IMPACT Executive Summary

A Better Way to Assess Developmental Needs in Early Childhood Systems: Mid-Level Developmental Assessment

Mid-Level Developmental Assessment (MLDA) is designed to promote efficient identification of needs and linkage to helpful services for children with mild and moderate behavioral and developmental concerns, who will not qualify for publicly funded early intervention services. It is family-centered, strength-based, uses standardized assessment tools, and results in a set of recommendations that can help ensure children arrive at kindergarten ready to learn. Although national and state mandates suggest that a system of early identification and linkage to services is in place for young children, gaps in follow up assessment services, stringent eligibility requirements for publicly funded programs, and lack of comprehensive system coordination cause many children to miss out on helpful early services that could put their development on a positive trajectory toward school and life success. 

It is estimated that while approximately 13% of young children have severe delays warranting intensive intervention, a far greater proportion of children (approximately 30%) have delays that are mild to moderate. In some states, as many as 35% of children who receive full developmental evaluations following identification of developmental concerns do not qualify for publicly funded services. Parents and providers, upon learning that a child is not eligible for early intervention programs, do not pursue any further services, and concerns go unaddressed until kindergarten, when children are already far behind their typically developing peers. MLDA closes the gap between development surveillance and screening and full evaluation for children with mild and moderate delays. 

The implementation of MLDA across several communities highlights important considerations for further diffusion of the service. These recommendations are further explored within the IMPACT. 

1. Embed MLDA within a broad continuum of resources to which young children and families can be referred for assessment and evaluation. 
2. Reimburse a range of personnel who perform MLDA.
3. Implement MLDA within early childhood services that have mechanisms for early identification of children at risk for delay.
4. Expand community resources to address the needs of children who will not qualify for Part C or Part B programs.
5. Support MLDA with care coordination to ensure that children and families are linked to services.
6. Reframe and develop policy to support the role of early childhood assessment services from one of determining eligibility to one of identifying needs and linking to services to ensure healthy development.

Download this executive summary.

Learn more  about our work supporting the development, pilot testing, and diffusion of Mid-Level Developmental Assessment.