Welcome to the training on Developmental Surveillance and Screening: Birth through 6 Years provided by the Texas Health and Human Services Commission (HHSC) and the Texas Department of State Health Services (DSHS).
Goal
The goal of this module is to equip Texas Health Steps providers and others to conduct developmental surveillance and screening during preventive medical checkups for children birth through 6 years, use approved screening tools, make appropriate referrals, and coordinate care in the primary care setting.
Target Audience
Texas Health Steps providers and other interested health-care professionals.
Specific Learning Objectives
After completing the activities of this module, you will be able to:
- Apply the requirements of the Texas Health Steps Periodicity Schedule for developmental surveillance and screening of children birth through 6 years.
- Specify how to respond when parents or caregivers express concern about a child’s development or behavior.
- Employ the validated screening tools approved by Texas Health Steps.
- Based on stated criteria and patient needs, determine appropriate referrals for a child who is at risk for, or determined to have, a developmental delay or disorder.
Note: In this course, the term "parent" also refers to guardians and other caregivers.
Please note this module expires on 8/18/2023.
This module was released on 8/18/2020.
Accreditation Statement
Continuing Medical Education
The Texas Department of State Health Services, Continuing Education Service is accredited by the Texas Medical Association to provide continuing medical education for physicians.
The Texas Department of State Health Services, Continuing Education Service designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Continuing Nursing Education
The Texas Department of State Health Services, Continuing Education Service is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The Texas Department of State Health Services, Continuing Education Service has awarded 1.25 contact hour(s) of Continuing Nursing Education.
Social Workers
The Texas Department of State Health Services, Continuing Education Service under sponsor number CS3065 has been approved by the Texas State Board of Social Worker Examiners to offer continuing education contact hours to social workers. The approved status of The Texas Department of State Health Services, Continuing Education Service expires annually on December 31. The Texas Department of State Health Services, Continuing Education Service has awarded 1.25 contact hour(s) of Continuing Social Work Education.
Certified Health Education Specialists
Sponsored by The Texas Department of State Health Services, Continuing Education Service, a designated provider of continuing education contact hours (CECH) in health education by the National Commission for Health Education Credentialing, Inc. This program is designated for Certified Health Education Specialists (CHES) and/or Master Certified Health Education Specialists (MCHES) to receive up to 1.25 total entry-level Category I contact education contact hours.
Certificate of Attendance
The Texas Department of State Health Services, Continuing Education Service has designated 1.25 hour(s) for attendance.
Disclosures
One of the requirements of continuing education is disclosure of the following information to the learner:
- Notice of requirements for successful completion of continuing education activity. To receive continuing education credit the learner must successfully complete the following activities:
- Create a Texas Health Steps account.
- Complete on-line registration process.
- Thoroughly read the content of the module.
- Complete the on-line examination.
- Complete the evaluation.
- Commercial Support.
The THSTEPS Web-based Continuing Education Series has received no commercial support. - Disclosure of Relevant Financial Relationships.
The THSTEPS Continuing Education Planning Committee and the authors of these modules have no relevant financial relationships to disclose. - Non-Endorsement Statement.
Accredited status does not imply endorsement of any commercial products or services by the Department of State Health Services, Continuing Education Service; Texas Medical Association; or American Nurse Credentialing Center. - Off-Label Use.
Using a disclosure review process, the THSTEPS Continuing Education Planning Committee has examined documents and has concluded that the authors of these modules have not included content that discusses off-label use (use of products for a purpose other than that for which they were approved by the Food and Drug Administration).
The following are policies and definitions of terms related to continuing education disclosure:
The intent of disclosure is to allow Department of State Health Services (DSHS) Continuing Education Service the opportunity to resolve any potential conflicts of interest to assure balance, independence, objectivity and scientific rigor in all of its Continuing Education activities.
All faculty, planners, speakers and authors of Department of State Health Services (DSHS) Continuing Education Service sponsored activities are expected to disclose to the Department of State Health Services (DSHS) Continuing Education Service any relevant financial, relationships with any commercial or personal interest that produces health care goods or services concerned with the content of an educational presentation. Faculty, planners, speakers and authors must also disclose where there are any other potentially biasing relationships of a professional or personal nature.
