Implementation of a Developmental Screening Program in a Childcare Setting

BACKGROUND: Children are not receiving the developmental support that is recommended due to multiple barriers in current practice of screening in primary care. Developmental delays are most effectively treated during early childhood and pose multiple consequences if they go unidentified and untreated.

LOCAL PROBLEM: Screening rates are significantly low in East Tennessee. An East Tennessee childcare center did not yet have a process for supporting development through screening or referrals. This project aimed to provide developmental screening to 75% of eligible children, share results with parents of at least 95% of those children, and refer at least 95% of children who are identified as at risk for developmental delays to their healthcare provider.

METHODS: The Evidence-based Practice Improvement (EBPI) model served as the guiding framework for this Doctor of Nursing Practice (DNP) project. The screening tools utilized in this project are the Ages and Stages Questionnaire, 3^rd edition (ASQ-3), and the Ages and Stages Social-Emotional Questionnaire, 2^nd edition (ASQ-SE2). Data on participation rates, screening rates, and referral rates were collected during a six-week implementation period.

INTERVENTIONS: Screenings were completed by the child’s parents and teacher. Based on the results, recommendations may have included following up with a pediatric healthcare provider, completing learning activities with the possibility of rescreening, or proceeding as advised by the healthcare provider. Resources to promote development were provided to the childcare center staff and parents.

RESULTS: 62.5% of enrolled children had parental permission to undergo screening. Out of 25 children, 22 received screenings from their parents, while all 25 were screened by their teachers. 20% of the screened students were referred to their healthcare provider, and every suspect screening was referred.

CONCLUSIONS: Utilizing a validated and reliable standardized tool for developmental screening in childcare settings may lead to earlier identification of developmental delays, allowing for prompt intervention and treatment.