Improving Pediatric Developmental Screening and Communication: A CME

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DESCRIPTION (provided by applicant): Developmental delays are common in early childhood, affecting at least 10 percent of children. While a delay does not always indicate an underlying condition, developmental delays are markers for more severe developmental conditions including autism, intellectual disability, and speech and language disorders. The tremendous adaptability of the brain in the first three years of life means that early treatment of delays leads to improved outcomes, whereas later intervention is less effective.1-3 In order to provide treatment to improve children's outcomes, early identification of delays and sensory impairments by pediatric primary care providers during their first three years of a child's life is critical. There is a tremendous need for and interest in early identification of children at risk fr development problems, with vast attention to this topic by leading organizations for pediatric health. The American Academy of Pediatrics (AAP) released updated recommendations on Developmental Surveillance and Screening in the Medical Home in 20065 and Autism Screening in 20076; the NICHD emphasize the need for Early Identification and Interventions for Infants and Young Children at Risk for Mental Retardation; and AHRQ has issued a Special Emphasis Notice for research on diagnostic errors (including delay in diagnosis) in the ambulatory care setting.7 Two key gaps noted in a recent AHRQ recommendation statement8 included the needed for screening strategies in diverse populations, and translating effective, evidence-based screening approaches for use in primary care practices. Screening tools are available for general developmental screening, but with no consensus on the specific screens to use in practice. While screening is being increasingly adopted by pediatricians, they often remain uncomfortable discussing the results with parents. This program addresses the need for educational materials that: ¿ bring together information to assist pediatric primary care providers in choosing tools from among those provided in the 2006 AAP recommendations5; ¿ provide guidance on implementation of screening in practice; and ¿ assist them to effectively communicate the purpose and results of these screens in practice. The key goals of this program directly address some of the difficulties involved in implementing developmental screening in practice. This resource will inform providers about the importance and challenges of conducting developmental screening; assist providers in understanding and communicating those results to parents, and identifying and acknowledging cultural considerations in screening strategies and delivery of results. The specific aims are: Specific Aim 1: To develop the full clinical content for a CME/CE program that will focus on implementation of the use, benefits, and limitations of development screening tools in primary care and communication of results. Specific Aim 2: Complete the web based CME/CE program based on the clinical content outline and findings from the Phase I grant, including culturally and socioeconomically diverse pediatric populations. Specific Aim 3: Conduct a rigorous evaluation of the program with pediatric primary care providers.