Systemwide Solutions to Improve Early Intervention for Developmental-Behavioral Concerns.

* Abbreviations: ECSE — : early childhood special education EI — : early intervention IDEA — : Individuals With Disabilities Education Act “Birth to Five: Watch Me Thrive!” (http://www.acf.hhs.gov/programs/ecd/child-health-development/watch-me-thrive) seeks to systematically increase early detection of developmental–behavioral problems among at-risk children, from birth through 5 years. This initiative represents a coordinated effort to increase early screening and detection rates across the health, education, and social service sectors. Although the earliest detection of children who need extra developmental–behavioral support is a laudable goal, these efforts will be for naught without appropriate supports to document follow-up and enrollment into services. To meet the challenge of what happens next, our nation must address its capacity crisis. The leadership issue across sectors is to build the capacity to increase and improve access to evidence-based services that are tailored to child and family needs. This initiative is the stated promise of early intervention (EI) for ages 0 to 3 years, early childhood special education (ECSE) for ages 3 to 5 years, and other high-quality early learning programs. In 2011 and 2012, 2% to 3% of US children received EI under the Individual with Disabilities Education Act (IDEA; https://ideadata.org/) Part C, and 5% to 6% of children received ECSE under IDEA Part B, Section 619.1 Twelve percent of children are diagnosed with any developmental disability between 3 and 10 years and 16% between 11 and 17 years.2 Mental health disorders emerge in 21% of children between 9 and 17 years.3 Although it can be challenging to reliably identify infants, toddlers, and preschoolers with the more prevalent mild disabilities and disorders, red flags (eg, positive or concerning screens) may be identifiable. Alas, the chasm between percentage identified and served is unacceptable given the assortment of interventions or supports proven to improve outcomes (http://www.ectacenter.org/topics/effective/effective.asp).4 This discrepancy exists in the face of a wide array of uncoordinated health, education, and social service supports. … Address correspondence to Kevin P. Marks, MD, PeaceHealth Medical Group, 4010 Aerial Way, Eugene, OR 97402. E-mail: kmarks{at}peacehealth.org