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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FPG Study on Autism Treatments Makes List of Top Advances | FPG Child Development Institute


The Interagency Autism Coordinating Committee of the U.S. Department of Health & Human Services has released its annual list of scientific studies that represent significant progress–naming FPG’s groundbreaking study on autism treatments one of the field’s top 20 advances in 2013.

It was the first study designed to compare longstanding comprehensive treatment models for children with autism spectrum disorders (ASD). A team of researchers from FPG and three other universities determined that preschoolers with ASD in high-quality classrooms make gains during the school year regardless of the treatment model–findings with substantial implications for the field.

“Previous research has shown that when children with autism spectrum disorders have access to high quality early intervention, the result is improved developmental performance, but until now debate has persisted over which approach to use,” said FPG fellow Brian Boyd, shortly after the Journal of Autism and Developmental Disorders first published the findings in 2013. Boyd was the study’s co-principal investigator and lead author of the article.

Early diagnosis and effective intervention can reduce ASD’s lifetime $3.2 million price tag by two-thirds, and more children are being diagnosed with autism each year. Two frequently used comprehensive treatment models for ASD have a long history: LEAP (Learning Experiences and Alternative Program for Preschoolers and their Parents) and TEACCH (now known only by its acronym).

Source: Frank Porter Graham Child Development Institute

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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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First Concern to Action Tool Kit | Early Access to Care/Resources for Parents


If you have a concern about how your child is communicating, interacting or behaving, you are probably wondering what to do next. The First Concern to Action Tool Kit can help you sort that out. The purpose of this tool kit is to provide you with specific resources and tools to help guide you on the journey from your first concern to action. The kit is also available in Spanish.The kit was developed to provide families of children under the age of five with:

  • An overview of early child development;
  • Guidance on what to do if you have a concern about your child’s development;
  • Information about obtaining an evaluation for your child’s development and treatment options, if needed.

Source: Autism Speaks

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Motor Delays: Early Identification and Evaluation

May 27, 2013

Pediatricians often encounter children with delays of motor development in their clinical practices. Earlier identification of motor delays allows for timely referral for developmental interventions as well as diagnostic evaluations and treatment planning. A multidisciplinary expert panel developed an algorithm for the surveillance and screening of children for motor delays within the medical home, offering guidance for the initial workup and referral of the child with possible delays in motor development. Highlights of this clinical report include suggestions for formal developmental screening at the 9-, 18-, 30-, and 48-month well-child visits; approaches to the neurologic examination, with emphasis on the assessment of muscle tone; and initial diagnostic approaches for medical home providers. Use of diagnostic tests to evaluate children with motor delays are described, including brain MRI for children with high muscle tone, and measuring serum creatine kinase concentration of those with decreased muscle tone. The importance of pursuing diagnostic tests while concurrently referring patients to early intervention programs is emphasized.

Source: Pediatrics. American Academy of Pediatrics.

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SERIES: An Integrated Approach to Supporting Child Development

Summer 2012

Developmental delays affect between 10 and 13 percent of U.S. children under the age of three; however, only two to three percent of children in this age group receive Early Intervention (EI) services.1-3 An approach that identifies concerns early and links children to services is vital. Many efforts have focused on implementing developmental screening in primary care, and have contributed valuable information about the feasibility and effectiveness of this strategy.4-8 However, few studies have evaluated the success of screening beyond the identification of a developmental concern and the initiation of a referral.9 Those studies that have looked beyond referral show significant gaps between the identification of a concern and the receipt of developmental services by children and families.10, 11 This has prompted increasing awareness of the need for better care coordination across systems involved in meeting the
developmental needs of children.12

To promote a more coordinated approach to meeting children’s developmental needs, this brief proposes the adoption of the SERIES paradigm of developmental screening in which each step—Screening, Early Identification, Referral, Intake, Evaluation, and Services—is seen not as an isolated activity, but rather an integral component of a single process. SERIES challenges all systems serving young children to broaden their focus to include practices that promote shared responsibility for ensuring that each child successfully completes the entire pathway from screening to services.13 This brief does not aim to be a comprehensive review of the evidence around developmental screening, as such reviews already exist.1, 14, 15 Instead, the brief explores barriers that may prevent children from completing the SERIES, highlights promising approaches for collaboration, and proposes practice and policy actions that may offer useful guidance for planning, financing, and delivering early childhood services.

Source: PolicyLab Center to Bridge Research, Practice, & Policy

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