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Developmental and autism screening through 2-1-1: reaching underserved families
Anne M Roux1, Patricia Herrera, Cheryl M Wold
1Health Communication Research Laboratory, Washington University in St Louis, St Louis, Missouri 63112, USA. aroux@wustl.edu
Insights
Telephone screening for developmental delays and autism spectrum disorders (ASDs) improved access for underserved children. This nontraditional model effectively identified at-risk youth, facilitating crucial early intervention services.
Area of Science:
- Pediatric developmental screening
- Autism spectrum disorder (ASD) identification
- Public health interventions
Background:
- Developmental disorders and ASDs are increasingly prevalent, necessitating early identification and intervention.
- Primary care access for developmental and autism screening is unequal, particularly for underserved populations.
- Nontraditional screening methods are crucial to reach diverse and low-income communities.
Purpose of the Study:
- To assess the feasibility of telephone-based developmental and autism screening in a diverse, low-income population.
- To evaluate the 2-1-1 Los Angeles County Developmental Screening Project (2-1-1 LA Project) as a nontraditional screening model.
- To enhance access to early identification services for at-risk children.
Main Methods:
- Review of aggregate data for 2845 children screened between September 2009 and October 2011.
- Utilized Parents' Evaluation of Developmental Status (PEDS) for developmental delays and Modified Checklist for Autism in Toddlers (M-CHAT) for autism risk.
- Data analysis conducted from December 2011 to February 2012.
Main Results:
- 56% of children screened with PEDS showed moderate to high risk for developmental delays (28.2% high-risk).
- 21.2% of children screened with M-CHAT had an elevated risk for ASDs.
- Care coordination facilitated referrals for diagnostic evaluation and early intervention for 2625 children.
Conclusions:
- The telephone screening approach successfully improved access to developmental and autism screenings for a hard-to-reach population.
- Findings support the potential of nontraditional developmental screening models to enhance service uptake.
- Early identification and intervention are critical for reducing challenges associated with developmental disorders.
Background:
Developmental disorders, including autism spectrum disorders (ASDs), are increasing in prevalence. Early identification is necessary for early intervention, which is critical for reducing challenges and lifetime costs, especially for ASDs. Because not all children have equal access to developmental and autism screening through primary care settings, nontraditional methods are needed to reach underserved populations.
Purpose:
In this proof-of-concept study, the 2-1-1 Los Angeles County Developmental Screening Project (2-1-1 LA Project) provided developmental and autism screening by telephone in a population of low-income and racially and ethnically diverse children.
Methods:
Aggregate data were reviewed for 2845 children who were screened for developmental delays using the Parents' Evaluation of Developmental Status (PEDS) instrument and/or autism using the Modified Checklist for Autism in Toddlers (M-CHAT) instrument between September 1, 2009, and October 31, 2011.
Results:
Data analysis was conducted December 2011 through February 2012. A majority of children (56%) screened with the PEDS had a moderate to high risk of developmental delays, including 28.2% classified as high-risk, which indicates need for further evaluation. Among 1605 children screened with the M-CHAT, 21.2% had an elevated risk of ASDs. Follow-up care coordination was provided for 2625 children to facilitate completion of referrals for diagnostic evaluation, early childhood education, and other developmental or behavioral needs.
Conclusions:
The project's approach enhanced access to screenings and referral uptake in a population of children that may have difficulty accessing primary care. Findings suggest the potential of nontraditional developmental screening models.
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