TMPPM 2008 > Texas Medicaid Services > Texas Health Steps (THSteps) > Clinical Information

   
 

43.2.3.5 Developmental Screening

Requirements for Developmental Screening by Physicians, PAs, and NPs

Medical check ups completed by physicians, PAs, and NPs for clients birth through 6 years of age must include:

A standardized developmental screen (the provider's choice of observational or parent questionnaire) for a client between 9 through 12 months of age, 18 through 24 months of age, and every other year thereafter, or when a parent expresses concern about the client's developmental progress.

A developmental screen at all other visits, including a review of milestones (gross and fine motor skills, communication skills and speech-language development, self help and care skills, social, emotional, and cognitive development) and mental health.

Requirements for Developmental Screening by RNs

RNs conducting THSteps medical check ups for a client birth through 6 years of age are required to conduct a standardized observational screen for a client 9 through 12 months of age and 18 through 24 months of age. If the client does not have a record of a standardized observational screen, the client should receive one between 24 months through 6 years of age. A standardized parent questionnaire is required at all other periodic visits through the 6th year of age or when a parent expresses concern about the client's developmental progress.

The combined use of a questionnaire and an observational screen reflects the client's developmental status more accurately than a single observational screen. If parents are unable to read or understand the questionnaire, the provider should use the parent questionnaire in an interview format. If the client fails the parent questionnaire, the provider should follow the instructions of the standardized screening tool concerning either observation testing or referral.

Clients 7 years of age and older should be screened by observation, history of school progress, and neurological assessment.

Choice and Use of Tools

A standardized screening tool is one that has been extensively evaluated through screening thousands of children and comparing the screen outcome of each individual client with the outcome of an in-depth developmental evaluation on that client.

If the screening tool used specifies that training is required to use the tool, the screener must complete this training.

Referrals for Developmental Assessment

Referral for an in-depth developmental evaluation is determined by the criteria of the specific tool. The screener should understand them. Referral for in-depth evaluation of development should be provided when parents express concern about their client's development, regardless of scoring on a standardized development screening tool.

An ECI program serves clients birth to 3 years of age with disabilities or developmental delays. Federal and state laws require a referral be made to an ECI within two business days of identifying a possible developmental concern. If the client is 4 years of age or older, referral should be made to the local school district, special education program.

Referrals may be based on professional judgment or a family's concern. A medical diagnosis or a confirmed developmental delay is not required for referrals.

Refer to: "Texas Health Steps Statutory State Requirements" for more information.


Texas Medicaid & Healthcare Partnership
CPT only copyright 2007 American Medical Association. All rights reserved.
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