and practice improvements, especially in the delivery of child development services. Three immediate suggestions for those initiating such work are:

Ensure that plans for measurement are in place at the start,
Identify an individual who is responsible for managing all measurement activity, and
Pilot measurement approaches early in the effort.

Specific examples of strategies used by the ABCD states to gauge success include:

Including developmental screening and surveillance in your state quality strategy as well as in routine assessment and audit of state systems
Enhancing the reporting of Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)
Using claims and enrollment data effectively
Using provider and/or family surveys and focus group as well as medical chart review data effectively
Partnering with other state agencies to collect robust, child-centered data

This section highlights resources for measuring and evaluating the important work of improving the quality of child development services.

Title	Description	Date Published	Resource	State
Tracking Linkages: A Closer Look at Data Tools in Minnesota and Oklahoma	(NASHP/CMWF: June 2011) This is a recording of two state presentations from an ABCD III Evaluation Workgroup Webcast. This recording features presentations from Minnesota on its Access Database and from Oklahoma on its Web Portal. The speakers described how these data tools 1) track information for the common outcome (and additional measures), 2) fit into clinic or organization office flows, 3) interact with EHRs, 4) change over time, and 5) inform (or might potentially inform) other state projects.	June 2011	NASHP - Commonwealth
Measurement to Support Effective Identification of Children at Risk for Developmental Delay	(Neva Kaye, Jennifer May, Colleen Peck Reuland: NASHP) This State Health Policy Briefing is the third in a series examining the efforts of 19 states, the District of Columbia and Puerto Rico to improve identification of children with or at risk for developmental delay. For 15 months, ending in July 2008, these states and territories worked together, with the support of NASHP and the Commonwealth Fund, to make policy and practice changes that supported primary care providers’ use of a validated developmental screening tool as part of well child care.	April 2009	NASHP - Commonwealth
CAHMI Pediatric Preventive and Developmental Health Care Survey	(CAHMI) This survey is part of the Child and Adolescent Health Measurement Initiative (CAHMI) project focused on providing useful information about the preventive and developmental health care delivered to young children (0-3 years old) in the Pediatrics Department at Kaiser Permanente Northwest (KPNW). This survey is designed to gather information on providers' practices, perceptions of, and barriers to preventive and developmental health care for young children. (www.cahmi.org/)	January 2009	Other
Medicaid and SCHIP Quality Practices: Tools, Tips, and Protocols	(The Centers for Medicaid and Medicare Services) CMS developed a useful kit of quality practices for use in Medicaid and CHIP programs. Quality Tools, Tips and Strategies. A number of resources are available on this website to assist states in enhancing their external quality review activities. Specific tips related to medical chart (or record) reviews are provided.	January 2009	Other
“Creciendo Juntos” Chart Review Process	(Puerto Rico ABCD Screening Academy “Creciendo Juntos” Project) Description of preferred chart review process of children eligible for the ABCD Screening project.	December 2008	State-specific	Puerto Rico
Developmental Screening Initiative New Mexico Chart Audit Tool (and Evaluation Tool)	(New Mexico ABCD Project) Chart audit tool used in New Mexico as a source for measurement data. Chart review is performed at baseline and one-month visits.	December 2008	State-specific	New Mexico
Preliminary Ohio Measurement Plan	(Ohio ABCD Project) Ohio developed a control chart using Medicaid claims data that assesses the number of screening claims (96110 and 96111) for children at one and two years of age. The state plans on tracking data quarterly and annotating the chart to assess how changes have impacted screening and its documentation. Ohio is also discussing chart review to measure and analyze data at the individual practice level and compare this with claims data, as a way to confirm the validity of these methods.	December 2008	State-specific	Ohio
Medicaid Paid Claims for Extended Developmental Testing under 96111 code	(Virginia ABCD Project) Chart providing visual display of claims paid under 96111 code for children birth through 5 years of age by month of service in Virginia, January 2005 through December 2007 (preliminary).	December 2008	State-specific	Virginia
Findings from Virginia's 2007 Primary Care Provider Developmental Screening Survey	(Virginia ABCD Project) Summary of Findings of 2007 Provider Survey. This report summarizes results of 30 completed and returned surveys of pediatric providers that were distributed at the fall 2007 Virginia Chapter of the American Academy of Pediatrics (AAP) meeting in Williamsburg, Virginia. This survey obtained a rough assessment of the use of developmental screening practices in the community.	December 2008	State-specific	Virginia
Medicaid Paid Claims for Extended Developmental Testing under 96110 code	Virginia ABCD Project. (2008). Chart providing visual display of claims paid under 96110 code for children birth through 5 years of age by month of service in Virginia, January 2005 through December 2007 (preliminary).	December 2008	State-specific	Virginia
New Jersey's ABCD Screening Academy Grant Baseline Chart Review	New Jersey ABCD Screening Academy Project (2008). Data from New Jersey's sample chart review, using 5 charts each from 9 month, 18 month, and 30 month well-child visits.	December 2008	State-specific	New Jersey
Number of infant screenings by pilot site	Delaware ABCD Screening Academy Project (2008). Table showing number of infant screenings by pilot site between January and June.	December 2008	State-specific	Delaware
California AAP Pilot Site Data Collection Template	California AAP (2008) Excel spreadsheet developed for recording and analyzing data from pilot sites implementing developmental screening. Results and indicators are immediately tabulated as data is entered. This file can take a few moments to download and open. If you experience any difficulties, please contact Ann Cullen, acullen@nashp.org, and she will send you a copy of the Excel tool.	December 2008	State-specific	California
