A vast amount of research suggests that many developmental problems, including cognitive delays and learning disabilities, mental illness like depression and anxiety, and social skill disorders in children, can be avoided or ameliorated through early identification by children’s healthcare providers and timely referral for intervention services.
Promoting healthy development by screening for problems and educating parents can promote children’s school readiness, academic success, and overall well-being. In addition, reducing the prevalence of developmental and behavioral disorders has long-term effects in terms of the education, child welfare, and juvenile justice systems.
Yet, unfortunately, many developmental problems go unrecognized—particularly among low-income children—and many others are not caught early or treated effectively, despite the fact that the American Academy of Pediatrics recommends developmental surveillance be performed at every preventive visit and a screening tool administered at certain regular visits.
In 1999, The Commonwealth Fund launched the Assuring Better Child Health and Development (ABCD) initiative to strengthen the capacity of the healthcare system to support the early development of children from low-income families. As part of ABCD, The Commonwealth Fund awarded a grant to the National Academy for State Health Policy to help states improve the delivery of early childhood development services to children through their Medicaid programs.
The program began with a five-state initiative and has since been disseminated to 26 states, along with Puerto Rico and the District of Columbia. Most states reported substantial increases in their rates of developmental screening, training to help physicians adopt new practices, and changes in policies related to benefit enhancement, reimbursement rates, and expectations of healthcare quality.The models and policies developed through ABCD are now serving as a roadmap for states around the nation.