Wednesday, September 30, 2009

Screening Developmental Disabilities

Between 12 and 16 percent of children in the U.S. have developmental disabilities. The pediatric medical community wants to identify children with developmental delays or disabilities as early as possible by using developmental surveillance and screening. Early intervention programs improve outcomes in children and are also cost effective.

Using computer decision support strategies offers the best hope to achieving this goal in pediatric practices. A program referred to as the “Child Health Improvement through Computer Automation” (CHICA) is available to provide pediatric guidelines, a paper user interface that can be scanned, and a HL7 compliant interface to existing electronic medical record systems.

Preliminary work with CHICA has demonstrated the feasibility of using the system to implement and evaluate clinical guidelines. The AHRQ grant awarded to the Department of Pediatrics, Indiana University, in the School of Medicine proposes to expand CHICA to include a developmental surveillance and screening module.

The researchers are going to evaluate the effect of the CHICA system on the developmental surveillance and screening practices at four pediatric clinics. They also plan to evaluate the effect of the CHICA system on referrals for developmental and medical evaluations as well as study early developmental interventions for children identified as having some problematic developmental screening results problems. The idea is to follow children identified with developmental disabilities over time to see the end results and then look at the effects of developmental screening on these results.

This study will include a randomized trial to compare changes in surveillance, provide for screening, diagnosis, and for the management of developmental disorders before and after implementation of the CHICA system. Data will be collected from medical records with the primary interest in children at 9, 18, and 30 month visits.

The study will also take into account the family’s involvement in treatment decisions and planning, whether treatments were based on an initial assessment, and whether the strategies used are building on the strengths of the child.

For information on the grant Computer Automated Developmental Surveillance and Screening (R01HS017939-01), email Aaron E Carroll, The initial year for the grant is 2009 with the study concluding in 2012.