The Fund also seeks to strengthen connections between physician practices and the other developmental services their patients and families need. A good example is the support provided for an evaluation of the Connecticut-based Help Me Grow program, a training and referral system that assists child health practices in securing services for at-risk children.⁽³⁾ Help Me Grow's toll-free telephone hotline contributed to a doubling of the rate of identification of developmental concerns in participating practices, from 9 percent to 18 percent. Because of the promise shown, Orange County, Calif., and the state of Hawaii are interested in replicating the model.

Following the tenet that holds "what gets measured is what gets done," health systems, state Medicaid programs, and physician practices continue to use the Promoting Healthy Development Survey (PHDS) to measure the quality of preventive child health care.⁽⁴⁾ Developed in part with Fund support by Christina Bethell, Ph.D., at the Oregon Health and Science University, PHDS, along with its variants, is the leading global measure of well-child care.

A recent Fund report by Henry Ireys, Ph.D., at Mathematica Policy Research, Inc., examined how Medicaid programs are using external quality review organizations to champion quality measurement, especially for child developmental services. A related toolkit provides practical advice to states on how to make the best use of their external quality reviews. To better measure progress toward high-quality developmental services, the Fund benchmarked the current provision of developmental services through the National Survey of Early Childhood Health and described the current status of children's development and its determinants through a partnership with Child Trends.⁽⁵⁾

Another key program strategy is to promote the review and revision of clinical standards of developmental care. The schedule for well-child care has not been substantially revised since it was first published by the American Academy of Pediatrics nearly 40 years ago. Under a project led by J. Lane Tanner, M.D., of the University of California, San Diego, experts will recommend a new schedule for well-child care that responds to the needs of today's families. Michael Weitzman, M.D., and colleagues at the University of Rochester, meanwhile, are developing the first authoritative and comprehensive guide to preventive pediatric care. The guide will likely be an important reference for teaching, practice, and evaluation.