PATHWAYS TO SCHOOL READINESS IN NASSAU COUNTY: Improving Developmental Screening, One Clinic at a Time

About Docs for Tots 23

About Docs For Tots Docs for Tots is a non-profit, non-partisan organization lead by pediatricians with a mission of bringing together children’s doctors and communities to promote practices, policies and investments in children from prenatal to five that foster children’s healthy development and future success. Our vision is that all families are able to fully support the healthy development of their children during early childhood. Supporting children’s development is the foundation for a healthy and successful society. Docs for Tots has five priority areas that are critical to realization of our vision: promoting the early childhood medical home, increasing developmental screening, improving access to high quality early care and education, improving social-emotional health, and addressing poverty. 344

Overview 45

Overview Importance of Developmental Screening Pediatric Primary Care Why Screening Works Common Barriers & Opportunities for Growth Accepting the Challenge! 566

Why is Developmental Screening Important? 67

Why Developmental Screening is Important Developmental and behavioral guidance and surveillance have always been an integral part of care of young children. The use of standardized screens at specific ages builds and strengthens this long tradition. Parents expect their doctor to identify developmental and behavioral problems early and accurately and by integrating standardized screening you can better meet this expectation. Formalized, evidence-based screening detects far more delays than surveillance alone. Developmental screening and appropriate referral are critical for school readiness and lifelong health. 788

Why Developmental Screening is Important New York lags behind the rest of the country, ranking 49 out of 50 states in implementing developmental screenings. Implementing AAP recommendations across Nassau County can improve school readiness by identifying needs and providing necessary services at the earliest, most effective times, saving against intervention and remediation costs later

Pediatric Primary Care 1011

Pediatric Primary Care: How We can Help Bride the Gaps As someone in the pediatric primary care field, you are uniquely situated to promote children’s developmental health – Long-term, trusted relationship with families – Unique access to children from birth to school age

Screening Works 1214

Screening Works 1314 Detection Rates Without standardized, valid, reliable tool With standardized, valid, reliable tool 30% of developmental disabilities identified (Palfrey et al. JPEDS. 1994; 111: ) 70-80% with developmental disabilities correctly identified (Squires et al., JDBP 1996; 17: )

Common Barriers & Opportunities for Growth 1416

Common Barriers & Opportunities for Growth Common barriers to developmental screening: Time Office capacity Comfort with referral process and sources Reimbursement What are some barriers you can identify in your work place, and what are some ways to work through these barriers?

Accepting the Challenge! 1618

Accepting the Challenge! Change is never easy, and success in implementing change is dependent on perseverance. In order to persevere, you will need to accept the challenge that current practice–whatever that is for you—is inadequate. The literature on developmental screening implementation points to critical barriers in physician knowledge and attitudes towards screening. Without addressing these barriers it is difficult to implement change

Survey Questions

Standardized screening significantly improves referral rates compared to surveillance alone in randomized clinical trial. TRUE or FALSE Parents expect and desire standardized screening TRUE or FALSE Standardized screening is possible in busy urban settings, it does not increase length of visit, and in some respect improves visit efficiency TRUE or FALSE Screening can improve detection rates of developmental delays from 20% without tools to 80-90% with the use of tools TRUE or FALSE Parents CAN complete the screens and their input is accurate TRUE or FALSE If you answered TRUE to ALL the questions you are ready for the challenge! Guevara Pediatrics 2013;131;30 Blumberg, Pediatrics 2004, Marion Earls PEDIATRICS –and commonwealth piece (king?) Palfrey JPEDS 1987 Morelli et al BMC Pediatrics 2014, 14:16

Thank You! 856-DOC4TOT ( ) For more information regarding developmental screening and Docs For Tots, log on to