By: Lisa Honigfeld, PhD
Mid-Level Developmental Assessment (MLDA) provides an improved way to assess developmental needs in early childhood. A new report from the Child Health and Development Institute (CHDI) highlights its successes in five communities in identifying and meeting the needs of children with mild to moderate developmental and behavioral problems. Initially developed by the Village for Children & Families in Hartford in consultation with CHDI, MLDA development, dissemination, and evaluation are now housed at Connecticut Children’s Office for Community Child Health (the Office).
MLDA is designed to efficiently assess the developmental needs of children with mild to moderate concerns, which would not qualify them for publicly-funded early intervention services. Following the assessment, families are connected to care coordinators at Help Me Grow, another program of the Office that supports developmental promotion in 29 states. Help Me Grow care coordinators link families to services that can address the concerns identified by the MLDA before they escalate and become more difficult and more expensive to treat.
Without a mid-level option, these mild and moderate types of concerns are likely to go unaddressed until kindergarten entry. Therefore, critical time for intervention to promote school readiness is lost.
In 2015, with support from the Lego Children’s Fund, MLDA expanded from its initial pilot at the Village to supporting families at three other locations around Connecticut. As the report highlights, an initial study found 139 families that participated in MLDA were connected to community services such as parenting education, play groups and family support services; mental or behavioral health programs; and medical and dental services. More than 90 percent of parents rated their satisfaction with the service as very high.
MLDA has also expanded to five Help Me Grow affiliates in four additional states, with generous support from the W.K. Kellogg Foundation. From January 2016 through March 2017, more than 500 assessments took place at those locations, after which families were linked to services through the Help Me Grow care coordinators in their communities.
The overall findings from the MLDA pilot projects and subsequent expansion highlight several important considerations for making MLDA the standard of care for children with mild and moderate developmental and behavioral concerns. Critical to meeting the needs of children and families through an MLDA-driven assessment model is the need to embed the assessment within an early childhood system that has mechanisms for early identification of concerns as well as a broad continuum of resources to which young children and families can be referred for assessment and evaluation. An array of community resources that support development and behavior in young children is also essential to meeting children’s and families’ needs when they do not qualify for publicly funded intervention services. The MLDA model also requires support through reimbursement for personnel who perform assessments and care coordinators who connect families to helpful community-based services.
If early childhood systems can re-frame and adopt policy to support the role of assessment services from one of determining eligibility to one of identifying needs and linking to services to ensure healthy development, MLDA within a comprehensive early childhood system can address the needs of the large majority of children who arrive at kindergarten lacking essential skills for school success.
Lisa Honigfeld, PhD, is the associate director of Connecticut Children’s Office for Community Child Health and vice president for health initiatives at the Child Health and Development Institute of Connecticut.
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