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Population/Community Health Promotion Project

Child Development Watch

Delaware Technical Community College

NUR 330 Population and Community Health

Danielle McWilliams

April 9, 2019
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Population / Community Health Promotion Project

Child Development Watch is a state-wide, early intervention program that is available to

residents across all of Delaware, that operates under Delaware Public Health. This program is

designed for parents, guardians, and families that have developmental concerns for children, ages

birth to three. Child Development Watch (CDW) is a voluntary program and uses a multi-

disciplinary approach for treatment. “The mission is to enhance the development of infants and

toddlers with disabilities or developmental delays, and to enhance the capacity of their families

to meet the needs of the young children” (Delaware.gov, n.d).

Assessment

The program requires a referral from either the parents, guardian, healthcare provider,

daycare provider, or teacher. This referral is received by CDW and is then triaged through the

system and assigned to the appropriate Family Services Coordinator located in the assigned area.

The Family Services Coordinator reaches out to the family to explain the program, determine

interest in the program and schedules either an appointment in the facility or within the home.

There are requirements that must be met for the child and family to qualify for services

through the program. It begins with a standardized developmental assessment by an assessor, the

assessors utilize a standardized booklet to guide their interactions with the child. Based on age of

the child, interactions are completed in relation to what the child should be able to complete at

their age. The child is assessed in a variety of areas including fine motor and gross motor skills,

problem-solving skills, receptive and expressive language, cognition and behavior.

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At the end of the assessment a score is derived from the standardized booklet and by use

of comparison of the score against a key, the presence of developmental delays is determined. As

a group, the child’s results are discussed between the Family Services Coordinator, Pediatrician,

and the assessors. A plan and recommendations are discussed if the child qualifies for services.

The results are then explained thoroughly to the family where the areas of assessment are

discussed in depth regarding to results, what the child did good as well as what the family needs

to be working on with the child to enhance development. The Family Services Coordinator

(FSC) explains to the family what to expect next and fills out an Individualized Family Service

Plan (IFSP), which outlines goals and interventions for the child as well as, sends referrals to

designated areas of interventions so therapies can begin.

By use of the windshield survey, a variety of individuals are served throughout Delaware

by Child Development Watch. This program does not discriminate based on language, ethnicity,

culture, religion; nor does it discriminate based on level of education of families, housing, or

insurance. Child Development Watch is state-funded program created for all individuals within

the Delaware state lines. This program serves individuals who speak creole, Spanish, Chinese,

and English. CDW was created to serve each family equally and provide families and children

with services regardless of type of housing to transportation; families who live in dilapidated

houses are treated equally to those who live in extravagant 3-story houses. Child Development

Watch offers means of in-home services, if families lack transportation, meetings can be set up at

the home including not limited to the intake, assessment, and IFSP updates. In some cases,

transportation is offered to those individuals/families who require assistance with getting their

children to and from scheduled appointments or follow-up Doctor appointments.

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Child Development Watch is affected by utilization of Healthcare Policies. As mentioned

earlier, this program is a state-wide and state-funded, voluntary program. Prior to the

developmental assessment of the child, consents are signed including the gathering of insurance

information, and a consent for CDW and the pediatrician to be in contact with the referring

doctor as well as the child’s pediatrician. The program operates under the Individuals with

Disabilities Education (IDEA) Act, Part C.

Part C of IDEA and its implementing regulations at 34 CFR Part 303, provide the

specific requirements for Child Development Watch. Child Development Watch provides early

intervention services to children with private insurance coverage as well as, Medicaid, Children’s

Health Insurance (CHIP), and Health Care Connection. If families do not possess insurance

coverage, families have the options to pay out of pocket for services or file an application for the

state to cover the services through Part C.

The nurse’s role at Child Development Watch varies including acting as a developmental

assessor, family services coordinator as well as a nurse. The public health nurses at Child

Development Watch are assigned the medically involved and medically complicated children.

Child Development Watch looks at the child developmentally however the nurses are there to

help coordinate care as it relates to the children’s and families’ medical needs; the nurses should

continue to practice critical thinking skills as during visits they must be able to quickly identify

medical interventions that are necessary in proper care, treatment and development of the child.

