Developmental Screening of Young Children
he Maternal and Child Health Bureau's (MCHB's) Title V Maternal and Child Health Services Block Grants to States Program has established 15 National Performance Measures for the 2015-2017 grant cycle. Performance Measure 6 is the percent of children, ages 9-71 months, receiving a developmental screening using a parent-completed screening tool. This evidence brief points to a selection of resources for state MCH programs about child developmental screening in general and about parent tools for developmental screening, with emphasis on evidence based information.
The Title V Maternal and Child Health Services Block Grant to States Program guidance1 defines the significance of this goal as follows:
Early identification of developmental disorders is critical to the well-being of children and their families. It is an integral function of the primary care medical home. The percent of children with a developmental disorder has been increasing, yet overall screening rates have remained low. The American Academy of Pediatrics recommends screening tests begin at the nine month visit.
Read More about Performance Measure 6
Performance Measure 6
Percent of children, ages 9-71 months, receiving a developmental screening using a parent-completed screening tool
To increase the number of children who receive a developmental screening
Numerator: Parent reporting they have filled out a questionnaire provided by a health care provider concerning child's development, communication or social behaviors for a child ages 9-71 months
Denominator: All children ages 9-71 months
Healthy People 2020 Objectives
Related to Maternal, Infant, and Child Health (MICH) Objective 29-1: Increase the proportion of children (aged 10-35 months) who have been screened for an Autism Spectrum Disorder and other developmental delays. (Baseline: 22.6%, Target: 24.9%)
Data Sources and Data Issues
The revised National Survey of Children's Health (NSCH) in 2017. States can use the 2011-2012 NSCH as a baseline until that time.
Data and Statistics
- National Survey of Children's Health (NSCH). Funded by the Health Resources and Services Administration's (HRSA's) Maternal and Child Health Bureau (MCHB), this survey provides national and state-level data on the physical and emotional health of American children 0 - 17 years old. Information is collected on factors related to the health and well-being of children, including access to and utilization of health care, receipt of care in a medical home, family interactions, parental health, school and after-school experiences, and neighborhood characteristics.
Since 2003, the NSCH has provided both national and state-level prevalence estimates for a variety of child health and health care indicators. MCHB also fielded the National Survey of Children with Special Health Care Needs (NS-CSHCN) in 2001, 2005-2006, and 2009-2010. Its purpose was to assess the prevalence and impact of special health care needs among children and their families in the U.S. The 2016 NSCH underwent significant redesign and administration changes and differs greatly from the prior survey cycles. From 2016 onward, the purpose of the NSCH remains the same, but the two individual surveys were combined into a single survey conducted every year.
You can access data from and information about the current NSCH through the Health Resources and Services Administration’s Maternal and Child Health Bureau, the Data Resource Center for Child & Adolescent Health, or the U.S. Census Bureau. Data from and information about past NSCH and NS-CSHCN are available through the Data Resource Center for Child & Adolescent Health or the CDC’s National Center for Health Statistics.
- Healthy People 2020: Maternal, Infant, and Child Health. Lists objectives, evidence-based interventions and resources, and a national data snapshot. Objective MICH-29 refers to developmental screening for young children with an autism spectrum disorder or other developmental delays.
- Caldwell J, Berdahl T. 2013. Trends in well-child visits: United States, 2002-2009. Rockville, MD: U.S. Agency for Healthcare Research and Quality.
- Birth to Five: Watch Me Thrive. This initiative of the Early Childhood Development office of the Administration for Children and Families is a coordinated federal effort to encourage healthy child development, universal developmental and behavioral screening for children, and support for the families and providers who care for them. The website includes a list of research-based developmental screening tools for use across a wide range of settings. Its Families page offers resources families can use to track their child's development and know how to take action when needed.
- Bright Futures. This multi-organizational national health promotion initiative includes guidelines, trainings, family materials, and these screening resources:
Bright Futures Tool and Resource Kit from the American Academy of Pediatrics (AAP).
What to Expect & When to Seek Help. Developmental tools for families and providers from Georgetown University.
- Learn the Signs, Act Early. This resource for parents from the Centers for Disease Control and Prevention provides information on milestones children should reach from birth to age 5 in how they play, learn, speak, act, and move. The website includes materials, training for early care and education providers, how to get involved, what to do about concerns with a child's development, autism case training, and multimedia and tools. It also provides a link to standardized, validated developmental screening tools for parents and providers from AAP.
