Supporting Individuals with Developmental Disorders through Uncertain Times
Screening in Primary Care
Identifying and Responding to Developmental Delay in Young Children
(David A Ansel MD, Christina Buysse, M.D)
- Free on-line CME course providing the knowledge and tools for the primary care clinician to identify children at risk for developmental delays and to refer them for appropriate therapeutic and diagnostic services.
- Using text, case-based learning, videos, and screencasts, course provides the knowledge and tools necessary for PCP to perform developmental screening and surveillance and to refer at-risk children for Early Intervention services
- Offered FREE through Stanford Center for Continuing Medical Education
The American Academy of Pediatrics recommends developmental surveillance at every well-child visit and developmental screening at 9, 18, and 24 or 30 months of age. They also recommend screening for autism at 18 and 24 or 30 months of age. Many tools for screening are proprietary and therefore must be purchased from the publisher. The list below include tools that are in the public domain.
Screening for developmental standing
PEDS: Pediatric Evaluation of Developmental Status
The Capute Scales: Cognitive Adaptive Test and Clinical Linguistic and Auditory Milestone Scale (CAT/CLAMS)
Screening for autism
M-CHAT for children 18 to 30 months of age
Screening for post-partum depression
Edinburgh postpartum depression scale
Screening for behavioral problems
Building the Capacity of Primary Care Practice
The increasing prevalence of children with special health care needs requires a new approach to primary care practice. The Institute of Medicine acknowledged this shift in a landmark report entitled, Crossing the Quality Chasm: A New Health System for the 21st Century. A model that documents the changes that must occur in primary care is entitled, The Improving Chronic Care Model. The American Academy of Pediatrics has developed the Medical Home as an approach to improve chronic care for children, especially children with special health care needs. The concept is well described here.
One of the most prevalent chronic conditions in pediatrics is Attention-Deficit/Hyperactivity Disorder or ADHD. A toolkit for diagnosing and managing this complex condition can be found here.
Another highly prevalent problem is obesity and being overweight. Tools for prevention and management of obesity can be found here.
The following toolkits were developed by the Developmental Disabilities Primary Care Initiative, Surrey Place Centre, Toronto, Canada, and designed to assist primary care providers in caring for adults with intellectual and developmental disabilities.
Linking to community-based services
Primary care clinicians identify children with developmental delays and disorders on the basis of surveillance and screening. The tools below will assist the treating clinicians in California in making appropriate and effective referrals to community-based services.