ABCD Programs

		North Carolina’s Success Story
		Before the ABCD initiative in North Carolina and the use of ASQ in participating physician practices, the average developmental screening rate for children across the state’s Medicaid systems was low—about 15%. Children were not receiving the screening required to catch delays early, because common screening practices in North Carolina required too much administration time and were dependent on assessments made by physicians during office visits rather than parents’ expert knowledge. After ASQ was adopted as the screening tool of choice within the model ABCD physician practices, screening rates had soared to more than 70% by 2002. Three years later—by March 2005—the screening rate had climbed to 85%. ASQ also helped improve provider-parent communication and increase parent knowledge about child development: in a 2003 survey, 71% of providers reported using ASQ as a guide when talking to parents, and parents reported that they valued the tool as a guide to developmental milestones. [3]

If your state or program is receiving funds and assistance through the Assuring Better Child Health and Development (ABCD) initiative, ASQ can help you meet the goal specified by ABCD: supporting optimal early development of all children, especially those from low-income families. ASQ is on the short list of screening tools recommended by 27 ABCD states [1], and it's been widely used in state projects during all three phases of the ABCD initiative:

ABCD I

The first ABCD initiative focused on overall development and provided funds and assistance to four states. ASQ was the screener of choice in

• North Carolina-used ASQ in providers' offices as part of well-child visits
• Utah-piloted ASQ at the community level, with parents receiving questionnaires by mail
• Washington-ASQ was administered by public health nurses and Head Start staff

ABCD II

Focused on improving mental health in early childhood, ABCD II provided funds and assistance to 5 states: California, Illinois, Iowa, Minnesota, and Utah. Screening tools for the ABCD II initiative were selected by each state's project staff, with heavy involvement from clinicians. After the review process, ASQ and ASQ:SE were recommended for the ABCD projects in all 5 participating states.

ABCD Screening Academy

The ABCD Screening Academy was launched to promote the use of standardized screening tools. ASQ is being used in many of the 19 states receiving funds and assistance as part of the Screening Academy-including Arkansas, California, Colorado, Kansas, Minnesota, Montana, New Jersey, Oregon, Puerto Rico, and Virginia. Using a variety of strategies and platforms, state ABCD teams are spreading the word about developmental screening in general and ASQ in particular:

• In Alabama, ASQ developers conducted trainings at select sites, which allowed these sites to serve as models and encouraged improvements in developmental screening at ad¬ditional practices. | set up your own ASQ training [link to on-site training page]
• In Arkansas, during their annual meetings, local chapters of the AAP and the American Academy of Family Physi¬cians featured information on the ABCD initiative and developmental screening with ASQ.
• In Kansas, using funds from the Kansas Health Founda¬tion ABCD Grant for Developmental Screening, the ABCD team purchased ASQ for on-site train¬ing at pilot sites.
• In Colorado, the ABCD team hosted a webcast on the benefits of validated screening tools in primary care. During the webcast, a provider from Denver Health described how her clinic successfully used ASQ. Within the year, all 11 of the Denver Health sites also began to implement ASQ. [2]

[1] National Academy for State Health Policy, Identifying Children and Families at Risk. Retrieved on June 3, 2009,

[2] National Academy for State Health Policy, State Strategies to Support Practice Changes that Improve Identification of Children at Risk for or with Developmental Delays Findings from the ABCD Screening Academy. Retrieved on June 3, 2009,

[3] The Commonwealth Fund, Providing Developmental Services in Primary Care: The North Carolina ABCD Project. Retrieved on June 3, 2009,