Last updated: 6-10-03

Federal programs

1. Bright Futures
   The goal of Bright Futures is to respond to the current and emerging preventive health promotion of infants, children, and adolescents. It 1) develops and disseminates materials for health professionals and families to implement the Bright Futures approach, 2) fosters partnerships among families, health professionals, and communities, and 3) encourages family participation in health promotion and disease prevention activities. It has created guidelines for health supervision for infants, children, and adolescents (since 1995 more than 1.3 million copies of guidelines have been distributed), and it also builds on the guidelines by providing tools and resources for health care providers and families.

   • Population and sample Works through influencing health professionals

   • Funded by Maternal Child Health Bureau (MCHB)

   • Administered by: Often MCHB in collaboration with other public or private organizations (for example, HMO’s and universities)

   • Duration Initiative was launched in 1990

   • Additional comments In 2002, MCHB began a partnership with the American Academy of Pediatrics (AAP) to carry on the Bright Futures initiative. One result of this is that AAP will establish the Bright Futures Health Promotion/Prevention Education Center to serve as the national hub for Bright Futures activities. The second result is a project that will focus on implementation of Bright Futures among pediatric providers.

   • Website http://www.mchb.hrsa.gov/programs/training/brightfutures.htm
      

2. Child Find Demonstration Projects:
   Child Find is a continuous process of public awareness activities, screening, and evaluation. It is designed to locate, identify, and refer, as early as possible, all young children with disabilities and their families who are in need of early intervention (Part C) or preschool special education (Part B), as mandated through the Individuals with Disabilities Education Act (IDEA). Each statewide Child Find system should include procedures for screening of health and development. Use of standardized, validated, accurate measures is highly recommended and informal detection methods (checklists, observations, review of milestones, or use of selected items on validated screening tools, etc.) are not. Some states encourage parents and caregivers to ask questions about a child’s health or development that might lead to screening and/or evaluation.
   
   There are six Child Find Demonstration Projects, five of which are relevant to DS, they are: Interagency Collaboration for Colorado Part C Child Find in Denver, CO; Strategies for Effective and Efficient "Keiki" (Child) Find (Project SEEK) in Honolulu, HI; Promoting Early Identification and Support for Families of Young Children: The Early Connections Project in Durham, NH; Dynamic Community Connections: A Process Model for Enhancing Child Find in Rural Areas in Missoula, MT; and Creating Partnerships between Pediatric Practitioners and Early Developmental Interventionists for Child Find (PEDI-Link) in Burlington, VT. Most of these projects work with health professionals and or intervention specialists.

   • Intervention population intervention on health professionals and intervention specialists in 5 states for improving services for the infants and children in those states.

   • Funded by Office of Special Education Programs, Department of Education

   • Run by Faculty and staff at a university in given state

   • Duration Most were funded in 1998 through 1999, for a 2 to approximately 4 year period.

   • Findings related to developmental screening

     • Hawaii Child Find Project: Through an intervention that involved a presentation series for primary care physicians (PCP’s) to address knowledge and attitude towards early intervention, they increased PCP referral rate. There was a highly significant difference between intervention and comparison communities (Spearman’s rho of r equal to -0.564, with P greater than or equal to 0.002).

     • New Hampshire Child Find Project: In two years, they increased the number of children 0 to 3year-of-age served by Part C in four of six regions, by 13% to 66%. Also, they increased the number of infants (0 to 1years-of age) served by Part C in four out of six regions and slightly statewide.

   • Data availability Some of the projects have reported their data (for example, Hawaii), while other have not made their preliminary findings public (e.g. Vermont).

   • Website http://www.nectac.org/topics/earlyid/chfindproj.asp
      

3. Title V
   Title V was converted to a block grant as part of the Omnibus Budget Reconciliation Act of 1981. Therefore, states annually apply for this grant, through a process of stating their objectives for spending. They must spend 30% of the grant allocations on preventive and primary care for children and youth, and 30% on services for children with special health care needs (CSHCN). Through the grant, states seek to ensure maternal and child health services, as well as those for CSHCN, through a variety of programs and initiatives. They are required to report the results of these programs and initiatives. Because of the flexibility of Title V, the grant can be an originating and supportive source for child development programs.

   • Population and sample Maternal and child health population and CSHCN in US

   • Funded by Maternal and Child Health Bureau

   • Administered by Title V/ CSHCN state agencies

   • Duration Annually apply for grant; continuous

   • Data availability A national survey was conducted on care coordination through surveying Title V state agencies (see national datasets document). Also, through applications and reports that are submitted annually by all 59 U.S. States, Territories, and Jurisdictions, information on key measures of maternal and child health (MCH) in the United States is collected. This information is captured electronically through the Title V Information System (TVIS).

