Georgia Chapter American Academy of Pediatrics

                                                       

 

Winner of Outstanding Chapter Award 1966, 1996, 2000 & 2004   

                    DEDICATED TO THE HEALTH OF ALL CHILDREN                                

 

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

  • 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

  • Screening & Surveillance Checklist-This checklist offers pediatricians and their staff a framework for implementing the new Medicaid requirements into their practice by identifying key areas for discussion.

Overview of Standardized Developmental Screening Tools

  • 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.

  • 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.

  • 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

  • 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

  • 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.

  • Parents Evaluation of Developmental Status (PEDS)-  Parents' Evaluation of Developmental Status (PEDS) is detects developmental and behavioral problems in children from birth to age eight by eliciting and weighing parents' concerns on 10 items.

  • 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.

  • 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

  • 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. 

  • 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.

  • 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.

  • 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

  • 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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