Find Established Evidence

NPM: 6: Developmental Screening
Intervention Components (click on component to see a list of all articles that use that intervention): Mini Grants
Intervention Description: N/A
Primary Outcomes: N/A
Conclusion: N/A
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 6: Developmental Screening
Intervention Components (click on component to see a list of all articles that use that intervention): Assessment
Intervention Description: 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.
Primary Outcomes: N/A
Conclusion: Developmental surveillance should be a component of every preventive care visit. Standardized developmental screening tools should be used when such surveillance identifies concerns about a child's development and for children who appear to be at low risk of a developmental disorder at the 9-, 18-, and 30-month* visits. When a child has a positive screening result for a developmental problem, developmental and medical evaluations to identify the specific developmental disorders and related medical problems are warranted. In addition, children who have positive screening results for developmental problems should be referred to early developmental intervention and early childhood services and scheduled for earlier return visits to increase developmental surveillance. Children diagnosed with developmental disorders should be identified as children with special health care needs; chronic-condition management for these children should be initiated.
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: Children ages 0-3 years old

NPM: 6: Developmental Screening
Intervention Components (click on component to see a list of all articles that use that intervention): Assessment
Intervention Description: This report provides the latest prevalence estimates for diagnosed autism spectrum disorder, intellectual disability, and other developmental delay among children aged 3–17 years from the 2014–2016 National Health Interview Survey (NHIS).
Primary Outcomes: N/A
Conclusion: During 2014–2016, there was a significant increase in the prevalence of children who had ever been diagnosed with any developmental disability. This increase was largely the result of an increase in the prevalence of children diagnosed with a developmental delay other than autism spectrum disorder or intellectual disability. There was not a significant change in the prevalence of diagnosed autism spectrum disorder or intellectual disability over the same time period. The prevalence of developmental disabilities described in this report is lower than findings described in previous reports using NHIS data (1). This report uses a more restrictive definition for a developmental disability that does not include conditions such as attention-deficit/ hyperactivity disorder or learning disabilities, which may account for differences in estimates. A similar definition was used in a 2015 National Health Statistics Report (2). For each condition examined, the prevalence was significantly higher among boys than girls, a finding common among children diagnosed with a developmental disability (1,3). The prevalence of any developmental disability diagnosis was lowest among Hispanic children compared with all other race and ethnicity groups; racial and ethnic disparities in the prevalence of developmental disabilities are findings commonly reported in the scientific literature (1,4). Prevalence among age groups varied by condition, which may reflect recent improvements in awareness and screening for developmental delay, resulting in younger cohorts having a higher diagnosed prevalence (4). However, for some children with less severe impairment, developmental disabilities, such as autism spectrum disorder and intellectual disability, may not be diagnosed until the child enters school and is observed by trained teachers (5).
Study Design: Report
Significant Findings: N/A
Setting: Data from NHIS collected in respondent's home or in some cases via telephone
Data Source: Data from the 2014–2016 NHIS
Sample Size: N/A
Age Range: Children ages 3-17 years old

NPM: 6: Developmental Screening
Intervention Components (click on component to see a list of all articles that use that intervention): Assessment
Intervention Description: N/A
Primary Outcomes: N/A
Conclusion: N/A
Study Design: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 6: Developmental Screening
Intervention Components (click on component to see a list of all articles that use that intervention): Assessment, Screening Tool Implementation Training
Intervention Description: N/A
Primary Outcomes: N/A
Conclusion: N/A
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: peer-reviewed articles published to December 2013
Sample Size: N/A
Age Range: N/A

