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Developmental Screening Workgroups

We are in the workgroup stage of the effort to define the structure of a system for Universal Developmental Screening (UDS) in the State of Washington. It will bring together and examine the issues that impact such a system. Ultimately, the workgroups will identify best practices and offer feedback on how to create a system under which we can join together to screen and obtain coordinated results and referrals.

The work of these Developmental Screening Workgroups will be based on   

• ‘Strategic Framework for Universal Developmental Screening for the State of Washington’,  
• ‘Universal Screening Outcome Map’ and
• Outcome Map-associated ‘Assumptions’ document 

The Framework document provides an overview of a number of efforts in developmental screening nationally and in Washington State.  It outlines one draft of an approach toward creating such a system statewide.  The Outcome Map and Assumptions documents reflect the concensus of the statewide Developmental Screening Partnerships group (a group meeting since December 2009, see below) as to the expectations of a universal screening system.

Workgroup Categories

• Screening System
• Reaching All Populations
• Resources and Care Coordination

Overarching:

• Data Needs

Meeting later:

• Outreach/Marketing
• Fiscal
• Evaluation

History

Washington is a diverse state with multiple complex systems and initiatives promoting children’s health & development and school readiness. Developmental screening is recommended in medical practices, on home visits and in preschool programs, such as Early Head Start/Head Start. For children with concerns/needs, there may be an array of services and supports in any given county. 

However, there is often a lack of coordination between services and programs involved with children and families in the early years of life. We have been working to create a shared vision and a strategic framework for a system for universal developmental screening in our state. In the health setting, developmental screening is a recommended element of well child care. It is also a key strategy in early learning - and is in both the Washington State Early Learning Plan and the Birth to Three recommendations presented to the Washington State Legislature by the Department of Early Learning.

Using blended funding from federally-funded grant projects at Washington State Department of Health, other federal grants, and American Recovery and Reinvestment Act funds from our state’s Early Support for Infants and Toddlers program, DOH has partnered with the University of Washington Medical Home Project to create a framework for Washington. We believe UDS is ambitious but achievable!

In December 2009, June 2010 and June 2011, a group of key state level stakeholders from public and private agencies, parents, physicians, the Washington chapter of the AAP, and leaders in early learning gathered to provide input into the framework, create a vision, and lay out areas to develop. Many of these partners continue working together to explore and refine components of the plan. A partnership to connect families with resources has begun by increasing information on developmental screening at WithinReach, a statewide call center and ParentHelp123.org website.

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Assumptions for the Universal Developmental Screening System

UDS Definition
The UDS system ensures that all children have opportunity and access to developmental screening consistent with nationally accepted pediatric guidelines. Screening will be voluntary, respecting parental/guardian choice. UDS system elements include (but are not limited to):

• The system meets people where they are;
• The system is continuous;
• Screening systems must coordinate with other systems;
• The system will reach all populations and be culturally relevant;
• Screening will be of equal quality across geographic, economic, and cultural strata.

Assumptions, Aspirations, and Future Decisions
Achieving universal developmental screening is ambitious, but achievable. Planning and implementation will launch in 2011 and will continue to be phased-in over a period of several years. The initial UDS system will be based on what is practical and feasible in the current landscape. The UDS system will build off of existing efforts, acknowledging that it is more efficient to build capacity of existing programs that support a UDS system than to start from scratch. The system will capitalize on strategic opportunities (e.g. ARRA funding) as they arise. Implementation decisions will be made as the system rolls out, making every attempt to adhere to the long term vision of ensuring developmental screening and linkages to appropriate health services for all young children in Washington State.

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Initial Implementation Assumptions
DOH expects to be in early stages of system planning and implementation by summer 2011. Key initial elements will likely include:

• An initial focus on birth to 3 years
• Many “providers” will be involved in the UDS system, including medical and other health providers, childcare and other early childhood providers, etc.
• There will be no wrong door for developmental screening information. Families will have access and links to screening information and tools through a variety of providers (e.g. primary care offices, medical home, early childhood providers, home visitors)
• Families will be able to access screening tools through a variety of methods (examples might include: online, provider office, library computer, public kiosks, phone, cell phone, etc)
• Screening tools will be standardized and available electronically through a variety of methods, including via technology that may not yet be available
• Screening tools will be age-appropriate and fit the needs of a variety of programs
• Monitoring and Evaluation will track process changes, system changes, and outcomes changes. The M&E plan will address barriers to system access and follow-up care (e.g. cultural barriers, referral barriers, provider barriers)

Aspirations
Achieving universal developmental screening is ambitious, but achievable. Planning and implementation will launch in 2011 and will continue to be phased-in over a period of several years. At full implementation, the UDS system aspires to:

• Make available developmental screening to all children birth to 8 years;
• Make available a broader width of screening services (e.g. maternal depression, autism);
• Be adaptable to future health reforms and technological advances.
• Ensure the availability of resources and infrastructure in all communities to support the healthy development of children for whom a developmental delay has been identified.

Future Decisions
Many implementation decisions will be made as the system rolls out. Workgroups, primarily made up of partner organization staff, will be tasked with addressing questions, including but not limited to, the following:

• What screening tool will be used?
• Will there be a menu of tools?
• Will we expand to include maternal depression, autism, and/or other screenings?

Timeline

Check back soon. Currently working on content.

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Links to articles

Referenced at Thrive by Five/Developmental Screening/Help Me Grow presentation April 22 2009.

Feb 2006 Supplement focusing on Connecticut's Help Me Grow program.  Results of a Roundtable Meeting sponsored by the Commonwealth Foundation in 2005.

Journal of Developmental and Behavioral Pediatrics, vol 27 Number 1S

• Article 1 Intro
• Article 2 Discussion
• Article 3 Enhancing Developmental Services in Primary Care: The Help Me Grow Experience
• Article 4 Securing Dev system
• Article 5 Barriers to Practice based dev screening
• Article 6 History from Childserv to Help Me Grow
• Article 7 Discussion 2
• Article 8 Statewide IR system
• Article 9 Evaluating Model programs
• Article 10 Keeping Dev Screening on Legislative agenda in tough fiscal times
• Article 11 Role of Training
• Article 12 Role of Philanthropy
• Article 13 General Discussion 3 and Next Steps

(NOTE: You need to login to access the above articles. Username = devscreen, PW=training)

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