   • Website
     For links to states and contacts http://cshcnleaders.ichp.edu/TitleVDirectory/directory.htm
     For fact sheet http://www.amchp.org/news/MCHBlockGrant2002.pdf

Foundation or private organization programs

1. Assuring Better Child Health and Development (ABCD) Program:
   This is a policy-oriented initiative that complements the Healthy Steps program by identifying policy changes to Medicaid, state Children’s Health Insurance Program, and community health centers that will help ensure a healthy start for children of low-income families. Because states have primary responsibility for implementing health care programs for low income families, ABCD works with state Medicaid agencies to develop projects. ABCD also includes efforts to improve national policies and develop and promote effective models of care that emphasize healthy child development. The program involves four state initiatives: North Carolina, Utah, Vermont, and Washington. The states are creating service models that may include developmental screening, referral, service coordination, and the provision of educational materials and resources for both parents and clinicians serving Medicaid children.
   
   A team of researchers from Northwestern University (led by Peter Budetti) and New York University (led by Carolyn Berry) are conducting a national process evaluation of ABCD and are coordinating with local evaluators for outcomes evaluation.

   • Population and sample Medicaid enrollees in four states

   • Funded by The Commonwealth Fund

   • Run by National Academy of State Health Policy (NASHP), which identified the states to fund and provided them with technical assistance

   • Duration Began in 1999, there is a five year evaluation; therefore, expected to end in 2004.

   • Data availability After 2004

   • Website http://www.cmwf.org/programs/prog_desc.asp?id=6
      

2. Healthy Steps for Young Children Program:
   This is a national initiative that works with health care practices and focuses on the importance of the first three years of life. It involves adding a new member to the health care team, the Healthy Steps Specialists (specialist in child development), to enhance the information and services parents receive about major behavioral and developmental issues. Clinical sites offer a comprehensive range of services for parents of young children from birth to three, including: well-child visits, home visits, tools to gauge child development and family health, parent groups, a child development telephone line, written material for parents, and links to community resources.
   
   An evaluation of this initiative began in 1995 by researchers at Johns Hopkins (Led by Bernard Guyer, M.D), in partnership with various funders and 24 pediatric and family practice sites across the country. They followed nearly 4,500 families who participated in Healthy Steps services for three years. The multiyear evaluation was expected to be complete by the end of 2002.

   • Population and sample This initiative is being done in 36 local practices, in 16 states (evaluation is of 15 sites); it has provided services to more than 8,000 families.

   • Funded by Currently the initiative is sponsored by community-based foundations and local health care providers (Commonwealth Fund funded the start of the initiative and AAP later became a co-sponsor).

   • Run by The Healthy Steps curriculum was designed by a research team at Boston University (led by Barry Zuckerman, MD). Sites are coordinated by the Commonwealth Fund.

   • Duration Initiative began in 1994 and will likely continue. Funding will likely depend on the results of the evaluation.

   • Findings related to developmental screening There are some preliminary data available on the website.

   • Data availability Since data collection was scheduled to be completed by the end of 2002, data is expected soon.

   • Website http://www.healthysteps.org/
      

3. TRACE: Tracking, Referral, and Assessment Center for Excellence:
   This project seeks to: 1) establish a center to identify and promote the use of scientifically based models and practices for early identification, child find, and referral for children eligible for Part C and Part B; 2) conduct research syntheses of early identification, child find, and referral models and practices with a focus on the characteristics of the practices and models associated with desired outcomes; 3)use the characteristics of effective models and practices to conduct studies on the extent to which educational programs, at all levels, are using scientifically based early identification, child find, and referral models and practices; 4) determine if the use of scientifically based models and practices is associated with desired outcomes; 5) compare and contrast the relative effectiveness of different models and practices; and 6) develop, validate, and evaluate the effectiveness of scientifically based training units for implementing effective early identification, child find, and referral models and practices.

   • Population and sample Seeks to benefit Infants (birth through 2 years-of-age) and preschoolers (3 through 5 years-of-age)

   • Funded by Office of Special Education Programs, Department of Education

   • Administered by Center for Evidence Based Practices

   • Duration Began on 10-01-2002 and is scheduled to end 09-30-2007.

   • Website http://www.cec.sped.org/osep/database/detailView.html?masterID=211