Doctor wearing a face masks reads a book with a young patient on an exam table during a well visit

Universal Developmental Screenings Will Put Kids on Track for Healthier Futures

With 11,000 pediatric patients under its care annually, Zufall Health is dedicated to the healthy development of all children, regardless of their circumstances. To that end, the health center is preparing to add a standardized approach to childhood development in its Dover and West Orange locations.

What Are Developmental Delays?

In the U.S., one in six children experiences developmental delays in their physical, cognitive, social, and emotional skills. Relative to their peers, children with developmental delays are slower to reach milestones like reacting to loud sounds (typical by 2 months), eating with a spoon (typical by 2 years), and counting to 10 (typical by age 5). A developmental screening, a formal questionnaire or checklist for a child’s development, serves as the initial step in identifying these delays. While not a definitive diagnosis, the screening helps determine if a more detailed assessment is required, enabling families to pursue interventions promptly.

New Jersey’s education system serves as a point of identification for developmental concerns in children, but there are significant gaps for children under age 5. Alarmingly, only 31 percent of children in the state undergo developmental screenings annually, dropping to 21 percent for children best served in a language other than English. Kids with demographic characteristics representative of Zufall’s patient population, like identifying as Hispanic, having low household incomes, and being uninsured/underinsured, also face significant barriers to screenings.

A Standardized, Evidence-Based Approach

In response, Zufall is introducing an Early Childhood Development (ECD) program, supported by a two-year, approximately $400,000 grant from the Health Resources and Services Administration (HRSA). This program will implement universal developmental screenings for Zufall patients aged 0 to 5 during pediatric well visits in Dover and West Orange and timely access to follow-up services.

Zufall has previously conducted various developmental screenings for children and families, but the ECD program marks the first instance of offering a standardized approach to all children at two clinical sites. Utilizing the evidence-based HealthySteps®
model that aligns with guidelines from the American Academy of Pediatrics, Zufall providers will conduct screenings that consider the child, their parent/guardian’s mental health, and the social determinants of health impacting their development.

Advancing Health Equity with Team-Based Care

Like many other Zufall programs, the ECD program integrates multiple health care disciplines and will operate with a team-based approach. Overseen by senior vice president of behavioral health services Sarah Aleman, MSW, LCSW, the ECD program also draws on the expertise of pediatricians Christine Pagano, MD, and Aviva Schein, MD, who will serve as ECD champions in Dover and West Orange, respectively. Licensed associate counselor Lesly Tinoco, LAC, will serve as the ECD specialist and current behavioral health MSW intern Cristian Urriola-Pinto will serve as the ECD project manager.

“Our team-based approach to developmental screenings will be especially beneficial for our significant population of new immigrant asylum-seeking families with young children,” said Aleman. “Identification of any delays in this population will advance equity, as this population is at increased risk for developmental delays due to their history of trauma and adverse childhood experiences.”

The ECD program will officially launch in early 2024. Based on historical data, Aleman and team anticipate that approximately 100 children in Dover and West Orange will be diagnosed with a developmental delay and assisted into follow-up care within the first year of the ECD program.

Above: ECD Champion and pediatrician Aviva Schein, MD, and a young patient read together during a well visit in West Orange. 

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