NPM: 6: Developmental Screening
Intervention Description: N/A
Primary Outcomes: N/A
Conclusion: N/A
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 6: Developmental Screening
Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (National), Educational Material, Screening Tool Implementation Training
Intervention Description: N/A
Primary Outcomes: N/A
Conclusion: N/A
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 6: Developmental Screening
Intervention Components (click on component to see a list of all articles that use that intervention): Educational Material
Intervention Description: N/A
Primary Outcomes: N/A
Conclusion: N/A
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 6: Developmental Screening
Intervention Components (click on component to see a list of all articles that use that intervention): Screening Tool Implementation Training, Assessment, Policy/Guideline (National)
Intervention Description: In an effort to document state and jurisdiction activity in National Performance Measure 6 (NPM 6), AMCHP conducted an environmental scan of Title V program developmental screening activities. AMCHP obtained information through the Title V Information System (TVIS) by filtering Title V programs that chose NPM 6 and reviewing the narrative and action plans to ascertain their NPM 6 strategies, their accompanying evidence-based/informed strategy measures (ESMs), and related challenges. Information included in this issue brief does not represent an exhaustive list of each state’s and jurisdiction’s developmental screening activity, nor is every state or jurisdiction that is implementing the strategies mentioned. However, the range of strategies presented and the states and jurisdictions referenced here provide a snapshot of Title V program approaches, strategies, and techniques being used to increase developmental screening rates.
Primary Outcomes: N/A
Conclusion: information on Title V program activities related to NPM 6. These data provide insight into identified needs in policy, systems coordination, training, data integration, as well as strategies to address these needs. The selected examples highlighted within each category may prove useful to other Title V programs as they implement developmental screening-related strategies and measures to build or improve systems of care for children. In coming years, NPM 6 data can be analyzed more in-depth to develop resources such as reports, toolkits, or guides to assist Title V programs with developmental screening and early identification system challenges. These data will also guide AMCHP’s efforts to create meaningful technical assistance opportunities including webinars, learning modules, conference sessions, and other in-person trainings, to help states in advancing NPM 6. These resources will expand the repository of promising policies and practices featured on the State Public Health Autism Resource Center website (http://www.amchp.org/SPHARC), which is accessible to all Title V programs and their state and national partners.
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 6: Developmental Screening
Intervention Components (click on component to see a list of all articles that use that intervention): Policy/Guideline (State), Screening Tool Implementation Training
Intervention Description: N/A
Primary Outcomes: N/A
Conclusion: Consistent and reliable developmental screening is a key feature of high-quality services for young children across the child development, early education, and health care sectors. As such, it is an area ripe for fiscal and policy partnerships at the community and state level. Efforts to improve developmental screening rates among medical professionals, incorporate screening into early childhood settings, and collaborate to better inform and educate families about the importance of monitoring developmental milestones and related screenings can work together to improve access to screening, particularly for those children who are the most vulnerable. Just as a variety of federal stakeholders are recognizing this opportunity to support child development, thoughtful state policies, financing initiatives, and community collaborations can work together to take the first steps for early success and achieve better child outcomes.
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 6: Developmental Screening
Intervention Components (click on component to see a list of all articles that use that intervention): Assessment

NPM: 6: Developmental Screening
Intervention Components (click on component to see a list of all articles that use that intervention): Assessment, Educational Material (Provider), Screening Tool Implementation Training
Intervention Description: N/A
Primary Outcomes: N/A
Conclusion: N/A
Study Design: N/A
Significant Findings: N/A
Setting: N/A
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 6: Developmental Screening
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, Expert Support (Provider), Modified Billing Practices, Screening Tool Implementation Training, Office Systems Assessments and Implementation Training, Chart Audits (Provider), Expert Feedback Using the Plan-Do-Study-Act-Tool, Engagement with Payers, STATE, POPULATION-BASED SYSTEMS, Collaboration with Local Agencies (State), Collaboration with Local Agencies (Health Care Provider/Practice)
Intervention Description: This report evaluates the impact of Phase II of Maine's First STEPS initiative
Conclusion: The authors summarize lessons learned in implementing changes in practices and challenges in using CHIPRA and IHOC developmental, autism, and lead screening measures at the practice-level to inform quality improvement.
Study Design: QE: pretest-posttest
Significant Findings: Yes
Setting: Pediatric and family practices serving children with MaineCoverage
Target Audience: Children ages 6 to 35 months
Data Source: Child medical record; MaineCare paid claims
Sample Size: Unknown number of chart reviews from 9 practice sites completing follow-up
Age Range: Not specified

