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. 

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 percentage 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 MIECHV Program and improving developmental screening practices and policies is an ongoing focus of HV's continuous quality improvement. The NJ MIECHV Program promotes, and monitors parent completed child development screening tools (ASQ and ASQ: SE). In SFY 2021 6379 NJ MIEC Home Visiting families with young children participated in a parent-led developmental screening across all 21 NJ counties.

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), CDC’s NJ ”Learn the Signs. Act Early.” (LTSAE) Ambassador and 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, 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 Connecting NJ (formerly known as 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 distributed 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 empower 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 the 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 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, 

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 Connecting NJ hubs. NJ’s expanded data system links developmental screenings with current Connecting NJ 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 ECCS Team for Essex County (EPPC) begin a pilot in testing the implementation of the ASQ Family Access online portal within their Connecting NJ 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 Connecting NJ System, which led to the 4 additional ECCS Placed Based Communities (PBCs) joining 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 Connecting NJ hubs. In FY20 EC Specialist received ASQ training, developed and activated the additional 16 ASQ Family Access portals. Outreach begins in the communities through in-person community events and via telephone. Once the Covid-19 pandemic hit all services were remote and/or virtual. The pandemic engagement of families continued through social media platforms, virtual events, and outreach through existing community partners (e.g. WIC, Family Success Centers, etc.

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 (CMK) curricula, developed by Share Our Strengths, is a 6-lesson series designed for children, in 3rd through 5th grades. The classes teach how to prepare healthy meals and snacks and to make healthier choices – whether at school, at home, at the store, or out to eat.

Cooking Matters for Teens (CMT) is a direct education intervention for SNAP-eligible teenagers, ages 11 to 18 years (or grades 6-12), that teaches healthy eating skills and builds confidence in shopping and eating healthier on a low budget. CMT is offered as a series of six, one-hour sessions and is designed to be implemented in schools, after-school programs, community centers, and non-profit organizations.

While the pandemic still had an impact on FFY21 implementation, in-person programming slowly returned, while some virtual programming remained. In total, SNAP-Ed delivered 1,146 CMK sessions, comprising 193 series across all 21 counties in NJ reaching 4,593 participants: most commonly at schools, before- and after-school programs, and family resource centers. SNAP-Ed delivered 297 CMT sessions, comprising 52 series across all 21 counties in NJ reaching 758 participants: most commonly at schools, before- and after-school programs, and large food stores and retailers.

New Jersey completed their statewide eWIC implementation in April 2022. To help with the implementation, New Jersey expanded the use of the WIC Shopper App.  This App allows participants and WIC store personnel to scan items to check for allowable WIC food items. The App also provides participants with their current WIC benefit balance, a listing of Authorized WIC Stores and WIC offices. WIC participants, WIC store personnel and partners can also access the NJ eWIC webpage:  Department of Health | WIC | eWIC for Participants (nj.gov)  where eWIC educational materials (how to use new eWIC card and redeem benefits) are posted. eWIC videos and a NJ WIC Orientation video are also available to view on this page. Subsequently, the team created The NJ WIC Participant Portal which has helped improve access to WIC for many by beginning the application process online.  There are enhancements that are planned for 2022 that include a Spanish version and access to third party referrals.

To increase enrollment in WIC and SNAP, the NDOH, Division of FHS entered in an agreement with the Department of Human Services, Division of Family Development, to electronically match SNAP and WIC participants and assess those that are eligible but not enrolled in either program and develop and outreach plan to ensure enrollment. 

Moreover, the www.NJWIConline.org  nutrition education website has been enhanced with additional nutrition and parenting resources as well as a new WIC Game show. The new Game Show lesson offers participants and guests opportunities to gain many eWIC shopping tips. Additionally, to monitor and further improve the WIC program, the NJ WIC is developing a dashboard that will allow user-friendly visualization of key metrics.