The Puerto Rico ABCD Screening Academy Project built upon the efforts of the Puerto Rico-Early Childhood Comprehensive Systems (PR-ECCS) initiative to increase the number of providers implementing developmental screening tests for children ages 0 to 5 years old. The Administración de Seguros de Salud de Puerto Rico (ASES) implemented training sessions for providers and parents at pilot practice sites aimed at enforcing the EPSDT handbook standards and reimbursement for primary care providers for conducting a screen with a standardized tool.

Specifically, the ABCD Screening Academy project in Puerto Rico improved developmental screening by:

• Improving state policy to better support developmental screening by revising the EPSDT schedule following the Bright Futures recommendations, including a developmental screening visit using the Ages and Stages Questionnaire (ASQ) for age 9, 18, and 24 months, and including a screening for autism at 18 months using The Modified Checklist for Autism in Toddlers (M-CHAT).
• Improving provider practice around the use of standardized developmental screening tools by training primary care physicians in the three pilot sites on standardized developmental screening and the ASQ as a screening tool, selecting the ASQ Spanish version as the standardized developmental screening tool for all Medicaid enrolled children between the ages of 9 and 60 months, and developing and distributing the provider manual “Protocol for the Administration of ASQ Questionnaire,” to assist providers in the use of the ASQ.
• Sustaining and spreading the use of standardized screening tools as part of well child care from a ‘best practice’ to a ‘standard of practice’ through obtaining a multisite license for the use of the Ages and Stages Questionnaire from Brooks Publishing Company.