Developmental Screening - Children in North Carolina

North Carolina

Regular well-child visits with a health care provider are an integral part of promoting healthy growth and development. During these visits, doctors screen for delays or problems in the child’s development. These screenings can lead to early detection of developmental disabilities such as autism or attention-deficit/hyperactivity disorder (ADHD), which can then lead to better treatments and improved outcomes.

According to data from the National Survey of Children’s Health, populations that are more likely than others to receive developmental screening include:

• Non-Hispanic white children, who have better access to primary care and, by extension, developmental screening, compared with Hispanic and Asian children.
• Children who speak English at home compared with children who speak a language other than English at home.
• Children from higher-income households.
• Children whose parents have a college degree or higher compared with children whose parents have less educational attainment.
• Children who have insurance coverage compared with children who are uninsured.

The American Academy of Pediatrics recommends that every child receive developmental screenings at 9, 18, 24 and 30 months of age during their well-child visits. The 2010 Affordable Care Act included coverage for important early intervention preventive services, such as developmental and autism screenings, behavioral assessments as well as hearing and vision screenings.

Other pilot initiatives to increase the proportion of children who receive developmental screening include:

• Assuring Better Child Health and Development (ABCD), which has been implemented in multiple states and is currently being used to develop developmental screening policies. The ABCD model aims to increase developmental screening coordination between health care providers and other child and family service providers.
• New Mexico’s Developmental Screening Initiative, which increased standardized developmental screening to 92% among the health care practices involved.
• The 2-1-1 Los Angeles County Developmental Screening Project, which targeted high-risk and low-resource communities for intervention and improved developmental screening among underserved communities.

Healthy People 2030 has an objective to increase the proportion of children who receive developmental screening.

Ferris, Melanie, and Darcie Thomsen. “Coordinating Communities for Healthy Development: Lessons Learned through Minnesota’s Assuring Better Child Development (ABCD III) Project.” Saint Paul, MN: Wilder Research, October 2012. https://www.wilder.org/sites/default/files/imports/ABCD_III_FinalReport_10-12.pdf.

Germuth, Amy A. “Evaluation of the North Carolina Partnership for Children and Smart Start’s Race to the Top-Early Learning Challenge: Assuring Better Child Health and Development (ABCD) Program: Final Summary Report.” Durham, NC: EvalWorks, LLC, 2016. https://files.nc.gov/ncelc/abcd_evaluation-_final_summary_report.pdf.

Malik, Fauzia, John M. Booker, Shannon Brown, Catherine McClain, and Jane McGrath. “Improving Developmental Screening Among Pediatricians in New Mexico: Findings From the Developmental Screening Initiative.” Clinical Pediatrics 53, no. 6 (March 20, 2014): 531–38. https://doi.org/10.1177/0009922814527499.

Roux, Anne M., Patricia Herrera, Cheryl M. Wold, Margaret C. Dunkle, Frances P. Glascoe, and Paul T. Shattuck. “Developmental and Autism Screening Through 2-1-1: Reaching Underserved Families.” American Journal of Preventive Medicine 43, no. 6 (December 2012): S457–63. https://doi.org/10.1016/j.amepre.2012.08.011.

Zuckerman, Katharine E., Kimber M. Mattox, Brianna K. Sinche, Gregory S. Blaschke, and Christina Bethell. “Racial, Ethnic, and Language Disparities in Early Childhood Developmental/Behavioral Evaluations: A Narrative Review.” Clinical Pediatrics 53, no. 7 (June 1, 2014): 619–31. https://doi.org/10.1177/0009922813501378.