Published online July 3, 2006
PEDIATRICS Vol. 118 No. 1 July 2006, pp. e183-e188 (doi:10.1542/peds.2006-0475)
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SPECIAL ARTICLE

Setting the Stage for Success: Implementation of Developmental and Behavioral Screening and Surveillance in Primary Care Practice—The North Carolina Assuring Better Child Health and Development (ABCD) Project

Marian F. Earls, MD, FAAPa and Sherry Shackelford Hay, BSW, MPAb

a Guilford Child Health, Inc, and Department of Pediatrics, University of North Carolina School of Medicine, Greensboro, North Carolina
b ABCD and Special Programs, Office of Rural Health and Community Care of North Carolina, Raleigh, North Carolina

Early identification of children with developmental and behavioral delays is important in primary care practice, and well-child visits provide an ideal opportunity to engage parents and perform periodic screening. Integration of this activity into office process and flow is necessary for making screening a routine and consistent part of primary care practice. In the North Carolina Assuring Better Child Health and Development Project, careful attention to and training for office process has resulted in a significant increase in screening rates to >70% of the designated well-child visits. The data from the project prompted a change in Medicaid policy, and screening is now statewide in primary practices that perform Early Periodic Screening, Diagnosis, and Treatment examinations. Although there are features of the project that are unique to North Carolina, there are also elements that are transferable to any practice or state interested in integrating child development services into the medical home. Included here are lessons learned and a listing of practical tools for implementation.

Key Words: assessment and surveillance • quality of care • developmental care • clinical practice

Abbreviations: AAP—American Academy of Pediatrics • ABCD—Assuring Better Child Health and Development • EPSDT—Early Periodic Screening, Diagnosis, and Treatment • ASQ—Ages and Stages Questionnaire

Accepted Apr 10, 2006.


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