Learning Objectives for START
The purpose of the START program is threefold:
- To increase early identification and referral of children with developmental delays or behavioral problems using standardized screening tools.
- To better understand referral resources in your community.
- To learn about better documentation of services, coding and payment.
Surveillance & Screening
Most pediatric health professionals practice developmental surveillance. Surveillance is a flexible, ongoing process where knowledgeable professionals perform skilled observations of children during the health care visit.
Developmental screening, on the other hand, is a brief procedure, using a standardized validated tool, available either commercially or in the public domain, to determine whether a child requires further and more comprehensive evaluation. Developmental screening enhances surveillance. Screening may be a part of routine well child visit or it may be used during acute care visits in response to a specific concern about a child. The AAP recommends routine surveillance and using standardized developmental and behavioral screening at least 3 specific times: the 9, 18 and 24/30 month visits.
In an updated 2006 policy statement, the AAP recommends routine surveillance and standardized developmental and behavioral screening. The statement reiterates what was said in the 2001 policy statement but also provides an algorithm as a strategy to support health care professionals in developing a pattern and practice for addressing developmental concerns in children from birth through 3 years of age. It recommends that developmental surveillance be incorporated at every well-child preventive care visit and any concerns raised during surveillance should be promptly addressed with standardized developmental screening tools. In addition, screening tools should be administered regularly at the 9, 18, and 24 or 30-month visits.
Tennessee’s Early Intervention System (TEIS)
The START program is a collaboration with Tennessee's Early Intervention System (TEIS) funded by the Tennessee Department of Education.
Tennessee Early Intervention System (TEIS) is a statewide program sponsored by the Tennessee Department of Education. It is mandated under the Individuals with Disabilities Education Act (IDEA), Part C, to provide early intervention services to children eligible under this act. TEIS is a network of nine district offices that provide home-based, early intervention services to young children with special needs (birth to three years) and their families.