Childhood Developmental Screening

• Referral Form
• Reimbursement Information

We at WVP Health Authority have partnered with the Oregon Pediatric Improvement Project (OPIP) on a performance improvement project that is centered around childhood developmental screening. The Oregon Assuring Better Child Health and Development Early Childhood Screening (ABCD III) initiative is a project to improve the system for identifying and referring children with developmental and behavioral delays. The ultimate goal of the ABCD III project is to coordinate care between the provider, Early Intervention, and WVP Health Authority.

In order to facilitate this care coordination, WVP has contacted several pediatricians and have determined that the Ages and Stages Questionnaire (ASQ) is a great tool for general developmental screening of children. For those offices that do not utilize the ASQ, please contact us, and the tool will be provided for you. This is a tool that will be filled out by the parent before the Well Child Visit. The recommended periodicity of this tool is 9 (vs. 12), 18, 24 (vs. 30), and 36 months of age. For those who require training on the use of the ASQ, SMART training can be scheduled to assist with this.

In order to assist in the coordination between the provider and Early Intervention, we have included a common referral for to EI/ECSC. For children identified with a medical condition that puts them at risk for developmental delay we can identify them with a physician’s statement for birth to age 3. This referral form has been approved by OHA and the referral form also provides the consent release we need to share information back to you if parents sign it before you send it to us. Remember you can bill for the developmental screenings by using the code 96110.

For those providers who are seeking Medical Home certification through NCQA or OHA, the use of this common referral form fits the requirement of Providing Referrals to Community Resources.

For any additional information about ABCD III, please contact:

Chris Grinstead – cgrinstead@mvipa.org
Stuart Bradley – sbradley@mvipa.org

For any information on Early Intervention or Early Childhood Special Education, please contact:

Devora Gramson – Devora.Gramson@wesd.org

To schedule SMART Training on the use of the ASQ and other childhood developmental screening, please contact:

E. Dawn Creach – dawn.creach@oraap.org