Regional and National Leadership
Screening in Primary Care
The American Academy of Pediatrics recommends developmental surveillance at every well child visit and developmental screening at 9, 18, and 24 or 30 months of age. They also recommend screening for autism at 18 and 24 or 30 months of age. Many tools for screening are proprietary and therefore must be purchased from the publisher. The list below include tools that are in the public domain.
Screening for developmental standing
- Ages and Stages Questionnaire, go to http://www.brookespublishing.com/store/books/bricker-asq/index.htm
- PEDS: Pediatric Evaluation of Developmental Status, go to http://www.pedstest.com/
- The Capute Scales: Cognitive Adaptive Test and Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS), go to http://www.brookespublishing.com/store/books/accardo-8167/index.htm
Screening for autism
Screening for post-partum depression
Screening for behavioral problems
Building the capacity of primary care practice
The increasing prevalence of children with special health care needs requires a new approach to primary care practice. The Institute of Medicine acknowledged this shift in a landmark report entitled, Crossing the Quality Chasm: A New Health System for the 21st Century. You can review the report at http://www.nap.edu/openbook.php?isbn=0309072808. A model that documents the changes that must occur in primary care is entitled, The Improving Chronic Care Model. You can check this model out at http://www.improvingchroniccare.org/. The American Academy of Pediatrics has developed the Medical Home as an approach to improve chronic care for children, especially children with special health care needs. The concept is well described at http://www.medicalhomeinfo.org/ or http://www.medicalhome.org/.
One of the most prevalent chronic conditions in pediatrics is Attention-Deficit/Hyperactivity Disorder or ADHD. A toolkit for diagnosing and managing this complex condition can be found at the following site: http://www.nichq.org/NICHQ/Topics/ChronicConditions/ADHD/.
Another highly prevalent problem is overweight and obesity. Tools for prevention and management of obesity can be found at the following site: http://www.nichq.org/NICHQ/Topics/PreventiveCare/Obesity/
Linking to community-based services
Primary care clinicians in practice are identifying children with developmental delays and disorders on the basis of developmental surveillance and screening. The tools below will assist the treating clinicians in California in making appropriate and effective referrals to community-based services.
Referring to the Early Start Program for early intervention for children birth to age 3 years
Referring to California Children’s Service Medical Therapy Program
Referring for Special Education Services for children 3 to 21 years old
- Referral algorithm
- Referral letter [English | Spanish]
