Child Development: Interventions : Part 2

by CDC

(Page 2 of 3)

3. Title V

Title V was converted to a block grant as part of the Omnibus Budget Reconciliation Act of 1981. Therefore, states annually apply for this grant, through a process of stating their objectives for spending. They must spend 30% of the grant allocations on preventive and primary care for children and youth, and 30% on services for children with special health care needs (CSHCN). Through the grant, states seek to ensure maternal and child health services, as well as those for CSHCN, through a variety of programs and initiatives. They are required to report the results of these programs and initiatives. Because of the flexibility of Title V, the grant can be an originating and supportive source for child development programs.

Foundation or private organization programs

1. Assuring Better Child Health and Development (ABCD) Program

This is a policy-oriented initiative that complements the Healthy Steps program by identifying policy changes to Medicaid, state Children's Health Insurance Program, and community health centers that will help ensure a healthy start for children of low-income families. Because states have primary responsibility for implementing health care programs for low income families, ABCD works with state Medicaid agencies to develop projects. ABCD also includes efforts to improve national policies and develop and promote effective models of care that emphasize healthy child development. The program involves four state initiatives: North Carolina, Utah, Vermont, and Washington. The states are creating service models that may include developmental screening, referral, service coordination, and the provision of educational materials and resources for both parents and clinicians serving Medicaid children.

A team of researchers from Northwestern University (led by Peter Budetti) and New York University (led by Carolyn Berry) are conducting a national process evaluation of ABCD and are coordinating with local evaluators for outcomes evaluation.

2. Healthy Steps for Young Children Program

This is a national initiative that works with health care practices and focuses on the importance of the first three years of life. It involves adding a new member to the health care team, the Healthy Steps Specialists (specialist in child development), to enhance the information and services parents receive about major behavioral and developmental issues. Clinical sites offer a comprehensive range of services for parents of young children from birth to three, including: well-child visits, home visits, tools to gauge child development and family health, parent groups, a child development telephone line, written material for parents, and links to community resources.

An evaluation of this initiative began in 1995 by researchers at Johns Hopkins (Led by Bernard Guyer, M.D), in partnership with various funders and 24 pediatric and family practice sites across the country. They followed nearly 4,500 families who participated in Healthy Steps services for three years. The multiyear evaluation was expected to be complete by the end of 2002.

3. TRACE: Tracking, Referral, and Assessment Center for Excellence

This project seeks to: 1) establish a center to identify and promote the use of scientifically based models and practices for early identification, child find, and referral for children eligible for Part C and Part B; 2) conduct research syntheses of early identification, child find, and referral models and practices with a focus on the characteristics of the practices and models associated with desired outcomes; 3)use the characteristics of effective models and practices to conduct studies on the extent to which educational programs, at all levels, are using scientifically based early identification, child find, and referral models and practices; 4) determine if the use of scientifically based models and practices is associated with desired outcomes; 5) compare and contrast the relative effectiveness of different models and practices; and 6) develop, validate, and evaluate the effectiveness of scientifically based training units for implementing effective early identification, child find, and referral models and practices.

Research

American Academy of Pediatrics (AAP), Periodic Survey of Fellows

This survey queries pediatricians about their attitudes and practices on a wide range of current child health topics. Three or four surveys are conducted per year, each mailed to a unique random sample of approximately 1600 active, US members of the AAP.

Sample Finding "Pediatricians who are reimbursed predominantly by Medicaid, serve minority families, and practice in urban cities are less likely to refer families to several community-based health services."

Annual Early Periodic Screening, Diagnostic, and Treatment (EPSDT) Report

EPSDT is Medicaid's comprehensive and preventive child health program for individuals under the age of 21, which includes periodic screening for developmental delays and anticipatory guidance for parents. The annual report documents, for each state, the number of children provided child health screening services, initial or periodic screening, and referrals for treatment.

Sample Finding Only about one-third of US children who are eligible for EPSDT receive these checkups.

About the Author

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