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Improving Early Childhood Development

Effect on Practice


Dr. Neal Halfon, Director of the Center for Healthier Children, Families, and Communities, University of California, Los Angeles (UCLA) School of Public Health, Los Angeles, CA.

Intervening early is critical. Many mental health problems begin early in a child's life and many developmental delays go unrecognized until school. Nearly one in four low-income young children are reported to be at risk for developmental or behavioral delays.

The pediatric provider is in a strategic position to assess the development of the child and address potential problems through the provision of ongoing well-child care, preventive services, and acute care. However, at present, most of the health and developmental interventions occur outside of the pediatric setting.

As described by Dr. Halfon, the role of the child health care provider can be strengthened to improve the linkages with community-based services and systems that address early child development.

Ideally, the child's health care provider provides preventive, acute, and chronic care and developmental services and is connected to community-based resources such as:

  • Early intervention.
  • A home-visiting network.
  • Lactation support services.
  • Parenting support services.
  • Child mental health services.
  • Early HeadStart and HeadStart.
  • Child care resources.

This constellation of services supports the medical home and provides a comprehensive delivery system to promote early child development and positive parenting.

Pediatric providers can take steps to improve the delivery of developmental services by redesigning their practices to incorporate more comprehensive developmental services and connections to community resources and by improving the quality of developmental services by spending more time in assessing the psychosocial well-being of the family and the concerns of the parent.

At a policy and systems level, administering agencies and payers can:

  • Encourage linkages between pediatric health care providers and other providers of early childhood services.
  • Provide models of best practice that address the needs of both child and parent.
  • Set standards for accountability, quality, and performance.
  • Develop data collection systems that track and link data from birth through school.

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