I wanted to take today’s blog post to share an important new online resource, along with a technical assistance center, and informational website meant to help primary care providers and clinics screen for developmental delays, maternal depression and social determinants of health. For subscribers and readers of my blog, I’ve written about how important it is for the screening process to happen. “Screening” is how pediatricians ask about key health risks or to ensure a child’s development is happening as it is expected. Screening is a specific process and more than simply asking some questions during a conversation. Screening uses formal valid paper or electronic forms with a series of questions for the parent (or sometimes teachers) to complete. Screening helps pediatricians know whether a certain child or family is ‘at-risk” for a particular health risk or condition. It is also important to note that the conditions your child’s doctor wants to know about are often times not visible just by looking at someone for a few quick minutes in the clinic. Things like depression, domestic violence or food insecurity are among the trickiest to figure out just by “looking.” Doctors will need to ask more questions should there be a worrisome answer to any of the screening questions. However, screening helps to start the conversation so that help and resources can be offered as needed.
There are many things that pediatricians and family providers are being asked to consider when they see a child at the clinic during those well child visits (see AAP Schedule of Well-Child Care Visits). They must consider how the child is growing and developing by checking the child’s weight and plotting the results on a growth chart. They must do a complete physical exam, talk with the family about how things are going at home and school and make sure children are up to date on their vaccinations/shots. A child’s development usually happens in an expected way — ‘milestones’ are expected within a certain age range–but the rate may be different for each child.
RELATED: Is your baby’s physical development on track? (HealthyChildren.org)
Professional organizations, such as the American Academy of Pediatrics, offer guidance to providers to follow so that health care is the same no matter where you live and who you see. This important online resource is meant to help providers and clinics learn to use valid screening tools for a variety of conditions and do so without causing too much disruption to the day to day flow of the clinic.
RELATED: Milestones Matter: 10 to Watch for by Age 5 (HealthyChildren.org)
Most offices screen for developmental delays and if a delay is found, families are often referred to early intervention or EI for speech therapy (if a child has challenges with their language or speech–what they can say or what they can understand), occupational therapy (if a child has challenges using their hands to button, scribbling or use utensils), or physical therapy (if a child has challenges with walking, running, turning over).
RELATED: What are the Early Signs of Autism? (HealthyChildren.org)
However, there is still much work to do to get more providers to screen for maternal depression, especially in the postpartum period (from birth to one year after having a baby) because it is known that if undetected or not treated it can affect a baby’s health or how the mother and baby interact with each other (see my other blog post, Postpartum Depression & Motherhood…Need to Get Moms Help). Even though the Academy has put forth guidance to providers on when and how often to screen, less than 50% of providers are screening.
The other health risks to talk with families about are those “related to conditions in the places where people live, learn, work and play”, which can affect people’s health and wellness which are referred to as social determinants of health.
These can include things like: housing and food access, income, access to healthcare, education, personal and community safety.
Here is a great introductory VIDEO to understand why social determinants are important and how it can influence health: Social Determinants of Health-An Introduction (6 minutes, 27 seconds)
This new online resource was developed with input from so many who all have the goal of ensuring more children and their families are screened for these various conditions during well child visits so that concerns are identified as early as possible and supports and resources are provided to help the child and family.
Here is the promotional video: Screening Time: Tuning in to the Needs of Families (1 minute 6 seconds) with information on how to do screening in busy clinics and conversation simulations.
I hope providers reading this blog will be excited to check out the resource and use it with their practices! The more providers and clinics we have doing routine screening for developmental delays, maternal depression and social determinants of health, the better the health of our children and their families will be.
And while there is much we can do as a society to fund programs and services to help children and families once issues are identified, screening is the first key step to help families understand how to best support their child’s health and what to do next.
This includes understanding how to partner with the larger “team” outside of the clinic to address these issues. As I have said before, a child’s team will depend on what issue is identified, but can include the child’s daycare provider/teacher, tutor, therapist(s), other doctors with special expertise and knowledge about a specific condition.
Screening is key to helping improve the outcomes for children who are identified with conditions such as autism, speech delays, ADHD, learning problems and more. Remember, parents can help providers by simply talking about any concerns you might about how your child is growing, learning or behaving, or whether you are feeling overwhelmed and stressed out. We are here to help.