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Issue Brief 50 - Addressing Child Developmental Concerns Early

October 5, 2016

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Addressing Child Developmental Concerns Early:
Engaging Early Care & Education Providers in Development Monitoring & Screening

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Children who experience delays early in life are at risk for poor outcomes in education, careers and social connections in adulthood. The ability of children with developmental challenges to succeed requires the early detection of concerns and referral to appropriate treatment providers. More than 60% of children younger than five spend significant time in early care and education (ECE) settings (center, group or family-based). Thus, staff in these settings, are well positioned to work with families to identify children with developmental concerns and connect them and their families to further assessments and interventions when needed.

In 2013, the US Department of Health and Human Services, Maternal Child Health Bureau awarded Connecticut a three-year Early Childhood Comprehensive Systems (ECCS) planning grant to support an effort to enhance the ability of ECE programs to use developmental surveillance (monitoring) and screening to identify young children at risk for poor developmental outcomes and connect them to follow up services. Under the direction of the Office of Early Childhood (OEC), the United Way of CT, supported by a statewide ECCS Advisory Committee, has coordinated this effort.

Enhancing the Role of ECE Providers in Addressing Developmental Concerns: ECCS Grant Phase 1

In support of the ECCS planning process, the Child Health and Development Institute (CHDI), working with Lorentson Consulting, completed a statewide assessment using focus groups and surveys to identify how Connecticut ECE programs monitor and screen children for developmental delays, maintain data collected from these activities, communicate results to family members, and refer children with identified needs to appropriate service providers. CHDI published the results of the needs assessment in an IMPACT, Developmental Surveillance and Screening in Early Care and Education: Family and Provider Perspectives, and recommendations for improving developmental screening, coordination of results, and linkage of children and families to services in Connecticut.

 Recommendations included:

  • Provide training opportunities to a wide variety of professionals who can monitor development and administer screening;
  • Integrate monitoring and screening into the State’s initiatives focused on young children’s development;
  • Develop and maintain a data system to track monitoring, screening and connection of children to services when needed;
  • Strengthen the system of services for children who require developmental assessments and intervention services;
  • Raise public awareness among families about the importance of developmental monitoring and screening.

An Action Plan for Connecticut: ECCS Grant Phase 2

The ECCS Advisory Committee developed an action plan containing 20 possible priorities to address each of the above recommendations. In the spring of 2016, ECCS staff and consultants shared the possible priorities with community providers and parents through four community discussions and an online survey. One hundred and ninety-five responses to the survey were received, including input from several parents across the State.

Community discussions and surveys showed a high degree of support for the priorities identified by the Advisory Committee with more than 90% of respondents indicating agreement with 14 of the 20 planning priorities. Respondents were most likely to agree with the need to strengthen the existing system of services for children who require developmental assessment and intervention services, as well as activities designed to support screening in ECE settings. They were least likely to support priorities related to maintaining and sharing data.

Strengthening Connecticut’s Capacity to Identify and Support Children with Delays

As the ECCS planning work winds down, early childhood stakeholders remain committed to ensuring that Connecticut strengthens providers’ and parents’ capacity to detect risk for development delays early and connect children for whom there are concerns to intervention services. Activities underway include:

  • A subcommittee of the ECCS Advisory Committee prepared, and the United Way has posted, a free developmental monitoring toolkit and online educational tutorial for ECE providers
  • CHDI continues to train child health providers in developmental monitoring and screening and to monitor implementation in practice sites across Connecticut.
  • Child Development Infoline has remodeled its website to improve access to developmental information, tools, and community resources for families and providers.
  • The results of screening completed by community providers will be included in Birth to Three online referral forms.
  • The OEC will highlight the importance of developmental monitoring and screening as part of the orientation and ongoing training and professional development of child care providers who receive the Care4Kids subsidy.
  • Connecticut Children’s Office for Community Child Health is disseminating a mid-level developmental assessment model to ensure that children with mild and moderate developmental concerns, who will not quality for Birth to Three, receive assessment and connection to community services.

The ECCS Advisory Committee recognizes that continuation of this work and initiation of additional enhancements requires an integrated system in which health, mental health, early care and education, home visiting and other services work together. Stakeholders will continue to meet regularly to monitor progress in addressing recommendations and priorities identified and supported by the ECCS planning process.

For more information, visit or contact Lisa Honigfeld at or 860-679-1523.