The first Core Component is Child Health Care Provider Outreach to support early detection and intervention.
Child health care providers, who have near universal access to young children, are in a unique position to identify children who are at risk for developmental delay. Their work with families also requires that they provide ongoing monitoring of children's developmental status.
Given their critical role in child development, HMG staff members conduct targeted outreach to child health care providers through office-based education and training. The purpose is to educate and motivate physicians and other child health care providers to: 1) conduct developmental surveillance and screening of children from birth to age five; 2) use the call center; and 3) systematize developmental surveillance and screening and the use of HMG in their practices. In addition, HMG staff members conduct follow-up office visits to leave materials, maintain visibility of HMG, and learn about local issues, specific needs, and best practices in supporting developmental surveillance and screening.
Note: Developmental surveillance is a flexible, continuous process in which knowledgeable professionals perform observations of children while providing care. Development is continuously monitored within the context of overall well-being, rather than viewed in isolation during a testing session. Developmental surveillance is broader in scope than screening and occurs at every well child visit.1 Developmental screening is performed at selected ages or when concerns arise using standardized tools such as parent-completed questionnaires and professionally administered tests. The periodic use of such tools enhances the effectiveness of ongoing surveillance.
1. American Academy of Pediatrics, Council on Children with Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee and Medical Home 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 118, 1 (2006): 405-420. Available online: http://pediatrics.aappublications.org/cgi/content/full/118/1/405.
The second Core Component is Community Outreach to promote the use of HMG and provide networking opportunities among families and service providers.
A community presence encourages support for and participation in the HMG system and helps with marketing the service. It also facilitates gathering information to include in a resource directory and keeping the directory up-to-date. The resource directory includes at minimum:
- Primary and specialty medical care providers
- Early childhood education and child care programs
- Developmental disabilities assessment and intervention programs
- Mental health services
- Family and social support programs
- Child advocacy and legal services
Staff members who are responsible for outreach serve as a conduit between local programs and the call center and support service providers by facilitating local networking opportunities. In addition, outreach staff members focus on engaging families by participating in community meetings, forums, and fairs and facilitating sessions that help families learn about child development and the role of HMG.
The third Core Component is a Centralized Telephone Access Point for connecting children and their families to services and care coordination.
The call center serves as the "go-to" place for family members, child health care providers, and other professionals seeking information, support, and referrals for children. Telephone services have proven to be an effective single point of access to community resources.2 They are cost-effective, easy to promote, efficient in identifying needs, and effective in supporting callers and triaging to appropriate services.
To ensure that callers feel safe, respected, and heard, the call center must be adequately staffed with individuals who are trained in telephone casework and cultural sensitivity, and have backgrounds in child development. As part of their role, call center staff members provide education and support to families around specific developmental or behavioral concerns or questions, which include:
- Discussing various strategies the families may want to try;
- Helping families understand what is typical for a child at a given age
- Exploring what has been tried before and what has and has not worked
- Mailing information to families on specific topics
- Having families enroll their children in a developmental monitoring program, such as the Ages and Stages Child Monitoring Program
- Providing referrals to parenting and support programs
- Providing follow-up and advocating for families as needed
In 2007-2008, the call center in Connecticut handled over 2,500 calls and made nearly 4,000 service referrals to families.3 The majority of calls were from parents and guardians (69%).4 Pediatricians make up the second-largest group of callers (19%) and the remaining calls were evenly distributed among social service agencies, childcare providers, relatives and friends, and the Department of Children and Families.5
2. Marijane Carey, "The Role of a Statewide Information and Referral (I&R) System in Enhancing the Access of Children and Their Families to Developmental Programs and Services," Journal of Developmental and Behavioral Pediatrics 27, 1 (2006): 13-16. http://journals.lww.com/jrnldbp/pages/toc.aspx?year=2006&issue=02001
3. Marcia Hughes and M. Clay Damboise, "Help Me Grow: 2008 Annual Report." Center for Social Research, University of Hartford (prepared for The Connecticut Children's Trust Fund, March 1, 2009).
4. Hughes and Damboise, "Help Me Grow: 2008 Annual Report."
5. Hughes and Damboise, "Help Me Grow: 2008 Annual Report."
The fourth core component is Data Collection to understand all aspects of the HMG system, including identification of gaps and barriers.
Call centers are in a unique position to collect data that reflect system-level issues—information not only on who calls and why, but also on what happens to families seeking help. This includes identification of gaps in and barriers to services.
Call centers collect:
- Information on how callers heard about the service
- Caller demographics
- Facts about the person in need
- Information on what assistance is being requested
- Records of actions taken to assist callers
- Outcomes of the contacts with the call center
Data collection also includes gathering information on how well the other components of the HMG system are operating. This can be done through surveys of child health care providers who participated in training, surveys of families and providers who participated in educational sessions and networking opportunities, an "audit" of the resource directory, and other methods. An annual analysis and summary report on available data help to assess how well the HMG system is working or what may need to be changed to improve or enhance the service. In addition, the data can be shared with funders and policy makers to guide their thinking around service delivery and to demonstrate how to best use resources to promote optimal child development.