Response
Performance Standards
Resources

See PDF version: EHS Tip Sheet No. 1: Screening Premature Infants [PDF, 24KB]

Response:

Screening a premature baby requires that the child’s age is adjusted to the infant’s estimated due date rather than the infant’s actual birth date. If the child is too young for the developmental scale, one of two paths is followed:

1. Wait until the child is old enough and document why the screening is late; or
2. Administer a screening that is appropriate for, or as close as possible, to the child’s physical age. If the child does not pass the screening, designate the child for a rescreening. Unless there is a clinical reason to do otherwise, wait 6 to 8 weeks to rescreen the child with the same tool.

Findings and referrals

Staff should be aware that there are “findings” SO BIG that even with age-adjustments, make a referral not only necessary but also urgent. Programs should work with the local medical community and, if necessary the local Part C Agency, to ensure that the appropriate measures are taken.

Obtaining screening information from other sources

If the child has had a developmental screening conducted by personnel experienced in the development of premature infants, the program should obtain copies of these documents.

Questions to Consider for Planning and Programming:

• How does the program document and track the screening process for premature infants?
• How does the program work with the local medical community to ensure that the procedures are thorough and appropriate? What is the role of the Health Services Advisory Committee?
• How does the program partner with its local Part C Agency to ensure that concerns from the screenings are addressed?

Performance Standards, Title 45, Code of Federal Regulations:

• 1304.20(b)(1) In collaboration with each child’s parent, and within 45 calendar days of the entry into the program, grantee and delegate agencies must perform or obtain linguistically and age appropriate screening procedures to identify concerns regarding a child’s developmental, sensory (visual and auditory), behavioral, motor, social, cognitive, perceptual, and emotional skills.

Resources:

Academy of Pediatrics. “Developmental Surveillance and Screening of Infants and Young Children.” PEDIATRICS, 108(1). (2001): 192–196. http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/1/192 (accessed August 14, 2010).

Academy of Pediatrics. “Identifying Infants and Young Children with Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening.” PEDIATRICS, 118(1). (July 2006): 405–420.
http://aappolicy.aappublications.org/cgi/content/abstract/pediatrics;118/1/405 (accessed August 14, 2010).

Early Head Start National Resource Center. Technical Assistance Paper, 4: Developmental Screening, Assessment, and Evaluation: Key Elements for Individualizing Curricula in Early Head Start Programs. DHHS/ACF/ACYF/HSB. 2000.

Mathematica Policy Research, Inc. Resources for Measuring Services and Outcomes in Head Start Programs Serving Infants and Toddlers. DHHS/ACF/OPRE. http://www.acf.hhs.gov/programs/opre/ehs/perf_measures/reports/resources_measuring/resmeas_title.html (accessed August 14, 2010).

Policy Clarifications. The Early Childhood Learning and Knowledge Center. DHHS/ACF/OHS.

• OHS-PC-B-018: When Does the 45 Day Requirement for Completing Screenings Begin? July 13, 2007.
• OHS-PC-K-017: Our Program Uses a Standardized Developmental Screening Instrument which is Developed to Begin for Children at 4 Months. We have not Been Able to Locate a Screening Tool for Use with Children Under 3 Months of Age. Are We Required to Screen Children who are Younger than 4 Months of Age? October 10, 2007.
  

08/10 (03/03; 08/01)

This Tip Sheet is not a regulatory document. Its intent is to provide a basis for dialogue, clarification, and problem-solving among Office of Head Start, Regional Offices, T/TA consultants, and grantees. If you need further clarification on Head Start policies and regulations, please contact your Regional Program Specialist.

See also:
     Early Head Start (EHS) Tip Sheets