Glossary of Terms
Conflict of Interest: Circumstances create a conflict of interest when an individual has an opportunity to affect Continuing Education content about products or services of a commercial interest with which she/he has a financial relationship or where there are any other potentially biasing relationships of a professional or personal nature.
Commercial Interest: Any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.
Financial Relationships: Those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, teaching, membership on advisory committees or review panels, board membership, and other activities for which remuneration is received or expected. Relevant financial relationships would include those within the past 12 months of the person involved in the activity and a spouse or partner. Relevant financial relationships of your spouse or partner are those of which you are aware at the time of this disclosure.
Off Label: Using products for a purpose other that that for which it was approved by the Food and Drug Administration (FDA).
Browser Requirements
Texas Health Steps courses are best viewed using a current browser. If you are using an out-of-date browser or a version of Internet Explorer less than 11, lesson progress and interactive features may not function properly.
- American Academy of Pediatrics, Building Your Medical Home.
- American Academy of Pediatrics, Star Center Screening Tools, Online screening tool finder
- Ages and Stages Questionnaire (ASQ) website.
- Ages and Stages Questionnaire (ASQ) Family Access website.
- Birth to 5: Watch Me Thrive! A Primary Care Providers Guide for Developmental and Behavioral Screening from the U.S. Department of Health and Human Services and the U.S. Department of Education.
- Centers for Disease Control and Prevention. Milestones in Action, a free library of photos and videos of developmental milestones.
- Centers for Disease Control and Prevention. Developmental Milestones, free checklists, downloadable resource materials and videos.
- Centers for Disease Control and Prevention. Developmental Disabilities: Free Materials, free resource materials about ADHD, ASD, fetal alcohol spectrum disorders, fragile X syndrome and other developmental disorders.
- Center for Evidence-Based Practices at Case Western Reserve University. Motivational interviewing resources, including a workbook for practitioners on building MI skills and “Motivational Interviewing: Helping People Change” (Miller & Rollnick, 2013) and training.
- Child Health and Development Interactive System (CHADIS).
- Edinburgh Postnatal Depression Scale (EPDS) to screen mothers for depression.
- Early Childhood Intervention (ECI), Texas Health and Human Services Commission.
- Early Childhood Intervention (ECI) Referral Form for Physicians.
- ECI Qualifying Diagnosis Search.
- Edinburgh Postnatal Depression Scale.
- First Signs, an educational website about developmental disabilities.
- Modified Checklist for Autism in Toddlers M-CHAT and M-CHAT-R/F questionnaires.
- Motivational Interviewing Network of Trainers (MINT), an international organization of trainers in motivational interviewing.
- Parents’ Evaluation of Developmental Status (PEDS). Texas-specific information about PEDS and PEDS:DM.
- Patient Health Questionnaire.
- Postpartum Depression Screening Scale.
- Relay Texas. Telephone access for people with speech or hearing loss who find it challenging or impossible to use a traditional telephone.
- Texas Early Hearing Detection and Intervention (TEHDI). Provides services to children to prevent delays in vocabulary, communication, and cognitive skills development.
- Texas Education Agency, information about special education services.
- Texas Department of Family and Protective Services. Texas Home Visiting.
- Texas Health Steps, Anticipatory Guidance–A Guide for Providers.
- Texas Health Steps Checkup Components.
- Texas Health Steps. Medical Checkup, including Clinical Record Forms and Developmental and Health Screening Tools.
- Texas Health Steps, Periodicity Schedule.
- Texas Medicaid & Healthcare Partnership (TMHP). Texas Medicaid Provider Procedures Manual (TMPPM).
- Texas Medicaid & Healthcare Partnership (TMHP), monthly updates to TMPPM.
- Texas Medicaid & Healthcare Partnership (TMHP), Online Provider Lookup
- Texas Medicaid Provider Procedures Manual (TMPPM), Comprehensive Care Program.
- American Academy of Pediatrics, healthychildren.org. What is a Developmental-Behavioral Pediatrician?
- Centers for Disease Control and Prevention, Developmental Monitoring and Screening.
- Centers for Disease Control and Prevention, Learn the Signs. Act Early.
- Centers for Disease Control and Prevention. Developmental Disabilities: Free Materials, free resource materials about ADHD, ASD, fetal alcohol spectrum disorders, fragile X syndrome and other developmental disorders.
