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Developmental Screening as a Key Message

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Article – Developmental Screening

baby playing with blocks Strengthen the Capacity of Local Programs to Offer Comprehensive Services by Partnering with Community Organizations

Developmental screening is a critical foundation for high-quality infant and toddler programs because it helps Early Childhood professionals and parents understand and support a child’s development and promotes the creation of environments and relationships that are individualized, responsive, nurturing, and supportive for infants and toddlers. Since infant and toddler teachers are regularly nurturing infants and toddlers in their care, supporting their ability to identify children’s competencies and potential delays and communicate with parents is of particular importance. Developmental screening is one of many avenues to gather information on children’s development and cultural and linguistic influences need to be considered when interpreting the results.

Child Care and Development Block Grant Act (CCDBG) of 2014 and Final Rule support awareness and usage of developmental screening by requiring states, territories, and tribes to provide information to providers, family, and the general public about developmental screenings (45 C.F.R. § 98.33, 2016). States, territories, and tribes are also required to offer information about programs that provide services to children with special needs through Section 619 and Part C of the Individuals with Disabilities Education Act (IDEA) (45 C.F.R. § 98.33(b)(1)(iii), 2016). This information must include a description of ways in which eligible child care providers or families can use resources for children with potential developmental delays, such as cognitive, social, emotional, physical, and language delays (45 C.F.R. § 98.33(c)(2), 2016). With the support of the requirements from CCDBG Act of 2014 reauthorization and Final Rule, the Administration for Children and Families (ACF) encourages Child Care Development Fund (CCDF) Lead Agencies to work toward expanding the accessibility of developmental screenings to all child care settings (Administration for Children and Families, 2016).

The following is an overview of policies, practices, resources, and strategies outlined by ACF (2016) to help states, territories, and tribes design and implement CCDF plans for consumer education on developmental screening.

Help Families and Providers Participate in Developmental Screening and Recognize Milestones

  • Provide infant and toddler programs with resources to promote staff’s capacity to engage in regular and linguistically and culturally appropriate discussions with families about infants’ and toddlers’ healthy development.
  • Encourage infant and toddler programs to maintain a practice of suggesting that families discuss their children’s development with their primary health care providers during each infant and toddler wellness visit.
  • Implement the regular use of developmental screeners, and provide parents with the opportunity and support to take an active role in completing the screeners.

Strengthen the Capacity of the Infant and Toddler Workforce

child engaged with teacher

  • Provide infant and toddler care teachers with ongoing professional development on children’s social, emotional, cognitive, and physical development, as required by the CCDF Final Rule (45 C.F.R. § 98.44(b)(1)(iii), 2016).
  • Require infant and toddler child care programs to provide ongoing training that supports staff members’ ability to administer developmental and behavioral screening, foster children’s social-emotional development and behavioral health, engage in appropriate strategies to promote positive behaviors, and understand how to refer children for additional screening and assessments, when appropriate.
    • Watch Me! Celebrating Milestones and Sharing Concerns is a free online training provided by the CDC. This course promotes infant and toddler care teachers’ awareness and understanding of developmental monitoring in a 1-hour, four-module format (Centers for Disease Control and Prevention, 2016c); https://www.cdc.gov/ncbddd/watchmetraining/index.html.
    • Early Educator Central (ECC) is an online initiative that promotes the careers of infant and toddler educators by providing resources that increase their competencies and advance their education. EEC leverages and makes accessible high-quality, federally funded coursework, and provides tools and resources for professionals and systems supporting the infant and toddler workforce (Early Childhood Central, n.d.); https://earlyeducatorcentral.acf.hhs.gov/.
  • Use CCDF quality funds to offer training that promotes infant and toddler care teachers’ skills to engage with families, enhance families’ understanding of child development and developmental screeners, and provide outreach in a culturally and linguistically appropriate manner.
  • Enhance the professional development of the infant and toddler workforce by requiring that preparation programs are aligned with up-to-date research and best practices regarding family engagement, child development, developmental screening and referrals, and strategies for positive behavioral guidance.
  • Establish state and territory entry-level credentials that include requirements for infant and toddler care teachers to demonstrate competencies in early childhood development, social-emotional development, skillful parent partnerships, and family engagement.

Leverage and Distribute Existing Resources on Developmental Screening, Monitoring, and Family Outreach That Can Support Child Care Providers

two children

  • States, territories, and tribes can disseminate resources through multiple channels, such as, websites (both those of the Lead Agency and other relevant stakeholders), state subsidy programs, CCR&R agencies, parent associations, local early childhood advisory councils, provider associations and unions and other existing state networks.
    • Birth to 5: Watch Me Thrive! is a public campaign launched by the U.S. Departments of Health and Human Services and Education “to encourage healthy child development, universal developmental and behavioral screening for children, and support for families and providers who care for them” (Early Childhood Development, 2015a, p.1). The website provides guides to developmental screening for specific audiences, including early care education providers, early intervention/early childhood special education providers, families, primary care providers, and communities; http://www.acf.hhs.gov/ecd/child-health-development/watch-me-thrive.
    • The Birth to 5: Watch Me Thrive! A Compendium of Screening Measures for Young Children compiles research-based screening tools for children ages birth to 5 years and provides information on the required training, cost, age range, administration time, and quality level associated with each tool (U.S. Department of Health and Human Services, 2014b); https://www.acf.hhs.gov/sites/default/files/documents/ecd/screening_compendium_march2014.pdf.

Strengthen the Capacity of Local Programs to Offer Comprehensive Services by Partnering with Community Organizations

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Support Universal Developmental Screening by Strengthening Standards for Licensing and QRIS

  • States, territories, and tribes can use quality improvement CCDF funds to create, implement, and improve quality rating and improvement system (QRIS). States, territories, and tribes can develop quality standards that include developmental screenings.
    • Caring for Our Children Basics: Health and Safety Foundations for Early Care and Education offers guidelines to strengthen licensing and QRIS health and safety standards, including support for developmental and behavioral screening (Administration for Children and Families, 2015); https://www.acf.hhs.gov/archive/ecd/caring-our-children-basics.

Use and Promote Opportunities in Medicaid and the Children’s Health Insurance Program to Enhance Child Well-Being and Provide Preventive Screenings

  • Encourage families to enroll in health insurance and educate them about existing resources.
  • Develop a partnership with state Medicaid agencies.
    • Consider express lane eligibility, which allows states, territories and tribes to us eligibility factors gathered by one express lane agency for determining a child’s eligibility for another express lane agency. Agencies that fall in this category might include Head Start, Temporary Assistance for Needy Families (TANF), CCDF-funded child care programs, and others (Centers for Medicare & Medicaid Services, n.d.).
    • Consider presumptive eligibility options, which can help eligible children obtain Medicaid or CHIP before their application is processed.
    • Develop a unified application that allows families to apply for CCDF subsidies in conjunction with Medicaid or CHIP. For more information, visit the Center for Medicare & Medicaid Services’ Continuous Eligibility for Medicaid and CHIP Coverage webpage at https://www.medicaid.gov/chip/index.html.

References

Administration for Children and Families, U.S. Department of Health and Human Services. (2015). Caring for our children basics: Health and safety foundations for early care and education. Retrieved from https://www.acf.hhs.gov/sites/default/files/ecd/caring_for_our_children_basics.pdf

Administration for Children and Families, U.S. Department of Health and Human Services. (2016, January 19). Provisions in the CCDBG Act of 2014 related to developmental and behavioral screenings in child care and afterschool care programs, and potential policies for implementation (Information Memorandum CCDF-ACF-IM-2016-01). Retrieved from https://www.acf.hhs.gov/sites/default/files/documents/occ/ccdf_acf_im_2016_01.pdf

Centers for Disease Control and Prevention. (2016a). Information for families [Web page, last updated October 17, 2016]. Retrieved January 16, 2017, from https://www.cdc.gov/ncbddd/actearly/parents/index.html

Centers for Disease Control and Prevention. (2016b). Learn the signs. Act Early. [Web page, last updated October 17, 2016]. Retrieved January 16, 2017, from https://www.cdc.gov/ncbddd/actearly/

