Four Simple Steps
Administering the checklists is very simple and can be easily adapted to any clinic flow.
Below is how checklists are typically integrated into certification and mid-certification assessment appointments. Keep in mind that the checklist can also be used during other appointments or any time a parent or WIC staff has a concern or question about a child’s development.
The WIC staff member offers the parent the opportunity to complete an age-specific checklist for each child being certified that day.
- If a child was born prematurely (<37 weeks gestation), offer the checklist that fits his or her corrected age. Find instructions for calculating corrected age here: https://www.healthychildren.org/English/ages-stages/baby/preemie/Pages/Corrected-Age-For-Preemies.aspx
- If a child is between checklist ages, always use the younger checklist. For example, if the child is 20 months old (actual or corrected age), use the 18-month checklist rather than the 2-year checklist.
- If the parent informs you that their child has already been diagnosed with a developmental delay or is receiving specialized services for developmental concerns (e.g., speech/language therapy, early childhood special education, or other early intervention like speech therapy), there is NO need for the parent to complete a checklist or provide a referral to the doctor. Often, this can be indicated in a child’s record, so the checklists are not brought up with the parent in the future.
- Refer to the Deskside Reference Guide for examples of simple, clear language staff can use with parents:
- “You may have noticed the graphics on the walls and floor about child development and milestones.” [OR “You might remember that I shared the link to an online milestone checklist/CDC’s milestone tracker app.”] “Tracking milestones that (child’s name) is reaching is an important way to help your child learn and grow.”
- “These checklists help us track your child’s development. If you haven’t completed it yet, we can do it together now.”
- “Let’s go through the milestone checklist to see how ______is doing on his/her milestones. Let’s answer these first two questions together. Does ______ (read first item on checklist)? Does ______ (read second item)?”
- “Go through the rest of the checklist and be sure to ask me if you have any questions. Be sure to add ______’s name and age on top, along with today’s date.”
This can be done while information is entered into your data system, if applicable, thus taking advantage of some “down time” for parents during an appointment.
- When the parent has finished, the WIC staff member notes whether there are any missing checkmarks alongside the milestones, or any concerns noted in the pink box. This makes determining the need for a referral simple. When ALL milestone boxes are checked AND NO concerns are noted in the pink box or otherwise, this indicates the child is reaching his or her developmental milestones. You can reassure the parent by saying:
- “It looks like ______ is on track for meeting these developmental milestones.”
- “Take this checklist home with you and share it with your family and ____’s doctor so they can see how great ______ is doing.”
- “If you have a smart phone, you can download a free app called CDC’s Milestone Tracker to keep tracking milestones until your next visit.”
- “If you ever have any concerns or questions about ______’s development, be sure to talk to his/her doctor.”
- Check the first two items under “Your Next Steps” to encourage the parent to “share this checklist with the doctor” and to “keep tracking milestones” and then return the checklist to the parent.
- If they are missing a milestone or have noted a concern, continue to step 4, make a referral.
When ONE or more milestone boxes are NOT checked OR ANY concerns noted in the pink box or otherwise, this indicates the need for a referral. You can support the parent by saying:
REMINDER: Developmental milestone checklists are not screening tools nor are they indicators of developmental delay or disability. Rather, they are designed to engage parents in monitoring children’s development and to help staff and parents decide when to refer for developmental screening.
Unless there is another referral protocol in place, refer the parent to the child’s doctor for review of the checklist and for developmental screening:
“We know you want to support your child’s development…”
- “It would be a good idea to talk with your health care provider about this checklist. I really care about what the doctor has to say about _____’s development.”
- “Please call _______’s doctor to schedule a follow-up appointment for developmental screening.”
- “I am going to turn this checklist over and write _____’s doctor name on it so that he/she knows exactly what you want to talk about.”
- “I want to know what the doctor has to say the next time you come for your (date) WIC appointment.”
Pro Tip: Record the Referral, Set an Alert!
When possible, note the referral in the child’s record. If available, an alert can be set as a follow-up reminder for staff to ask the parent about the outcome of this referral at the next visit. If appropriate in your state, following up on the referral can be included as a participant-centered goal.