IV. Priority Recommendations (continued)
depressed mothers’ infants and children. Nearly 50 percent of mothers of subpopulations of children with conditions that can lead to developmental delay (e.g., preterm birth, autism spectrum disorders, and cerebral palsy) experience depression. While high prevalence is alarming, effective treatment for maternal depression, including parent-child dyadic treatment to improve child development, is well established. Professional organizations and governmental guidelines, including the American Academy of Pediatrics, recommend postpartum depression screening for all mothers during the first year of a child’s life as part of the child’s regular check-ups. Clear, effective screening and referral processes related to a positive maternal depression screening are critical to minimizing its impact. Because the risk of developmental issues for infants and toddlers is high when mothers are depressed, referrals to Part C for assessment of developmental status are warranted. (Harmon et al.,2019 https://doi.org/10.1007/s10802- 020-00740-6; Slomian et al., 2019 https://doi. org/10.1177/1745506519844044; Meany, 2018 https:// doi.org/10.1176/appi.ajp.2018.17091031; Trussell et al., 2018 https://doi.org/10.1177/0009922818769450; Feinberg et al., 2012 https://doi.org/10.1007/s10995- 010-0715-3; Ertel et al., 2011 https;//doi.org/10.1089/ jwh.2010.2657; Knitzer et al. 2008) Linkages with pediatric primary care/medical home: Primary health care providers are among the most frequent source of referrals for Part C EI program services because of the more frequent check-ups, called well-child visits, that occur in the first two years of a child’s life. The effectiveness and number of referrals to Part C EI for those beyond the newborn period depends heavily on the practices of pediatric primary care providers (including pediatricians, family physicians, and others). The American Academy of Pediatrics and other expert bodies recommend developmental screening and surveillance for infants and toddlers at specified intervals and a response to screen results that warrant further action. National surveys of pediatric
primary care providers report an expectation to be informed about the results of the referral and ongoing EI services for their patients, in effect to have timely and ongoing flow of information between the medical home and the Part C program. (Sanders et al., 2021 https://doi.org/10.1097/ DBP.0000000000001004; US Department of Education, 2011; Adams et al., 2013 https://doi. org/10.1542/peds.2013-2305; Ross et al., 2018 https://doi.org/10.1007/s10995-018-2540-z; Jimenez et al., 2014 https://doi.org/10.1016/j.acap.2014.01.007) Referrals from Child Welfare to Part C EI: Since 2003, federal law has required states to have policies and procedures in place for the referral to Part C EI of all children younger than 3 with substantiated cases of abuse or neglect. (42 USC Section 5106(a)) States have the discretion as to whether to refer every such infant and toddler for early intervention services, or to first employ a screening process to determine whether a referral is needed. The available data suggest that only a small proportion of these vulnerable infants and toddlers are connected to and ultimately enrolled in the Part C EI system. Lack of familiarity with or training for conducting screening among child welfare agency personnel are a barrier to screening and linkage with Part C EI. Studies of states’ implementation show that this requires increased EI system capacity, strong interagency linkages, and strategies to engage families entering the child welfare system. The effectiveness of screening and evaluation processes makes a difference. (Shannon, 2020 https://doi.org/10.1080/ 15548732.2020.1727395; Administration for Children and Families, Children’s Bureau, 2019; Administration for Children and Families, CAPTA 2018; Casanueva et al., 2008 https://doi.org/10.1177/1077559508318397; Derrington & Lippitt, 2008 https://doi. org/10.1177/0271121408320350; Mott & Dunst, 2006 https://doi.org/10.1177/105381510602900102; Robinson & Rosenberg, 2004 https://doi. org/10.1177/105381510402600404)
June 2022
14
Made with FlippingBook. PDF to flipbook with ease