The Economics of Developmental Screening: How Developmental Screening Protects Children’s Health and Increases Revenue 

American children are currently facing a health epidemic: developmental delays affect 1 in 4 children under age 5. Although developmental screening is recommended by the American Association of Pediatrics, many doctors are unable to give kids timely developmental screenings. In the state of California, a survey of several hundred pediatricians reported that fewer than 1 in 3 children received timely developmental screenings. There are many reasons for this; time, high costs, training accessibility, and inefficient paper-based based tools are just some. In 2017, BabyNoggin surveyed 118 medical practitioners at the AAP National, in order to acquire data on current screening methods. Lack of training and an inability to integrate current tools with EMR systems was cited as a primary driver behind professionals not using AAP-approved screening tools. An overwhelming 76% reported using only paper-based screening tools to administer tests. More data can be viewed in this survey summary: BabyNoggin-AAPNationa2017-SurveySummary.

Young brains are extraordinarily plastic, particularly from birth to three years of age. The brain grows to about 80% of adult size by 3 years of age, and more than a million neural connections are happening each second. Not surprisingly, if developmental delays are found and treated early, parents and health care providers are given the opportunity to not only prevent further delayed development in children but, in many cases, ensure that children actually improve in functionality from the point of their developmental diagnosis. According to the Center for Disease Control and Prevention, rehabilitative efforts can help children to not only compensate for but also overcome their setbacks.

Catching delays early also yields promising recovery and improved functionality. According to Griffiths & Hochman (2015), all systems within young children are constantly interacting to reach their developmental milestones; in other words, for children to be able to develop healthy speech patterns, they need a variety of developmentally appropriate skills. Here is an example: if children are not properly engaged in their environment, they will not undergo the cognitive pattern detection process that is necessary for language development. Similarly, if children lack motor control over their tongue and mouth, they will be unable to practice speech and fall behind due to a lack of practice. These cognitive and motor skills interact to produce speech and decreased functionality in one domain will ultimately spill over and negatively impact another domain. During infancy and toddlerhood, children experience sensitive periods for a range of skills; therefore, providing children with the appropriate experience during these time-sensitive “windows of opportunity” is paramount to proper development. While damage to the child accumulates when intervention efforts are delayed, the child’s ability to be successful compounds when intervention efforts are implemented.

In addition to the hordes of developmental issues that can arise due to delayed detection, there is yet another area that is heavily impacted by neglecting prevention: finances. When at-risk kids are screened early and receive early intervention, everyone benefits! The ROI of early screening and early intervention are clear:

• Providers get reimbursed. When pediatricians, family physicians, and nurses practitioners conduct developmental screenings, they can be reimbursed up to $62 through Medicaid and approximately $16 through private insurance companies– per screening! Therefore, doctors gain money by instituting preventative measures.

• Families can receive FREE intervention by the state. In many cases, when developmental delays are discovered in children before age three, intervention efforts (physical, social, emotional) are financially covered by the state, regardless of family income. After the age of three, while some states may cover a percentage of treatment cost, it is often the responsibility of their school district.

• The society benefits as a whole. Nobel Laureate, James Heckman, estimates that targeted investments in early childhood can yield 7% to 10% return on investment per year based on increased school and career achievement as well as reduced costs in remedial education, health, and criminal justice system expenditures. That is about $17 in return for every dollar invested. Additionally, this has a large effect on closing the achievement gap for disadvantaged children. In essence, developmental screening can be the first step to investing in early childhood.  

All children deserve the opportunity to be their best selves. When we conduct proper developmental screenings, we not only save money and resources, but we also set children and families up for success. The Center for Disease Control and Prevention estimate that 1 in 4 children under 5 has a developmental delay, but, if we treat them early, we can provide better outcomes for America’s children and future.

References

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