More young children will be screened for developmental delays under a new law signed by Gov. Gavin Newsom.
The new law, Assembly Bill 1004, requires doctors to screen children enrolled in Medi-Cal for developmental delays using surveys recommended by the American Academy of Pediatrics and at three specific times — nine months, 18 months and 30 months.
The screenings are designed to help a doctor determine if the child is developing normally or has some delays that need attention. Young children might need speech or language therapy, for example, or occupational therapy to work on motor skills.
Currently, many doctors use their own questions or observations to screen children for delays rather than using the surveys and timeline recommended by the American Academy of Pediatrics. According to data from the California Department of Health Care Services, only about a third of children under 3 years old enrolled in Medi-Cal were reported to have received developmental screenings at the recommended times in 2015, though that may be because doctors did not all report the screenings in the same way.
One survey for parents of children around 2½ years old includes the following questions, among others:
- When your two-and-a-half year-old is looking in a mirror and you ask “Who is in the mirror?,” do they say either “me” or their own name?
- Can your child string small items such as beads or macaroni onto a string or shoelace?
- Does your child make sentences that are three or four words long?
Newsom has made “cradle-to-career” support of children a priority of his governorship. The 2019-20 state budget includes about $54 million to reimburse doctors for developmental screenings, in addition to about $45 million for screenings for traumatic experiences, such as abuse or being separated from a parent. Newsom, who was diagnosed in 5th grade with dyslexia, has said that his own late screening caused him to fall behind in school.
“It’s very personal for me,” Newsom told the L.A. Times in January. “If you get those screens early, you can not only change a person’s life, you can save taxpayers a lot in the process.”
Three children’s advocacy organizations — First 5 Association of California, Children Now and First 5 L.A. — co-sponsored the bill.
“The earlier we identify developmental delays in California’s children, the sooner we can make sure they are referred and receive interventions,” said Moira Kenney, executive director of First 5 Association of California, a nonprofit organization that works with counties to serve children under 5 years old.
Kenney said the best time to work with children who have developmental delays is during their first five years of life, because their brains are growing the fastest at that time. If interventions are delayed until elementary school, she said, they take longer to have an effect and children often have to miss classes.
A similar bill passed the Legislature in 2018, but former Gov. Jerry Brown vetoed it, arguing that Medi-Cal already required the screenings and the legislation was not necessary.
The American Academy of Pediatrics — California, which represents over 5,000 pediatricians in the state, supported AB 1004. The California Medical Association did not have a position on the bill.