Act Early, Read Daily: A Developmental Monitoring & Language Enrichment Educational Intervention in Delaware WIC Clinics

2021

Approximately 1 in every 4 children is at-risk for developmental delays, yet in Delaware (DE) only 30.8% of children ages 0-5 years receive developmental screening. Children who are identified early and receive early intervention see more positive outcomes than children detected at school-age. While healthcare providers remain a primary target for integrating validated and standardized screening tools, other community settings have proven valuable as agents for increasing developmental surveillance and parent engagement prior to formal screening. Several states have integrated education on child development into Women, Infants, and Children (WIC) programs with demonstrated success. Missouris WIC Developmental Milestones Program integrated Learn the Signs. Act Early. (LTSAE) developmental checklists and educational graphics to increase parent awareness of milestones and referrals to primary care doctors for developmental concerns in a manner that was reportedly feasible and sustainable. Developmental risk is heightened among the 40% of DE children from low-income households. Children who live in poverty are less likely to live in communities that foster language development, pre-literacy skills, social-emotional wellness, school readiness, and grade-level academic achievement. The negative impact of poverty on childrens language learning, in either English or Spanish, can be identified as early as 18 months and is pronounced by 24 months. A critical mediating factor is the amount of language stimulation children receive in the home and other settings in the first years of life, and there is ample evidence that families can learn to facilitate their childrens language development through language enrichment activities. The DE WIC Program is a conduit to thousands of children and families living in poverty, and targeted educational programming in which WIC staff are trained as change agents has shown great success. The purpose of this study is to examine the impact of adding a pre-screening developmental checklist and language enrichment materials into the WIC Certification and Mid-Certification appointments. The intervention will be implemented at WIC centers across the State of DE. During certification and mid-certification visits, WIC staff will offer parents the opportunity to complete a brief developmental checklist for their child. Staff will review the checklist when complete. When developmental concerns arise, parents will be referred to Help Me Grow/2-1-1 for developmental screening and the WIC electronic record will be flagged for follow-up with the family at their next visit. Parents will receive a copy of their checklist and a parent kit to promote continued developmental monitoring at home. LTSAE materials are available in the three most prominent languages served in DE WIC clinics: English, Spanish, and Haitian Creole. At each measurement point (pre, during, and post), the following data will be collected: WIC staff surveys and WIC electronic site records indicating the number of checklists completed and referrals for developmental screening. Pre-intervention, retrospective review of WIC electronic site records for risks/referrals will take place. Post-intervention, a series of interviews will be conducted with WIC staff and families to assess feasibility, sustainability, and institutionalization of practices. Comparison will be drawn between rural and urban WIC clinics.

Developmental Monitoring, Early Literacy, WIC

Performing Direct and/or Demonstration Services, Continuing Education/Community Training

Education & Early Intervention, Health-Related Activities

Professionals and Para-Professionals, Family Members/Caregivers, Children/Adolescents with Disabilities/SHCN

Racial or Ethnic Minorities, Disadvantaged Circumstances, Limited English, Geographic Areas, Rural/Remote, Urban

State

Federal

N/A