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In this Developmental Screening & Referral Toolkit for Pediatric Medical Clinics you’ll learn the phases to implement a new developmental screening initiative, or refine existing screening practices to strengthen quality and effectiveness within a pediatric medical setting. Each phase is comprised of a series of steps. Click on each section below to see details and materials. Appendices provide additional information and materials to support implementation.

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Phases of Screening Implementation

Phase 1: Plan

Step 1 – Assemble Implementation Team

Step 2 – Set Goals

Step 3 – Create Developmental Screening Plan

Step 4 – Plan Developmental Conversations and Developmental Guidance

Step 5 – Developmental Referral and Linkage Plan/Workflow

Step 6 – Pilot Workflow and Screening Process

Step 7 – Establish Implementation Timeline

Phase 2: Launch

Step 8 – Develop Training Plan and Conduct Training

Step 9 – Launch Implementation

Phase 3: Evaluate, Refine, Spread, and Sustain

Step 10 – Implement Quality Improvement Tracking

Step 11 – Spread to Other Clinic Sites


Appendix A: After Screening Letter: ASQ-3 and ASQ:SE-2 (tool can be customized for your local audience)

Appendix B: Referral Handout [English | Spanish]
(tool can be customized for your local audience)

Appendix C: Resources for Navigating Service Systems for Young Children

Appendix D: Parent Phone Survey

Appendix E: Training Materials – PowerPoint Presentations (PPTs can be customized for your local audience):

    • Developmental Screening Overview [PPTX | PDF]
    • Developmental Screening: Developmental Conversations with Parents/Caregivers [PPTX | PDF]
    • Screening Measures: Administration, Scoring, and Interpretation [PPTX | PDF]
    • Developmental Screening: Linkage to Resources [PPTX | PDF]

Appendix F: Training Worksheets

Create your own user feedback survey

We gratefully acknowledge the contributions of the following healthcare providers, all three Federally Qualified Health Centers (FQHCs) that participated in First Connections and contributed to the development and testing of the toolkit materials.

Suggested Citation: Zamora, I., Harley, E., Escamilla, C., Poulsen, M. K., Wheeler, B. Y., & Williams, M. E. (2020). Early Screening, Better Outcomes: Developmental Screening & Referral Toolkit for Pediatric Medical Clinics. First 5 LA.