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National Center Surveillance
and Screening Activities
The National Center of Medical Home Initiatives for Children
with Special Needs engages in many types of surveillance and
screening activities including hearing, vision, developmental
and newborn metabolic/genetic screening. Partnerships with the Maternal
Child Health Bureau, Centers for Disease Control and Prevention's
National Center for Birth Defects and Developmental Disabilities
and the Federal Department of Education, allow the National
Center to promote the natural role of surveillance and screening
within quality primary care. Information contained on these
pages aims to assist you with incorporating continuous surveillance
and structured screening into the medical home you provide
or is provided to your child.
What is surveillance?
Surveillance is the process of recognizing children who may be at risk of developmental delays. Developmental surveillance is a flexible, longitudinal, continuous, and cumulative process whereby knowledgeable health care professionals identify children who may have developmental problems. There are 5 components of developmental surveillance:
- Eliciting and attending to the parents’ concerns about their child’s development
- Documenting and maintaining a developmental history
- Making accurate observations of the child
- Identifying the risk and protective factors
- Maintaining an accurate record and documenting the process and findings1
The Child Health Professional's
Role:
- Pay attention to parental concerns
- Ask questions about the child's
development
- Observe the WHOLE child, not
just a diagnosed condition
- Note any risk factors that may
be present
- Document your observations/findings
The Family's/Guardian's Role:
- Voice and document any concerns
about your child's development to your child's health
professional
- Provide needed family history
information
- Participate at a "partner-level"'
in the decision-making process with your child's health
professional
What is screening?
Screening is the administration of a brief standardized tool aiding the identification of children at risk of a disorder. Screening that targets the area of concern is indicated whenever a problem is identified during surveillance.1
- The Child Health Professional's Role:
- Administer (or oversee the administration) of screen
- Evaluate screening test results
- Depending on results:
- Refer appropriately; initiate follow-up care
- Continue surveillance
- Work continuously in partnership with family
- The Family's/Guardian's Role:
- Voice and document any concerns about your child’s
development to your child's health professional
- Participate at a "partner-level" in the
decision-making process with your child's health professional
Early Intervention:
Increasingly, the benefits of early identification and treatment
on child health outcomes are being proven.2
A child's primary healthcare professional's ability to perform
continuous surveillance and structured screening within
the context of a routine, well-child care visit provides
an opportunity to identify special health care needs. However,
once a child is identified with having a special health
care need, appropriate diagnosis and follow-up must readily
occur. It is in this "next step" phase that the
relationship between the medical home and an Early Intervention
program becomes critical. To learn more about Early Intervention,
and strategies to access their services, click
here.
General Surveillance & Screening
Resources
Fact Sheets
Policy Statements
- AAP
Periodicity Schedule: Recommendations for Preventive
Pediatric Health Care. Pediatrics.
Elk Grove Village, IL. American Academy of Pediatrics;2000
Tools
- Bright
Futures
Bright Futures, initiated by the Maternal and Child Health
Bureau (MCHB) over a decade ago, is a philosophy and approach
that is dedicated to the principle that every child deserves
to be healthy, and that optimal health involves a trusting
relationship between the health professional, the child,
the family, and the community. As part of this initiative,
Bright Futures: Guidelines for Health Supervision of Infants,
Children, and Adolescents was developed to provide comprehensive
health supervision guidelines, including recommendations
on immunizations, routine health screenings, and anticipatory
guidance.
- "Surveillance
& Screening" component in the Every Child
Deserves a Medical Home training curriculum
Learning Objectives:
- Define and understand the importance of ongoing
surveillance.
- Understand what constitutes surveillance, the proper
methods of screening, and their importance as part
of the care provided in the medical home.
- Describe the barriers to surveillance and screening
and identify strategies to address them.
- Identify recommended tools and resources to assist
in integrating screening into practice.
- Identify proper follow-up strategies after screening
tests are performed.
1. American Academy of Pediatrics; Council on Children With Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee and Medical Home Initiatives for Children With Special Needs Project Advisory Committee. Identifying Infants and Young Children With Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening. Pediatrics. 2006;118(1):405-420
2. American Academy of Pediatrics, Committee
on Children with Disabilities. Role of the pediatric clinician
in family-centered early intervention services. Pediatrics.
2001; 107:1155-1157
Last Updated November 19, 2008
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