211 LA County (211 LA) provides care coordination in its pilot program aimed at screening children birth to 5 years of age using Parents’ Evaluation of Developmental Status (PEDS), PEDS Developmental Milestones (PEDS:DM) and the Modified Checklist for Autism in Toddlers (M-CHAT), these are high quality, web-based tool employed over the telephone. PEDS is an evidence-based brief screening that elicits and addresses parents’ concerns to detect 70-80% of a wide range of developmental and behavioral issues in children. The M-CHAT tests for Autism Spectrum Disorders against typically developing children.
To increase the number of low income children getting screened for developmental delays, 211 LA partnered with the Early Identification and Intervention Collaborative of Los Angeles County (includes 350 organizations across multiple sectors) dedicated to improving and expanding timely identification of and intervention for children with or at risk of delays, disabilities and other barriers of development. The partnership focused on callers to the Parent Helpline staffed by 211 LA information and referral specialists and funded by the First 5 LA Commission, created a unique and innovative approach to screen children using online evidence based screening tools to identify children birth to 5 years of age who need intervention services.
From September 2009 to October 2011, 2,845 children have been screened. A total of 28% (803) of the children screened were found to be in the highest risk category for developmental delay or disability; another 28% (782) were found to be at moderate risk and 16% (463) were at elevated risk for behavioral or mental health problems; only 28% (797) were at low risk. In addition to the PEDS, 211 LA care coordinators employed the Modified Checklist for Autism in Toddlers (M-CHAT), finding 21% of children screened having an elevated risk for Autism. These incredible outcomes motivated the Los Angeles County Office of Education-Special Education Division, the Los Angeles County Office of Education Head Start State Preschool, Comprehensive Autism Related Education, Inc., the Child Development Institute, and several other key service providers to partner with 211 LA so that children who demonstrate elevated risk receive follow-up and continuing services. This powerful regional partnership attracted grant funding from the following foundations: W.M. Keck, Weingart, S. Mark Taper; and matching grants from Robert Wood Johnson Foundation and First 5 LA to fund the specialized care coordination work at 211 LA and to expand the program to reach more children.
Results from the Intervention Early Developmental Screening:
The findings suggest that the project is consistently and continuously identifying children at a much higher risk for developmental delays and disabilities as compared to the general population. Close to 70% of the children being screened by the project are found to have some level of risk that requires follow-up and care coordination. This is disconcerting given that the proportion of children expected to have a “Path A” result from a PEDS screening is more typically 11%, while approximately 9.7% would be expected to fail the M-CHAT.