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).
