Published online February 1, 2006
PEDIATRICS Vol. 117 No. 2 February 2006, pp. 591 (doi:10.1542/peds.2005-2793)
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Developmental and Behavioral Services and Child Welfare

Edward L. Schor, MD
Child Development and Health Promotion,
The Commonwealth Fund,
New York, NY 10021

To the Editor.—

The recent article by Stahmer et al1 highlights the continuing inability of our public systems, starting with the child welfare system, to recognize and address the developmental and emotional needs of vulnerable children. Federal law now requires that young children aged 0 to 3 years in the foster care system be referred for evaluation by early-intervention programs in each state.2 However, Stahmer et al found that those referrals are being completed for only a small portion of these children.

Many other children are known to the child welfare system, but the review of their cases results in their remaining in or returning to their homes rather than entering foster care. These children are also at high risk for developmental and behavioral problems, but they are not eligible for automatic referral. Consequently, many high-risk children fail to be evaluated and treated for developmental and behavioral problems.

Child welfare workers must be better informed about the high prevalence of developmental and behavioral problems in the populations they serve. They must be better equipped to appropriately screen or refer all children with whom they come in contact. In turn, child health care providers must assist social service agencies and staff in implementing screening and referral protocols. They also must integrate developmental services into their own practices to better serve all their patients. Professionals in child welfare, pediatrics, early child care and education, public health, and other services should collaborate to build systems and service pathways to address the gap in identifying and treating children with or at risk for developmental and behavioral problems.

REFERENCES

  1. Stahmer AC, Leslie LK, Hurlburt M, et al. Developmental and behavioral needs and service use for young children in child welfare. Pediatrics. 2005;116 :891 –900[Abstract/Free Full Text]
  2. Individuals With Disabilities Education Improvement Act of 2004, Pub L No. 108–446, Part C, §637(a)(6)(A&B)
PEDIATRICS (ISSN 1098-4275). ©2006 by the American Academy of Pediatrics



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