Increasing ASQ-3 Child Developmental Screenings: Quantity and Validity


Impact Statement: 
Early intervention has been shown to positively impact outcomes across developmental domains. The Fond du Lac County Health Department increased the number of children being screened for developmental delays from 5 to 9 per month, allowing more children to be appropriately connected with services to enhance their early childhood development through early intervention and minimize potential developmental delays.

Fond du Lac County Health Department’s (FCHD's) Maternal Child Health (MCH) program participates in the Wisconsin Healthiest Families Initiative (WHFI), in which local health departments work with community partners to build an integrated system that promotes optimal physical, social-emotional, and developmental health of children and their families. Mental health is the focus area in this initiative, and FCHD is a partner in the Fond du Lac County Community Partnership for Young Children (Supporting Positive Relationships so Our children Under 6 can Thrive [SPROUT]), a coalition whose goal is for all Fond du Lac County children to be healthy, nurtured, safe, and successful from birth to school entry.

As a result of this public-private partnership, Fond du Lac is the first county in Wisconsin to offer a community-wide developmental screening site that meets the critical need of improving quality early childhood development. The screening site, unveiled in July 2013, is located at the Fond du Lac County Women, Infants, and Children (WIC) office and offers parents the opportunity to select and complete age-appropriate Ages & Stages Questionnaires™ (ASQ-3). The questionnaires are scored, and parents are notified of results, provided with activities to do with their children, and given recommendations for follow-up. In the process of data entry of screening results, it was discovered that since the initiation of the screening site, nearly 29% of the screens returned and scored were invalid because of incorrect screen selection. As a result, inappropriate referrals were made to Birth to 3, and the validity of the screen results of children who scored in the “above cut-off” range when the wrong screen was used was questioned. This is a problem, as inappropriate referrals made to an agency waste staff time, and can damage the referring agency’s credibility. And, although a child may score “above cut-off” on a screen, if the screen was chosen incorrectly, the child could be experiencing unidentified delays.

What we desired to accomplish with this project was to reduce the percentage of invalid developmental screens completed at the FCHD developmental screening site, thus preventing inappropriate referrals and missed opportunities in identifying children with potential delays, and to increase the number of screens being completed by parents and returned to FCHD for scoring.

Organization that conducted the QI initiative: 

Mittelstadt-Lock, K. Public Health Quality Improvement Exchange. Increasing ASQ-3 Child Developmental Screenings: Quantity and Validity. Tue, 09/26/2017 - 11:40. Available at Accessed May 23, 2024.

Submission Status: 
0 users have voted.