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A Watchful Eye
A new childhood intervention program identifies developmental problems sooner, jumpstarting treatment.


Pediatrician Tracy King calls it the hand-on-the-doorknob moment: that instant before the doctor leaves the examining room when a mother finally asks the question that has been tugging at her all along.

I’m not sure he’s speaking as much as he should for a 2-year-old. He throws horrible tantrums and sometimes acts funny. Should I be worried

Many pediatricians may reserve judgment until the next well-child visit, potentially losing six months to a year of addressing an unidentified developmental problem. Now King and other researchers at the Harriet Lane Clinic are working to establish a better way for physicians and parents to identify such difficulties.

The early childhood intervention program uses developmental surveillance and screening strategies recommended by the American Academy of Pediatrics to identify developmental problems in children under 5.

The project requires parents to fill out a survey with roughly 30 questions about a child’s age-appropriate skills before seeing the pediatrician. Not only can this waiting-room exercise influence the subsequent discussion, but it also alerts the physician to other potential problems, such as illiteracy, that a parent may have. In such cases, parents can be directed to other resources to help prepare themselves and their children.

The program is part of a two-and-a-half-year $395,000 grant funded by the United Way of Central Maryland. It illustrates how the agency is working to improve the lives of disadvantaged families in East Baltimore neighborhoods near Hopkins––one of the institution’s areas of concern.

The need could hardly be greater. According to the state’s school readiness report, only 58 percent of children entering kindergarten in Baltimore are able to speak, think and socialize as well as they should, greatly increasing their risk for later problems in school. The doctor’s office is a natural place to educate parents who don’t realize that their children are lagging behind the norm, says health services researcher Anne Duggan, the project’s principal investigator.

The Hopkins investigators have also launched this program at East Baltimore Medical Center and hope to extend it throughout the city and surrounding counties as well.

—Linell Smith



Johns Hopkins Medicine

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