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OVERVIEW:
The American Academy of Pediatrics (AAP) is a national organization comprised of over 62,000 members, 66 state and local chapters, 30 national
committees, 49 sections, 6 councils, and a staff of nearly 400. On March 25, 2009, AAPs Healthy Child Care America (HCCA)/Child Care and Health
Partnership (CCHP) program hosted a summit on Developmental Screening in Early Childhood Systems in Elk Grove Village, Illinois.* Recognizing
that it is now possible to do high-quality and low-cost developmental screenings, invited participants representing a full range of academic, govern-
ment, health and education-related professions from across the country were given the opportunity to review the current recommendations and
common language integral to the effective implementation of developmental screening, learn about existing approaches and efforts in several repre-
sentative states, and then discuss the challenges and barriers faced in the process.
* This summit was hosted by the AAPs HCCA/CCHP, a program jointing funded under a cooperative agreement (U46MC04436) with the US Department of Health and
Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB), and the Child Care Bureau (CCB).
The AAPs Developmental Screening common language and shared goals. To do so effectively first requires
a closer look at what is involved in the actual implementation of devel-
Initiatives & the Medical Home opmental screening.
V. Fan Tait, MD, FAAP
In keeping with the AAPs overarching mission to attain optimal
physical, mental, and social health and well-being for all infants, Developmental Screening:
children, adolescents, and young adults, the AAPs 2009-2010 Strategic Implementation in Early Childhood Settings
Plan has established early brain and child development as one of the
Elaine Donoghue, MD, FAAP
organizations top 4 agenda items (along with special health care needs,
foster care, oral health, and mental health). The implementation of well-performed developmental screening in
In efforts that pre-dated this formal recognition, the AAP has helped the early childhood setting can be very useful in the identification of
lay the groundwork for future developmental screening efforts through children with otherwise undiagnosed developmental delays. It is impor-
its collaboration with the Centers for Disease Control and Preventions tant to recognize that this implementation requires adequate prepa-
National Center on Birth Defects and Developmental Disabilities to ration, communication, and follow through. To effectively conduct
promote optimal child development within public and private health developmental screening in child care, it is therefore important to
systems a collaboration that resulted in 2 crucial components of the address the following 5 objectives.
developmental screening implementation effort:
1. Clarify rationale for developmental screening
1. Development of the AAP policy statement (and algorithm) regard-
To emphasize the importance of developmental screening in early
ing developmental screening and surveillance.1
childhood, the AAPs 2006 developmental screening policy included
2. Subsequent funding of the AAPs Developmental Surveillance and
the strong statement that early identification of developmental disorders
Screening Policy Implementation Project (D-PIP).2
is critical to the well-being of children and their families.1 Yet we know
The AAP is not only committed to promoting high-quality devel-
that a significant number of developmental delays continue to go undi-
opmental screening, but doing so in a coordinated fashion in both the
agnosed. Studies show that only 20% to 30% of children with disabilities
pediatricians office and within a family-centered systems network of
are identified before entering school. In addition, Early Intervention
community-based services. The ultimate goal of this medical home
programs currently serve 2.3% of children under the age of 3 years, in
approach is to effectively provide developmental screening, assessment,
contrast to the approximately 10% of children who actually have devel-
and services to those children who need it. Making these services more
opmental delays.3 This translates into a missed opportunity to signifi-
accessible to families within their communities involves communication
cantly improve the developmental outcomes for the large number of
and working relationships within diverse communities and between
children who are not diagnosed and treated early.
wide-ranging organizations such as those represented at this summit.
It also requires attention to such factors as accessibility, cultural com- 2. Define common terminology
petence, and ongoing quality improvement. With this concept and It may sound simple, but ensuring that everyone involved in the imple-
commitment in mind, it becomes particularly important for all who mentation of developmental screening uses agreed-upon terminology
are involved in, or have a vested interest in, high-quality developmental is not trivial, as even the words developmental screening are often
screening in early childhood to work in concert with one another using misunderstood to mean more than the administration of a brief tool to