The domain of Child Health includes the State Priority Needs of #3 Improving Nutrition and Physical Activity and the selected National Performance Measures of #6 Developmental Screening. NPMs #6 was selected during the Five-Year Needs Assessment process for their impact on overall child health and wellness and for the evidence-based strategies implemented by NJDOH and its partnerships.

Child Health – Annual Report

Annual Report - NPM #6: (Percent of children, ages 10 through 71 months, receiving a developmental screening using a parent-completed screening tool)

Increasing NPM #6 is an important focus in the domain of Child Health to improve overall child health and well-being. Early identification of developmental disorders is critical to the well-being of children and their families. It is an integral function of the primary care medical home. The percent of children with a developmental disorder has been increasing, yet overall screening rates have remained low. The American Academy of Pediatrics recommends screening tests begin at the nine month visit.

Source – National Survey of Children's Health (NSCH) https://www.childhealthdata.org/browse/survey

Developmental screening is a required benchmark performance measure for the NJ MIEC Home Visiting Program and improving developmental screening practices and policies is a current focus on HV evaluation and continuous quality improvement. The NJ MIEC Home Visiting Program promotes and monitors parent completed child development screening tools (ASQ and ASQ: SE). In SFY 2020 6303  families with young children participated across all 21 NJ counties. 6272 Developmental screenings were completed through NJ MIEC Home Visiting programs.

The NJDOH is an active interdepartmental partner with the NJ Council for Young Children (NJCYC), the  Preschool Development Grant: Birth to five (PDG B-5)and CDC’s NJ ”Learn the Signs. Act Early.” (LTSAE) Ambassador.. The NJCYC, Infant Child Health Committee has established a priority of improving system connections for children and families with health care providers, community services, early intervention, child care, home visiting to expand screening (prenatal & child development) in health care and early care & education settings. Through the NJ ECCS CoIIN work improvements on early childhood systems continued with a focus on creating universal access to evidence- based developmental screening through the early childhood central Intake system (Help Me Grow Central Access point) that supports linkages and access to programs and services for families within their community.  NJ’s LTSAE Ambassador and the LTSAE COVID Response Project activities focus on promoting parent-engaged developmental monitoring and screening, and referral and connection to services through trainings, presentations, and materials distribution across the state. As the State Parent Lead for the ECCS Impact CoIIN and MIEC Home Visiting programs, the LTSAE Ambassador also supports the teams with accessing LTSAE materials and with family-engagement activities. NJ’s Child Developmental Passport, created in collaboration between the LTSAE Ambassador and the ECCS CoIIN team (available in English & Spanish) includes a developmental tracker to empowers parents to track their child’s developmental screening information. In addition, the CDC’s Milestone Tracker App is embedded in the NJ WIC Shopper App to support monitoring of children receiving WIC services. Grow NJ Kids (GNJK) a Quality Improvement Rating System (QRIS) developed for early learning programs requires the use of a “state approved” developmental screening at Level 2 of a 5 level rating with the expectation that 90% of high needs infants and children participating in GNJK will receive developmental screening with an emphasis on using the parent completed child monitoring system Ages and Stages Questionnaires (ASQ and ASQ: SE) screening tools.

Additionally, SPAN is collaborating with the NJ Chapter of the American Academy of Pediatrics on the Early Identification and Referral for Autism (EIRA) ECHO project to provide education to pediatric practices on the early identification, referral and care coordination of children with ASD. SPAN is also collaborating on a project with the NJ site for the Autism & Developmental Disabilities Monitoring (ADDM) Network to promote awareness about the importance of parent-engaged developmental monitoring and the early identification of ASD using a validated screening tool in the Newark area,

NJ is part of a national Project LAUNCH initiative funded by HRSA that is designed to promote the wellness of young children ages birth to 8 and to reduce racial and ethnic disparities including an emphasis on routine developmental screening. NJ Project LAUNCH is targeting urban Essex County and is using a Help Me Grow systems approach to strengthen the connections between physicians, parents/families, and community providers to addresses the physical, social, emotional, cognitive, and behavioral aspects of child development. Project LAUNCH ensures that parents/families have access to a continuum of community-based evidence-based programs (EBP) that support parent-child interaction and young child development across a range of settings—health care, home visiting, child care, Early Head Start/Head Start, preschool/school to promote early identification of health and developmental issues that impact child wellness. In FY18, the NJ Project Launch grant ended, however many of the activities to the NJ Project Launch Essex County team aligned with Central Intake, the Help Me Grow System and ECCS Impact continued, which include the reach and linkage of families with young children to services and programs that support family and child well-being; inclusive of developmental health promotion and screening.