Sample summary of data collected during Minnesota's parent survey of well-child visits	Minnesota ABCD Screening Academy Project (2008). Summary of findings from first administration of parent survey of well-child visits, arranged by: Parent and Family Concerns; Provider-Patient Discussions; Experience of Care; Family Questions; and Health Care Provider.	December 2008	State-specific	Minnesota
Virginia's Medicaid Paid Claims for 96110 code for January 2005 through April 2007	Virginia ABCD Screening Academy Project (2008). Two charts showing Medicaid Paid Claims for Developmental Screening For Children Birth through 5 Years of Age by Month of Service Virginia, January 2005 through April 2008, and Children with a Medicaid Paid Claim for Developmental Screening For Children Birth through Five by Age and Year of Service Virginia, Calendar Years 2005, 2006, and 2007.	July 2008	State-specific	Virginia
Virginia's Medicaid Paid Claims for 96111 code for January 2005 through April 2008	Virginia ABCD Screening Academy Project (2008). Two charts showing Medicaid Paid Claims for Developmental Testing For Children Birth through 5 Years of Age by Month of Service Virginia, January 2005 through April 2008, and Children with a Medicaid Paid Claim for Extended Developmental Testing For Children Birth through Five by Age and Year of Service Virginia, Calendar Years 2005, 2006, and 2007.	July 2008	State-specific	Virginia
ASQ screenings performed at Piedmont Health Department WIC Clinic January-May 2008	Virginia ABCD Screening Academy Project (2008). Table showing data on ASQ Screenings performed at Piedmont Health Department WIC Clinic January-May 2008.	June 2008	State-specific	Virginia
Proposal for ABCDII Evaluation Study Focus Groups	The Iowa ABCDII Evaluation Committee (March 2006) This document details the ABCD project's recommendations for using focus group methods to obtain data regarding project-related questions of interest beyond the three required NASHP performance measures.	December 2007	State-specific	Iowa
Summary of interviews with Ohio ABCD Screening Academy pilot practices	Ohio ABCD Project (2007) Summary of interviews with pilot practices regarding use of standardized developmental screening practices.	December 2007	State-specific	Ohio
Preliminary Ohio Measurement Plan	Ohio ABCD Project (2007) Ohio developed a control chart using Medicaid claims data that assesses the number of screening claims (96110 and 96111) for children at one and two years of age. They are also considering chart review to measure and analyze data at the individual practice level and compare this with claims data, and exploring how to track referrals using Help-Me-Grow data.	December 2007	State-specific	Ohio
Medicaid Paid Claims for Developmental Screening	Virginia ABCD Project (2007) Two charts showing Medicaid paid claims for developmental screening for children from birth through 5 years of age in Virginia for calendar years 2005 and 2006.	December 2007	State-specific	Virginia
Description of Wisconsin Division of Public Health- DHFS Developmental Screening Survey	Wisconsin DHFS (2007) This resource provides a description of the Wisconsin survey designed to identify what methods primary care providers in Wisconsin are using to assess child development.	December 2007	State-specific	Wisconsin
Questions for Wisconsin Division of Public Health- DHFS Developmental Screening Survey	Wisconsin DHFS (2007) This survey was developed to collect information on the use of developmental screening in clinical practice by Wisconsin primary care providers.	December 2007	State-specific	Wisconsin
Claims Data Cheat Sheet	Colleen Reuland (2007) Cheat sheet for using claims data to measure the percent of children screened to identify developmental concerns.	December 2007	NASHP-Commonwealth
Parent Report Cheat Sheet	Colleen Peck Reuland (2007). This document (shared at the June 5, 2007 ABCD TA call) contains key clarifying questions and helpful hints for using parent reports to measure the percentage of children screened to identify developmental concerns.	December 2007	NASHP-Commonwealth
Measuring the "Fruits of Your Labor"	Colleen Peck Reuland. (2007). This presentation (shared during the June 5, 2007 ABCD TA call) includes tips and strategies to identify, develop, and implement measures to assess screening and evaluate Screening Academy Efforts. It covers medical chart review, parent reports, and claims data.	December 2007	NASHP-Commonwealth
Measuring your progress, approaches, resources, and considerations	Colleen Peck Reuland. (2007). PowerPoint presentation for ABCD Screening Academy Learning Session, July 2007. This presentation describes measurement criteria and provides tips specific to using different data sources.	July 2007	NASHP-Commonwealth
Medical Chart Cheat Sheet	Colleen Peck Reuland. (2007). This document (shared at the June 5, 2007 ABCD TA call) contains key clarifying questions and helpful hints for using medical charts to measure the percentage of children screened to identify developmental concerns.	July 2007	NASHP-Commonwealth
The Promoting Healthy Development Survey (PHDS)-PLUS: Implementation Guidelines for Medicaid and Other Settings	Christina Bethell, Colleen Reuland, and Brooke Latzke. (New York, NY: The Commonwealth Fund, February 2007). This manual provides detailed guidelines for implementing the Promoting Healthy Development Survey-PLUS (PHDS-PLUS) in Medicaid and other programs and settings.	February 2007	NASHP-Commonwealth
Measuring and Evaluating Developmental Services: Strategies and Lessons from the ABCD Consortium States	Colleen Peck Reuland and Christina Bethell. (Portland, ME: National Academy for State Health Policy, December 2006) This paper explores how ABCD Consortium states measured the effectiveness of their efforts to improve the delivery of mental health services for very young children. It provides states seeking to implement efforts similar to those in ABCD II Consortium information on evaluation methodologies as well as real-world examples and lessons learned by the ABCD II states during their measurement efforts.	December 2006	NASHP-Commonwealth
Promoting Healthy Development Survey - PLUS (PDHS-PLUS)	CAHMI (The Child and Adolescent Health Measurement Initiative, 2006) This document provides a high-level summary of the questions asked in the PHDS-PLUS, a 128-item telephone/interviewer-administered survey largely derived from the mail/self-administered Promoting Healthy Development Survey (PHDS). (From Survey cover)	December 2006	NASHP-Commonwealth
