Promoting Universal Developmental Screening in Yakima County, WA: A Case Study of Cross-Sector Collaboration

Abstract

<bold>Objective:</bold> Developmental screening of infants and young children increases early identification of developmental delay and disability and creates an opportunity to connect families with needed services. Ensuring screening for all children requires collaboration across the medical, educational, childcare and family resource sectors. This study examines the approach and activities of a collaborative community work group in Yakima County, WA, to create a system to improve access to developmental screening and related resources to all children in the county. <bold>Methods:</bold> An array of child health and early learning professionals gathered in January 2010 to discuss developmental screening in the county. From this large group, a smaller work group, the Yakima County Developmental Screening Work Group, was formed in January 2011 and met regularly to formulate a county-wide plan for a universal developmental screening system. This case study examined the work of the Work Group through key informant interviews, review of meeting minutes and grant-related documents, and direct observation. The degree to which the group collaborated across sectors was evaluated using the framework of Collective Impact, a model for cross-sector collaboration. <bold>Results:</bold> Within-group collaboration was marked by Work Group members' strong personal commitment to the goal of developmental screening, their ability to think at a systems level, and their belief in the "whole child" approach to child wellness. Collaboration between the Work Group and partner agencies involved four strategies: 1) visiting the partner's site, 2) customizing presentations about child development, 3) listening to concerns, and 4) supporting partners' knowledge of their service population and their decisions regarding screening implementation activities. The Collective Impact framework indicated the Work Group's strengths in the areas of continuous communication and mutually-reinforcing activities. Backbone support and a shared measurement system were the most challenging components of the Collective Impact framework to fulfill. <bold>Conclusions:</bold> Systems level thinking and a flexible approach towards supporting community partners as they implement screening in their settings were key strategies of the Yakima County Developmental Screening Work Group. Efforts to develop systems of universal developmental screening in other communities should prioritize funding for backbone support staff and shared measurement to ensure effective coordination and accountability among collaborating agencies.