Office Systems

The office system page provides information on how to integrate developmental screening into your practice. Resources include Web sites, handouts, PowerPoint presentations on how to get started in your practice, and screening, coding and referral information.

Resources to Help the Practice Change Process

• Improvement Checklist: Steps to Using Screening and Surveillance in Your Office 
  Careful preparation will increase the likelihood you will successfully implement and sustain new systems for using screening and surveillance in your practice. This resource will help you integrate DSS into your office.
• Integrating Developmental Screening Worksheet 
  This resource provides step-by-step instructions on how to begin implementing DSS into your practice.
• Developmental Screening Tools Grid 
  Use this grid to help select a screening tool.
  
• Centers for Disease Control and Prevention—Sample Delineation of Pediatric Staff Roles for Developmental Screening
  This chart provides an example of how to delineate staff roles in the screening process.
• Screening Implementation
  A worksheet developed by the Common Wealth Fund that generates questions about staff responsibilities for developmental screening.
  
• North Carolina ABCD Program—Office Resource Guide: Getting Started Office Workflow Worksheet
  A worksheet to help you integrate developmental screening into your practice's workflow.

PowerPoint Presentations

• Introduction to Policy Statement Algorithm 
  Nancy Swigonski, MD, MPH, FAAP
  Provides case studies of how the developmental surviellance and screening algorithm can be used in office settings
• Putting the Office Systems in Place/Overview of Data Collection 
  Paula Duncan, MD, FAAP
  Provides example of office system resources and data collection strategies
• Screening Tools: Those Used and Others to Consider 
  Paul Lipkin, MD, FAAP
  Provides an overview of developmental screening instruments

Developmental and Behavioral Pediatrics Online (DB Peds)
This site is for professionals interested in child development and behavior, especially in the medical setting. It focuses on primary care development and behavior, especially early identification and screening. The learning section features the Toolbox, which is your link to special article features, keywords, and evidence. Their handouts, which include both original and borrowed material suitable for parents.

Developmental Screening Tool Kit—Children's Hospital of Boston
This site is for primary care providers considering or planning to start screening children for developmental needs using a validated tool.

First Signs, Inc.
The mission of First Signs is to promote the early identification of, and intervention for, autism and other developmental disorders.

Integrating Screening and the Medical Home 
Surveillance within a medical home is a flexible, continuous process, in which knowledgeable professionals perform skilled observations of children throughout the provision of health care. This is often done in consultation with families, specialists, child care providers, and other health care professionals. This factsheet explains how to combine these important services.

Screening Tools Grid 
This grid lists available screening tools and information about each, including a short description, age range, number of questions, etc.

Developmental Screening Practice Initiatives Bibliography 

PowerPoint Presentations

• Developmental Surveillance and Screening 
  Paul Lipkin, MD, FAAP
  The Developmental Surveillance and Screening Policy Implementation Project Principle Invesigator, Paul Lipkin presentation discusses the components of surveillance and screening.
• Developmental Screening Tools 
  Michelle Macias, MD, FAAP
  D-PIP Faculty member, Michelle Macias's presentation on developmental screening tools provides information on benefits and challeges of screening

Developmental Surveillance
Surveillance is the process of recognizing children who may be at risk of developmental delays. Developmental surveillance is a flexible, longitudinal, continuous, and cumulative process whereby knowledgeable health care professionals identify children who may have developmental problems. There are five components of developmental surveillance.

• Eliciting and attending to the parents’ concerns about their child’s development
• Documenting and maintaining a developmental history
• Making accurate observations of the child
• Identifying the risk and protective factors
• Maintaining an accurate record and documenting the process and findings

ASD Video Glossary
The ASD Video Glossary, an innovative Web-based tool designed to help parents and professionals learn more about the early red flags and diagnostic features of autism spectrum disorders. This resource contains more than a hundred video clips and is available free of charge.

CDC's - Learn the Signs Act Early
The Centers for Disease Control and Prevention (CDC), in collaboration with a coalition of national partners, is launching a new phase of the "Learn the Signs. Act Early" public awareness campaign. This childhood development campaign is designed to help increase awareness about the importance of tracking a child's social and emotional development, including the potential early warning signs of autism and other developmental disabilities.

CDC's - Learn the Signs Act Early: Developmental Toolkits
The Centers for Disease Control and Prevention and the National Center on Birth Defects and Developmental Disabilities have produced a toolkit to help parents learn about the milestones in their children's growth, from birth to age 5 years, as well as developmental delays and other disabilities. The "Learn the Signs. Act Early" campaign and toolkit helps parents recognize any delays so their children can be screened and receive early treatment, if necessary.

Available in both English and Spanish, the toolkit includes an informational card on developmental milestones, a growth chart, and a series of factsheets on milestones and developmental and behavioral delays. These materials can be downloaded from the Web site or ordered in bulk. In addition, the "Learn the Signs. Act Early" Web site has an interactive tool for parents and information for health providers on becoming involved with the campaign.

Handouts

• AAP’s Appeal Letter Regarding Reporting CPT Code 96110 Separately From a Preventive Medicine Services Code 
• 96110/96111 Payment by State Handout 
• Developmental Screening/Testing Coding Fact Sheet
  This Coding Fact Sheet provides guidance on how pediatricians can appropriately report limited and extended developmental screening and testing services.

PowerPoint Presentations

• Developmental Screening: Billing and Coding 
  Michelle Macias, MD, FAAP
  Provides information on terminology and principles of CPT coding
• Developmental Screening Billing and Payment: Stories From the Front Line
  Michelle Macias, MD, FAAP 
  Explains ICD-9-CM, V codes, and basic principles of use

Resources to Implement Practice Changes

• Community Resource Template 
  Developed for use by the D-PIP project, the Community Resource Template helps track patients referral programs/contact information
• Chart Labels 
  Chart labels can be attached to patient charts to document surveillance actions
• Referral Tracking Worksheet 
  This form can be used the track referral, feedback, and diagnosis information

American Academy of Pediatrics; Council on Children With Disabilities. Role of the Medical Home in Family-Centered Early Intervention Services. Pediatrics. 2007;120(5): 1153-1158

The National Dissemination Center for Children with Disabilities—Early Intervention
This page provides a wide range of information and sources of assistance regarding early intervention, including: resources by state, key agencies involved with EI, and tools and materials for parents and providers.

National Early Childhood Technical Assistance Center (NECTAC)
This center supports the implementation of the early childhood provisions of the Individuals with Disabilities Education Act (IDEA)

Early Intervention Referral Form 
This editable form is designed to simplify the referral process to early intervention programs and allows primary care professionals to indicate the types of information they would like to receive from the early intervention program.

Referral Forms on MedicalHomeInfo.org
A collection of other referral forms for use in practice.

Tracking, Referral and Assessment Center for Excellence (TRACE)
The major goal of TRACE is to identify and promote the use of evidence-based practices and models for improving child find, referral, early identification, and eligibility determination for infants, toddlers, and young children with developmental delays or disabilities who are eligible for early intervention or preschool special education.

PowerPoint Presentations

• Screening Implementation: Referral and Follow-up 
  Paul Lipkin, MD, FAAP
  Provides information on what to do when a screening test is concerning

Boys Town CME Proposal 
Example of a proposal to develop a continuing education program for health care providers on developmental surveillance and screening of infants and young children in primary care clinics.

Ohio Pediatrics Referral Form 
This form covers a number of different referrals that are made in a pediatric practice. It has simplified ordering referrals for providers as well as for staff who make the referral. The referral sheet is printed on bright colored paper so it doesn't get lost in progress notes and is easy to find in the chart for follow up.