PEDS

10 questions to elicit parent’s concerns and fi nd children at risk

In this issue:• Getting reimbursed

• Finding local services

• Advising parents

• Improving satisfaction and attendance at well-visits

• Increasing detection rates

• Complying with AAP policy on early detection

• Teaching staff and trainees to use good tools

• Improving patient fl ow

Prescriptions for Practice Improvement

1. Are your milestones really working?

Only 30% of children with disabilities or delays are detected by their health care provider. Why? Most providers rely on selected items from longer screening tests such as the Denver-II or on informal milestones checklists. These approaches are not valid; they lack accuracy, and are the equivalent of putting a hand to a forehead to measure for a fever.

Solution:Parents’ Evaluation of Developmental Status (PEDS) and PEDS: Develop-mental Milestones are two highly accurate, valid developmental-behavioral screening and surveillance tools. Used alone or together, they comply with AAP policy.

Spring 2010 DS&S News is published by PEDSTEST.com (Ellsworth and Vandermeer Press, LLC/Forepath.org)

PEDS:DM

• Hands-on or parent-report • 6 - 8 items per visit• Actively promotes child development• Includes M-CHAT and other mea-

sures• Includes screens for older children• NICU follow-up version available• Fast (< 2 minutes to score) • Inexpensive ~ 2¢ per visit

PEDS

• Elicits and addresses parents’ concerns

• 10 parent-concerns items per visit

• Evidence-based decision support• Avoids “door-knob concerns”• Platform for parent-professional

collaboration• Fast (< 2 minutes to score)• Inexpensive ~ 35¢ per visit

PEDS:DM

6-8 questions that use validated mile-stones to screen for delays in each

developmental domain

Both Measures• For ages 0 - 8 years • Assess all developmental domains including

social-emotional and behavior • 96110 code - reimbursable • Validated, accurate, nationally standardized• Monitor progress over time• Includes professional training guides

Developmental Screening&

Surveillance News

2. Is your referral rate about what you should expect?A simple way for a practice to assess the accuracy of their early detection efforts is to look at rates of referral to early intervention programs. Is it 1 out of 25 patients? One out of 100? One out of 200? Would you be surprised to know that the rate should be 1 out of 25 for 2-year olds? 1 out of 8 for 4-year olds? The Centers for Disease Control and Prevention found the overall prevalence of disabilities to be 16% to 18% in the 0 - 21 year age range.

Solution:

PEDS and/or PEDS:DM increase early identification rates to match the prevalence of disabilities.

3. How can you manage visit length but still allow time for developmental screening?Another obstacle to early identification is the misperception that screening with good tools takes too much time. But this must be compared with the time spent not screening effectively. A worthwhile practice-assessment exer-cise is to look at the time currently spent eliciting children’s developmental skills, and having parents describe what their children can and can’t do. Include the time spent on “oh, by the way” concerns that disrupt sched-ules—these “grenades of the day” decrease sharply when parents have a chance to express concerns in writing prior to the encounter. How much time do you spend discerning parents’ often hidden agendas?

Solution:PEDS focuses the visit, reveals hidden agendas, eliminates “oh by the way” concerns, and can be completed by parents before the encounter.

4. How well are you getting reimbursed for screening?Are you billing and coding correctly? Are you receiving roughly $13.00 reimbursement for each screen you administer? A helpful self-assessment exercise is to view reimbursement before and after implementing a good screening tool. A quality instrument will earn back many times its cost.

Solution:Reimbursement is only assured when quality instruments (see “SPARV” sidebar) are used correctly:

After administering PEDS and/or the PEDS:DM, there are two options for coding screening as a procedure:

A) Attach the - 59 (or - 25) modifier to your preventive service code or E/M service code (to denote the office visit is a separate service from the screening. Then list 96110 times the number of screens given, e.g., X 3 if using PEDS+PEDS:DM+MCHAT. [Note that some States (e.g., North Carolina) do not allow an unbundled 96110 but have increased reim-bursement substantially for the entire well-visit].

SPARV!

