parents rather than through clinician observation, requiring minimal staff time to administer. Clinicians felt these tools also helped parents learn about child development, identify concerns, and organize questions prior to an appointment.

ABCD II found that to ensure young children’s healthy mental development and to successfully change provider practices, it was necessary not only to improve screening of young children for potential social and emotional development problems but also to help families and clinicians access resources for appropriate follow-up services. Thus, the states also undertook efforts to identify existing resources for assessment and treatment, remove policy barriers to accessing those services, and facilitate referrals. All five ABCD II states were able to increase screening in selected practices, and most states also increased the percentage of children referred for services, including assessment, secondary developmental surveillance, child psychologist evaluation, rehabilitation, early intervention, and school services. There was no consistent measurement of follow-up services received after referral, and child outcomes as a result of screening and referral were not assessed. The states also initiated policy changes that improved program coverage, reimbursement, and system performance; worked with physician practices to test and spread practice innovations; and relied on key partnerships with other state agencies and provider organizations.

Building on this work as well as other advances in the field, the ABCD Screening Academy was established in 2007. It provides technical assistance to help implement practices and policies designed to increase the use of developmental screening tools as part of the standard practice of well-child care delivered by primary care providers.

SOURCES: Pelletier and Abrams (2003); Kaye, May, and Abrams (2006); Kaye and Rosenthal (2008).