Developmental, Social-Emotional, and Autism Spectrum Disorder Screening in Early Childhood CHILD AND TEEN CHECKUPS (C&TC) FACT SHEET FOR PRIMARY CARE PROVIDERS

C&TC Requirements name of the screening instrument(s) used, the score(s), and the anticipatory guidance General provided to the parent or caregiver related to the screening results. If the screening results Developmental surveillance is required at all are atypical, documentation must include the C&TC visits, at all ages. Routine and periodic plan of care and, when appropriate, a referral screening, using a recommended standardized to a local community service agency. instrument, is strongly recommended for all infants and young children: For documentation examples, refer to the ▪ Developmental screening at intervals C&TC Documentation Forms for Providers and recommended by the American Academy Clinics (www.dhs.state.mn.us). of Pediatrics (AAP): at 9, 18, and 24-30 months of age and at preschool age. Procedure ▪ Social-emotional screening beginning at 6 months of age, continuing every 6 months Surveillance through 2 years of age, then yearly. ▪ Autism Spectrum Disorder (ASD) screening Surveillance, or developmental monitoring, is a at 18 and 24 months of age. non-standardized but essential part of ongoing pediatric preventive care. It includes asking for When surveillance or screening reveal parent or caregiver concerns about their child’s developmental concerns, refer as soon as development, making accurate observations of possible for additional evaluation and the child’s development, identifying risk and intervention services. Any parent concerns protective factors, and accurately documenting about development warrant further evaluation. the process and findings. Personnel A history of a child’s social-emotional and current functioning must be obtained, including: must be performed by a licensed Surveillance ▪ Identification of mental health needs or health care provider: physician, nurse risks, including history of trauma, practitioner, or physician assistant, or by a ▪ Family mental health history, registered or public health nurse (RN or PHN) ▪ Attention and behavioral concerns, and who has completed the C&TC Comprehensive ▪ Social and relationship skills. Screening training through the Minnesota Department of Health (MDH). Screening Recommendations Screening personnel qualifications are Instruments instrument-specific; refer to each instrument’s For developmental and social-emotional instruction manual for more information. screening, separate instruments are needed. Clinic settings refer to C&TC Developmental - Documentation Social Emotional Screening Developmental surveillance must be (www.health.state.mn.us). For other programs documented in the C&TC visit record. that follow C&TC recommendations refer to All Screening documentation must include the Instruments at a Glance (state.mn.us) AUTISM SPECTRUM DISORDERS (ASD) SCREENING C&TC FACT SHEET

For ASD-specific screening, the Modified Follow Up Checklist for Autism in Toddlers Revised (M- Establish a process for follow up with the family CHAT-R/F) (www.mchatscreen.com) is a after referral to ensure access to appropriate commonly used, standardized screening and effective services. Communicate and instrument. Follow instrument scoring coordinate with educational and other instructions to accurately determine whether professionals, with the parent’s permission. the follow-up interview and referral is needed. Timing and Frequency of Screening Resources It is generally not feasible to complete more than two screenings at a single well visit. Clinics Minnesota Department of Human should determine their standard screening Services protocols, aiming for this as a minimum: ▪ C&TC Schedule of Age-Related Screening ▪ 3 developmental screenings by age 3 years, Standards (www.dhs.state.mn.us) ▪ 2 ASD-specific screenings by age 2 years, ▪ Minnesota Health Care Programs (MHCP) ▪ Social-emotional screening every 6-12 Provider Manual - C&TC Section months. (www.dhs.state.mn.us) Referral and Management Minnesota Department of Health Review the screening results with the child’s ▪ Child and Teen Checkups (C&TC) parent or caregiver. Ensuring prompt referral, (www.health.state.mn.us) evaluation, and treatment for concerns raised by surveillance, screening, or the parent, can Additional Resources improve a child’s developmental path. For children with milder concerns or whose parents decline referral, offer other Screening ▪ Medical Evaluation – A comprehensive Resources (www.health.state.mn.us) and medical evaluation determines the cause and extent of any delay, and treatment provide information on expected milestones options. A medical diagnosis is required for from either the Help Me Grow or Learn the some supportive services and insurance Signs Act Early website. coverage. For children with ASD and related disorders, ▪ Educational Evaluation - Refer the child for refer to the Pathway to Services and Supports early intervention screening and/or for Autism Spectrum Disorder (ASD) evaluation as soon as concerns are (https://edocs.dhs.state.mn.us) to learn more. identified, either directly to the local school ▪ Learn the Signs. Act Early. (www.cdc.gov) district or through Help Me Grow (1-866- ▪ Minnesota Autism Resource Portal 693-GROW or Help Me Grow (https://mn.gov/autism) (www.HelpMeGrowMN.org). ▪ Mental Health Evaluation - A qualified early For More Information childhood mental health professional can The Child and Teen Checkups (C&TC) program is support families and young children with administered through a partnership between the social-emotional concerns, and provide Minnesota Department of Human Services and the comprehensive evaluation for ASD, trauma, Minnesota Department of Health. and more. Refer to the map of Early Childhood Mental Health services by For questions about this fact sheet or to obtain this county (www.dhs.state.mn.us) to find local information in a different format, call 651-201-3760 or email [email protected]. providers. Revised 8/2021

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