All participants in the BCAP workgroup sought ways to more effectively incorporate

developmental screening tools into routine well child care. Many plans initiated

provider surveys to learn whether standardized tools were being used during well 

child visits.  Some plans examined whether their providers were billing for develop 

mental screening and assessment and if they were aware of the proper coding or

reimbursement for these services.  Many of the health plans in the workgroup chose

to pilot parent questionnaire screening tools.  Both the Ages and Stages

Questionnaire (ASQ) and the Pediatric Evaluation of Developmental Status

(PEDS) tools are parent completed instruments that are validated and have high

levels of sensitivity and specificity.

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Many health plans in the workgroup (Figure 3)

selected one or both of these tools for their pilot projects.  The advantages and limi 

tations of both of these tools are described below.

Figure 3: Developmental Screening Tools Used by BCAP Health Plans

Organization Name

PEDS

ASQ

Other

Screening Method

ABC Health Plan

Parent questionnaires mailed to parents of children at

high risk for developmental delay.

BlueCross BlueShield 

Parent questionnaire administered during well visit.

of TN

DC Chartered Health Plan

Parent questionnaire administered during well visit; 

plan scored the questionnaire and provided feedback

to provider and members.

Lovelace Health Plan

 *

Practice site and health fair administration of parent 

questionnaires by health professionals.

CommunityCARE

Practice site could choose from a menu of six 

accepted tools. 

Missouri Care

Parent questionnaire filled out in the waiting room.

Network Health

Parent questionnaire administered at home visit.

Virginia Premier

Parent questionnaire administered during well visit.

*Lovelace used a modified PEDS questionnaire in a health fair setting.

Ages and Stages Questionnaire (ASQ)

Advantages

Parent involvement

The ASQ relies on parents to observe their child and to complete simple question 

naires about their child's abilities. The basic premise is that parents can reliably

assess their child's development when asked,  Can your baby do _____ now?  ASQ

helps health care providers involve parents in a conversation about the child's

health and development.  

Fast and simple design

Each questionnaire includes a title page with instructions, an information sheet for

identification, 30 simply worded activities   six for each of the five developmental

areas (communication, gross motor, fine motor, personal social, and problem solv 

ing), and an information summary sheet for scoring and general comments.  The

35

F. P. Glascoe and H. Shapiro,  Introduction to Developmental and Behavioral Screening,  March 2005, www.dbpeds.org/articles/detail.cfm?TextID=5.

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