The evidence base

Child Screening and Connection to Services 

Early identification and treatment of child developmental concerns can change a child’s developmental path. Intervention is likely to be more effective when it is provided earlier in life.[1]

This is why the American Academy of Pediatrics recommends that developmental screening and social-emotional developmental surveillance be incorporated into routine pediatric care. However, results from a nationally representative survey indicate only 36% of young children receive a developmental, behavioral, or social-emotional screening.[2]

And early identification does not end with screening; referral and follow-up are needed to make sure children receive the services they need. Less than half of children with a developmental delay receive treatment before starting school, highlighting the need for effective interventions to bridge the gap and ensure timely treatment.[3] 

How HealthySteps Supports Child Screening and Connection to Services

The HealthySteps Specialist (HS Specialist) joins the pediatric primary care team to ensure universal child developmental, social-emotional, and behavioral screening, referrals, and follow-up. When a referral is needed, HS Specialists partner with community resource providers to help families coordinate and navigate complex systems, such as Part C Early Intervention (EI), and offer parents close follow-up and support to make sure services are accessed.

Research on HealthySteps demonstrates that HealthySteps identifies whether children are reaching developmental milestones and addresses any challenges early by successfully connecting children to the services they need most.


  • Children were 8x more likely to receive a developmental assessment and had significantly higher rates of developmental and other nonmedical referral [4][5]
  • One HealthySteps practice with a dedicated family services coordinator quadrupled its Early Intervention successful referral rate after implementing HealthySteps[6]
  • Across a network of HealthySteps practices, the median age of autism diagnosis for children who screened at the high-risk level was two years earlier than the national median[7]



[1] Center on the Developing Child at Harvard University (2008). InBrief: The science of early childhood development. Accessed 4/2/21.

[2] Data Resource Center for Child and Adolescent Health. (2021). 2018-2019 National Survey of Children’s Health: Data query, National Performance Measure 6,, Accessed 3/9/21.

[3] Glascoe FP. Evidence-based approach to developmental and behavioural surveillance using parents’ concerns. (2000). Child Care Health Dev, 26(2), 137–149

[4] Guyer, B., Barth, M., Bishai, D., Caughy, M., Clark, B., Burkom, D., Genevro, J., Grason, H., Hou, W., Keng-Yen, H., Hughart, N., Snow Jones, A., McLearn, K.T., Miller, T., Minkovitz, C., Scharfstein, D., Stacy, H., Strobino, D., Szanton, E., & Tang, C. (2003). Healthy Steps: The first three years: The Healthy Steps for Young Children Program National Evaluation.

[5] Hughes, S., Herrera-Mata, L., & Dunn, J. (2014). Impact of Healthy Steps on developmental referral rates. Family Medicine, 46(10), 788-791.

[6] The HealthySteps National Office. (2020). Embracing Growth: 2019 Annual Report.

[7] Mitchell, J., Levine, S., & German, M. (2020, April 29 – May 6) Screening for Autism at 18 months in primary care and age of diagnosis of Autism Spectrum Disorder [Poster Session]. Pediatric Academic Societies. Note: this conference was canceled due to COVID-19.