NPM: 6: Developmental Screening
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, Educational Material (Provider), Participation Incentives, Quality Improvement/Practice-Wide Intervention, Expert Support (Provider), Modified Billing Practices, Data Collection Training for Staff, Screening Tool Implementation Training, Office Systems Assessments and Implementation Training, Chart Audits (Provider), Expert Feedback Using the Plan-Do-Study-Act-Tool, Collaboration with Local Agencies (State), Collaboration with Local Agencies (Health Care Provider/Practice), Engagement with Payers, STATE, POPULATION-BASED SYSTEMS
Study Design: QE: pretest-posttest
Significant Findings: Yes
Setting: Pediatric and family medicine practices in Vermont
Target Audience: Children up to age 3
Data Source: Child medical record; ProPHDS Survey
Sample Size: Chart audits at 37 baseline and 35 follow-up sites (n=30 per site) Baseline charts (n=1381) - Children 19-23 months (n=697) - Children 31-35 months (n=684) Follow-up charts (n=1301) - Children 19-23 months (n=646) - Children 31-35 months (n=655)
Age Range: Not specified

NPM: 6: Developmental Screening
Intervention Description: HV CoIIN 2.0 aims to achieve improvements in 25 states and territories and 250 home visiting agencies through two workstreams: 1) scaling improvements in previously tested topic areas and 2) developing and testing improvements in new topic areas through the implementation of national breakthrough series collaboratives.
Primary Outcomes: N/A
Conclusion: N/A
Study Design: N/A
Significant Findings: N/A
Setting: 25 states and territories
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 6: Developmental Screening
Intervention Components (click on component to see a list of all articles that use that intervention): PATIENT/CONSUMER, Home Visits, PROVIDER/PRACTICE, Quality Improvement/Practice-Wide Intervention
Intervention Description: To measure progress toward the collaborative aim, the HV CoIIN developed a common group of measures that local implementing agencies (LIAs) report and analyze monthly. HV CoIIN measures were selected to capture steps in the process of promotion, early detection, and intervention.
Study Design: Quality improvement time series design
Setting: Maternal, Infant, and Early Childhood Home Visiting Programs within 8 states and one Tribe: AR, MI, IN, NJ, GA, OH, PA, FL and White Earth Home Health Agency
Target Audience: Prenatal to age 5 children and families
Data Source: Local team data registries
Sample Size: • Phase I – 11 sites (n≈1019) • Phase II – 5 sites (n≈676) N=families per month
Age Range: Not specified

NPM: 6: Developmental Screening
Intervention Components (click on component to see a list of all articles that use that intervention): Medicaid, Expanded Insurance Coverage
Intervention Description: The evaluation included a large survey conducted in 2012 of CHIP enrollees and disenrollees in the 10 states, and Medicaid enrollees and disenrollees in three of these states. It also included case studies conducted in each of the 10 survey states in 2012 and a national telephone survey of CHIP administrators conducted in early 2013. Data from the Current Population Survey and the American Community Survey were analyzed to document national coverage trends from 1997 to 2012.
Primary Outcomes: N/A
Conclusion: The evaluation found CHIP to be successful in nearly every area examined. CHIP succeeded in expanding health insurance coverage to the population it is intended to serve, particularly children who would otherwise be uninsured, increasing their access to needed health care, and reducing the financial burdens and stress on families associated with meeting children’s health care needs. These positive impacts were found for children and families in states with different CHIP program structures and features, across demographic and socioeconomic groups, and for children with different health needs. Medicaid and CHIP have worked as intended to provide an insurance safety net for low-income children during economic hard times. Awareness of both Medicaid and CHIP was high among low-income families, most newly enrolling families found the application process at least somewhat easy, and the vast majority of children remained enrolled through the annual renewal period. The evaluation also identified a few areas where there is room for improvement. One in four children in CHIP had some type of unmet need, and although most CHIP enrollees received annual well-child checkups, fewer than half received key preventive services such as immunizations and health screenings during those visits, and fewer than 40 percent had afterhours access to a usual source of care provider. While most CHIP enrollees received annual dental checkups, a significant share of them did not get recommended follow-up dental treatment. There is also room for improvement in reducing the percentage of children who cycle off and back on to Medicaid and CHIP, and reducing gaps in coverage associated with moving between Medicaid and separate CHIP programs. And while participation rates have grown to high levels in most states, further effort could be targeted to the 3.7 million children who are eligible for Medicaid or CHIP but remain uninsured
Study Design: Survey
Significant Findings: Yes
Setting: National Level and Alabama, California, Florida, Louisiana, Michigan, New York, Ohio, Texas, Utah, and Virginia
Data Source: N/A
Sample Size: N/A
Age Range: N/A

