Developmental Screening

Transcription

1 Developmental Screening Overview and Resources February 28, 2018 MCAH Webinar MCAH Division Eileen Yamada, MD, MPH Public Health Medical Officer

2 Overview Definitions Developmental Surveillance Developmental Screening AAP/Bright Futures Recommendations Title V Action Plan Draft Developmental Screening Data for California Developmental Screening Resources

3 Developmental Surveillance At every preventive care visit: Elicit and attend to parent concerns about child s development Maintain a developmental history Making accurate and informed observations of the child Identify risk and protective factors Periodically use screening tests Developmental milestones are intended for discussion with parents about a child s developmental progress

4 Developmental Screening Bright Futures (AAP): Guidelines for Health Supervision of Infants, Children, and Adolescents, 4 th edition (2017). Recommends general developmental screening at 9, 18 and 30 months using evidence-based tools, or whenever a concern is expressed.

5 AAP/Bright Futures Recommendations Autism screening at 18 and 24 months and if concerns about social development Social-emotional screening is recommended at regular intervals Maternal depression surveillance and screening at the 1-, 2-, 4-, and 6-month visits Surveillance for risk factors for social determinants of health at all patient encounters (e.g., food, housing, etc.)

6 Why is developmental screening important? Standardized developmental parentcompleted questionnaires make it easier for health care professionals to systematically elicit information that is reliable and valid. Early identification of children with developmental delay is critical for diagnosing issues and providing early intervention treatment and services.

7 CPT Codes for Screening General Developmental/ Autism Screening CPT Behavioral Screening: CPT Brief emotional/behavioral assessment, with scoring and documentation, per standardized instrument Updates on Bright Futures and How to Code: June 2017 Archived webinar. AAP Coding Factsheet: factsheet_developmentalscreeningtestingandemotionalbehvioraassessment.pdf

8 Title V National Performance Measure: Developmental Screening Percent of children, ages 10 through 71 months receiving a developmental screening using a parent-completed screening tool 20.9% from 2016 National Survey of Children s Health (NSCH)

9 Title V Action Plan Draft Objective By June 30, 2020, increase the rate of children ages 9 months through 5 years screened for being at risk for developmental, behavioral and social delay, using a parent-completed standardized developmental behavioral screening tool during a healthcare visit from 20.9 percent (2016 NSCH) to 25.1 percent.* Note: Previously current rate 28.5% with objective of 29.5%

10 Title V Action Plan Draft Strategies Collaborate with relevant partners/systems: Improve rates of behavioral, social, and developmental screening Improve referrals and linkage to needed services Provide technical assistance to state MCAH programs to promote the use of appropriate materials and develop protocols for early identification and referral for needed services. Assist MCAH LHJs to implement developmental screening, referral and appropriate linkages, to improve provider, family and community outreach, and develop centralized telephone access and data collection processes.

11 Resources Birth to 5: Watch Me Thrive! CDC s Learn the Signs. Act Early Help Me Grow FHOP Webinars Statewide Screening Task Force/Collaborative Developmental Screening Landscape Analysis Healthcare Provider Developmental Screening Toolkit AAP s online screening resources

12 Birth to 5: Watch Me Thrive! A coordinated federal effort to encourage developmental and behavioral screening and support for children, families, and the providers who care for them. Celebrates milestones, promotes universal screening, identifies possible delays and concerns early, enhances developmental supports. Toolkit includes: a compendium of research-based screening tools, user guides for multiple audiences, an electronic package of resources for follow-up and support, including a Screening Passport for Families. Builds on and complements other federal resources: Learn the Signs, Act Early and Bright Futures with new resources.

13 CDC s Learn the Signs. Act Early Aims to improve early identification of children with autism and other developmental disabilities so children and families can get the services and support they need. Includes tools for parents to track developmental milestones, including an App Online app for smartphones

14 actearly/milestones/index.html

15 Help Me Grow A system model to promote cross-sector collaboration in order to build efficient and effective early childhood systems. Four components: Centralized access point, child health provider outreach, family and community outreach, and data collection and analysis. Led by First 5 Association in California.

16 The Help Me Grow California system follows the Help Me Grow National model that advances the use of developmental screenings to detect developmental and behavioral delays in children and successfully linking them to appropriate interventions and services within their community

17 FHOP Webinars

18 Statewide Screening Collaborative and Task Force To develop appropriate tools and resources aimed at improving rates of developmental and behavioral screening for very young children in primary care To increase rates of early referrals to Part C services and behavioral health services in California To support policies and practices aimed at ensuring receipt of appropriate services as early as possible in an infant s life Leadership from CDPH and DDS Slide from Karen Moran Finello, PhD, WestEd

19 Statewide Screening Collaborative and Task Force Ca Healthcare Provider Developmental Screening Toolkit Development and Behavioral Mental Health Developmental Screening Landscape Analysis watch-me-thrive

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21 21 Slide from Karen Moran Finello, PhD, WestEd

22 Screening Landscape Analysis Designed for the two departments as a report of primary screening activities across the state Was not intended to be inclusive of every screening activity in the state or at local levels Highlights some challenges & barriers, along with current status of several projects Edited by staff from the two departments; final version (June 2017) available in pdf format by request Slide from Karen Moran Finello, PhD, WestEd

23 Screening Technical Assistance and Resource Center (STAR Center) Child Development Autism Social-emotional Development Maternal Depression Social Determinants of Health

24 AAP Podcasts Episode 1: Early Childhood Screening and Surveillance Episode 2: Family-Centered Care and Conversation Techniques Episode 3: Referral, Follow-up, and Partnership Building:

25 Other Resources First 5 California: AMCHP: Lucile Packard Foundation for Children s Health: CHDP Development, Socio- Emotional/Behavioral Surveillance, Screening, and Anticipatory Guidance: ments/hag/10developsoc.pdf

26 Upcoming Plans--CYSHCN NPM 11: Percent of children with and without special health care needs having a medical home. NPM 12: Percent of children with and without special health care needs who received services necessary to make transitions to adult health care. CYSHCN Stakeholder Discussion May 4, 2018 MCAH Directors Meeting: May 9, 2018 Announcement: Sarah Leff, MPH

27 Acknowledgements Paula Curran, RN, BSN, PHN, MHA CDPH, MCAH Karen Moran Finello, PhD WestEd, Statewide Screening Collaborative, Lead Lissa Pressfield, MHS CDPH, MCAH, Child and Adolescent Health Seleda Williams, MD, MPH DHCS, Integrated Systems of Care Division Lisa Albers, MD DHCS, Managed Care Quality and Monitoring Division Asuncion Williams, RN San Bernardino County Public Health Department

28 THANK YOU FOR ALL THE WORK THAT YOU DO! Contact Information: Eileen Yamada, MD, MPH