PEDS Tools On A Home Visit
Why PEDS Tools Work for Home Visits
Welcome Home Visitors!
As a home visitor you are an important member of the team of professionals responsible for monitoring child development. One of the critical aims of home visiting programs is to improve coordination of services – a vital necessity to empowering parents of young children identified with a developmental delay.
Although young children typically have regular contact with primary care providers, developmental/behavioral and mental health screening rates remain low. The American Academy of Pediatrics and Bright Futures urges clinicians to conduct screening with a validated developmental screening at the 9, 18, and 30-month well-child encounters or whenever a parent or provider raises a developmental concern. However, the average age of identification of developmental issues is 5.9 years1 with only 20 to 30% of children identified prior to entering school.2 This is far too late and is a missed opportunity for linking children with developmental issues to quality interventional services that are proven to make a difference.
Home visitors are uniquely positioned in the natural environment of a developing young child and their family members. Being in the home environment you have the ability to observe through a lens that most other providers will never get to view. You also have the ability to observe a child and their family over time or longitudinally, which can aid in facilitating family engagement and positive parenting. You can make a difference by providing developmental/behavioral and mental health screening to the young children you serve. To begin:
- Make the commitment to conduct universal developmental screening
- Select an appropriate developmental screening for your setting. Remember, not all tools are created equal!
- Tools differ in sensitivity/specificity, length, administration time, language translations, cultural sensitivity, appropriateness for different age ranges, and training needed to employ them. Read Comparison of Peds Tools and ASQ Tools to learn some of the differences.
- Develop an implementation plan for your setting. Learn more by reading: Implementing Developmental-Behavioral Screens in Primary Care
- Begin your training by checking out our Training Overview
References: 1Blackorby, J., Schiller, E., Mallik, S., Hebbeler, K., Huang, T., Javitz, H., … Williamson, C. (2010). Patterns in the identification of and outcomes for children and youth with disabilities. Executive Summary (NCEE 2010-4006). Washington, DC: US Department of Education. Retrieved April 29, 2017, from https://ies.ed.gov/ncee/pubs/20104005/pdf/20104006.pdf; 2Palfrey, J.S., Singer, J.D., Walker, D.K., & Butler, J.A. (1987). Early identification of children’s special needs: a study in five metropolitan communities. The Journal of Pediatrics, 111 (5): 651- 659.
Why Do PEDS Tools Work with Home Visits?
- Parents' Evaluation of Developmental Status (PEDS) – a surveillance and screening tool, for children 0 to 8 years, that elicits and addresses, with evidence-based support, parents’ concerns about development, behavior and mental health. PEDS saves time, promotes family collaboration and willingness to return for future visits. It is published in many languages and includes abundant information to support helping parents learn about child-rearing.
- PEDS: Developmental Milestones (PEDS:DM) — a surveillance and screening tool for children 0 – 8 that enables a swift view of children’s skills in development and mental health, including expressive and receptive language, fine and gross motor skills, self-help, academics, and social-emotional skills. The PEDS:DM also includes supplemental measures of psychosocial risk, resilience, autism-specific screening (M-CHAT-R), and several screens for older children including the Vanderbilt ADHD Scale. An Assessment Level version (PEDS:DM Assessment Level) is also available to help with early intervention intake and NICU follow-up.
- PEDS Online — our electronic application of PEDS, PEDS:DM, PEDS:DM Assessment Level and the Modified Checklist of Autism in Toddlers-Revised. The site offers automated scoring, generates summary reports for parents, referral letters when needed, and ICD-10 and procedure codes to optimize billing. The site is easy to use, eliminates the need for hand-scoring and referral letter writing, and works well with or without electronic records. Each licensee has a unique administration panel that facilitates quality improvement initiatives and research. The panel is exportable and can be added to existing databases.
Why is Developmental/Behavioral and Mental Health Screening Important?
- 2 to 6 times more children identified with validated tools1-4
- 54 to 62% of children are able to leave early intervention with age appropriate development5
- Early identification is key to long-term outcomes
References:1-4 Hix-Small, H., Marks, K., Squires, J., & Nickel, R. (2007). Impact of implementing developmental screening at 12 and 24 months in a pediatric practice. Pediatrics, 120, 381–389; Jee, S. H., Conn, A., Szilagyi, P. G., Blumkin, A., Baldwin, C. D., & Szilagyi, M. A. (2010). Identification of social-emotional problems among young children in foster care. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 51(12), 1351–1358; Jee, S. H., Szilagyi, M., Ovenshire, C., Norton, A., Conn, A.-M., Blumkin, A., & Szilagyi, P. G. (2010). Improved detection of developmental delays among young children in foster care. Pediatrics, 125(2), 282–289; Schonwald, A., Horan, K., & Huntington, N. (2009). Developmental screening: Is there enough time? Clinical Pediatrics, 48(6), 648–655.; 5 Goode, S., Diefendor, M., & Colgan, S. (2011). The importance of early intervention for infants and toddlers with disabilities and their families. The National Early Childhood Technical Assistance Center. Retrieved March 16, 2015, from http://www.nectac.org/~pdfs/pubs/importanceofearlyintervention.pdf
Do Home Visiting Programs Improve Child Development?
Several randomized controlled trials have shown quality home visiting programs improve child development. Key findings in this area of research include: reduction in language delays, improved academic achievement, reduction in behavioral issues, and increased cognitive and mental health development.
Links to studies:
Other papers and resources for home visits:
- Using Online Developmental-Mental Health Measures for Home Visits: Engaging Families, Monitoring Progress and Evaluating Program Success
- Home Visits and PEDS for Project Launch
- Birth to 5: A Compendium of Screening Measures for Young Children
- Birth to 5: A Home Visitor's Guide for Developmental and Behavioral Screening