Feature Story

March 12, 2008

Improving the Delivery of Health Care that Supports Young Children's Healthy Mental Development: Update on Accomplishments and Lessons from a Five-State Consortium

From The Commonwealth Fund:

It provided five states (California, Iowa, Illinois, Minnesota, and Utah) an opportunity to develop and test strategies for improving the delivery of developmental services to young children at risk for or with social or emotional development delays, especially those in need of preventive or early intervention services.

The states sought, by different means, to improve the identification of children in need of developmental services and improve the likelihood that those identified with a potential need received appropriate follow-up services, including intensified surveillance, assessment, and treatment.

Identification: There is evidence in the literature that physicians who use an objective screening tool will more effectively identify children who may be at risk for, or have, a developmental delay than physicians who do not use such a tool.

All five ABCD states were able to increase screening using an objective screening tool in selected practices in which they tested their approaches to encouraging this practice.

Receipt of follow-up services: The ABCD II states had less success in measuring whether their interventions improved the likelihood that children received appropriate follow-up services.

This is likely due both to problems the states encountered in measuring children's receipt of follow-up services1 and a lack of resources for those services.

The paper updates a previously released report on interim accomplishments and lessons.

Identified validated screening tools and promoted pediatric provider use of these tools through activities such as modifying Medicaid provider handbooks and holding training sessions.

Efforts to identify and help families and clinicians access resources for assessment and treatment were critical to project success.

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