Building Comprehensive Developmental Screening Systems through State and Community Engagement: Highlights from an Environmental Scan

BACKGROUND:   Rising trends in the number of children at risk for developmental delay or disability have highlighted the need for coordinated, comprehensive systems for developmental and behavioral screening. As states look to improve developmental screening and early identification, collaborations across early childhood programs and implementation of data-driven, evidence-based strategies are critical to having functional and efficient statewide screening systems.

METHODS:   In 2014, the Association of Maternal & Child Health Programs (AMCHP) conducted an environmental scan of 185 source documents to capture the wide range of developmental screening activities occurring within all U.S. states and territories. AMCHP conducted a qualitative analysis of the compiled source documents using ATLAS.ti software and identified themes across state activities. All text was double coded with a state code and content code to indicate the state or territory where the text originated and reference the content of the text. Content codes were grouped into general categories including guidelines and recommendations, training methods and audiences, screening processes, coordination efforts, family involvement, health equity, data collection, quality improvement, funding, sustainability, and challenges.

RESULTS:  Broad themes emerged from each coded category. For example, the scan identified information related to data in the areas of: data sources to assess and measure developmental screening and early identification; strategies to improve/streamline systems for data collection; measurement and evaluation approaches (including state performance goals, process and outcome measures) and methods to track developmental screenings. The scan also revealed a strong emphasis on community engagement, collaboration among state agencies, and engagement of providers and families to improve developmental screening systems.

CONCLUSIONS:  The scan, while providing a broad picture of current activities, has limitations: it does not represent an exhaustive list of every state activity, describe trends over time, or provide recommendations on how states should implement initiatives moving forward. However, it contributes essential information into the current state of developmental screening activities, including common strategies and opportunities for improvement. An initial report of findings is available on the AMCHP website. Results will be further used to inform technical assistance opportunities to help state build and improve developmental screening and early identification systems. The goal is to have an accessible repository of information where states can compare systems of care, and for state and national partners to identify promising trends and practices for wide and sustained impact that improves the health and access to care for all children and families.