- First Signs. Hallmark Developmental Milestones.
- HelpGuide.org. Autism Symptoms and Early Signs.
- KidsHealth.org. Delayed Speech or Language Development.
- Navigate Life Texas. Information about early childhood special education, including tips for parents about how to access this service for their children.
- Parent Companion: First Five Years. A peer guide for Texas parents and caregivers of children with diagnosed or suspected disabilities from birth through 5 years of age.
- Protected Tomorrows. The Importance of Developmental Screening for Children.
- Texas Department of Family and Protective Services. Texas Home Visiting. Home Instruction for Parents of Preschool Youngsters (HIPPY).
- Texas Department of Family and Protective Services. Texas Nurse-Family Partnership.
- Texas Department of Family and Protective Services. Texas Home Visiting. Texas Parents as Teachers Sites.
- Texas Department of State Health Services, Audiovisual Library ECI collection. Any Texas resident can check out videos, books, assessment instruments, audio resources and medical journals about children who have disabilities or developmental delays.
- Texas Parent to Parent. Family peer support, information and education for families of children of all ages who have disabilities or chronic illness.
- The Arc@School. This website from The Arc provides individual advocacy, training and resources to help families and other stakeholders navigate the special education system.
- The Arc of Texas. Individuals with Disabilities Education Act Manual (2018). Contains a variety of resources for parents, including templates for letters requesting assessment for special education and other services.
- U.S. Department of Health and Human Services and U.S. Department of Education. Birth to 5: Watch Me Thrive! web page for families.
- Zero to Three. Information about early development and well-being.
- American Academy of Pediatrics. (2020). Principles of Financing the Medical Home for Children. Pediatrics, 145(1): e20193451.
- American Academy of Pediatrics. (2019). Technical Report: Incorporating Recognition and Management of Perinatal Depression Into Pediatric Practice. Pediatrics, 143(1), e20183259.
- American Academy of Pediatrics Policy Statement. (2006/2014). Identifying Infants and Young Children with Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening. Pediatrics, 118(1), 405-420.
- American Academy of Pediatrics. (2002/2008). Policy Statement: The Medical Home. Pediatrics, 110, 184–186.
- Centers for Disease Control and Prevention. (2020). Why Act Early if You’re Concerned about Development?
- Centers for Disease Control and Prevention. (2020). Data & Statistics on Autism Spectrum Disorder: Prevalence.
- Centers for Disease Control and Prevention. (2019). Increase in Developmental Disabilities Among Children in the United States.
- The Children’s Hospital of Philadelphia Policy Lab. (2014). Watch Them Thrive: The Case for Developmental Screening.
- Glascoe, F. P., & Marks, K. P. (2011). Detecting children with developmental-behavioral problems: The value of collaborating with parents. Psychological Test and Assessment Modeling, 53(2), 258-279.
- Mackrides, P. S., & Ryherd, S. J. (2011). Screening for developmental delay. American Family Physician, 84(5), 544-9.
- Marceau, L., Sices, L., Ranganathan, G., Coleman, J., Zuckerman, B. (2018). Effect of a Web-based Course for Pediatricians on Communication About Developmental Screening. Pediatrics, 141 (1 Meeting Abstract) 28.
- Raspa, M., Levis, D. M., Kish-Doto, J., Wallace, I., Rice, C., Barger, B., Green, K. K., & Wolf, R. B. (2015). Examining Parents' Experiences and Information Needs Regarding Early Identification of Developmental Delays: Qualitative Research to Inform a Public Health Campaign. Journal of Developmental and Behavioral Pediatrics, 36(8), 575–585.
- U.S. Department of Education. The Individuals with Disabilities Education Act (IDEA) Amendments of 1990 to 1997.
- Zablotsky, B., Black, L. I., Maenner, M. J., Schieve, L. A., Danielson, M. L., Bitsko, R. H., Blumberg, S. J., Kogan, M. D., & Boyle, C. A. (2019). Prevalence and Trends of Developmental Disabilities among Children in the US: 2009–2017. Pediatrics, 144(4), e20190811.
The medical definitions in this module were obtained or adapted from the Centers for Disease Control and Prevention and the U.S. National Library of Medicine.
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