The selected ESM 6.1 will monitor progress on increasing the use of parent-completed early childhood developmental screening using an online ASQ screening tool and how well early childhood developmental screening is promoted across the Departments of Health, Children and Families, Human Services, and Education which will drive improvement in NPM #6 (Developmental Screening). NJ DCF implements the ECCS Impact grant in 5 communities to promote parent-completed early childhood developmental screenings in children less than 3 years old. ASQ Enterprise software (Brookes Publishing) is being utilized to add a parent/family portal for easy access to developmental screening and links screening to Central Intake hubs. NJ’s expanded data system will link developmental screenings with current Central Intake assessments to enhance engagement of families not connected to early childhood services/programs that could potentially be engaged and linked for additional services and supports as identified, including developmental needs as determined by the completed ASQ and in partnership with the parent regarding their child’s developmental milestones. Families will be supported in linking with pediatric primary care and/or other systems partners that include at a minimum Home Visiting; and may extend to quality Child Care, Early Head Start/Head Start, and Preschool programs. In FY18, the Project Launch/ECCS Team for Essex County (EPPC) begin a pilot in testing the implementation of the ASQ Family Access online portal within their Central Intake system. They developed, implemented and tested policies and procedures on the use and experience of the Family Access Portal by parents, as well as outreach and engagement strategies.  EPPC was able to provide no cost development screening to 32 children/families, they provide appropriate follow-up and linkage, as well as education to parents on monitoring their child’s developmental milestones and activities parents can do to support their child’s developmental progress. EPPC led the way to the infusion of the ASQ Family Access Portal with the statewide Central Intake System, which led to the 4 additional ECCS Placed Based Communities (PBC’s) to join in the implementation in FY19.

In FY19 Plans for statewide expansion of screening to the additional 16 counties were slated and implementation begin in FY 20 with the expansion of Early Childhood Specialist staffed within all 21 Central Intake hubs.  In FY20 EC Specialist received ASQ training, developed and activated the additional 16 ASQ Family Access portals. Outreach begin in the communities through in-person community events and via telephone. Once the Covid-19 pandemic hit all services were remote and/or virtual. Through the pandemic engagement of families continued through social media platforms, virtual events and outreach through existing community partners (eg. WIC, Family Success Centers, etc; In FY20 the CI/EC Specialist network completed (N=1,108) parent led developmental screens through the ASQ Family Access Portal. Age breakdown is as follows:

In FY2020, the 1,029 children (ages 10 – 71 months) receiving an ASQ developmental screening through the ECCS Impact grant through the NJ Home Visiting Program and Central Intake (ASQ Family Access Portal).

SPN #3: Improving Nutrition and Physical Activity

Annual Report: The New Jersey Supplemental Nutrition Assistance Program-Education (NJ SNAP-Ed) in FHS is a federally funded nutrition and physical activity program that aims to improve the likelihood that persons eligible for SNAP will make healthy food and lifestyle choices that prevent obesity. NJ SNAP-Ed provides behavior-focused educational classes for all ages, including specialized workshops to meet the needs of children. The Cooking Matters for Kids curricula, developed by Share Our Strengths, is a 6-lesson series designed for children, 3rd through 5th grades. The classes teach how to prepare healthy meals and snacks and to make healthier choices – whether at school, home, the store, or out to eat. Cooking Matters for Kids (CMK) recorded a total of 2071 total participants reached in five elementary schools prior to March 2020 when COVID19 disrupted lesson delivery for all direct education interventions. The proportion of female students was higher (55%) than males (45%).