The Measure of a Quality Instrument

Standardized: Tested on a repre-sentative sample

Peer-Reviewed: With research published in an appropriate journal

Accurate: Minimal over- or under-detection

Reliable: Gives consistent resultsValid: Predicts results of diagnostics

Key items from longer screens do not work or meet this

standard!!

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B) Multiple units, with the modifier appended to the visit as described above, best describe the separate entity of performing multiple 96110s. For insurers not accepting units, the distinct procedural service of each test is best represented with - 59 modifier appended to each additional unit of 96110.

Appeal all denied claims--sometimes State Medicaid Directors aren’t aware of the federal ruling from 2005, in which the Centers for Medicare and Medicaid Services published a total relative value unit (RVU) of 0.36 for 96110, which amounts to a Medicare payment of $13.64. This RVU repre-sents only malpractice expense and office expense --no physician work is included.

None of this can guarantee that a valid claim will be accepted, so the American Academy of Pediatrics (AAP) is willing to help with de-nied claims via their Coding Hotline: 800-433-9016, ext. 4022, or at aapcodinghotline@aap.org. Information on ICD-9 codes can be found at www.pedstest.com (FAQs).

5. Are you tailoring the advice you give families to be sure they get what they need, want, and will use? It isn’t humanely possible to go through the entire list of anticipatory guid-ance and developmental promotion topics with each family at each visit. How do you decide which topics to cover? Are parents listening and learn-ing?

Solution:www.pedstest.com and both PEDS and the PEDS:DM manuals allow you to elicit parents’ concerns beforehand, thus focusing the encounter on issues of interest to families. www.pedstest.com and both PEDS and the PEDS:DM manuals:

• include parent education materials (in Spanish and English)

• enhance “teachable moments”

• provide links to websites on parentings

• offer suggestions for other resources for parents

6. How able are you to find intervention services?A barrier to the adoption of quality screens is the misperception that refer-ral resources are lacking.

Solution:The early childhood community is, in fact, rich with resources. Every county has good quality early-intervention services that are free to qualify-ing children. Head Start and Early Head Start programs exist everywhere. Good preschool and day care programs are also a form of intervention. Lo-cal parenting classes and Internet-based parent-education services abound.

PEDS Manual

Contains guides for giving advice to parents on developmental and

behavioral issues, interpreting results to families, and more. Families whose

concerns are addressed are more satisfied with the care they receive.

PEDS:DM Professional Manual

Contains an extensive set of handouts and copyable education materials, information on billing and coding, finding intervention services, and

more.

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Here are a few of the websites that can help you find local services:

• www.nectac.org. Links to State, regional and local early interven-tion and testing services for young children with suspected or known disabilities

• www.ehsnrc.org. Help finding Head Start Programs.

• www.childcareaware.org and www.naeyc.org. Assistance locating quality preschool and day care programs

• www.patnc.org. Information about parent training classes.

• www.pedstest.com includes:

- a professional discussion list for medical and non-medical providers,

- developmental promotion guidance and materials

- downloadable referral letter templates

- live links to resources

The PEDS:DM manual also includes advice on working effectively with public schools and early intervention programs.

7. How satisfied are you, and the families you care for, with the care you provide? What percentage of your families return for well-visits as your patients get older? With so many undetected children, what is the toll on parent satis-faction with services from pediatric clinics? What happens to families with undetected children? Why, as children get older, do so many families not keep their appointments for well visits? Why do some families leave a prac-tice and seek services elsewhere?

Solution:Blue Cross-Blue Shield of Tennessee and the Promoting Healthy Develop-ment Survey found that when providers used PEDS, attendance at well-visits increased significantly and that families and providers were more satisfied with care.

PEDS, with its emphasis on parents’ concerns:

• increases attendance rates at well visits

• decreases “oh by the way concerns”—so disruptive to quality of care

• improves parent satisfaction

• improves provider confidence in decisions

• leads parents to use more positive parenting practice like time-out rather than spanking

PEDS is available on printed forms in English, Spanish, and Vietnamese. We also have licensable translations in Thai, Indonesian, French, Swahili, Arabic, Somali, Taiwanese, Chinese, Hmung, Malaysian, Russian, Haitian-Creole, Portuguese, and other languages. We can also work with you on other translations as needed. Contact research@pedstest.org.