NPM: 6: Developmental Screening
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, Educational Material (Provider), Expert Support (Provider)
Intervention Description: To increase primary care providers' use of validated tools for developmental, social/emotional, maternal depression, and domestic violence screening and to increase early awareness of autism symptoms during pediatric well-child visits in children aged 0 to 3 years.
Conclusion: The Enhancing Developmentally Oriented Primary Care (EDOPC) project enhanced confidence and intent to screen among a large group of Illinois primary health care providers. Among a sample of primary care sites at which chart reviews were conducted, the EDOPC project increased developmental screening rates to the target of 85% of patients at most sites and increased social/emotional screening rates to the same target rate in nearly half of the participating practices.
Study Design: QE: pretest-posttest
Significant Findings: Yes
Setting: Primary care medical homes (federally qualified health centers, residency training programs, private practices) primarily in Chicago, Illinois, metropolitan area
Target Audience: Children ages 4 to 24 months
Data Source: Child medical record
Sample Size: Chart audits at 16 sites (n=25 per site)
Age Range: Not specified

NPM: 6: Developmental Screening
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, Educational Material (Provider)
Intervention Description: We modified the Enhancing Developmentally Oriented Primary Care (EDOPC) program to provide a formal curriculum to pediatric residents serving children in distressed neighborhoods.
Conclusion: Chart audits 1 year after the intervention demonstrated increased use of screening tools and more referrals to community services. This article will discuss lessons about facilitators and barriers to teaching residents about vulnerable preschool children.
Study Design: QE: pretest-posttest
Significant Findings: Yes
Setting: University of Chicago Pediatric Residency Program in Chicago, Illinois
Target Audience: Children ages 6 to 24 months
Data Source: Child medical record
Sample Size: Chart audits - Baseline (n=27 of 50 selected) - Follow-up 1: (n=61 of 100 selected) - Follow-up 2: (n=82 of 100 selected) - Follow-up 3: (n=94 of 100 selected) - Follow-up 4: (n=74 of 100 selected)
Age Range: Not specified

NPM: 6: Developmental Screening
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, Provider Training/Education, Educational Material (Provider), Expert Support (Provider), Participation Incentives, Modified Billing Practices, Data Collection Training for Staff, Screening Tool Implementation Training, Office Systems Assessments and Implementation Training, Chart Audits (Provider), Expert Feedback Using the Plan-Do-Study-Act-Tool, Collaboration with Local Agencies (State), Collaboration with Local Agencies (Health Care Provider/Practice), Engagement with Payers, STATE, POPULATION-BASED SYSTEMS
Intervention Description: Early identification of children with developmental and behavioral delays is important in primary care practice, and 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.
Conclusion: Although there are features of the project that are unique to North Carolina, there are also elements that are transferable to any practice or state interested in integrating child development services into the medical home.
Study Design: QE: pretest-posttest
Significant Findings: Yes
Setting: Partnership for Health Management, a network within Community Care of North Carolina
Target Audience: Children ages 6 to 60 months receiving Early Periodic Screening, Diagnosis, and Treatment services
Data Source: Child medical record
Sample Size: Unknown number of charts – screening rates tracked in 2 counties (>20,000 screens by 2004)
Age Range: Not specified