Connecticut Children’s Medical Center – Mid-Level Developmental Assessment

Hartford, CT
November 2017

Overview
Mid-Level Developmental Assessment (MLDA) addresses a gap in care for children with mild to moderate challenges whose needs typically are not severe enough to qualify for publicly funded intervention programs, such as Birth to Three or preschool special education, and often go unaddressed. In 2009, Connecticut Children’s partnered with The Village for Families & Children to develop MLDA and pilot the model in Hartford. The program is now part of Connecticut Children’s Office for Community Child Health, which facilitated its statewide expansion. MLDA was subsequently diffused to children and families in seven additional sites around the country through the Help Me Grow® National Center, which provides peer-to-peer learning, technical assistance, and customized training. MLDA is cost-effective and efficient in determining the needs of vulnerable children, who avoid long waits for higher-level evaluations that often are costlier and unnecessary. In addition to the assessment, MLDA’s partnership with Help Me Grow provides a path for families to access community-based programs that can intervene before concerns escalate.

Impact
Core metrics regarding the implementation of MLDA within communities are tracked at both the state and national levels. In the first 15 months of diffusion, nearly 550 children were referred for a MLDA across the various implementation sites. To date, nearly all families report satisfaction with MLDA; moreover, the majority report that they understand more about their child’s development and know more about available community services as a result of completing MLDA, which demonstrates a positive impact in promoting strength in families to improve long-term outcomes for children. Cost data show that MLDA saves an average of $540 per child, compared with evaluations done by subspecialists or early-intervention programs. Preliminary data demonstrates that less than 20 percent of children receiving an MLDA following identification of developmental or behavioral concerns need further evaluation.

Lessons Learned
Dissemination of the MLDA model has demonstrated the critical need to develop and sustain partnerships across those agencies that play a role either in assessing children as part of MLDA or in linking children and families to needed services identified through MLDA. Further, an emphasis on continuous quality improvement has enabled MLDA providers to identify key programmatic and procedural improvements to maximally support children and families.

Future Goals
Lessons learned from the development and dissemination of MLDA will be used to spread and scale this model to additional states that would benefit from MLDA as an alternate assessment option that is less costly than full evaluations by pediatric subspecialists and expensive tertiary providers. Future efforts will focus on continuing to diffuse the model and evaluating the efficacy of MLDA as a strategy to build resilience among vulnerable children and families.

Contact: Paul Dworkin, M.D.
Executive Vice President for Community Child Health
Telephone: 860-837-6228
Email: pdworki@connecticutchildrens.org