A Community Approach to Comprehensive Early Childhood Health and Developmental Screening

Healthy Beginnings Health and Developmental Screening Program

Identifying children with health and developmental concerns through evidence-based screening tools has been shown to have many benefits for individual children, their families, and our society. Children identified early, and treated for health and developmental concerns are less likely to have long-term disabling conditions that can impact their life time ability for employment and self-sufficiency. Yet, many families rely on their health care providers to perform these screening tests in spite of ongoing evidence that less than 50% of health care providers perform standard screening, and that more and more families cannot afford to obtain preventive health care due to lack of health insurance, language and cultural barriers, and lack of time within health care practices. Several communities have supported community screenings for a select population (i.e.., Head Start), but these screenings are not open to the general public and are limited to select geographic areas.

Healthy Beginnings Community Screening Project is a project designed to provide free health and developmental screenings to all children ages birth through five years regardless of the family's race, cultural practices, ability, or socioeconomic factors. The children screened at Healthy Beginnings are referred from public, private, and non-profit agencies serving young children and their families. Following screening at 12 health and developmental stations, children are referred for assessment and treatment for identified developmental and health concerns.

"Healthy families are the foundation of a healthy society. Families who are unable to promote their children's development ultimately place the entire society at risk." So states the National Resource Center for Family Support Programs. Healthy Beginnings works to strengthen this foundation, and the community, by bringing preventative, accessible, cost-effective, educational screenings to all children aged birth to five in Deschutes County. Further, Healthy Beginnings helps to foster healthy, nurtured children and advance parental ownership for their young child's sound health and development by providing attendees with education, information, connections to community resources and support in their important role as parents.

Providing a single point of access to all children, screenings are held monthly on a rotating basis in Bend, LaPine, Redmond and Sisters. With the help of in kind professionals, paraprofessionals and age-appropriate diagnostic tools, one-on-one assessments are provided in health, dental, nutrition, vision, speech, motor, concepts, infant toddler development, hearing, car seat safety, emergency preparedness/community resources and behavior. Our goal is to provide our service to any child who may be perceived to have a concern or is in an at risk population however, our data indicates that the number and types of referrals is not significantly tied with at risk populations but rather, the need for referrals has been shown to not follow low income or risk populations. Consequently all children benefit from a health and developmental screening. Follow-up is also a significant factor in the success of the service. Through Healthy Beginnings' evaluation results, parents are reassured of their child's development and provided the important community resources to help the family be a successful partner in their child's development. More importantly this screening and referral process provides parents with the tools needed to help prepare their child for kindergarten at the highest level of his or her ability and positive social interaction.

This affordable, available program is offered to all children, ages birth to five. While this service is open to all children in Deschutes County, we target and provide extensive outreach to at risk families, especially low income families who do not have health insurance or a primary health care provider. We also provide extensive outreach in the growing Latino communities of Deschutes County.

One of HB's chief strengths is its collaboration with other organizations that provide significant in-kind staff, training, materials, equipment, facilities, office space, food, marketing, contacts, and publicity. Participating organizations and individuals include Deschutes Children's Foundation; Ready*Set*Go; Together For Children; Early Intervention; Early Childhood Special Education; Central Oregon Regional Programs; Family Resource Center of Central Oregon; NeighborImpact-Head Start; Bend-LaPine, Sisters, and Redmond School Districts; St. Charles Medical Center (Bend and Redmond); Deschutes County Mental Health and Health Department; Central Oregon Community College, Oregon State University Cascades Campus; professional community dentists, dental hygienists, and speech therapists; and many other private and public organizations around Deschutes County. Funding partners include United Way of Deschutes County, Deschutes County Commission on Children and Families, Child-find funding from local school districts, foundations, local corporations and community service club support, and volunteer in-kind valued at over $80,000.00 per year.

HB works with families of young children to increase parent knowledge, parenting skills, and community service awareness and, most important, the child's chances for entering kindergarten ready to learn. The current estimate indicates that for every dollar spent on early intervention for high-risk families, seven dollars is saved through prevention of long-term negative outcomes (Children's Defense Fund). American Academy of Pediatrics estimates that 16% of young children have a developmental disability but only 20%-30% are identified prior to entering kindergarten. In addition, the Academy of Pediatrics estimates that early intervention provides “savings to community of $30,000-$100,000 per child.” Due to this clearly demonstrated need, this proposed project will focus on connecting parents with a starting point especially in rural outreach for high-risk families. Last fiscal year, HB screened 391 children providing 278 children with 422 referrals to different community agencies for a more extensive service and care. According to the data collected through HB nearly 1/3 of the children we serve are without medical or dental insurance and nearly 1/3 do not currently have a medical or dental home. Our program is the starting point for essential services that families are not able to access on their own. Since its beginnings in 1994, Healthy Beginnings has offered over 150 screening clinics throughout Deschutes County providing extensive consultations to over 6,000 children and their parents and provided over 4,000 referrals for needed additional services.

Every child and parent who attends our screening has time dedicated with a community nurse, dentist, nutritionist, audiologist, four developmental specialists, vision therapists, a volunteer from the American Red Cross, a car seat safety technician, and a behavior specialist to discuss the health and development of the child and to identify and discuss any concerns the parents or caregivers have. One additional benefit is that our screening places health professionals; dentists, vision specialists, audiologists and nutritionists in close proximity to each other to assure parents receive information consistent with the child's entire health needs.

Healthy Beginnings operations began in 1994, when the screening programs were introduced to the public. It works under the umbrella of the High Desert Education Service District (HDESD), which provides the fiscal oversight, but no financial support, for the program. In 1997, Deschutes County Healthy Beginnings, Inc., was formed as a 501(c)(3) non-profit organization, under governance of a Board of Directors, which has direct oversight for the programmatic and policy issues, as well as direction of future development for the organization..

The active use of volunteers is a source of strength for Healthy Beginnings. The volunteer corps consists of parents, guardians, board members, professional screeners, the general public, and both youths and adults who represent a variety of agencies such as the Retired and Senior Volunteer Program (RSVP), Deschutes Human Resource Volunteer Services, School to Career, Rotary clubs, Kiwanis, and the Quota Club. Since January 1994, when the operations began, 800 volunteers have been involved in providing this service.

Assessments are conducted by specialists who are trained in the related areas. These professionals include:

• Nurses from St. Charles Medical Center as well as health care providers volunteering from the community.

• Volunteer Pediatric Nutritionists and nutrition students from Central Oregon Community College nutrition program.

• A Central Oregon Regional Program Services audiologist.

• A vision therapist or trained vision screener.

• Trained volunteers, educators from Head Start and other local early childhood development programs, and interns from Oregon State University Cascades Campus for motor and concepts and early childhood development.

• Local speech pathologists.

• Behavior specialists from Oregon State University Cascades and early childhood behavior specialists as well as retired therapists.

• Pediatric dentists, dental hygienists, and dental assistants from Redmond, Sisters, LaPine, and Bend.

• Car Seat Technicians from Oregon Department of Transportation and local fire stations.

This program has successfully been replicated on other communities providing a quality service link to young children and their families.