Evaluation summary from Assuring Better Child Development (ABCD) Project Training Session Three March 30th, 2006	Iowa ABCD Project (2006). This resource is summary of evaluation responses from the ABCD Training Session Three held on March 30th, 2007.	December 2006	State-specific	Iowa
Iowa ABCD II Focus Groups: Selected Participant Comments	Iowa ABCD Project (2006) A summary of comments from a focus group of selected participants that examined the implementation of standardized screening and referral protocols during the ABCD project.	December 2006	State-specific	Iowa
ABCD Healthy Beginnings Evaluation: Lessons Learned--Stakeholders	Illinois ABCD Healthy Beginnings. (2006). This resource lists interview questions for the Healthy Mental Development panel workgroup and subcommittee members regarding their overall experience with the ABCD project.	December 2006	State-specific	Illinois
ABCD Healthy Beginnings Pediatric practice Social/Emotional (S/E) and Maternal Depression questionnaire	Illinois ABCD Healthy Beginnings. (2006). This survey is the final questionnaire for pediatric practices on their use of Social/Emotional (S/E) and Maternal Depression screening.	December 2006	State-specific	Illinois
ABCD Healthy Beginnings: Parent Satisfaction Survey	Illinois ABCD Healthy Beginnings (2006) This survey was given to parents who had completed the ASQ:SE to evaluate their satisfaction with the instrument.	December 2006	State-specific	Illinois
Illinois' 2005 Perinatal/Postnatal Evaluation Tool for maternal depression screening	Illinois Department of Healthcare and Family Services. (2006). This evaluative resource identifies the percentage of enrolled women that were screened for depression - as documented in the medical record - during the prenatal and/or postpartum period. In addition, the study was designed to collect data on whether or not treatment and follow-up occurred if the screening was positive for depression.	December 2006	State-specific	Illinois
Minnesota Early Childhood Comprehensive Screening Systems Focus Group Report	Minnesota ABCD Project. (2005). This resource summarizes an environmental scan of Minnesota’s screening for young children. 11 focus groups were held during March and April 2004 at five Minnesota sites—Detroit Lakes, Grand Rapids, Redwood Falls, Rochester, and Roseville. The focus groups were designed to gather information from regional experts to assess how the early childhood screening system for children from birth to age five addresses the five key elements of the Minnesota Early Childhood Comprehensive Screening Systems (MECCSS) Planning Grant.	December 2006	State-specific	Minnesota
Parent Survey	North Carolina ABCD Project. (2006). This parent survey was used to evaluate whether standardized screening was being implemented in primary care practice and to assess further parental needs.	December 2006	State-specific	North Carolina
Practice Screening Tool Usage Survey	UPIQ. Survey of practice screening tool usage.	December 2006	State-specific	Utah
ABCD II Evaluation Physician Focus Group	Iowa ABCD Project. (April 2006). A summary of a provider focus group examining the implementation of standardized screening protocols in the Pella demonstration sites conducted on April 20, 2006.	April 2006	State-specific	Iowa
Using External Quality Review Organizations to Promote Young Children's Healthy Mental Development	NASHP. (Portland, ME: National Academy for State Health Policy, April 2006) This brief examines case studies of states' use of EQRO's in collaborative performance improvement projects.	April 2006	NASHP-Commonwealth
Focus Group Results--Physicians and Nurse Practitioners at an Urban Pediatric Practice	Iowa Focus Group Results (April 2006). This resource is a summary of participant comments at a focus group examining the implementation of standardized screening and referral protocols in the Dubuque demonstration sites conducted on April 6, 2006.	April 2006	State-specific	Iowa
Studying and Tracking Early Child Development from a Health Perspective: A Review of Available Data Sources	Brett Brown and Martha Zazlow (Washington, DC: Child Trends, February 2006) In this report, the authors review existing national data sources in terms of their capacity to inform child health policy and practice in their efforts to promote early child development. The body of the report provides an overview of existing areas of strength, identifies gaps, and makes recommendations for future data development.	February 2006	Peer-reviewed
Questionnaire for Best PCP Stakeholders	Cricket Mitchell. California ABCD Project (2005). A questionnaire used to glean information regarding potential stakeholder interests & potential roles.	December 2005	State-specific	California
Parent Satisfaction with Edinburgh survey	Illinois ABCD Healthy Beginnings. (2005). This resource is a survey of parent experience with standardized maternal depression screening.	December 2005	State-specific	Illinois
Using External Quality Review Organizations to Promote Young Children's Healthy Mental Development	Henry Ireys, Tara Krissik, James Verdier, et al. (New York, NY: The Commonwealth Fund, June 2005). This study provides state Medicaid programs, managed care organizations, EQROs, and other child health professionals with strategies for using EQROs to enhance the quality of preventive and developmental services for young children. (From Abstract)	June 2005	NASHP-Commonwealth
Developmental Screening Practices and Autism Awareness of Utah's Primary Care Physicians: 2004 Survey Results	Jennifer Chapman Lloyd et al. (Utah Department of Health; University of Utah School of Medicine, April 2005). Results from a mail survey of Utah family physicians and pediatricians about developmental screening and referral practices, and autism spectrum disorder.	April 2005	State-specific	Utah
California Best PCP measures of outcomes - Diagram	California ABCD Project (February 2005) Flowchart: California Best PCP Measures of Outcomes showing the relationships between Primary Care and "Outside" resources.	February 2005	State-specific	California
Integrating Measures of Early Childhood Health and Development into State Title V Maternal and Child Health Services Block Grant Plans	Holly Grason, Catherine Hess, Karen Van Landeghem, et al. (Baltimore, MD: Johns Hopkins University, June 2004). This brief provides information about measures of preventive health and developmental services for children from birth to age five and how those measures can be integrated into MCH plans. The brief also is intended to assist policymakers, program managers, and providers concerned with early childhood health and development learn about opportunities with state MCH programs. (From Overview)	June 2004	Other
