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Developmental Surveillance
& Screening
If you have any questions about the material listed
below, please contact Fozia Khan Eskew at the Chapter office at
404-881-5074 or via email at
feskew@gaaap.org.
The American Academy of Pediatrics (AAP) recommends
developmental surveillance at every well-child visit. In addition, the
AAP also recommends developmental screening using a standardized
developmental screening tool at the 9, 18, and 30-month well child
visits. This recommendation is included in the newly released AAP/Bright
Futures Periodicity Schedule.
Click here to view the new
periodicity chart.
Click here for a summary of
changes to the periodicity schedule.
In addition to developmental screening,
pediatricians are encouraged to screen children for Autism Spectrum
Disorders (ASD) at the 18 and 24-month well child visits. Siblings of
children with ASD should also be screened with a standardized tool that
evaluates social and communication skills.
The Georgia Medicaid program and SCHIP program,
PeachCare for Kids, mandates the use of a standardized developmental
screening tool with a specificity and sensitivity of 70% – 80% at the 9,
18, and 24-month HealthCheck visits. Use of a standardized developmental
screening tool at the 36-month visit is optional. The State's Care
Management Organizations (CMOs) also adopted this requirement.
Surveillance remains a component of HealthCheck during other well-child
visits using an office checklist that attends to any possible parental
concerns about their child’s development.
The Chapter has compiled
the information listed below as a resource to assist you in implementing
the process of developmental surveillance and screening into your
pediatric practice. Providing this information should not be
constructed as an endorsement by the GA/AAP, either explicit or
implied. The GA/AAP does not endorse or recommend any tool, methodology
or service.
Practice Resources for Using Standardized
Developmental Screening Tools
AAP Web Resource on Screening & Surveillance
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The Academy's affiliated website,
National Center for Medical Home Initiatives for Children
with Special Needs has created a web page to provide
information on implementing developmental surveillance and
screening. The page includes an interactive developmental
surveillance and screening algorithm, and information on
mentorship opportunities, community resources, how to create
an office system, forming partnerships, training and
education and additional resources for clinicians and
parents. To visit the site click here
http://www.medicalhomeinfo.org/screening/DPIP%20follow%20Up.html
Screening & Surveillance Checklist
Overview of
Standardized Developmental Screening Tools
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Overview of
Standardized Developmental Screening Tools-This
chart was prepared using data from the AAP and Developmental Behavioral Pediatrics to outline the
various tools, the age ranges for each, languages, and purchase
information.
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Coding Fact Sheet on Developmental Screening from the American
Academy of Pediatrics
The
AAP recently updated its fact sheet on coding of developmental
screening; visit the Member’s Only Channel of the AAP’s website for
a copy of this information. CIGNA
Health Plan also worked with the AAP to draft a
coding fact sheet
for those pediatricians who see patients enrolled in CIGNA.
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AAP Recommends Payers Cover Payment
of Developmental and Autism Screens In a November
3, 2008 letter to carriers, the AAP clarified the recommendations
for developmental and autism screening. Pediatricians have reported
that some carriers continue to bundle the screens with the
evaluation and management (E/M) service or are limiting the number
of developmental screenings as reported by CPT code 96110 (developmental
testing; limited with interpretation and report). If the AAP
receives responses from payers, it will be posted on the private
payer advocacy page on the AAP Member Center. To view the letter
click here.
Children 1st Screening & Referral form
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Children 1st Screening & Referral form-
When referring children to Babies
Can't Wait, Georgia's early intervention system for children birth
to three, use the Children 1st Screening & Referral form and submit
it to the health department of the county where the child resides.
Be sure to include a copy of the child’s developmental screening
results, findings of any hearing, vision, or lead screens, and a
prescription for the child’s evaluation for Babies Can’t Wait.
Also include the signature of the referring pediatrician.
Online Resources
for Standardized Developmental Screening Tools
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Ages and Stages Questionnaires
3 (ASQ)-The
Ages & Stages
Questionnaires 3 ® (ASQ) system screens infants and
young children for developmental delays during the first 5 years of
life. Parents complete a
30-item questionnaire which covers five key
developmental areas: communication, gross motor, fine motor, problem
solving, and personal-social.
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Child Development Review
System-The Child Development Review approach obtains information from parents and
helps professionals record their direct observations. It can be used for brief screenings to track "normal" development
or for assessment when more detailed information is wanted or needed.
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Brigance Inventories-The Brigance Inventories offer on-going
assessment, record-keeping and instructional planning system for skills from
birth through adult.
Autism Spectrum Disorders (ASD)
Click on the following to view additional information on Autism
Spectrum Disorders
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Modified Checklist for Infants &
Toddlers (MCHAT)-The Modified Checklist for Infants and Toddlers (MCHAT) is a screening tool
to detect the possibility of autism or autism spectrum disorders. This test
is for children age 18 or 30 months. This free on line screening tool
consists of 23 yes/no items that can be scored in 5 minutes by a
professional or paraprofessional. Yes/no answers convert to pass/fail
responses. The child fails the checklist when two or more critical items are
failed OR when any three items are failed. Although the M-CHAT is not
designed to detect all possible developmental disorders nor will all
children who fail the checklist meet criteria for a diagnosis on the autism
spectrum, it can identify children who should be evaluated by the
pediatrician or referred for a developmental evaluation with a specialist.
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New Website on MCHAT - Click
here for the new Modified Checklist for Autism in Toddlers
(M-CHAT) website. This site includes downloads, instructions,
translations, and articles related to the M-CHAT.
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Order the AAP Autism Tool Kit - Clinical Resource toolkit and
two screening tools to assist in the recognition, evaluation, and
ongoing management of autism spectrum disorders.
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Identification and Evaluation of Children With Autism Spectrum
Disorders - This AAP
clinical report offers the pediatrician information on how to
recognize the signs and symptoms, create assessment strategies, and
encourages awareness of local resources for making definitive
diagnosis and management of ASD. Published: PEDIATRICS, November 2007 (Clinical Report)
Authors: Chris Plauché Johnson, MD, MEd, Scott M. Myers, MD and the
Council on Children With Disabilities
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Management of Children With Autism Spectrum Disorders -
This AAP clinical report offers the
pediatrician educational strategies
and associated therapies that are the primary treatments for
children with ASD. Published:
PEDIATRICS, November 2007 (Clinical Report) Authors: Scott M. Myers,
MD, Chris Plauché Johnson, MD, MEd and the Council on Children With
Disabilities
Other Resources
Links
AAP Policy Statement:
Identifying Infants and Young Children With Developmental Disorders in the
Medical Home: An Algorithm for Developmental Surveillance and Screening
Bright Futures
Developmental Behavioral Pediatrics
Georgia Medicaid Health Check Manual
Babies Can't Wait
Nation Center
of Medical Home Initiatives for Children with Special Health Care Needs
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