Step 2: Train the Team

Once you have documented your implementation plan via the Project Planning Worksheet, you will need to train staff members who will be involved in the developmental screening process. This step is broken down into two parts.

Part 1 focuses on how to use the recommended screening tools for each domain. A summary of each recommended tool will be presented along with a training video. The videos will teach you what each tool screens for, how to score it, and how to interpret the score.
Part 2 focuses on having conversations with families and making referrals. This part includes tips for incorporating conversations about developmental screening into regular visits, the importance of reviewing results with families, and navigating conversations when a screen indicates risk and further evaluation is needed.

Staff may express feelings of discomfort when implementing new developmental screening processes. These tips on Engaging Staff Members will help you anticipate feedback you may receive, and how you can address it while building communication and trust.

Training Part 1: Screening Instruments

On the Project Planning Worksheet, you should have identified staff members who will be involved in developmental screening. This team of people will need training, specifically on how to introduce, administer, and score each screen.

The Louisiana Developmental Screening Guidelines recommended instruments for each domain are listed in the table below. For some domains, we recommend a single instrument, whereas we endorse multiple options for others. Each instrument consists of questions about a person’s behaviors or feelings. Some questions ask about the child, while others ask about the caregiver. After the screening is complete, providers score the screen and interpret the results according to a standardized process.

Screening Instrument Training Pages

We have created a training page for each of the 5 screening domains contained in the Louisiana Developmental Screening Guidelines. Each page contains information about the recommended tools, videos on how to use and score the tool, and additional helpful resources. Click on the buttons below the Recommended Instruments table to access domain-specific trainings.

Training Part 2: Conversations with Families & Referrals

We encourage practices to use family-centered approaches for all visits including well-child developmental screening visits. It is important to talk with all families about what they should expect for their children, in terms of growth and development across all domains, at every appointment. Parents and families are the experts on their children and all decisions should be made together as a team.

These conversations should emphasize realistic timelines for achieving developmental milestones and should be culturally relevant to each family. For example, culturally relevant guidance may mean that for some cultures, not making eye contact is deferential and is not necessarily a “red flag” for autism. Using milestone checklists, such as those provided by the CDC’s Learn the Signs. Act Early. Initiative can help guide the conversation and serve as a helpful take-home tool for families. You can find more resources like this on our Resources page.

Whether a family is new to your practice, or you already have an excellent rapport and history with them, conversations about screening results can be challenging to navigate. We offer guidance on what to do with findings from screenings and co-developing next steps with families.

Screening Results Do Not Indicate A Need for Further Assessment (Not at Risk)

Your team has scored the screening tool and the child and/or caregiver is not at risk…now what?

When no risk is identified through screening, it is still important to go over the results with the family and talk about the next stages of development for the child. This anticipatory guidance will look different depending upon the domain assessed in the screen (e.g., perinatal depression, autism spectrum disorder), but reviewing results and giving anticipatory guidance should be provided at each visit whether additional evaluation is needed or not.

Screening Results Indicate A Need for Further Assessment (At Risk)

When a screen indicates further assessment is needed, it is crucial to discuss findings and make decisions together with the family regarding the next steps. We strongly recommend always referring a family to EarlySteps for any child under 3 years of age with developmental concerns and referring them for further evaluation or therapy as indicated.

For General, Social Emotional Development & Autism Spectrum Screens:

Explain what the screening results indicate - explain that the screen indicates the child is at risk for a developmental delay and that further evaluation is needed. Emphasize that their follow-up actions are critical to their child's development.

Conversations about screening findings set the tone for the family’s experience with the entire spectrum of evaluations and services needed for the child and family to thrive. What you say and how you say it is important. This could be the first time anyone is talking to the family about a possible developmental delay, so you should explain what that means, why additional evaluation is needed, and the importance of early intervention. Here are some points to emphasize:

A screen that indicates risk is not a diagnosis.
A screen that indicates risk means that further evaluations by a specialist are needed. Further evaluations will help determine if a child needs early intervention services and support.
We perform screens to catch issues or concerns as soon as possible so that children can get the early intervention services that best fit their family's wants and needs, and help them thrive as early as possible.

