Implementing Developmental Screening and Referrals: Lessons Learned From a National Project

Abstract

A diverse sample of practices successfully implemented developmental screening as recommended by the AAP. Practices were less successful in placing referrals and tracking those referrals. More attention needs to be paid to the referral process, and many practices may require separate implementation systems for screening and referrals.

Early Screening of Autism Spectrum Disorder: Recommendations for Practice and Research

“…9 The uptake of ASD screening into pediatric practice has been modest. 10,11 Although potential facilitatorsand barriers to ASD screening have been researched and debated, [11][12][13] screening rates in many regions of the United States remain low. Community-based interventions aimed at implementing or increasing utilization of ASD screening have emphasized training primary care physicians and their front-line staff, providing ongoing technical assistance (eg, scoring, data management support), and clear referral pathways for specialized assessments.…”

Autism Screening With Online Decision Support by Primary Care Pediatricians Aided by M-CHAT/F

“…30 In addition to reducing false-positive findings, use of the follow-up interview facilitates a structured clarification process and discussion of parent perceptions that led to the positive screen, encouraging parents to follow through with a referral for further evaluation.…”

“…16 This limitation is not restricted to research studies, as similar suboptimal rates of successful referral from screening occur in practice. 30 The requirement to travel to an AC may have been an impediment because our subsequent study offered in-home assessments and had higher participation rates.…”

Improving Delivery of Bright Futures Preventive Services at the 9- and 24-Month Well Child Visit

“…The project measured a combination of nationally endorsed measures and measures tested in and/or adapted from previous QI preventive services projects. 8,11,12,[15][16][17][18][19] Measurements included in the PreSIP are detailed in Table 2. One particularly challenging but critical measurement area was the "partnership with parents," a unique and integral component of Bright Futures not reflected in adult practice guidelines.…”

“…She reviewed and revised the manuscript, making several significant additions for tables; Dr Shaw contributed to the conceptualization and design of the study, participated as faculty at the first learning session, and reviewed the manuscript with hospitals, meeting over a defined timeframe to effect the specific change targeted for improving care. [8][9][10][11][12][13] A natural extension of the collaborative model is an organized network of providers or institutions engaging its members in topic-specific collaboratives. In 2005, the American Academy of Pediatrics (AAP) developed the Quality Improvement Innovation Networks (QuIIN) to organize a platform of practices for testing "change packages" of new measures, guidelines of care, and innovative care delivery approaches before widespread dissemination.…”