Screening for special health care needs: Preschool and health care provider practices in low-income neighborhoods

Early identification of special health care needs and developmental delays ensures that children who need help receive it early, before these issues begin to interfere with their growth and learning. Although a child from any background may have a special need or developmental delay, there are some risk factors – such as low birth weight, poverty, maternal depression, and abuse or neglect – that have been linked to an increased risk for such concerns. Two of the best sources for conducting developmental screenings to detect delays or special needs are children's pediatric providers and their preschool and other early care providers. A recent survey of ECE providers in low-income and under-served areas of Santa Clara County, CA, explored providers' knowledge of various developmental screening tools, their screening practices, and the barriers they report experiencing in identifying and addressing possible delays in their students. Results showed some familiarity with and use of common screening tools, with stark differences in knowledge and practices observed between providers in child care centers versus licensed family child care homes. Providers' responses also indicated a need for more effective strategies for communicating information to parents; both center-based and family child care providers reported that the biggest barrier to identifying delays and special needs was parent resistance to the information. A complementary survey of pediatric health care providers is currently under way to assess their knowledge, practices and attitudes regarding developmental screenings. Pediatric provider practices will be compared for providers serving different patient populations.