Screening Interviews

Pediatric Tools


Screening Interview

Screening Interviews
 
Technology is providing the computing power and connectivity to upgrade simple paper-based screening into a comprehensive screening interview. Pediatric Tools enables you to combine de facto standard screenings like ASQ-3, ASQ:SE-2, SWYC, EPDS , M-CHAT-R, ESQ, ACE and SDoH for greater breadth and depth. This takes work off providers and staff while supporting parents and providers with a greater range of information and follow up actions. Systemically we need a comprehensive screening interview to better support child health and development.

A Systemic Solution is Needed

Early detection

Whether it is developmental delay, autism or a range of other issues, early detections enables more effective treatment. It is imperative to detect issues as early as possible. The AAP has issued guidelines of at a minimum, administer three developmental screenings by the age of three, two autism screenings in the second year and start behavioral health screenings as early as one year old. We need to be reaching children as early as possible.

100% reach

Social and wealth inequities manifesting in health inequities, results in children that are the hardest to reach often being the ones who need help the most. The easiest reach is into Medical Clinics during well-visit checks, covering the vast majority of children. After that, Public Health services pick up a portion of the remaining children but generally Community Health, including Early Learning Centers and other agencies, is needed to obtain 100% reach. The screening interview needs to support all types of connection and whatever administration method works for the parent. Technology is making 100% reach a goal that we can easily obtain.

What should be measured and monitored

Simply following the AAP guidelines, developmental delay, autism and behavioral issues are the primary concern. Work supported by CMS shows that social determinants of health and environmental factors are also key drivers to children’s health and development. ACESAware.org is an excellent reference on the effects and treatment of adverse childhood experiences. Under a grant being administered by Help Me Grow, the Pediatrics Supporting Parents project brings a sharp focus to parent and family engagement, education and advocacy. A screening interview needs to support the breadth and depth of information required without being too onerous for the parent to complete.

What follow up actions should be supported

Typically screenings are provider facing meaning that results are reported to the provider and they need to handle all follow ups on the information collected. Technology enables much of the follow up work to be automated. Often additional information is need, as well as recruitment of the parent into linked resources and services, which can be included in the screening interview. Along with better analysis for the provider report, a pre-visit parent report coaching the parent, as well as an in-depth report for the parent as a take away after the visit should be standard practice. Linkages, care coordination and data sharing should be supported within the community health network.

Breadth and Depth Required

Screening Interview

Development

Child development is crucial to their trajectory and success in school. Developmental delay and autism are the primary concerns typically measured using the ASQ-3 for developmental delay and the M-CHAT-R for autism. The SWYC has a general measure of delay, however it does not provide the depth of the ASQ-3 which has separate measures of delay for communication, gross motor, fine motor, problem solving and social-emotional.

Screening Interview

Behavioral

Social, emotional, relational and psychological issues are the primary concerns typically measured using the ASQ:SE-2 or the SWYC for social emotional and PEARLS/ACE for trauma and toxic stress. Further depth around self-regulation, compliance, social communication, adaptive functioning, autonomy, affect and interaction with people can be obtained from the ASQ:SE-2 or inflexibility, irritability and routine can be obtained from the SWYC.

Screening Interview

Parent & Family

Parental concerns about their child’s development and behavior typically measured with the ASQ-3 and ASQ:SE-2 respectively need to be addressed. Postpartem depression on the part of the parent typically measured with the EPDS needs to be managed. Other screenings can be added to cover these measures and extend them to include parent & family priorities leading to a parent led agenda for the visit.

Screening Interview

Environment & Community

Social determinants of health and physical factors measured using the PEARLS, ESQ and others, are key drivers of a child’s health and development. These break down into social determinants like food, housing, financial and physical safety, transportation and access to early education and physical factors like tobacco use, substance use, nutrition and family violence.

Dynamically Combine Screenings Into an Interview

Screening logic makes it work

Simply administering all the screenings required, one after the other, is too onerous for the parent and not a viable strategy. Pediatric Tools has worked with Brookes Publishing and others to create dynamic versions that break down the screenings into their component measures. There is redundancy which can be eliminated and software logic can be applied to only go as deep as necessary to get adequate information.

Triggers and branching

Using concurrent validation, triggers have been created that accurately determine when the depth of questioning is adequate or when branching to a measure is required. Triggers and branching, along with elimination of redundant measures, enables screenings to be dynamically combined into a single interview that gathers adequate information in a manageable amount of time.

Effective Result Actions
sample report

Triggered Follow Up Questions and Recruitment

As part of the screening interview trigger more in-depth questioning, as well as provide information, about referral and linkage to services and resources.

Clinical Report

The Clinical Report summarizes all the information that has been gathered. Parental concerns, measure results, secondary measures, trended graphs and item responses with computed scores eliminate staff time to compile and give the Clinician the information to conduct a comprehensive visit.

View Clinical sample report

Parent Reports

A Parent Pre-Visit Report focuses on parental concerns enabling a parent led agenda for the visit. Coaching about what to expect sets the stage for a successful visit.
Additionally, visits are teachable moments for parents addressing their concerns, seeing how their child is doing, learning new ways to support their child’s development and setting expectations about what should happen before the next visit. A comprehensive Parent Takeaway Report reinforces what has been discussed with the Clinician and supports the Parent going forward.

View Parent Takeaway sample report

Linkage to Services and Resources

Using the screening interview to educate, gather follow up information and recruit into linkage to services and resources supports both manual and automated follow up actions. API connection to automatically connect parents are currently being developed.

Evidence-Based AI Interviewing (coming soon)

Probabilistic scoring using validation evidence

Conventional scoring sums answer values from all questions into a severity score. The result is then determined using cut scores to classify which result region of the measure corresponds to the severity score. Probabilistic scoring uses validation data to measure the result region directly on a question-by-question basis. It quicker and more accurate.

Structured probability networks versus neural networks

Rather than training a neural network, a structured probability network uses probabilistic evidence computed directly from validation datasets, making the process evidence-based. Additionally each node corresponds to a screening measure result and can be combined with other flag and action nodes to form an intelligent screening interview.

Give the Comprehensive Pediatric Screening Interview (CPSI) a try!
Try the CPSI
See how easy it is to combine the ASQ-3, ASQ:SE-2, SWYC, EPDS, M-CHAT-R, ESQ, ACE, and SDoH into a single comprehensive interview.

Pediatric Tools
877-433-5900 | info@pediatrictools.com
 
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