Statewide Collaboration to Educate on Developmental and Behavioral Monitoring and Screening

Tennessee’s Screening Tools and Referral Training (START) program

Toni M. Whitaker, MD, Medical Director, University of TN Health Science Center, Department of Pediatrics, Division of Developmental Pediatrics, Memphis, TN
Jason A. Yaun, MD, Training Director, University of TN Health Science Center, Department of Pediatrics, Division of General Pediatrics, Memphis, TN
Susan H. Rollyson, MEd, Program Manager, Tennessee Chapter of the American Academy of Pediatrics, Nashville, TN
Quentin A. Humberd, MD, Founder, Vanderbilt University School of Medicine, Nashville, TN

Why What How

The Screening Tools and Referral Training (START) program is a statewide
evidence-based educational program for a variety of professionals designed
to help pediatric medical, early education, home visiting program, and other
providers learn skills and strategies to implement routine developmental,
behavioral, and autism monitoring and screening.
Strong partnerships within and among systems help ensure a wide
interdisciplinary audience and include many agencies and stakeholders that
connect with and serve children and their families.
The START program is The START program includes a case-based format that teaches participants to
• developed and managed by the Tennessee Chapter of the American • recognize the importance of early identification and early intervention for
Academy of Pediatrics (TNAAP), developmental and behavioral concerns,
• funded and attended (as co-trainers) by the Tennessee Department of • recognize the difference between monitoring (surveillance) and screening
Education Early Intervention System (TEIS, an IDEA Part C program) as part of and how they work together to improve outcomes,
“Child Find” activities, and • select and use tools for screening,
• supported and promoted by multiple local and state contributors, including • discuss monitoring and screening results with families, and
the CDC’s Learn the Signs. Act Early. program Ambassador to Tennessee.
• implement efficient office procedures for screening and referrals.

Where
The START program has provided training to
Healthcare Education and Community
• Medical practices – Pediatric and • TN Child Care Resource and Referral
Family Medicine Physicians, Network (TN CCR&R) - Early
Nurse Clinicians, Physician Childhood Educators, Directors
Assistants, Staff • University of Memphis Coordinated
• TN Department of Health Clinics Effort to Enhance Development
– Nurse Practitioners and Nurse (CEED) program - Early Childhood
Who Supervisors Educators, Directors
The START program has • Medical and other health • TN Department of Health - Evidence-
• trained over 560 practices and 5130 individuals over the span 2004-2018 professions schools - Students based Home Visiting (such as HUGS
• Medical intern and resident Program and Children’s Special
• trained over 1096 individuals during 2018-2019 year
training programs - Pediatrics, Services)
Family Medicine • Project Launch, Early Success
Content delivery by physician trainers (Pediatrics, Developmental Pediatrics)
Coalition – Evidence-based Home
may include: in-person, train-the-trainer, and online Visitors, Early Childhood Educators

Developmental and Behavioral Screening Tools Resources Provided

Postnatal Depression Screening Tool Detailed information on Tennessee Early Intervention System (TEIS) with links to other states’ IDEA Part C programs
Edinburgh Postnatal Depression Scale (EPDS) Medical billing/coding assistance, TNAAP staff
Developmental Screening Tools Homework: Map the Workflow
Parents’ Evaluation of Developmental Status (PEDS)
National resources
Ages and Stages Questionnaire - Third edition (ASQ-3)
AAP’s Screening Technical Assistance & Resource Center [STAR] Center
(some trainings include: Ages and Stages Questionnaire –Social Emotional (ASQ-SE) CDC’s Learn the Signs. Act Early. including free materials and Autism Case Training modules
Autism Screening Tool
State resources
Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT R/F)
KidCentralTN
Broad Band Screening Tools Disability Pathfinder
Pediatric Symptom Checklist (PSC-17) TNAAP Behavioral Healthcare in Pediatrics (BeHiP) training program information (screen for, assess, and manage patients with
Patient Health Questionnaire (PHQ-9) emotional, behavioral and substance abuse concerns)
Alcohol and Substance Abuse Screening Tool (CRAFFT) TNAAP Pediatric Healthcare Improvement Initiative for Tennessee (PHiiT) Quality Improvement project for Developmental
Attention Deficit /Hyperactivity Disorder Screening Tool (NICHQ Vanderbilt ADHD Scales) Screening, optional for medical practices who participate in START training

The START program is funded under an agreement with the State of Tennessee. It is adapted with permission from the Illinois Chapter of the American Academy of Pediatrics and the AAP Medical Home Initiative, D-PIP (Developmental Surveillance & Screening Policy Implementation Project).