Measuring the Quality of Preventive and Developmental Services for Young Children: National Estimates and Patterns of Clinicians	Christina Bethell, Colleen Reuland, Neal Halfon, and Edward Schor. Pediatrics, June 2004; Vol. 113, pp. 1973-83. This study, part of a special issue of Pediatrics, generates a national picture of performance in the area of preventive and developmental services for young children using four composite quality measures in the areas of 1) anticipatory guidance and parental education, 2) screening for family psychosocial risks, 3) screening for smoking and drug and alcohol use in the home, and 4) provision of family-centered care. (From Abstract)	June 2004	Peer-reviewed
The National Survey of Early Childhood Health	Stephen J. Blumberg, Neal Halfon, and Lynn M. Olson. Pediatrics Vol. 113 No. 6 June 2004, pp. 1899-1906. The National Survey of Early Childhood Health (NSECH) is a new survey that was designed to provide nationally representative data on the health and development of children and to fill an information gap in the pediatric literature on parents’ views of the delivery of health care to their young children.	June 2004	Peer-reviewed
Evaluation data on the number of children screened and referred under ABCD	North Carolina ABCD I Project These charts contain data on the number of children screened and referred with the Ages and Stages questionnaire and include baseline and post intervention rates.	December 2003	State-specific	North Carolina
Assuring Better Child Health and Development (ABCD) Evaluation	North Carolina ABCD I Project. (2003). This resource outlines a stakeholder group's work plan to measure and evaluate program goals, screening rates, and ongoing data tracking/trending. Strategies were designed to track improvements throughout the initiative.	December 2003	State-specific	North Carolina
Survey of Primary Care Providers: Developmental Screening and Referral for Early Intervention Services	North Carolina ABCD I Project.(2003). This survey was designed to elicit an understanding of primary care providers' views on, and experience with, developmental screening and referral services.	December 2003	State-specific	North Carolina
The Health and Well-Being of Children: A Portrait of States and the Nation 2005	U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. The National Survey of Children's Health 2003. This chartbook (based on data from the National Survey of Children's Health) includes state-level information about the percentage of children ages 0-5 whose parents reported one or more concerns about learning, development or behavior.	December 2003	Other
Summary of Interviews & Focus Groups with Parents of Young Children: Reporting the Promoting Healthy Development Survey (PHDS) Findings to Parents	CAHMI (2003) CAHMI summary of focus groups and interviews with parents. Information about how to report on quality of care findings about well-child care.	December 2003	Other
National Evaluation of the ABCD Initiative	Center for Health and Public Service Research, New York University and University of Kansas (October 2003) This report examines results from a national evaluation of the ABCD I program conducted by a combination of researchers from Northwestern University, New York University and University of Kansas funded by The Commonwealth Fund as the national evaluators for ABCD. The evaluation team adopted a case study approach, involving primarily qualitative data collection.	October 2003	NASHP-Commonwealth
Touchpoints Implementation Survey	Vermont ABCD I Project. This survey was used to collect data about provider and staff implementation of the Touchpoints guiding principles presented during the Touchpoints seminar.	July 2003	State-specific	Vermont
Touchpoints Post-Training Assessment Form	Vermont ABCD I Project. This post-training assessment of Touchpoints for University of Vermont faculty and other trainees was designed to determine the sustainability of the Touchpoints model.	July 2003	State-specific	Vermont
A Practice Survey 2002, ABCD Pilot in Raleigh, North Carolina	North Carolina ABCD I Project (2002) This report details findings from the ABCD provider/practice survey.	December 2002	State-specific	North Carolina
A summary of the FACCT survey findings	NASHP. (Portland, ME: National Academy for State Health Policy, October 2002) News from the Assuring Better Child Health and Development Program: This brief discusses the findings from a survey of parents assessing the quality of preventive and developmental services for young children enrolled in Medicaid.	October 2002	NASHP-Commonwealth
Partnering With Parents to Promote the Healthy Development of Young Children Enrolled in Medicaid: Results From a Survey Assessing the Quality of Preventive and Developmental Services for Young Children Enrolled in Medicaid in Three States	Christina Bethell, Colleen Peck, Melinda Abrams, et al. (The Commonwealth Fund, New York, NY, September 2002). This paper presents results of a survey of 1,900 parents of children under age four who were covered by Medicaid. The Promoting Healthy Development Survey-PLUS survey of parents also examined issues surrounding the health of young children and their parents as well as family health behaviors and routines. The survey was administered in three states participating in the ABCD program: North Carolina, Vermont, and Washington. (From the Executive Summary)	September 2002	NASHP-Commonwealth
Evaluation Plan for Vermont's Healthy Babies, Kids, and Families Program	Judith Shaw, Annette Rexroad. (Vermont ABCD I Project, May 24, 2002) This Evaluation Plan submitted as part of the Vermont Healthy Babies, Kids, and Families Expansion grant focuses primarily on documenting the processes by which Medicaid services are administered.	May 2002	State-specific	Vermont
Methods for evaluating the provision of well child care	Kathleen M. Schneider et al. Joint Commission Journal on Quality Improvement. Dec 2001;27(12):673-82. This article compares administrative data and medical record review to ascertain the number of well child visits provided.	December 2001	Peer-reviewed
Using Peer Review for Self-Audits of Medical Record Documentation	Ronald Bradshaw (2000) American Academy of Family Physicians 7 no. 4 (April 2000) A good general overview about medical chart reviews.	April 2000	Peer-reviewed

