Improving Developmental and Autism Screening in Primary Care

Toddler boy standing in grassVermont has a long-standing history of collaboration in support of the provision of high-quality developmental care for children including a common set of health supervision guidelines, Bright Futures, and coordination of services under Children’s Integrated Services. In 2009, VCHIP partnered with the Departments of Health and Vermont Health Access along with the American Academy of Pediatrics and the American Academy of Family Physicians in a state-wide quality improvement project to promote guideline-based developmental care in the medical home by providing routine surveillance, recommended developmental and autism screening, and connections to evaluation and intervention services for children with a concern or with a developmental delay. 

Over the course of three years, this project impacted the developmental care of almost two-thirds of Vermont children birth to three years. Project activities included statewide surveys of primary care practices, an 18-month quality improvement intervention with 40 pediatric and family medicine practices, and parent surveys eliciting their perceptions of the delivery of preventive and developmental care in the context of well child visits.

Objectives

  • Promote guideline-based developmental care in the Medical Home by providing routine surveillance.
  • Perform recommended developmental and autism screening.
  • Connect children and families, with a concern or with a developmental delay, to evaluation and intervention services.

Accomplishments

  • Over the course of three years, this project impacted the developmental care of almost two-thirds of Vermont children birth to three years.
  • Survey results indicate that in 2009, one in four practices utilized psychometrically sound developmental screening tools. By 2011, two thirds of practices reported using such tools. In addition, in 2011, 77% of practices responding to the survey performed autism screening, a 30% increase from 2009.
  • Based on data from medical record review, approximately 70% of children had one or more factors that put them at risk for a developmental delay.
  • The proportion of children with one or more developmental screens at recommended screening visits increased from 21% to 51% from 2009-2011 (the QI intervention period).

Project Contact

Sara Barry, MPH