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PEDS Printed Forms

PEDS Forms are available in English, Spanish, and Vietnamese, with

licensable translations in Thai, Indo-nesian, French, Swahili, Arabic, So-mali, Taiwanese, Chinese, Hmung, Malaysian, Russian, Haitian-Creole,

Portugese, Galician, and Laotian.

If other translations are neededcontact:

research@pedstest.org

PEDS Response Form(Vietnamese)TÍn em tr» TÍn ba mÀ

Ng‡y sinh c˚a em tr» Tu∞i c˚a em tr» Ng‡y «iän «÷n

Xin vui lÚng liåt kÍ nhªng «iäu Ùng b‡ bÊn khoÊn lo l°ng vä v√n «ä hÜc v√n, sø ph·t triãn v‡ c·ch c‹ x∫ c˚a con Ùng b‡.

‘ng b‡ cÛ bÊn khoÊn lo l°ng vä c·ch nÛi chuyån v‡ c·ch ph·t ‚m c˚a con Ùng b‡ khÙng?

‘ng b‡ cÛ bÊn khoÊn lo l°ng vä viåc hÜc c˚a con Ùng b‡ tÂi nh‡ tr» hay hÜc ™ chá kh·c khÙng?

‘ng b‡ cÛ bÊn khoÊn lo l°ng vä viåc tø hÜc hay c·ch l‡m viåc c˚a con Ùng b‡ khÙng?

‘ng b‡ cÛ bÊn khoÊn lo l°ng vä c·ch hÚa nh∆p vÛi ng‹©i kh·c c˚a con Ùng b‡ khÙng?

‘ng b‡ cÛ bÊn khoÊn lo l°ng vä c·ch c‹ x∫ c˚a con Ùng b‡ khÙng?

‘ng b‡ cÛ bÊn khoÊn lo l°ng vä viåc x∫ d¯ng c·nh tay v‡ ch‚n c˚a con Ùng b‡ khÙng?

‘ng b‡ cÛ bÊn khoÊn lo l°ng vä viåc x∫ d˘ng b‡n tay hay ngÛn tay c˚a con Ùng b‡ khÙng?

‘ng b‡ cÛ bÊn khoÊn lo l°ng vä viåc thâ n‡o con c˚a Ùng b‡ hiãu Ùng b‡ nÛi gÏ khÙng?

Xin vui lÚng liåt kÍ t√t c‰ nhªng gÏ Ùng b‡ quan t‚m v‡ lo l°ng vä con c˚a Ùng b‡.

#730PEDSv3-2008

PEDS Response Form Provider

PEDS: Formulario para Respuestas(Spanish) Provider

8. How do I train my staff, students and residents, given that RVUs don’t cover physician time for screening?Staff and trainees need practice using tools and a good understanding of the rationale for their use.

Solution:Both PEDS and the PEDS:DM Manuals and website, www.pedstest.com in-clude: case examples, downloadable/online slide shows, a video showing how to administer the tests, training guidelines, a post-test for measuring competence, and abstracts of research studies on both measures.

In addition, a comprehensive training package for pediatric residents is in development for download and use without charge. Check www.pedstest.com for updates, and send suggestions to Frances.Page.Glascoe@pedstest.org.

9. How do I comply with AAP recommendations for sur-veillance and periodic screening?The AAP recommends:

• eliciting and addressing parents’ concerns at each visit

• tracking milestones

• periodically screening using quality tools

• use of an autism specific screening tool at 18 and 24 months

• monitoring risk and resilience factors

• promoting development

• referring as needed

Solution:Use the PEDS System. PEDS combined with PEDS:DM forms an evidence-based approach to early detection: This involves

• PEDS (For eliciting and addressing parents’ concerns)

• PEDS:DM for monitoring milestones

Both measures, correctly scored, offer periodic screening and surveillance.

The PEDS:DM also includes laminated copies of other measures helpful for surveillance:

• the Modified Checklist of Autism in Toddlers (18 – 48 months)

• The Brigance Parent-Child Interactions Scale (0 – 30 months)

• The Family Psychosocial Screen (all ages)

• the Pediatric Symptom Checklist (5 – 18 years)

• the Vanderbilt ADHD Diagnostic Rating Scale (5+ years)

• The Safety Word Inventory and Literacy Screener (6 – 14 years)

PEDS:DM Family Book

The PEDS:DM Family Book, in English or Spanish, contains the laminated validated milestone

screener plus supplementary mea-sures helpful in implementing full

surveillance that meets AAP recom-mendations.