Early Childhood Services Costs, Financing, and Return on Investment

ABCD states each endeavored (and still continue to do so) to improve the delivery of care to young children, mostly without seeking new appropriations, changing state law, or obtaining federal approval. States found that they could make improvements to care without new funding or legislation They accomplished their work by leveraging existing resources (such as federal EPSDT provisions) and partnering with other stakeholders, including their sister agencies, private organizations, and providers.

This section includes resources on the costs and financing associated with the delivery of early childhood health and developmental services. It includes a guide to federal funding for early childhood supports and services, an evidence base for the types of programs that have been demonstrated to be effective, the potential for returns to society that exceed the resources invested in program delivery, and specific information on ABCD states’ strategies to pay for improvement.

Title	Description	Date Published	Resource	State
Billing Codes for Iowa's EPSDT Care for Kids Services	Iowa Department of Human Services. This section of the EPSDT Care for Kids website contains billing code information for developmental, social, emotional, and family risk screening as well as developmental and mental health assessment and diagnosis. It clarifies that providers may crosswalk the Early Childhood DC: 0-3 with the DSMIV or ICD-9 diagnostic codes to bill for the screening service.	January 2009	State-specific	Iowa
Improving Early Childhood Health and Developmental Services Using EPSDT Policy: EPSDT Services and the Coding Conundrum	Joel Bradley, (Americhoice by United Health Care, 2009). This PowerPoint presentation describes the correct coding for EPSDT services and helps readers understand how the correct use of existing coding systems can facilitate EPSDT data tracking and provide opportunities to reward providers for higher screening rates. Dr. Bradely presented this information to EPSDT Coordinators during a webcast of the same name in March 2009.	January 2009	NASHP-Commonwealth
Medicaid Reimbursement Numbers	Medicaid reimbursement codes by carrier and state. accessed and compiled by Dr. Michelle Macias, September 2007.	September 2007	Other
ABCD local funding resource document	Jennifer May. (Portland, ME: National Academy for State Health Policy, 2006.) This resource explores what ABCD Consortium states accomplished by partnering with local funders to support children's healthy development.	December 2006	NASHP-Commonwealth
Billing and Policy Technical Assistance	North Carolina ABCD Project. (2006). This PowerPoint presentation clarifies billing procedures for developmental screening around existing EPSDT requirements for Medicaid eligible children as well as providing state-specific information on billing private insurers.	December 2006	State-specific	North Carolina
Investing in Infants and Toddlers: The Economics of Early Childhood	Kimberly Lucas. (Washington, DC: Zero to Three Policy Center, September 2006). This article outlines current economic research, its application within the field of child development, and ways in which early childhood professionals and economists can join forces to advocate for greater investment in program s that support infants, toddlers, and their families. (From Overview)	September 2006	Other
Financing Strategies for Medicaid Reimbursement of Maternal Depression Screening by Pediatric Providers	Karen VanLandegehm. (Portland, ME: National Academy for State Health Policy, April 2006). This news brief explores how pediatric providers (e.g., pediatricians, family physicians, and nurse practitioners) can play a key role in early intervention for maternal depression and provides sound financing strategies for Medicaid reimbursement.	April 2006	NASHP-Commonwealth
Early Childhood Interventions: Proven Results, Future Promise	Lynn Karoly, M. Rebecca Kilburn, Jill Cannon. (San Diego, CA: The Rand Corporation, January 2006). This report explores the potential consequences of not investing additional resources in the lives of children as well as the range of early intervention programs, the demonstrated benefits of interventions with high-quality evaluations, the features associated with successful programs, and the returns to society associated with investing early in the lives of disadvantaged children. (From web overview)	January 2006	Peer-reviewed
Views on the Early Childhood Mental Health System in Ramsey County	Cheryl Holm-Hansen. (Foundations For Success newsletter, December 2005). This report summarizes the results of a survey of mental health services in Ramsey County.	December 2005	State-specific	Minnesota
Illinois ABCD II Healthy Beginnings Pilot Community Evaluation Report: Baseline data	Illinois ABCD Healthy Beginnings. (July 2005). This report outlines baseline data (collected in needs assessments and surveys described elsewhere) prior to project implementation and outlines the initiative's goals to build the social/emotional health capacities of pediatricians and family physicians.	July 2005	State-specific	Illinois
State Medicaid Policy for Reimbursement of Maternal Depression Screening	Illinois ABCD Healthy Beginnings. (March 4, 2005). This resource outlines the Illinois State Medicaid Policy for Reimbursement of Maternal Depression Screening.	March 2005	State-specific	Illinois
How Medical Claims Simplification Can Impede Delivery of Child Developmental Services	Anne Markus, Sara Rosenbaum, and Alexandra Stewart. (New York, NY: The Commonwealth Fund, August 2005). This report examines HIPAA administrative standardization and the process of modifying the standardized codes. It assesses the implications of HIPAA standardization for payment of Medicaid-covered early childhood preventive and developmental services, drawing on findings from a 50-state, point-in-time review of readily available state HIPAA compliance documents conducted in December 2004. (From web Executive Summary)	December 2004	NASHP-Commonwealth
Illinois provider notice: Billing for Screenings Under the Healthy Kids Program	Illinois Department of Public Aid (2004) Provider notice explaining Illinois attempt to unbundle payment for Developmental screening services to ensure policies conform with Medicaid reimbursement rules.	December 2004	State-specific	Illinois
Illinois provider notice: Screening for Perinatal Depression	Illinois Department of Public Aid (2004) This notice provides information on DPA’s initiation of reimbursement for screening for perinatal depression and information about consultation services available to providers.	December 2004	State-specific	Illinois
Strategic Financing: Making the Most of the State Early Childhood Comprehensive Systems-Building Initiative	Cheryl Hayes, Margaret Flynn, Helene Stebbins. In: Halfon N, Rice T, Inkelas M, eds. Building State Early Childhood Comprehensive Systems Series, No. 5. (Los Angeles, CA: National Center for Infant and Early Childhood Health Policy, 2004).	December 2004	Other
Coding and Reimbursement for Developmental Screening	North Carolina ABCD I Project.(2003). Description of coding and reimbursement procedures for preventive visits for various public and private payors.	December 2003	State-specific	North Carolina
Early Childhood Development: Economic Development with a High Public Return, web-based fedgazzette March 2003	Art Rolnick and Rob Grunewald. fedgazette, (Minneapolis, MN: Federal Reserve Bank of Minneapolis, March 2003). This study finds that well-focused investments in early childhood development yield high public as well as private returns and how this return on investments in early childhood development results in better working public schools, more educated workers, and less crime. (From Introduction)	March 2003	Other
Making Dollars Follow Sense: Financing Early Childhood Mental Health Services to Promote Healthy Social and Emotional Development in Young Children	Kay Johnson, Jane Knitzer, Roxane Kauffman. (New York, NY: National Center for Children In Poverty, 2002). This report highlights innovative approaches states and communities have used to finance preventive and early intervention services, as well as more traditional mental health treatment services for young children. It explores what else might be done to mix, match, and leverage all available resources for early childhood mental health needs. (From web Overview)	December 2002	Other
Using Title V Maternal & Child Health Services Block Grant to Support Child Development Services	NASHP (Portland, ME: National Academy for State Health Policy, March 2002) News from the Assuring Better Child Health and Development Program: The flexibility of Title V allows for it to be an originating and supportive source for child development programs, including direct care for mothers and children as well as interventions for an entire family. This brief examines state flexibility to maximize Title V funding and Title V Coordination requirements.	March 2002	NASHP-Commonwealth
Using Title V Maternal & Child Health Services Block Grant to Support Child Development Services	Sara Rosenbaum, Michelle Proser, Andy Schneider, et al., (New York, NY: The Commonwealth Fund January 2002). This report explains how services provided through the Title V Maternal and Child Health Services Block Grant can be used to foster optimal child development intervention services in the early years of life. (From Executive Summary)	January 2002	NASHP-Commonwealth
Assessing Costs and Benefits of Early Childhood Intervention Programs: Overview and Application to the Starting Early Starting Smart Program	Lynn A. Karoly, M. Rebecca Kilburn, James H. Bigelow, et al. (Santa Monica, CA: RAND, 2001). This report identifies the conceptual and methodological issues associated with the analysis of costs and outcomes of early intervention programs in general and makes recommendations regarding the application of these tools for subsequent demonstration studies of a particular intervention program: Starting Early Starting Smart. (From Introduction)	December 2001	Peer-reviewed
Estimating the cost of developmental and behavioral screening of preschool children in general pediatric practice	Deborah Dobrez, et al. Pediatrics. Oct 2001: 108(4): 913-922. This article develops a model for estimating the cost of providing pediatric developmental and behavioral screening that can be scaled to reflect a pediatric practice's patient population and choice of screening offered. (From abstract)	October 2001	Peer-reviewed

All ABCD states established demonstration sites—primary care practices willing to serve as laboratories for improvement and a nucleus from which to spread successful improvements. These sites committed to various activities, including implementing developmental screening as part of designated well-child care visits; promoting linkages between primary care providers and other child and family service providers; receiving and helping to refine training; contributing to evaluative activities; sharing their experience with the stakeholder group; and serving as ‘champions’ in statewide spread plans. In return, these practices helped to shape state policy—and knew their work could not only improve the delivery of care to their patients but lead to improvements across their state and beyond.

This section will include resources that summarize successful pilot site selection and support strategies for improving the delivery of child health and development services—including ABCD consortia findings.

