Systemwide Solutions to Improve Early Intervention for Developmental–Behavioral Concerns


by Kevin P. MarksAdriane K. GriffenPatricia HerreraMichelle M. MaciasCatherine E. RiceCordelia Robinson

“Birth to Five: Watch Me Thrive!” ( seeks to systematically increase early detection of developmental–behavioral problems among at-risk children, from birth through 5 years. This initiative represents a coordinated effort to increase early screening and detection rates across the health, education, and social service sectors. Although the earliest detection of children who need extra developmental–behavioral support is a laudable goal, these efforts will be for naught without appropriate supports to document follow-up and enrollment into services. To meet the challenge of what happens next, our nation must address its capacity crisis. The leadership issue across sectors is to build the capacity to increase and improve access to evidence-based services that are tailored to child and family needs.

This initiative is the stated promise of early intervention (EI) for ages 0 to 3 years, early childhood special education (ECSE) for ages 3 to 5 years, and other high-quality early learning programs. In 2011 and 2012, 2% to 3% of US children received EI under the Individual with Disabilities Education Act (IDEA; Part C, and 5% to 6% of children received ECSE under IDEA Part B, Section 619.1 Twelve percent of children are diagnosed with any developmental disability between 3 and 10 years and 16% between 11 and 17 years.2 Mental health disorders emerge in 21% of children between 9 and 17 years.3 Although it can be challenging to reliably identify infants, toddlers, and preschoolers with the more prevalent mild disabilities and disorders, red flags (eg, positive or concerning screens) may be identifiable. Alas, the chasm between percentage identified and served is unacceptable given the assortment of interventions or supports proven to improve outcomes (

Source: American Academy of Pediatrics, Pediatrics

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Birth to 5: Watch Me Thrive!


Birth to 5: Watch Me Thrive! is a coordinated federal effort to encourage healthy child development, universal developmental and behavioral screening for children, and support for the families and providers who care for them.

Birth to 5: Watch Me Thrive! will help families and providers:

Celebrate milestones. Every family looks forward to seeing a child’s first smile, first step, and first words. Regular screenings help raise awareness of a child’s development, making it easier to expect and celebrate developmental milestones.

Promote universal screening. Just like hearing and vision screenings assure that children can hear and see clearly, developmental and behavioral screenings track a child’s progress in areas such as language, social, or motor development.

Identify possible delays and concerns early. With regular screenings, families, teachers, and other professionals can assure that young children get the services and supports they need, as early as possible to help them thrive alongside their peers.

Enhance developmental supports. Combining the love and knowledge families have of their children with tools, guidance, and tips recommended by experts can make the most of the developmental support children receive.

Source: Administration for Children and Families

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Developmental and Behavioral Screening Initiative


Maximizing the health and developmental potential of children and families in the United States is an urgent priority—developmental and behavioral challenges are associated with lower scores on developmental assessments as well as later behavior issues and lower academic achievement.[1] Recent statistics indicate that 1 in 6 children have a developmental disability in the United States. Young children who live in families with incomes below the Federal Poverty Level are even more likely to have a developmental delay.[2]

Effective promotion of healthy child development and wellness is best achieved early in a child’s life with well-coordinated, multi-sector coordination of services and communication with families. Public awareness of typical child development and risks for delay, developmental and behavioral screening, early identification of delays as well as linkages to referral and follow up services can be delivered anywhere young children and families spend time–in the home and in communities through a range of programs and services.

The Departments of Health and Human Services and Education have partnered to launch a public awareness campaign—targeted at numerous sectors (e.g. early care and education, medical, primary health care, child welfare, mental health) —highlighting the importance of universal developmental and behavioral screening and support within the context of normative child development. The package of materials that will be launched as part of the public awareness campaign will include the following:

1.      A compendium of first line screening instruments for children, birth to 5 years, will list pertinent information, including cost, administration time, quality level, training required, and age range covered, on a host of high quality screening instruments.

2.      Multiple “User’s Guides” for developmental and behavioral screening and support, each tailored to early care and education programs, pediatricians, home visitors, social workers, mental health professionals, and various other relevant partners, will describe the importance of screening, how to talk to parents, where to go for help, and how to select the most appropriate tool for the population served as well as the provider implementing the screen.

3.      An electronic package of resources for follow-up and support to help children, parents and providers through the process. This collection of federal resources includes materials, information, and contact information from each partner agency and relevant grantees, that will serve to bring awareness to parents and providers about general early child development, how and where to get help if a concern exists, tips and techniques to help children with disabilities or delays, and free online training modules on a range of topics.

Source: Administration for Children and Families

Available at:

Developmental Screening, Assessments and Evaluations for Infants and Toddlers


This webinar discusses how to integrate data from assessments into daily experiences. Early Head Start staff also learn how to identify behavioral and developmental concerns observed while working with infants and toddlers.

