Developmental Surveillance and Screening: Birth through 6 Years
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).
Credit Hours: 1.00 CE
EnrollGoal
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 ages 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 ages birth through 6 years.
- Specify how to respond when parents or caregivers express concern about a child’s development or behavior.
- Employ the validated standardized 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: References to parents in this module also imply guardians and caregivers.
Please note this module expires on 10/12/2026.
This module was released on 10/12/2023.
Featured
- American Academy of Pediatrics. (2019). Incorporating Recognition and Management of Perinatal Depression Into Pediatric Practice. Pediatrics, 143(1): e20183259.
- American Academy of Pediatrics. (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.
- Centers for Disease Control and Prevention. (2023). Why Act Early if You’re Concerned about Development? (English | Español)
- Centers for Disease Control and Prevention. (2022). Developmental Surveillance Resources for Healthcare Providers.
- Centers for Disease Control and Prevention. (2022). Facts About Developmental Disabilities.
- Centers for Disease Control and Prevention. (2023). Learn the Signs. Act Early: CDC's free Milestone Tracker.
- Centers for Disease Control and Prevention, Autism Spectrum Disorder (ASD). (2023). Data & Statistics on Autism Spectrum Disorder.
- Cogswell, M. E., Coil, E., Tian, L. H., Tinker, S. C., Ryerson, A. B., Maenner, M. J., Rice, C. E., & Peacock, G. Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report (MMWR). (2022). Health Needs and Use of Services Among Children with Developmental Disabilities—United States, 2014–2018. 71(12):453–458.
- 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.
- Khan I., & Leventhal B.L. (2023). Developmental Delay. StatPearls Publishing.
- Lipkin, P. H., & Macias, M. M., AAP Council on Children with Disabilities, Section on Developmental and Behavioral Pediatrics. American Academy of Pediatrics. (2020). Promoting Optimal Development: Identifying Infants and Young Children with Developmental Disorders through Developmental Surveillance and Screening. Pediatrics. 145(1): e20193449
- Raspa, M., Levis, D. M., Kish-Doto, J., Wallace, I., Rice, C., Barger, B., Green, K. K., & Wolf, R. B. Examining Parents' Experiences and Information Needs Regarding Early Identification of Developmental Delays: Qualitative Research to Inform a Public Health Campaign. (2015). Journal of Developmental and Behavioral Pediatrics. 2015;36(8):575-585.
- Tofani, M., Scarcella, L., Galeoto, G., Giovannone, F., & Sogos, C. Behavioral gender differences across Pre-School Children with Autism Spectrum Disorders: a cross-sectional study. (2023). J Autism Dev Disord. 53(8):3301-3306.
- U.S. Department of Education. The Individuals with Disabilities Education Act (IDEA).
- 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. American Academy of Pediatrics. (2019). Prevalence and Trends of Developmental Disabilities among Children in the United States: 2009–2017. Pediatrics, 144(4): e20190811.
- Zubler, J. M., Wiggins, L. D., Macias, M. M., et al. American Academy of Pediatrics. (2022). Evidence-Informed Milestones for Developmental Surveillance Tools. Pediatrics, 149(3): e2021052138.
Medical Definitions
The medical definitions in this module were obtained or adapted from the National Institute of Neurological Disorders and Stroke and the U.S. National Library of Medicine.
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 1.00 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 1.00 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 1.00 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 1.00 total entry-level Category I contact education contact hours.
Certificate of Attendance
The Texas Department of State Health Services, Continuing Education Service has designated 1.00 hour(s) for attendance.
General Disclosure
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).
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Health-Care Providers
- American Academy of Pediatrics. Medical Home.
- American Academy of Pediatrics. Screening Technical Assistance and Resource (STAR) Center.
- Ages & Stages Questionnaires. ASQ Online: Buiild a Better Screening System with ASQ Online.
- Centers for Disease Control and Prevention. CDC's Developmental Milestones. Available in English and Spanish.
- Centers for Disease Control and Prevention. Free Materials on Developmental Disabilities. Available in English and Spanish.
- Case Western Reserve University, Jack, Joseph and Morton Mandel School of Applied Social Sciences Center for Evidence-Based Practices. Motivational Interviewing Resources.
- Child Health and Development Interactive System (CHADIS).
- Texas Health and Human Services, Early Childhood Intervention Services (ECI). ECI Information for Health and Medical Professionals.
- Texas Health and Human Services, Early Childhood Intervention Services (ECI). ECI Qualifying Diagnosis Search.
- Texas Health and Human Services, Early Childhood Intervention Services (ECI). Make a Referral to ECI.
- First Signs.
- The Modified Checklist for Autism in Toddlers (M-CHAT R/F).
- Motivational Interviewing Network of Trainers (MINT).
- PEDStest. For Texas Users.
- Relay Texas: Dial 7-1-1. Available in English and Spanish.
- Texas Department of State Health Services. Texas Early Hearing Detection and Intervention (TEHDI).
- Texas Education Agency. Special Education.
- Texas Department of Family and Protective Services. Texas Home Visiting (THV): In-home parent education for families with children 0-5 years of age.
- Texas Health Steps. Anticipatory Guidance Provider Guide.
- Texas Health and Human Services, Texas Heath Steps. Checkup Components.
- Texas Health and Human Services, Texas Heath Steps. Forms: Medical Checkup.
- Texas Health Steps Medical Checkup Periodicity Schedule for Infants, Children and Adolescents.
- Texas Health Steps Medical Checkups: Preventive Care for Infants Postpartum Depression Screening.
- Texas Medicaid & Healthcare Partnership. Provider Search.
- Texas Medicaid & Healthcare Partnership. Texas Medicaid Provider Procedures Manual.
- Texas Medicaid & Healthcare Partnership. Texas Health Steps Comprehensive Care Program.
Families
- American Academy of Pediatrics, healthychildren.org. What is a Developmental-Behavioral Pediatrician?
- Centers for Disease Control and Prevention. Free Materials on Developmental Disabilities.
- Centers for Disease Control and Prevention. (2023). Developmental Monitoring and Screening.
- Centers for Disease Control and Prevention. (2023). Learn the Signs. Act Early: CDC's free Milestone Tracker.
- Navigate Life Texas: For families raising children with disabilities. Early Childhood Special Education Program (ECSE). Available in English and Spanish.
- Nemours KidsHealth. (2022). Delayed Speech or Language Development.
- Texas Department of Family and Protective Services. Texas Home Visiting (THV): In-home parent education for families with children 0-5 years of age.
- Texas Health and Human Services, Early Childhood Intervention Services. ECI Library Collection. Available in English and Spanish.
- Texas Parent to Parent.
- The Arc@School.
- The Arc of Texas. Individuals with Disabilities Education Act Manual. (2018).
- U.S. Department of Health and Human Service, Office of Early Childhood Development. (2017). Birth to 5: Watch Me Thrive - Families.
- Zero To Three.