For Barriers to Health & Perinatal Depression Screens

Screening for Barriers to Health and Perinatal Depression is crucial to supporting a family after the birth of a child. However, pediatric providers often report being unsure of the next steps when a caregiver shows signs of depression on the barriers to health and/or perinatal depression screens. The SEEK provides algorithms that have key phrasing to walk you through addressing screens that indicate risk (e.g., substance use, caregiver depression) while using Motivational Interviewing techniques.

Further, the Provider-to-Provider Consultation Line (PPCL) can help. When pediatric providers enroll in PPCL, they can call the program to receive real-time, expert consultation from a psychiatrist and mental health consultants about the best ways to help their patients. This includes helping providers determine if and how to safely prescribe medication to caregivers (including pregnant and postpartum women) and providing resource and referral information to help providers build a more complete treatment plan.

Some screening questions address sensitive topics that could indicate a child is in danger. When there is evidence of abuse, neglect, or exploitation, follow the mandated reporter protocols in your organization. Below are a couple of additional resources if needed:

For cases that require immediate attention, call 1-855-4LA-KIDS or 1-855-452-5437
Use the Mandated Reporter Portal for children who are not at immediate risk of harm.

Our developmental screening expert is available to assist you with any and all steps! Our team can provide information and customized training on how your specific practice can implement developmental screening. Learn more on our Implementation Training and Support page including how to reach out to us.

Making Referrals

Referrals are the other half of the conversation when a screening indicates further assessment is required. It is necessary not only to initiate the referral but also to follow up to ensure the family connects to services. By developing a plan together, provider-family teams are set up for success. Everyone in the child’s life is invested in ensuring the child receives the needed assessments and interventions so the child and family can thrive.

Regional Resources

Department of Education's Early Childhood Community Network:

Use this interactive map to find customized Learn the Signs. Act Early materials and local early child care and education contact information for each parish.

Developmental Screening Resource Guides

These guides were created to help providers refer families to relevant services and share screening-related resources. Go through these guides together with the family to help them begin to explore and evaluate their options. Each regional guide has local contact and referral information for agencies and services, as well as more family-oriented resources such as milestone tracking apps. Check out this video to learn more about these guides and how you can use them with families!

Click on the buttons below to access the guide for your region.

Statewide Resources

EarlySteps is the Early Intervention Program for Louisiana Families with children ages 0 - 3 years old. Anyone can refer a child to EarlySteps, and they will do the necessary evaluations to determine if the child is eligible. To receive early intervention services, a child must exhibit deficits in two domains (e.g., physical, verbal, visual). As such, many children are not eligible if they have risk indications in only one area, or are not already experiencing significant delays. Thus, it is crucial to ensure that EarlySteps is not the only referral – families should immediately be referred for additional evaluations and services beyond EarlySteps. To refer a patient, contact the Intake Coordinator at the System Point of Entry Office in your region to complete the referral form.
The Family Resource Center is available to support pediatric providers and families of children with special health care needs across the state of Louisiana. The Family Resource Center assists providers in linking families to resources, including support services such as early intervention, childcare assistance, insurance, and disability support.
Universal Newborn Hearing Screening and Early Identification follows children who do not pass their newborn hearing screen. If the child does not seem to be responding to noises (a common red flag for developmental delays), check the LA EHDI-IS system to view their newborn hearing screening result, or contact the EHDI program for more information. If a parent is concerned about their child’s hearing, refer them to an audiologist to have the child’s hearing screened again. Use EHDI-PALS to locate an audiologist in your area. They can help make referrals to additional community resources.
Provider-to-Provider Consultation Line (PPCL) is a no-cost provider-to-provider telephone consultation and education program that provides consultation to health care providers serving pediatric patients ages 0-21, pregnant/postpartum women and their caregivers across Louisiana. PPCL can help providers address pediatric and perinatal behavioral health issues, substance use disorders, autism spectrum disorders, intellectual and developmental disabilities, interpersonal violence, and more.
Managed Care Organizations are required to provide care coordination services for children and families enrolled in Medicaid. You can find contact information for referring children and families to the care coordination services with each Managed Care Organization here.
Louisiana Department of Early Childhood Special Education Resources has information such as how to help children transition from the early intervention system to the school special education system.