Source: Early Childhood Learning and Knowledge Center

Available at:

Autism Speaks Launches New Ad Council Campaign – “Maybe” | News | Autism Speaks

May 2013

Extending its award-winning “Learn the Signs” campaign, Autism Speaks today launched the “Maybe” campaign, a new series of public service advertisements (PSAs) designed to reach African American and Hispanic parents. According to research, children in these communities are often diagnosed later than the national average. The PSAs, which are being distributed to media outlets nationwide this week, show some of the early signs of autism and encourage parents to take immediate action if their child is not meeting standard developmental milestones. Read a story on the campaign launch from the New York Times.

According to the CDC, the average age of diagnosis is 4-5 years, but a reliable autism diagnosis can be made as early as 18-24 months. While early detection is critical, research shows that many parents have very little knowledge about autism and its symptoms. The current age of diagnosis among low income families, as well as African Americans and Hispanics, is higher than the general public. With appropriate early intervention services from ages 3-5, between 20 percent and 50 percent of children diagnosed with autism will be able to attend mainstream kindergarten.

The new “Maybe” PSAs show parents observing the unusual behavior or non-reaction of their child in seemingly ordinary situations. A child’s lack of eye contact, babbling or big smiles invite parental worry and speculation: “maybe it’s this” or “maybe it’s that.” Showing the subtle presence of potential problems in otherwise everyday instances, the PSAs emphasize that these “maybes” are reasons enough for parents to consult their pediatrician or primary care provider for further screening. The PSAs encourage parents to seek further information about the early signs of autism and additional screening resources at and for Spanish information.

Source: Autism Speaks

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Charting Progress for Babies in Child Care: 15 Policy Recommendations. Promote Access to Early, Regular and Comprehensive Screenings

“The tremendous adaptability of the brain in the first three years of life means that early treatment of delays leads to improved outcomes, whereas later intervention is less effective. In order to provide treatment to improve children’s outcomes, early identification of delays and sensory impairments … is critical.” – Laura Sices, Developmental Screening in Primary Care: The Effectiveness of Current Practice and Recommendations for Improvement[1]

Source: CLASP

Available at:

Promote Access to Early, Regular and Comprehensive Screenings


Promote access to early, regular, and comprehensive screening—make early and regular health, mental health, and developmental screenings and related services available at recommended ages for vulnerable infants and toddlers through connections with all infant and toddler providers and caregivers.

This document presents research supporting the recommendation to establish core competencies. Visit for materials related to this recommendation, including ideas for how state child care licensing, subsidy, and quality enhancement policies can move toward this recommendation; state examples; and online resources for state policymakers.

Source: CLASP

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Developmental Screenings, Assessments, and Evaluations for Infants and Toddlers

Thursday, December 15, 2011
2:00 – 3:30 p.m. (EST)

This webinar will highlight how American Indian/Alaska Native (AI/AN) Early Head Start programs can develop systematic approaches to screening, assessing, and evaluating infants and toddlers. Speakers will present on the importance of engaging families during infant-toddler screening and assessment, and how the Head Start Program Performance Standards fit into this process.

The Webinar Will Include:

  • A presentation from representatives from the Cherokee Early Head Start program on their experiences with the screening process and the importance of engaging families;
  • A discussion of ongoing assessments and individualization by a consultant with experience and knowledge in the field of program management and disabilities; and
  • A presentation from the Education for Parents of Indian Children with Special Needs (EPICS) of New Mexico on indicators that may warrant further evaluation and partnership in early intervention.

Who Should Watch?
Early Head Start managers, staff, and mental health providers.

Note: While faculty will speak from their tribal perspectives, the topics of screening, assessment, and evaluation are required areas for all Head Start and Early Head Start programs. All are welcome to register.

Registering for the Webinar
Select this link to register for the webinar:

Source: Early Head Start National Resource Center

Trends in the Use of Standardized Tools for Developmental Screening in Early Childhood: 2002–2009


Findings from a new study show that pediatricians’ use of standardized screening tools increased from 23% to 48% between 2002 and 2009, which is good news considering the importance of developmental screening in early identification, evaluation, and intervention. However, the percentage remains less than half of respondents who work with children under the age of 3, suggesting that additional research needs to be done to identify barriers to the use of standardized screening tools in practice.

Source: NECTAC Enotes/Pediatrics

Full citation: Radecki, L., Sand-Loud, N., O’Connor, K. G., Sharp, S., Olson, L. M. (2011). Trends in the Use of Standardized Tools for Developmental Screening in Early Childhood: 2002–2009. Pediatrics. Published online June 27, 2011. doi: 10.1542/peds.2010-2180. Abstract is available at: