Child development services are an integral component of well child care and are
designed to promote children's healthy development. Broadly, child development
services fall into four categories described below.
14,15,16
The BCAP Workgroup on
Enhancing Child Development Services in Medicaid Managed Care focused primarily on
the first two categories.
Developmental Screening, Surveillance and Assessment
Screening and surveillance is the collective effort by parents and providers to ensure
that children with potential developmental delays are identified and referred, if nec
essary, to appropriate health care services. Surveillance is a flexible, continuous
process, in which knowledgeable professionals perform skilled observations of chil
dren during child health care. The components of developmental surveillance
include eliciting and attending to parental concerns, obtaining a relevant develop
mental history, making accurate and informative observations of children, and shar
ing opinions and concerns with other relevant professionals.
17
This ongoing process
can be facilitated by the use of standardized screening tools,
18
which can help
providers and parents assess child development and behavior. The American
Association of Pediatrics (AAP) Committee on Children with Disabilities, along
with many leading organizations, recommends the use of standardized screening tools
at well visits.
Developmentally Based Health Promotion and Education
Health promotion and parent education, including anticipatory guidance, informs
parents on child development and ways of promoting their child's learning and
growth. Developmental topics addressed include areas such as sleeping patterns,
encouraging learning, discipline, toilet training, and injury prevention. Age specific
information is typically given to parents by providers at well child visits, but also can
be provided creatively by health plan member education coordinators, through day
care facilities, social services agencies, public service campaigns, etc.
Developmental Interventions
Early interventions for developmental problems are usually carried out by profession
al educators, but often involve other health professionals such as speech and lan
guage therapists and occupational therapists. Early intervention services for children
and families commonly occur outside of the traditional health care system, often
through educational or social service contacts.
Care Coordination
Care coordination is required for a comprehensive and child centered approach to early
child development services. There are often multiple entities involved in the care of a
child in need of developmental intervention and early intervention and other services
must be coordinated.
14
M. Regalado and N. Halfon, Primary Care Services Promoting Optimal Child Developmental from Birth to Age 3 Years, Archives of Pediatric and Adolescent
Medicine 155 (2001): 1311 1322.
15
K. VanLandeghem, D. Curtis and M. Abrams, Reasons and Strategies for Strengthening Childhood Development Services in the Healthcare System, The
Commonwealth Fund, October 2002.
16
N. Halfon, M. Inkelas, M. Abrams and G. Stevens, Quality of Preventive Health Care for Young Children: Strategies for Improvement, The Commonwealth
Fund, May 2005.
17
P.H. Dworkin, Detection of Behavioral, Developmental, and Psychosocial Problems in Pediatric Primary Care Practice, Current Opinion in Pediatrics 5 (1993):
531 536.
18
For more information, see the Early Identification Using Standardized Developmental Screening Tools section on page 17.