Title	Description	Date Published	Resource	State
Illinois Early Intervention Referral Form	(Illinois ABCD III Project) This is Illinois' most recent iteration of its form to refer children to EI for eligibility determination.	April 2011	State-specific	Illinois
Illinois Early Intervention Program, Child and Family Connections Referral Follow-up Form	(Illinois ABCD III Project) This form is used to provide a summary on the status of a referral to the EI system point of entry (Child and Family Connections).	April 2011	State-specific	Illinois
Linking Children to Services: Building on Community Assets to Pilot Test Improvement Strategies	(Carrie Hanlon: NASHP) This issue brief describes: 1) how the five ABCD III states are building on existing local partnerships and assets to organize community pilots, and 2) preliminary lessons that have emerged from these states, including new federal opportunities to bolster community partnerships that will improve service linkages for children.	December 2010	NASHP - Commonwealth
Setting the stage for Success... Screening & Surveillance in Primary Care: Working with Demonstration Sites	(Chris Collins and Marian Earls) PowerPoint presentation for ABCD Screening Academy Learning Session, July 2007. This presentation describes how North Carolina implemented its demonstration sites and provides insight into how demonstration site experience can be used in policy improvement and statewide spread of innovations.	July 2007	NASHP - Commonwealth
Working with demonstration sites: Consultation with Iowa's ABCD II project staff	(Carrie Fitzgerald and Alfred Healy) Accompanying handout for Fitzgerald/Healy ABCD Screening Academy Learning Session presentation, July 2007. This handout includes key details about working with demonstration sites, based on the Iowa experience.	July 2007	NASHP - Commonwealth
Working with demonstration sites	(Scott G. Allen and Deborah Saunders) PowerPoint presentation for ABCD Screening Academy Learning Session, July 2007. This presentation describes how Illinois implemented its demonstration sites and provides insight into how demonstration site experience can be used in policy improvement and statewide spread of innovations.	July 2007	NASHP - Commonwealth
ABCD Healthy Beginnings Evaluation: Lessons Learned - Providers	(Illinois ABCD Healthy Beginnings) This resource is a list of interview questions for pilot site providers and office staff - part of an overall evaluation to learn more about their experience with the ABCD project. The questions focus on successes and challenges in the implementation of social-emotional and maternal depression screening.	December 2006	State-specific	Illinois
Key Informant Interview Template for Children's Hospital	(Minnesota ABCD project) This resource is a script/template for conducting informative interviews with critical stakeholders at the Children's Hospital pilot site with a particular focus on assessing mental health screening activities in primary care settings.	December 2006	State-specific	Minnesota
Quarterly Screening Form	(Foundations for Success: Minnesota ABCD Project) This form was used by pilot sites to track and report screening rates and outcomes.	December 2006	State-specific	Minnesota
Setting the Stage for Success: Implementation of Developmental and Behavioral Screening and Surveillance in Primary Care Practice	(Marian F. Earls and Sherry Shackelford Hay: Pediatrics Vol. 118 No. 1 July 2006, pp. e183-e188) This report examines how early identification of children with developmental and behavioral delays is important in primary care practice, and how well-child visits provide an ideal opportunity to engage parents and perform periodic screening. Integration of this activity into office process and flow is necessary for making screening a routine and consistent part of primary care practice. (From Abstract)	July 2006	Peer-reviewed
Memorandum of Understanding Between Dubuque Medical Associates and The Iowa ABCD II Healthy Mental Development Initiative	(Iowa's ABCD Project) This MOU is a nonbinding agreement between the Iowa ABCD II Initiative partners and Dubuque Medical Associates to participate as a demonstration site in the Iowa ABCD II Healthy Mental Development Initiative.	December 2005	State-specific	Iowa
ABCD Healthy Beginnings Social-Emotional Screening Card	Illinois ABCD Healthy Beginnings. (2005). This document was designed for Illinois ABCD pilot sites to track implementation and results of social-emotional screening.	December 2005	State-specific	Illinois
ABCD/Healthy Beginnings Social/Emotional and Maternal Depression Information, Screening, and Referral program needs assessment form	Illinois ABCD Healthy Beginnings. (2005). This needs assessment was performed at pilot sites prior to each Healthy Beginnings training/presentation on social emotional screening implementation to assess the needs of each practice/clinic and tailor the program presentation to fit the needs identified in the survey responses.	December 2005	State-specific	Illinois
Healthy Beginnings: The Illinois ABCD II Initiative: Core Elements of the Primary Care Social Emotional Pilot	Illinois ABCD Healthy Beginnings. (2004). The Illinois ABCD Initiative included a social emotional pilot project to test the integration of a social emotional component/protocol into three primary health care sites. There were core elements of the social emotional component/model that all three pilot sites implemented. The evaluation process will include identifying how these elements are implemented differently based on the characteristics of each site.	December 2004	State-specific	Illinois
Communication Tool Telephone Survey Morrisville Pilot Site	North Carolina ABCD I Project. This telephone survey assesses provider perceptions of the implementation of peri-natal and pediatric communication tools developed for use at the pilot sites.	December 2003	State-specific	North Carolina
Ages and Stages Questionnaire (ASQ) Procedures	(Washington ABCD I Project: Whatcom County Bright Futures) This flowchart was used in ABCD pilots to assist in implementing and integrating the Ages and States Questionnaire (ASQ).	August 2002	State-specific	Washington
The North Carolina ABCD Project: A New Approach for Providing Developmental Primary Care Practice	Helen Pelletier, Melinda Abrams. (Portland, ME: National Academy for State Health Policy, July 2002). This field report provides an overview of the North Carolina ABCD project, its accomplishments to date, and lessons for other states.	July 2002	State-specific	North Carolina
Physicians' attention to parents' concerns about the psychosocial functioning of their children	Beth Wildman, Ali Kizilbush, William Smucker. Arch Fam Med 1999;8(5):440. This report examines whether parental disclosure of concerns was a better predictor for physician identification of child psychosocial problems than was the presence of child behavior problems. (From overview)	December 1999	Peer-reviewed

Based on the successes of ABCD consortia, participating states are now beginning to implement a plan for spreading the innovations developed and tested in the demonstration sites statewide. Many have developed key partnerships that will continue beyond the project, including organizations such as provider organizations, state agencies, and other public/private partnerships. These partnerships enabled states to pool resources to more effectively support providers in practice improvements, first among a limited number of demonstration sties, and then across the states. This ‘spontaneous lateral spread’ serves to make the case for Medicaid agencies to improve and/or clarify policies that promote child health and development and as an impetus for states to begin addressing creating effecient systems linkages that support families in securing appropriate care and services once needs have been identified.

This section will provide resources to assist states in sustaining and spreading the policy and practice improvements first tested in demonstration sites and designed to improve the quality of pediatric preventive services throughout their states.

