The CHICA Developmental Screening Study
Condition: Developmental Delay
Study type: Interventional

Summary: 
      The aims of this study are to (1) Expand and modify an existing computer-based decision
      support system (CHICA) to include the 2006 AAP developmental surveillance and screening
      algorithm; (2) Evaluate the effect of the CHICA system on the developmental surveillance and
      screening practices of four pediatric clinics; (3) Evaluate the effect of the CHICA system on
      referrals for developmental and medical evaluations as well as early developmental
      intervention/early childhood services for those children identified as having concerning
      developmental screening results; and (4) Develop a cohort of children with identified
      developmental disabilities that can be followed over time in order to look at the end
      results/effects of developmental screening
    

Detailed description: 
      Between 12 and 16% of children in the United States have a developmental disability. Research
      has demonstrated that early intervention programs are not only essential for improved
      outcomes in these children, but also cost-effective. As a result, there has been a push
      within the pediatric medical community to identify children with developmental delays or
      disabilities as early as possible. Currently, most pediatric primary care providers do not
      use standardized methods for developmental surveillance and screening. Instead they rely on
      intuition and clinical judgment which has been shown to have limitations when compared with
      standardized screening methods. Researchers and physician organizations such as the AAP have
      called on pediatric primary care providers to institute a standardized approach for the
      identification of developmental delays that includes both developmental surveillance and
      screening. In fact, the AAP recently published an algorithm for developmental surveillance
      and screening within a primary care setting. Physicians, however, cite several barriers to
      the implementation of these recommendations within their practices, including lack of time,
      lack of office staff, inadequate reimbursement, and language barriers.

      The investigators have developed a novel computer decision support system (CDSS) for
      implementing clinical guidelines and algorithms within pediatric practices called CHICA. The
      investigators believe that this CDSS has the potential to address the barriers cited in
      previous studies as obstacles specific to the implementation of developmental surveillance
      and screening within primary care practices. CDSS will allow for developmental surveillance
      and screening to fit within the workflow of a busy pediatric practice without requiring an
      additional investment of time on the part of the physician and without requiring additional
      office staff.

      The aims of this study are to (1) Expand and modify an existing computer-based decision
      support system (CHICA) to include the 2006 AAP developmental surveillance and screening
      algorithm; (2) Evaluate the effect of the CHICA system on the developmental surveillance and
      screening practices of four pediatric clinics; (3) Evaluate the effect of the CHICA system on
      referrals for developmental and medical evaluations as well as early developmental
      intervention/early childhood services for those children identified as having concerning
      developmental screening results; and (4) Develop a cohort of children with identified
      developmental disabilities that can be followed over time in order to look at the end
      results/effects of developmental screening
    

Intervention name(s): CHICA DevScreen Module
Intervention type(s): Other
Intervention description(s): This module assists in the diagnosis and management of developmental screening
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Health Services Research
Keywords: Developmental Delay