Early Identification and Referral for Developmental and Social-Emotional Concerns
Early Screening

Early screening for and identification of developmental concerns expanded across the county.  Providers are trained to use standardized developmental and social-emotional screening tools, and to coordinate referrals and access community supports

Why is this important? 

One in eight children has a problem with movement, mental health, autism, hearing, hyperactivity, language, learning, seizures or sight.  Lower-income children have higher rates of developmental problems.


Research shows that the earlier children with special needs are identified and receive services, the higher their chances are for a better outcome. Providers who depend on surveillance to identify developmental concerns capture only 30% of children at risk for developmental delay compared to 70-80% of children identified by providers who use a standardized screening tool.  Early identification for developmental concerns also requires that providers are knowledgeable about appropriate follow-up activities and the availability of supports and resources. 





Result 1

Expanded opportunities for identification of developmental and social-emotional concerns in children


3,834 children were screened, using standardized tools, across a wide range of settings.  This is an increase of 1,668 over last year.

Provider Voice:

“Nina is a 38-year old woman who immigrated to the U.S.…20 years ago. Nina and her son (age three) experienced chronic homelessness from the time [her son]…was 6 months old, due to severe…domestic violence…the clinician implemented an ASQ which revealed…[multiple] concerns…

A referral was made to a children’s hospital and for the past 8 months the child has received medical, speech and language services, occupational therapy, and individual play therapy.…[there have been] improvements in all areas of the child’s development.”

Detail 1: Expanded Developmental Screening [more]

Screenings now take place in selected:

  • Homeless shelters and transitional housing sites
  • Early care and education classrooms
  • Family resource centers
  • Agencies serving children with special needs
  • Home-based family support programs
  • Pediatric sites


Detail 2: Screening and Referrals at Pediatric and ECE Sites [more]

Due to early screening, families of 1,443 children were able to address concerns before their children entered Kindergarten 


ABCD (Assuring Better Child Health & Development) pairs screening using the Ages and Stages Questionnaires (ASQ) with anticipatory guidance at well child visits

    • 23 pediatric sites including small private practices and large community clinics received technical assistance in improving office flow to accommodate screening activities
    • 4 ABCD sites utilize F5AC Child Development Specialists to support screening and referrals
  • ABCD Sites


    Children screened using the ASQ


    Children that scored “of concern”


    Children needing further follow-up


    Referrals to Regional Center


    Referrals to school districts




    4 agencies providing mental health consultation in early care & education sites conducted 64 ASQs screenings


    400 children in 22 classrooms (at 5 preschools) were screened with the ASQ.  36% scored “of concern” and 9% were referred to the SART Linkage Line for additional supports.


    9 months after launching the SART Linkage Line, nearly 350 child-specific referrals had been made



    Detail 3: Screenings and Referrals at Home and in the Community [more]

    Through home-based postpartum support programs, 1,072 children were screened

    • Special Start program, which offers home-based support for families with infants discharged to the neonatal intensive care unit, screened 83% (n=648) of all children
    • Pregnant and Parenting Teen support services screened 76% (n=475) of the children served
    • Your Family Counts home visiting program, which serves pregnant and new parents experiencing very high social, mental health or substance use risks, screened 70% (n=240) of their clients


    284 children were screened by Child Development Specialists referred from preschools and kindergarten


    In the last 6 months of 2009, 9 community grantees conducted developmental screenings for 343 children.  Of these, 176 (51%) screened “of concern”.

    Result 2

    Expanded number of maternal depression screens using the Edinburgh


    Children of mothers who screen positive for depression have a higher incidence of developmental concerns.


    Depression screening is a standard of practice implemented by home visiting case managers. 



    Detail 1: Maternal Depression Screening and Support [more]

    1,014 mothers or primary caregivers were screened during postpartum home visits; 272 (27%) screened positive for depression; 181 who were referred for follow-up mental health services accepted or received supports


    Across 9 community grantees, 305 primary caregivers were screened for depression with 81 (27%) screening positive


    One grantee, a neighborhood medical clinic serving primarily low-income and non-English speaking clients, screened 275 mothers.  58 had positive screens; the clinic successfully connected 40 of these mothers to further assessment or treatment services.



    Result 3

    Increased Provider Knowledge & Awareness of Resources


    The F5AC Community Grants program helped raise the awareness of and connections to larger, coordinated systems of care serving children with developmental concerns.

    Detail 1: Referrals for Early Childhood Mental Health Support [more]

    Some grantees now screen and refer clients to specialized providers and 4 mental health programs now provide internal referrals and treatment to clients who score “of concern”

    Expanded opportunities for identification of developmental and social-emotional concerns in children
    Expanded number of maternal depression screens using the Edinburgh
    Increased Provider Knowledge & Awareness of Resources

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