1. State Screening Initiatives: Minnesota

2. New Publication: AAP Developmental Surveillance and Screening Implementation Study

State Screening Initiatives: Minnesota

The Minnesota Chapter of the AAP (MNAAP) has been leading the way for developmental and behavioral screening activities across the country. In 2003, the MNAAP was named as one of the states to participate in the Assuring Better Child Health and Development Program, an initiative of the National Academy for State Health and Policy funded by the Commonwealth Fund, and went on to declare developmental and behavioral health screening as one of the top priorities of the Minnesota Child Health Improvement Partnership (MNCHIP). MNCHIP is a network of public and private partners including the Minnesota Department of Health, CentraCare Health System, Bush Foundation, MNAAP, and others, charged with assuring that optimal child health care is provided within the state by creating and supporting continuous quality improvement in clinical practices. 

Through partnerships formed by MNCHIP, the MNAAP has worked to reach this goal by offering in-office training and workshops, establishing demonstration sites with HIT that contains screening tools, providing educational materials to pediatricians and their practices, and helping to develop pediatric health care policy at the state level. For more information, click here.

New Publication: AAP Developmental Surveillance and Screening Implementation Study

A new article, Implementing Developmental Screening and Referrals: Lessons Learned from a National Project, was early released on January 25, 2010 via Pediatrics eFirst Pages: www.pediatrics.org or http://pediatrics.aappublications.org/cgi/reprint/peds.2009-0388v1. The study will also appear in the February print edition of Pediatrics.

As background, in 2006, the AAP released a policy statement on developmental surveillance and screening, including an algorithm to aid practices in implementation. Simultaneously, the AAP launched a 9 month pilot project, the Developmental Surveillance and Screening Policy Implementation Project, in which 17 diverse pediatric practices sought to implement the policy statement's recommendations. The project assessed the degree to which a national sample of practices could implement recommendations for developmental screening and referrals, and identified factors contributing to the successes and shortcomings of these efforts.

At the project's conclusion, practices reported consistently screening more than 85% of patients at recommended ages. They achieved this by dividing responsibilities among staff and actively monitoring and measuring implementation. Challenges were identified in implementing a 30 month visit; administering a screen after surveillance suggested concern, and submitting simultaneous referrals both to medical subspecialists and local early intervention programs. Practices reported referring only 61% of children with failed screens. Many practices also struggled to track referrals.

Overall, the project uncovered that a diverse sample of practices successfully implemented developmental screening as recommended by the AAP. Practices were less successful in placing referrals and tracking those referrals. More attention needs to be paid to the referral process, and many practices may require separate implementation systems for screening and referrals.

Additional Related Links & Resources:
King TM, Tandon SD, Macias MM, Healy JA, Duncan PM, Swigonski NL, Skipper SM, Lipkin PH. Implementation of AAP Recommendations for Developmental Screening and Referrals:  Lessons Learned from a National Implementation Project, Pediatrics, published online: date (doi:10.1542/10.1542/peds.2009.0388). www.pediatrics.org or http://pediatrics.aappublications.org/cgi/reprint/peds.2009-0388v1

American Academy of Pediatrics, Council on Children With Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee, Medical Home Initiatives for Children With Special Needs Project Advisory Committee. Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening. Pediatrics. 2006;118 (1):405 -420

Developmental Surveillance and Screening Policy Implementation Project (D-PIP) information - includes research methods, practice teams, additional resources.

Various aspects of  this project were made possible through the support of the Centers for Disease Control and Prevention/National Center on Birth Defects and Developmental Disabilities, the Maternal and Child Health Bureau, the Commonwealth Fund, and the American Academy of Pediatrics.