Joint Release of Information and Referral to WI Birth to 3 Program Form
A Joint Release of Information and Referral to WI Birth to 3 Program form was recently approved by Wisconsin Department of Health Services and posted on their website for use. The release is both HIPAA and FERPA compliant. Signatures from parents on this single form will allow clinicians and Birth to 3 Program professionals to communicate directly with one another and expedite care for children identified with developmental delays.
A fillable version of the form is available at: http://www.dhs.wisconsin.gov/forms/F0/f00688.doc
Survey Results: Wisconsin Clinicians’ Use of Developmental Screening Tools (December 2012)
A survey on routine use of developmental and autism-specific screening tools by Wisconsin pediatric primary care clinicians was conducted in late 2012 by the Wisconsin Statewide Medical Home Initiative. 157 clinicians completed all or part of the survey.
Over 55% of respondents almost always used the general developmental screening tool Ages and Stages Questionnaire© (ASQ) and the autism-specific instrument Modified Checklist for Autism in Toddlers (M-CHAT) to identify children with possible delays.
With concerning screening results, over 85% of respondents referred children to the Wisconsin Birth to 3 Program, and over 80% almost always or sometimes provided learning activities for parents to promote their child’s development.

