For years, Mississippi children were more likely to miss out on early childhood development screenings than anywhere else in the country.
But after a $17-million federal grant and the work of a state health childhood development project, Mississippi’s early childhood screening rate shot up from dead-last to No. 33, according to ranking by the National Health Foundation. This means more children are receiving screenings designed to catch delays before they turn into serious problems later.
Dr. Susan Buttross, the University of Mississippi Medical Center’s director of the child development clinic, called it an unprecedented improvement.
“But we’re not done yet,” Buttross said.
Ultimately, most kids in Mississippi, and nationwide, still aren’t being screened.
Despite the end to the five years of federal funding that created the project to grow the number of early childhood screenings – dubbed Mississippi Thrive! – Buttross and her team are continuing their work as the Early Childhood Development Coalition. Buttross, the director of the coalition, said she’s garnered enough financial support to keep their work going while seeking more stable funding over the next year.
“Many times when we get grant money to work on a project, the work is done in a sort of silo fashion,” Buttross said. “The grant goes away and the work stops. But one of the benefits with this project was that part of the project was to really collaborate and work with other entities in the state.”
That means even with the official project over, the mission is still well alive.
That level of collaboration the project fostered, Buttross said, is what led Mississippi from having only 17% of children undergo developmental screenings in 2016 to 34.1% in the most recent data set available. At that rate, Mississippi is less than a single percentage point away from the national average.
“There is a great deal of data that shows children do better if they enter school healthy and ready to learn,” Buttross said. “The earlier you discover speech or language delay … and the earlier you correct them, the child is going to be way better off.”
The “Thrive!” project was a joint effort between the University of Mississippi Medical Center and the Social Science Research Center at Mississippi State University to educate pediatricians, nurse practitioners, social workers, childcare providers and parents on the importance of developmental screenings and how to conduct them.
The screenings are most commonly done by pediatric physicians. Ideally, doctors are checking with parents at their babies’ 3, 18 and 30-month checkups. Physicians are working off a checklist of age-appropriate milestones from eye contact to leg kicks, according to Dr. Ruth Patterson, a pediatric specialist at UMMC in the coalition with Buttross.
“A screening does not make a diagnosis,” Patterson said. “But it discerns if a child is at risk for a developmental delay.”
Often, speech delays are tied to hearing problems – but without the screening questions, a parent might not realize their child isn’t meeting the appropriate language benchmarks.
During the five-year project, Buttross, Patterson and others created a hands-on pilot program to show how much working directly physicians could improve screening rates and outcomes. The pilot focused on 31 physicians in six clinics between Jackson and the Gulf Coast.
The physicians who underwent that training improved their developmental screening rate to 85%.
“We went directly to these primary care provider offices to make sure we provided them with tools and training,” Patterson said. “We know the capability is there if the providers are provided with the right support.”
Some pediatricians in the state were trained years ago, and simply aren’t aware of the latest screening methods and tools.
Ideally, the screenings take place in a doctor’s office, said pediatric nurse practitioner Lauren Elliott.
“But we have engaged across communities, in whatever circles parents are in, we are trying to engage them,” Elliott said. “We have them complete a questionnaire to give them an idea.”
If parents find their child isn’t meeting the benchmarks mentioned on the form, they’re more likely to get into a doctor’s office. But even those with the best intentions are likely to face barriers.
In Mississippi, many children don’t have a primary care doctor. Some counties in the Delta don’t have a single pediatrician, and parents don’t have the means to travel far with their children for checkups. An urgent care or emergency room is handling a specific emergent health issue, not checking in on milestones.
Even if a physician screens a child, it may be difficult to get a referral to a specialist.
White children, insured children, children from an English-speaking household, or a higher-income home are all more likely to be screened, according to the National Health Foundation.
In Mississippi, federally funded child care centers called Head Start centers fill some of those gaps, completing 30% of the state’s overall screenings despite comprising only 10% of the state’s childcare center, according to a 2021 study by the Children’s Foundation of Mississippi.
Despite the five-year project concluding, much of the work is just starting, according to the coalition.
The Legislature, Buttross said, allocated funds to support a fellowship to train early childhood specialists, something federal funds once covered. The $1.2 million appropriation to UMMC supported fellows who will graduate this June. The same funding was approved again this most recent session to train another eight fellows arriving in the coming academic year, though the bill has not yet been signed by the governor.
The “Thrive!” website is still active and a trove of information for both parents and physicians with support from the state’s human services office.
All positive steps, Buttross said, but not enough.
“There has not been enough funding to our early intervention programs,” she said. “We fund it with far less dollars than any of the surrounding states.”
And it’s the children who lose out without early intervention.