Early Identification & Screening
Early Identification refers to a parent, educator, health professional, or other adult’s ability to recognize developmental milestones in children and to understand the value of early intervention.
Screening refers to the use of standardized developmental or autism specific assessments to identify
delays in development that may indicate the need for further evaluation.
Quality Indicators / Problems / Data Drivers
QI 1.1: All children receive coordinated broad developmental and autism-specific screening at prescribed intervals, as well as when concerns are raised about a child's development.
Problem: Many primary care practices do not follow the recommended guidelines for screening with standardized developmental or autism-specific assessments. Additionally, many parents feel that their concerns about their child’s development are not taken seriously by their primary care providers. Finally, parents across the general population may not be aware of typical development, signs of concern, and need for screening.
Data Drivers: The American Academy of Pediatrics (AAP) has adopted the Bright Futures guidelines which recommend that developmental surveillance be incorporated into the 9, 18, and 30-month well- child visits, and autism-specific screening at the 18 and 24-month visits.1 In addition, parental concerns raised during surveillance should be promptly addressed with standardized developmental screening tests.1
QI 1.2: Developmental concerns of all children are recognized early as part of routine surveillance and screening.
Problem: If developmental concerns are not recognized by parents or providers, children may not be screened or diagnosed, and thus may not receive early intervention services.
Data Driver: Children who are screened are more likely to receive early intervention services than their unscreened peers.2
QI 1.3: If developmental concerns are identified, families receive timely referrals for evaluation.
Problem: There are often long delays between screening and referral, as well as between referral and diagnostic appointments. This is especially true for rural families, who experience greater difficulty accessing services.
Data Drivers: Most parents identify concerns related to their children’s development by 18 to 24 months, 2 to 3 years prior to the average age of diagnosis.3, 4 The delay between an identified parental concern and diagnosis is longer for children from rural areas than those from urban areas; these children are diagnosed at later ages than urban children as well.5