Developmental Care

Developmental Care

Iowa Medicaid requires a range of developmental care for children who receive EPSDT health care benefits. This includes surveillance, screening and intervention, and evaluation and treatment. Anticipatory guidance and care coordination contribute to healthy child development.

Developmental Surveillance

  • Preventive developmental services for all children identifies those at risk for developmental delays.
  • Monitor at each visit from birth to 5 years of age.

Developmental Screening

  • Targeted screening and intervention for at risk children, looking at language, movement, thinking, behavior and emotions.

Developmental Evaluation

  • Evaluation of children with identified developmental or social-emotional concerns includes in-depth assessment and treatment by trained specialists.

Teacher and pupil with blocks

Developmental Surveillance and Screening for Autism Spectrum Disorder

Practice Recommendations

American Academy of Neurology and the Child Neurology Society Clinical 

  • Developmental surveillance should be performed at all well exams from infancy through school age, and at any age thereafter if concerns are raised about social acceptance, learning, or behavior.
  • Recommended developmental screening tools include the Ages and Stages Questionnaire, the BRIGANCE® Screens, the Child Development Inventories, and the Parents’ Evaluations of Developmental Status.
  • According to the CDC, "because of the lack of sensitivity and specificity, the Denver-II (DDST-II) and the Revised Denver Pre-Screening Developmental Questionnaire (R-DPDQ) are not recommended for appropriate primary-care developmental surveillance."

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Surveillance

For all children 

Federal Medicaid guidelines require primary health care providers to review development at every well child well exam. This includes:

  • Review cognitive, motor, language, adaptive, and social-emotional milestones.
  • Address parental concerns about development, behavior, or emotions.
  • Assess family risk factors, including parental stress, depression, violence, substance use, financial stress, etc.

Iowa Medicaid endorses the AAP recommendation for developmental and autism screening for all children.

  • Developmental Screening at 9 months, 18 months, and 24-30 months
  • Autism screening at 18 and 24 months

See Bright Futures for surveillance and screening resources and tools.

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Screening

For children identified as at-risk for delays or other concerns

  • Additional screening of development, social-emotional and behavioral concerns, and caregiver depression and family stress
  • General Development: Ages and Stages Questionnaires, Third Edition (ASQ-3)  can be administered at additional times (1-66 months)
  • Behavioral-Emotional: Ages and Stages Questionnaires: Social-Emotional (ASQ:SE-2) (3-66 months)
  • Care coordination to assist the child, family, and healthcare team develop a plan of care to optimize the child’s development and support the family
  • Brief interventions by the healthcare provider or other professional to promote child development and well-being

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Evaluation

For children with identified developmental or social-emotional concerns

  • Referral of children identified with a developmental or social-emotional concerns for a comprehensive diagnostic evaluation
  • Care coordination to assist the child, family, healthcare team, and other professionals to develop a family centered plan of care to optimize the child’s development and support the family
  • More intensive interventions to address the developmental or social emotional concern
  • Periodic reassessment of progress

Screening Tools

Recommended by Iowa EPSDT Care for Kids

General Development

Autism Spectrum Disorder

If high risk, refer to services and evaluation.

Caregiver Depression

Healthcare provider can asses and treat, or refer depending on experience.

Family Risk Factors

Healthcare provider can refer, as indicated, for services or care coordination.

Little girl flexing arm at doctor's office

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