Title	Description	Date Published	Resource	State
Improving the Quality of Care and Coordination of Services for Young Children -- ABCD, CHIPRA and Beyond!	(NASHP) This webinar highlighted how Illinois, Oregon, South Carolina, and Vermont are using ABCD III and/or CHIPRA quality grants to build on and align current efforts, such as medical home initiatives, health information technology or exchange, performance measurement, and health reform, to transform the delivery of care to children covered by Medicaid and CHIP. This event was sponsored by The Commonwealth Fund and built on a session held during the 2010 NASHP Annual Conference.	December 2010	NASHP - Commonwealth
EDOPC Social/ Emotional Screening and Referral training materials	Enhancing Developmentally Oriented Primary Care (Illinois EDOPC, 2009). This resource consists of an outline and the PowerPoint slide images of the Social/Emotional Screening and Referral program, a 1.5 hour Continuing Medical Education training program designed to be presented in the office/clinic setting to all staff by a trained healthcare provider.	January 2009	State-specific
Statewide Spread Strategy for Arkansas' ABCD Project	Arkansas ABCD Screening Academy Project (2008). Strategies and action steps for Arkansas' ABCD Project to promote statewide spread of innovations.	December 2008	State-specific	Arkansas
Brochure promoting The Infant & Toddler Connection of Virginia	Virginia Infant and Toddler Connection (2008). 2-page brochure aimed at providers describing the referral options provided by The Infant & Toddler Connection of Virginia, which assists families of infants and toddlers with developmental delays and/or disabilities help their children learn and develop through everyday activities and routines so that they can participate fully in family and community activities. Brochure provides information on referrals and phone numbers for Infant & Toddler Connection offices in various locations around the state.	December 2008	State-specific	Virginia
ABCD Goals and Strategies Matrix	California ABCD Screening Academy Project (2008). Table outlining ABCD Screening Academy project goals, strategies to achieve goals, measures to collect to evaluate progress, baseline data, and whether and what agency has data available.	December 2008	State-specific	California
Ohio's Preliminary Statewide Spread Plan for the ABCD Screening Academy	Ohio ABCD Screening Academy Project (2008). Ohio's ABCD Screening Academy Preliminary Spread Plan. These preliminary designs for implementation and spread of structured developmental assessment of young children in Ohio are under review.	June 2008	State-specific	Ohio
Ohio's Preliminary Measurement Plan for ABCD Screening Academy	Ohio ABCD Screening Academy Project (2008). Ohio's ABCD Screening Academy Preliminary Measurement Plan. These screening recommendations are under review due to the release of the 2008 AAP Periodicity Schedule.	June 2008	State-specific	Ohio
Infant & Toddler Connection of Virginia Referral Form	Virginia ABCD Screening Academy Project (2008). Referral consent form for physicians to complete when referring a child to early intervention. Includes option for providers to indicate the feedback they want to receive from the early intervention program in response to the referral.	March 2008	State-specific	Virginia
Iowa Child Health Maintenance Clinical Notes (CHMN)	Iowa Care for Kids EPSDT (2007) The resource can be used by providers to ensure that children who require developmental and physical supports are identified early and referred to services. It provides an age-specific format for the clinical examination that emphasizes developmental milestones and provides anticipatory guidance.	December 2007	State-specific	Iowa
Provider Survey	North Carolina ABCD I Project Provider Survey Evaluation. This survey was distributed to family practice and pediatric providers in three categories and analyzed according to a specific protocol. The survey instrument consists of questions designed to measure the provider’s perception of their individual knowledge and attitudes regarding developmental screening tools, early intervention services, and particular federal laws.	December 2007	State-specific	North Carolina
Infant Toddler Early Intervention Program (ITEIP) Website	Washington State Department of Social and Health Resources (2007) This Early Intervention website provides useful information on appropriate developmental milestones as well as services available to parents and providers.	December 2007	State-specific	Washington
Preliminary design for implementation and spread of structured developmental assessment of young children in Ohio	Ohio ABCD Project (2007) Description of preliminary design for implementation and spread of structured developmental assessment of young children in Ohio.	December 2007	State-specific	Ohio
Impact of Implementing ASQ Developmental Screening in a Pediatric Practice	Kevin Marks and Hollie Hix-Small (2007) PowerPoint presentation amended from a doctoral dissertation originally presented by Hollie Hix-Small, PhD. Provides information on why, where, and when to do developmental screening.	December 2007	State-specific	Oregon
Overview of Lessons Learned from the ABCD Experience in Working with Demonstration Sites	Melinda Abrams (July 2007). This PowerPoint presentation from the ABCD Screening Academy Learning Session provides an overview of the process of implementing a strategy for increasing developmental screening rates.	July 2007	NASHP-Commonwealth
History of the North Carolina ABCD Initiative	North Carolina ABCD Project. (March 2007). This PowerPoint presentation highlights the success and accomplishments of the North Carolina ABCD initiative, as well as ongoing project replication activities.	March 2007	State-specific	North Carolina
Informational letter: Billing Developmental services	Iowa Department of Human Services, Iowa Medicaid Enterprise (Jan 11, 2007). This resource is an informational release to physicians, nurse practitioners, and screening centers regarding payment for use of standardized screening tools. Payment for a standardized screening tool is not included in the reimbursement for a child’s preventive office visit or E/M service. The letter also describes the appropriate billing codes to use for services.	January 2007	State-specific	Iowa
Educational Objectives: Assuring Better Child Health and Development (ABCD II) Project	Iowa ABCD Project (2006). Educational objectives for a provider training on the revised approach to child health care delivered through the Medicaid EPSDT program. The training was held at Pella Medical Clinic, March 16, 29 & 30, 2006.	December 2006	State-specific	Iowa
Recommendations to implement the Iowa Medicaid standards for identification of young children with developmental or social-emotional problems	Iowa's ABCD II Healthy Mental Development Initiative. (2006). This draft document (for reveiw by providers) is a set of recommendations for protocols and tools to help providers implement standards of care that will appropriately identify developmental and social-emotional concerns in children from birth through 3 years who participate in Medicaid.	December 2006	State-specific	Iowa
New Office-Based Resources on Child Development/ Mental Health Issues, flyer	Illinois ABCD Healthy Beginnings. (2006). This announcement details a training presented by EDOCP and the ABCD project. This developmentally oriented continuing medical education (CME) opportunity was designed for pediatricians and family physicians.	December 2006	State-specific	Illinois
Emotional-Behavioral Screening by Primary Care Practitioner: Attitudes, Practices, and Barriers	Katherine Murray, Andrew Barnes, Marjorie Ireland, et al. (Minnesota ABCD Project, 2006). This study assesses the specific techniques and instruments primary care pediatricians and family practitioners use to detect emotional and behavioral problems and describes their beliefs about the prevalence of these problems and barriers to universal screening. (From Abstract.)	December 2006	State-specific	Minnesota
Utah Medhome Portal	Utah Medhome. (2006) This website was developed during the ABCD initiative in Utah. It provides information, tools, and resources to aid Primary Care Physicians in caring for Children with Special Health Care Needs (CSHCN) and providing a Medical Home for all of their patients. (From Website.)	December 2006	State-specific	Utah
