Cambridge Health Alliance

Using the Pediatric Symptom Checklist (PSC) and Pediatric Symptom Checklist -Youth Report (Y-PSC), Cambridge Health Alliance registration staff identified well-child visits in advance and attached a screening form to the patient's file. Upon arrival, the family was given the screen and advised that completing it was voluntary. The family brought the completed screen into the examination room. The provider scored the screen, signed it, and determined disposition. A medical assistant scanned the screen into the patient's electronic record.

Cambridge Health Alliance screened over 5000 children between four years, 11 months and 19 years of age starting in 2003. Over 70% of eligible children were screened and 6% screened "positive", indicating that they were at risk for a behavioral-health problem. There were no significant differences by race or language. More children with "negative" than "positive" results were referred for services because a large portion of the "positives" were already in counseling.

Children's Hospital, Boston

Using the Parents' Evaluation of Developmental Status (PEDS), Children's Hospital Boston screened 1800 patients under the age of 9 years at well-child visits in their Primary Care Center, where 90 providers serve 12,000 patients, of whom 65% qualify for MassHealth or free care.

Of the 1800 patients screened, 80% had no concerns or services; 8% were identified with concerns based on the screen; 4% were identified with concerns by the provider, despite "negative" screen results; and 8% were previously identified with concerns and were in services.

Regarding two- and three-year-olds, pre-implementation record review of over 300 patients revealed behavioral concerns in 8%. Postimplementation record review of more than 200 different patients found behavioral concerns in 12%. The biggest concern identified was temper tantrums.

This information is provided by MassHealth.