Developmental and behavioral problems can be subtle and difficult to assess in children. They often emerge in the context of family life, and frequently go unrecognized or untreated during health encounters. An estimated 70% of children with significant developmental and behavioral problems are not identified before school entry.
Parenthood, like childhood, is a developmental process. Each well-child visit presents opportunities for providers to help educate parents about their child’s development and to support effective parenting skills through anticipatory guidance.
Periodicity and Guidelines for Developmental and Behavioral Screening
Health Check requires a developmental/ behavioral assessment at each preventive health visit from birth to 21 years (including gross and fine motor development, communication skills, social-emotional development, cognitive skills, and self-help/self-care skills). This assessment consists of the developmental history, observations, physical and developmental evaluation, and assessment of developmental status and psychosocial adjustment.
Download a PDF developed by Nathaniel Beers, MD, MPA explaining Developmental Screening Tools in the Office Setting.
Remember to consult and follow the DC Medicaid HealthCheck Periodicity Schedule.
Behavioral Health Assessment
Since behavioral assessments (combined with developmental evaluations) are an integral part of pediatric preventive health care, the primary care provider (PCP) is usually the first to see children or teens with behavioral or mental health problems. Assessing behavioral health is crucial in identifying, documenting, and addressing potential problems.
For all children and teens
After performing a complete health history and physical examination:
- Conduct a psychosocial assessment including:
- Family history
- Childhood experience
- Developmental history
- School history, when applicable
- Frequency of moving
- Evaluate for risk in the following areas:
- Increased emergency room use
- Increased hospitalizations
- School attendance, truancy, or absences
- Attention deficit hyperactivity disorder (ADHD)
- Substance abuse by the child, teen or family member
- Violent behavior, including fire setting or cruelty to animals or other children
- Problems with the law, including theft or selling drugs
- Homicidal or suicidal ideation
- Review all information individually or as part of an interdisciplinary team
- Identify children and teens at risk
- Make referrals to appropriate behavioral or mental health providers