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Principal Investigator: PAUL J CHUNG
Organization: KAISER FOUNDATION RESEARCH INSTITUTE
Fiscal Year: 2022
Award: $132,460
Funding agency: Eunice Kennedy Shriver National Institute of Child Health and Human Development
PROJECT SUMMARY/ ABSTRACT
Although universal early childhood developmental screening is recommended by the American Academy of
Pediatrics, ample evidence suggests that child health providers are not meeting those recommendations, and
many early developmental delays are being missed. Additional evidence suggests that both providers and
parents struggle to navigate the early childhood developmental system of care, with few high-risk children
actually getting referred, and fewer still ultimately receiving services. The gaps in care processes have created
gaps in evidence linking developmental screening to developmental outcomes, leading the US Preventive
Services Task Force to state that there is not enough evidence to recommend for or against universal
screening for speech and language delays or Autism Spectrum Disorders. The proposed project is a
randomized controlled trial of a telephone-based early childhood developmental care coordination system, in
partnership with 2-1-1 Los Angeles County (211LA), part of a national network of 2-1-1 call centers covering
93% of the US population. We will test the effectiveness of 211LA in increasing referrals for developmental
evaluation, increasing the numbers of children deemed eligible for services, and increasing the number of
children actually receiving interventions. The trial will enroll 662 children ages 1-3 years who receive well-
childcare at one of 10 partner clinic sites. We will conduct developmental screening on all children using the
Parental Evaluation of Developmental Status (PEDS) Online system, and randomize children 1:1 into
intervention (connection to 211LA for developmental care coordination + usual care) or control (usual care
alone, with developmental care coordination conducted by clinic staff). Primary outcomes will include referrals
to early intervention evaluations, eligibility for intervention services, and receipt of services. We will measure
these outcomes through parent report, medical record review, and 211LA data, at 6 months after enrollment.
For children with elevated developmental risk based on the PEDS Online results, we will assess development
using the PEDS: Developmental Milestones – Assessment Level (PEDS:DM-AL), conducted at baseline and
12 and 24 months after enrollment. For all children, we will administer the language subscale of the PEDS:DM-
AL at baseline, 12 months and 24 months, to evaluate development over time in the two groups. We will
measure behavioral outcomes for all children using the externalizing behavior subscale of the Child Behavior
Checklist. Expected findings include higher rates of referrals, eligibility, and receipt of intervention services
among intervention group participants, and greater developmental gains among children in the intervention
group. We will also examine the costs of the program in relation to these outcomes, to estimate the costs and
potential long-term benefits of this model. If effective, the model has the potential to disseminate rapidly
throughout the 2-1-1 network and transform developmental care coordination in the US.
Terms: <0-11 years old><2019 novel corona virus><2019 novel coronavirus><2019-nCoV><3 year old><3 years of age><Academy><Address><Administrative Supplement><Advisory Committees><Affect><Age><American><Autism><Autistic Disorder><Behavioral><COVID><COVID crisis><COVID epidemic><COVID pandemic><COVID-19><COVID-19 crisis><COVID-19 epidemic><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 pandemic affected><COVID-19 pandemic consequence><COVID-19 pandemic effects><COVID-19 pandemic impact><COVID-19 pandemic impacted><COVID-19 public health crisis><COVID-19 virus><COVID19><COVID19 crisis><COVID19 epidemic><COVID19 global health crisis><COVID19 global pandemic><COVID19 health crisis><COVID19 pandemic><COVID19 public health crisis><COVID19 virus><CV-19><CV19><Caring><Child><Child Behavior Checklist><Child Behavioral Checklist><Child Care><Child Development><Child Health><Child Youth><Childhood><Childhood Behavior Checklist><Children (0-21)><Children Behavior Checklist><Clinic><CoV disease><CoV emergence><CoV-2><CoV2><Control Groups><County><Data><Development><Developmental Delay><Developmental Delay Disorders><Disasters><Disease><Disorder><Early Infantile Autism><Early Intervention><Economics><Effectiveness><Elderly><Eligibility><Eligibility Determination><Emergencies><Emergency Situation><Enrollment><Evaluation><Family><Financial Hardship><Funding><Future><Goals><Health><Health Care Providers><Health Care Systems><Health Personnel><Healthcare Providers><Healthcare Systems><Healthcare worker><Human><Infant and Child Development><Infantile Autism><Intervention><Intervention Strategies><Kanner's Syndrome><Language><Language Delays><Link><Los Angeles><Measures><Medical Records><Mental Health><Mental Hygiene><Modeling><Modern Man><Morbidity><Morbidity - disease rate><NICHD><National Institute of Child Health and Human Development><National Institute of Children's Health and Human Development><Nursery Schools><On-Line 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Service><Social Work><Specific Child Development Disorders><Speech Delay><Stress><System><Task Forces><Testing><Time><Unemployment><Vaccination><Visit><Wuhan coronavirus><advanced age><advisory team><age 3 years><ages><autism spectrum disorder><autistic spectrum disorder><base><behavior measurement><behavior outcome><behavioral measure><behavioral measurement><behavioral outcome><care coordination><care services><care systems><child services><chronic effect of COVID-19><community clinic><coordinating care><corona virus disease><corona virus disease 2019><corona virus disease 2019 epidemic><corona virus disease 2019 pandemic><corona virus emergence><coronavirus disease><coronavirus disease 2019><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 pandemic consequence><coronavirus 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