EDOPC Developmental Screening and Referral	Enhancing Developmentally Oriented Primary Care (EDOPC). This resource provides an outline and PowerPoint slide images of the Developmental Screening and Referral program, a 1.5 hour presentation designed to be presented in the office/clinic setting to all staff by a trained healthcare provider.	December 2006	State-specific	Illinois
Empowerment Professional Development Planning Committee Proposal Outline	Jane Borst. (Iowa Department of Health, July 7, 2006). This proposal outlines steps to improve the quality of well child services by conducting professional development activities for primary care providers who care for infants and children. This proposal was presented to the Empowerment Professional Development Planning Committee to spread the adoption of the standards for developmental screening to primary health care providers throughout Iowa. This proposal was later awarded $75,000.00.	July 2006	State-specific	Iowa
Community Care Fact Sheet	North Carolina ABCD Project. (June 2006). This newsletter provides an overview of relevant information for Medicaid providers in North Carolina. Through resources such as this newsletter, Community Care provider networks are working to put into place the local systems needed to achieve long-term quality, cost, access and utilization objectives in the management of care for Medicaid recipients.	June 2006	State-specific	North Carolina
Announcement of new web site available for Medicaid EPSDT/Care for Kids providers	Iowa Department of Human Services, Iowa Medicaid Enterprise (February 2006). A web site containing useful tools, resources, and links for providing EPSDT services with special emphasis on promoting healthy physical, mental, social, and emotional development of children birth through age three. http://www.iowaepsdt.org/	February 2006	State-specific	Iowa
A Practical Guide for Healthy Development	Web-resource. Copyright © 2005 by The University of North Carolina at Chapel Hill for its Center for Children's Healthcare Improvement and by the Vermont Child Health Improvement Program at the University of Vermont. A Practical Guide for Healthy Development consists of a set of materials and tools designed and tested in the Healthy Development Learning Collaborative, a 12-month quality improvement initiative.	December 2005	NASHP-Commonwealth
Assuring Better Child Health Development II: Project Training	Iowa ABCD Project (2005). Agendas for three training sessions organized to explain the purpose of the ABCD II project and to assist Dubuque health care and other personnel to gain the knowledge and skills necessary to include standardized screening and referral guidelines in daily practice.	December 2005	State-specific	Iowa
Iowa's ABCD II Healthy Mental Development Project: The ABCD II Project	Iowa's ABCD II Project. (2005). This document lists anticipated questions and answers regarding the ABCD II project. This resources seeks to address unanswered questions as to how the early development of young children, and their families, can be coordinated and improved. (From Introduction)	December 2005	State-specific	Iowa
Early Childhood Mental Health Summer Institute: Creating a Referral Protocol for Head Start	Glenace Edwall and Antonia Wilcoxon. (Minnesota Department of Human Services, July 26, 2005). This PowerPoint presentation was delivered at a session at the Early Childhood Mental Health Summer Institute and was designed to educate providers on improving access to follow-up services.	July 2005	State-specific	Minnesota
ABCD II Early Identification System Standards: Board Approved Recommendations for Implementation in the Demonstration Sites	Iowa ABCD Project (January 2005) Formal guidelines for implementation of standardized screening and referral practices used in demonstration sites and to be considered in the eventual development of a statewide system.	January 2005	State-specific	Iowa
"If it Worked for Us..."	William Hensel. (Greensboro, NC: Guilford Access Partnership, Guilford County Department of Public Health, 2004). Letter from William Hensel, Medical Director of the Guilford Access Partnership, to Sherry Hay, North Carolina's ABCD Coordinator, describing the successes of the ABCD I program implementation.	December 2004	State-specific	North Carolina
Screening for Perinatal Depression - Informational Notice	Illinois Department of Public Aid. (November 30, 2004). This informational notice from IL DPA to practitioners outlines screening protocols for perinatal depression and provides information on DPA's initiation of reimbursement for screening for perinatal depression and information about consultation services available to providers.	November 2004	State-specific	Illinois
Letter of Support to Colleagues on Standardized Screening	Marian Earls. (Greensboro, NC: Guilford Child Health, Inc., April 2004). This letter from a pilot site provider was sent to peers and colleagues in an effort to promote the use of the Ages and Stages Questionnaire.	April 2004	State-specific	North Carolina
Setting the Stage for Success, an Introduction for North Carolina Providers	(North Carolina ABCD I Project, 2004). This brochure was used as an introductory informational guide for providers on the Ages and Stages Questionnaire.	December 2002	State-specific	North Carolina
Bright Futures in Practice: Mental Health	Michael Jellinek, Chair. (Washington, D.C., National Center for Education in Maternal and Child Health, 2002). This resource is a two-volume set that considers the mental health of children in a developmental context, presents information on early recognition and intervention for specific mental health problems and mental disorders, and provides a tool kit with hands on tools for health professionals and families for use in screening, care management, and health education. (From web overview)	December 2002	Peer-reviewed
Child Development Programs in Community Health Centers	NASHP (Portland, ME: National Academy for State Health Policy, March 2002) News from the Assuring Better Child Health and Development Program: Child development programs at community health centers. Because of their ability to identify at-risk children and to assess their social and primary care needs, health centers are valuable and essential providers of child development services. This brief discusses health promotion program and parent education programs offered by community health centers.	March 2002	NASHP-Commonwealth
Building State Medicaid Capacity to Provide Child Development Services: Early Findings from the ABCD Consortium	Deborah Curtis. (Portland, ME: National Academy for State Health Policy, February 2002). This report is a summary of early findings from a four-state consortium dedicated to strengthening the early child health and development services offered through Medicaid. It outlines how the Consortium states – North Carolina, Utah, Vermont, and Washington – worked to expand or develop early child health and development services. It examines the various strategies used in each state, including how each of them sought to improve developmental screening for infants and toddlers.	February 2002	NASHP-Commonwealth
Healthy Babies Kids and Families, Pediatric Communication Tool	Vermont ABCD I Project. This form was designed to promote improved care coordination between MCH coordinators, Medicaid providers, and home visiting programs--allowing for a more streamlined approach to improve access to quality services for Medicaid eligible children.	February 2002	State-specific	Vermont
Overview of lessons learned in Iowa working with demonstration sites	Carrie Fitzgerald and Alfred Healy. (2007). PowerPoint presentation for ABCD Screening Academy Learning Session, July 2007. This presentation describes how Iowa implemented its demonstration sites and provides insight into how demonstration site experience can be used in policy improvement and statewide spread of innovations.		NASHP-Commonwealth

Title	Description	Date published	Resource	State
Improving the Delivery Health Care that Supports Young Children's Healthy Mental Development: Update on Accomplishments and Lessons from a Five-State Consortium	The five states that participated in the second Assuring Better Child Health and Development (ABCD II) Consortium were successful in improving child development services, increasing the rate of identification of children in need of developmental services, and improving the likelihood that those identified with a potential need received appropriate follow-up services.		NASHP-Commonwealth

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