Centers for Disease Control and Prevention. (2016c). Watch me! Celebrating milestones and sharing concerns [Web page, last updated May 16, 2016]. Retrieved January 16, 2017, from https://www.cdc.gov/ncbddd/watchmetraining/index.html

Centers for Medicare & Medicaid Services. (n.d.). Express lane eligibility for Medicaid and CHIP coverage [Web page]. Retrieved January 16, 2017, from https://www.medicaid.gov/medicaid/outreach-and-enrollment/express-lane/index.html

Child Care and Development Fund (CCDF) Program, 81 Fed. Reg. 67438 (September 30, 2016) (codified at 45 C.F.R. Part 98). Retrieved from https://www.gpo.gov/fdsys/pkg/FR-2016-09-30/pdf/2016-22986.pdf

Early Childhood Development, Administration for Children and Families, U.S. Department of Health and Human Services. (2015a). Birth to 5: Watch me thrive! [Web page, last reviewed July 14, 2015]. Retrieved on January 16, 2017, from https://www.acf.hhs.gov/ecd/child-health-development/watch-me-thrive

Early Childhood Development, Administration for Children and Families, U.S. Department of Health and Human Services. (2015b). Health insurance marketplace resources for early care and education providers [Web page]. Retrieved January 16, 2017, from https://www.acf.hhs.gov/ecd/child-health-development/affordable-care-act/marketplace-resources-for-ece-providers

Early Childhood Central, Office of Child Care, Office of Head Start, Administration for Children and Families, U.S. Department of Health and Human Services. (n.d.). Early educator central: Pathway to credentials and degrees for infant-toddler educators [Web page]. Retrieved January 9, 2017, from https://earlyeducatorcentral.acf.hhs.gov/

Healthcare.gov. (n.d.). Individuals and families [Web page]. Retrieved January 16, 2017, from https://www.healthcare.gov/

Insure Kids Now. (n.d.) Questions and answers [Web page]. Retrieved January 16, 2017, from https://www.insurekidsnow.gov/

U.S. Department of Health and Human Services, & U.S. Department of Education. (2014a). Birth to 5: watch me thrive! A community guide to developmental and behavioral screening. Retrieved from https://www2.ed.gov/about/inits/list/watch-me-thrive/files/communities-guide-march2014.pdf

U.S. Department of Health and Human Services, & U.S. Department of Education. (2014b). Birth to 5: Watch me thrive! A compendium of screening measures for young children. Retrieved from https://www.acf.hhs.gov/sites/default/files/documents/ecd/screening_compendium_march2014.pdf

U.S. Department of Health and Human Services, & U.S. Department of Education. (n.d.). Birth to 5: Watch me thrive! [Booklet]. Retrieved from https://www.acf.hhs.gov/archive/ecd/child-health-development/watch-me-thrive

Additional Resources

  • The Developmental Screening Resources in Support of Reauthorization (2015) by the National Center on Child Care Quality Improvement provides an overview of resources that support CCDF Administrators meet the requirements of the provisions of the Child Care and Development Block Grant Act of 2014; https://childcareta.acf.hhs.gov/sites/default/files/293_1508_developmental_screening_resources_final_0.pdf.
  • This resource compiles a list of assessment and screening tools for infants and toddlers https://www.acf.hhs.gov/opre/resource/resources-for-measuring-services-and-outcomes-in-head-start-programs
  • Zero to Three’s Developmental Screening and Assessment webpage at https://www.zerotothree.org/early-development/developmental-screening-and-assessment provides information designed to support parents’ awareness and understanding of and participation in the developmental screening and assessment process. It features the following:
    • The “Infants and Young Children with Special Needs” training;
    • The Infant and Toddler Development, Screening, and Assessment report;
    • “I Am Concerned About My Child’s Development. Who Do I Talk to About My Worries?” A resource for parents who are concerned about their child’s development;
    • The Developmental Screening, Assessment, and Evaluation: Key Elements for Individualizing Curricula in Early Head Start Programs policy resource; and
    • The Achieving the Promise of a Bright Future: Developmental Screening of Infants and Toddlers policy resource.