- Johnson K. From Evidence to Improved Policy and Program Practices: Developmental Screening. 2014. National Center for Education in Maternal and Child Health. Georgetown University: Washington, DC.
- Association of Maternal and Child Health Programs. 2014. Environmental scan: State strategies and initiatives to improve developmental and autism screening and early identification systems. Washington, DC: Association of Maternal and Child Health Programs.
- Centers for Disease Control and Prevention. 2014. Developmental monitoring and screening for health professionals. Atlanta, GA: Centers for Disease Control and Prevention.
- Coker TR, Windon A, Moreno C, Schuster MA, Chung PJ. 2013. Well-child care clinical practice redesign for young children: A systematic review of strategies and tools. Pediatrics 131 Suppl 1:S5-25.
- Dworkin PH. 2014. Fulfilling the promise: Interventions to promote children's healthy development. Hartford, CT: Help Me Grow National Center.
- Forsberg VC, Peters R, Napoles AI, Shah A, Ramos C, Devers KJ. 2014. Factors that influence preventive service utilization among children covered by Medicaid and CHIP: Environmental scan and literature review. Washington, DC: Urban Institute.
- Johnson-Staub C. 2014. First steps for early success: State strategies to support developmental screening in early childhood settings. Washington, DC: Center for Law and Social Policy.
- King TM, Tandon SD, Macias MM, Healy JA, Duncan PM, Swigonski NL, Skipper SM, Lipkin PH. 2010. Implementing developmental screening and referrals: lessons learned from a national project. Pediatrics 125(2):350-60. Epub 2010 Jan 25.
- Schonwald A, Huntington N, Chan E, Risko W, Bridgemohan C. 2009. Routine developmental screening implemented in urban primary care settings: more evidence of feasibility and effectiveness. Pediatrics 123(2):660-8. View abstract.
- Van Cleave J, Kuhlthau KA, Bloom S, Newacheck PW, Nozzolillo AA, Homer CJ, Perrin JM. 2012. Interventions to improve screening and follow-up in primary care: a systematic review of the evidence. Academic Pediatrics 12(4):269-82. View abstract.
- Center for Law and Social Policy, Charting Progress for Babies in Child Care. 2012. Promote access to early, regular, and comprehensive screenings. Washington, DC: Center for Law and Social Policy.
- Centers for Disease Control and Prevention. 2014. Use of selected clinical preventive services to improve the health of infants, children, and adolescents: United States, 1999-2011. Morbidity and Mortality Weekly Report 63(2, Suppl.):1-107.
- Coker TR, Moreno C, Shekelle PG, Schuster MA, Chung PJ. 2014. Well-child care clinical practice redesign for serving low-income children. Pediatrics 134(1):e229-39. View abstract. This study, done in collaboration with a multisite community health center and 2 small, independent practices serving predominantly Medicaid-insured children used (1) perspectives of WCC stakeholders and (2) a literature review of WCC practice redesign to create 4 comprehensive WCC models for children ages 0 to 3 years.
- Klein S, McCarthy D. 2009. North Carolina's ABCD program: Using community care networks to improve the delivery of childhood developmental screening and referral to early intervention services. New York, NY: Commonwealth Fund.
- Rice CE, Braun KVN, Kogan MD, Smith C, Kavanagh L, Strickland B, Blumberg SJ. 2014. Screening for developmental delays among young children—National Survey of Children's Health, United States, 2007. In Centers for Disease Control and Prevention. 2014. Use of selected clinical preventive services to improve the health of infants, children, and adolescents: United States, 1999–2011. Morbidity and Mortality Weekly Report 63(2, Suppl.):27-35.
- Ringwalt S. 2008. Developmental screening and assessment instruments with an emphasis on social and emotional development for young children ages birth through five. Chapel Hill, NC: National Early Childhood Technical Assistance Center.
- Zero to Three. 2013. Improving access to early identification and intervention: 211 LA County developmental screening and care coordination. Washington, DC: Zero to Three.
- For additional articles see this PubMed automated search.
Related NCEMCH Resources
1 Health Resources and Services Administration. 2014. Title V Maternal and Child Health Services Block Grant to States Program: Guidance and Forms for the Title V Application/Annual Report, Appendix F, p. 79.
Developmental Screening of Young Children: Evidence Brief, 1st ed. (November 2014).
Author: Olivia K. Pickett, M.A., M.L.S., NCEMCH