Disparities and/or Barriers

Improving the overall health of all populations is an important goal of Healthy People

2020, their definition of health disparities as “a particular type of health difference that is closely
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linked with economic, social or environmental disadvantages; health disparities adversely affect

populations who experience more obstacles to health based on race, religion, socioeconomic

status, gender, and age” (Braveman, 2014, p. 6).

Identified health disparities or barriers in this population include genetic predisposition,

insurance coverage or lack thereof, transportation, parental participation, living environment,

exposure, and level of education. This program is voluntary however the parents or guardians are

the ultimate decision makers. Many factors affect the ability to receive services however the

family services coordinators and therapists can make accommodations to meet the needs of the

child, as well as the family.

SMART Goals (SMART = Specific, Measurable, Achievable, Realistic & Timely)

1. Child Development Watch will set up a community awareness program in each of the

major counties to provide education to the community.

2. Child Development Watch will employ more family services coordinators to be able to

evenly distribute cases amongst the counties with the greatest needs, Kent County as well

as Lake and Milford areas.

3. Delaware Public Health and Child Development Watch will work together to create an

online tele-health system that is available to individuals across Delaware to increase

availability and accessibility of the program.

Identify Available Resources

Delaware has adequate resources available to residents state-wide including healthcare

providers, pediatricians and daycare providers that can make referrals to the program. One of the

pediatrician offices, Nemours DuPont Pediatrics, has pediatricians available to complete

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developmental assessments on their pediatric patients which aids in a quicker progression of the

program initiation with families. The state has many resources available to aid in early

intervention services such as early childhood educators and Easter Seals, including the physical

therapists, occupational therapists, and speech language pathologists. As families begin services,

the Family Services Coordinator recommends to families to attend Sunny Days or play and stay

days locally. For the medically complicated infants and toddlers, Bayada Pediatrics and Nurses

and Kids are available for services including nursing care at home and school or a daycare that

employs nurses to help care for children with tubes or lines. In some instances, depending on the

needs of the child and family, references will be made to other resources available to them

including vision services, deaf and blind services, autism doctor in Dover, Delaware, as well as

other specialty doctors.

These resources can be utilized as interventions to meet the SMART goals stated above.

Educational resources can be provided to the local facilities to provide accessibility to program

information. Education can be aimed at not only families needed assistance but also,

professionally. By providing more information on a professional level, it could make individuals

more aware of job opportunities promoting increased employment of family service

coordinators. In today’s healthcare, tele-health is becoming increasingly more common; all the

resources available have means of online promoting and planning, if all resources combine

together with Child Development Watch and Delaware Public Health, the program could

explode with cases all across Delaware because it will be more accessible to all Delaware

residents.

Evaluation Plan
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Early intervention services must be evaluated frequently for improvements or new

concerns or needs of the child or family. The Family Service Coordinator utilizes an

individualized family service plan (IFSP) to identify goals that address the developmental needs

or concerns of the child, while recommending or updating interventions to enhance

developmental progression with services. Currently, the IFSPs do not have a required time to

update the plan of care however to accurately assess the child’s progression with services,

Family Service Coordinators should be communicating at a minimum, monthly with parents and

guardians to address any new concerns and to discuss the child’s current activities and

progression with current interventions. The primary therapists should provide the Family Service

Coordinators with weekly updates throughout services.

Conclusion

The early years of a child’s life is crucial for development, “in the first five years of life,

a child’s brain develops more and faster than at any other time in their life” (Raising Children

Network Limited, 2019). “In the early years, a child’s main way of learning and developing is

through play” (Raising Children Network Limited, 2019). Early intervention “has a significant

impact on a child’s ability to learn new skills and overcome challenges” (Centers for Disease

Control and Prevention).

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References

Braveman, P. (2014). What are health disparities and health equity? We need to be clear. Public

Health Reports, Nursing in 3D: Diversity, Disparities, and Social Determinants, 140(2).

Centers for Disease Control and Prevention. (2019). Early intervention. Retrieved from

https://www.cdc.gov/ncbdd/actearly/parents/states.html

Delaware.gov. (n.d). Child development watch. Retrieved from

https://dhss.delaware.gov/dph/chs/chscdw.html

Raising Children Network Limited. (2019). Child development: The first five years. Retrieved

from https://raisingchildren.net/newborns/development/understanding-

development/development-first-five-years
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