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10. What’s available for electronic health records?Practices are increasingly adopting electronic records. This enables routine tasks to be automated: Scoring screens, generating referral letters, locating billing/procedure codes, etc.

Solution: Via PEDS Online:

• Parents can take screens in advance of a visit (online from home, or on a waiting/exam room computer)

• Providers can type in parents’ written responses to PEDS Online questions or administer the measure(s) by interview

Results are scored in real-time so providers know immediately when to refer, counsel, reassure, etc. The site provides numerous time-savers by au-tomating scoring, generating billing/procedure codes, recommending what to do next, and providing a referral letter when needed. Online PEDS also includes the (optional) Modified Checklist of Autism in Toddlers and will indicate when such a measure is needed, as recommended by the Ameri-can Academy of Pediatrics.

Online PEDS services are secure, HIPPA, FERPA, and HL-7 compliant. The service can be used for surveys, prospective research studies, and com-puter-assisted telephone interviews focusing on both needs assessment and producing clinically relevant information on children’s developmental and behavioral status. For a trial license and pricing information go to pedstest.com and follow links to “Electronic Applications”.

Coming Soon: Online PEDS:Developmental Milestones (PEDS:DM).

11. How will you learn more about developmental-pediat-rics and early detection?

Solution: www.dbpeds.org is the American Academy of Pediatrics website on all things db peds: conditions, medication management, public school and other services, implementation ideas, etc.

www.pedstest.com has early detection slide shows, videos, training mate-rial, parent education handouts (in English and Spanish), and a discussion list on db screening.

www.firstsigns.org First Signs promotes early detection of autism and other developmenal disorders through routine screening, and collagoration among medical and non-medical professionals. The organization assem-bled an information kit for physicians including a wonderful video showing the behaviors of children on and off the spectrum. States can contract with First Signs for local training. The website is a repository of information for both parents and professionals.

www.aap.org is the American Academy of Pediatrics website housing

Electronic PEDS

The PEDS Online is a service providing automated scoring of PEDS measures, and the (optional) Modified Checklist of Autism in Toddlers. The site generates ICD-9 and procedure codes, referral letters when needed, and information sheets for parents.

Go to www.pedstest.com and follow links to electronic

records for trials and licensing information

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policy statements, parenting information, and its online book store offers brochures for families, texts on parenting and health-related topics.

www.reachoutandread.org Reach Out and Read (ROR) helps providers promote school success by encouraging book reading. The site explains the process, training requirements, sells appropriate books for different age children, etc.

www.developmentalscreening.org This site at Harvard University includes a video of reluctant providers who tried PEDS and discovered it helped them lots--both for health and developmental concerns! The site offers implementation advice and covers ongoing research (e.g., showing that screening via information from parents reduced “Oh by the way” concerns and shortened visit length).

12. How will you fi nd parenting information handouts?

Solution:•American Academy of Child and Adolescent Psychiatry: Facts for Fami-lies (www.aacap.org) Has numerous handouts that can be downloaded for free. Written in mul-

tiple languages, they address such topics as divorce, disaster recovery and how to chose a psychiatrist.

•American Academy of Pediatrics: You and Your Family (www.aap.org)

Describes child-care books, videos, hand-held health records, waiting room magazines, etc.

•British Columbia Council for Families(www.bccf.bc.ca/)

Well maintained site with articles, online questionnaires and links to resources on a variety of parenting and family topics. Carries individual and bulk copies of books and brochures on such topics as adolescence, marriage, family cohesion, and child development, as well as a parent-ing program, Nobody’s Perfect.

•Children and Youth Health (www.cyh.sa.gov.au)

From the South Australian Department of Human Services, this site has extremely rich information for parents on a huge range of psychosocial issues for teens and young children. Diapers are “nappies” and ear infections are “glue ear,” but other than that, the depth and quality of parenting advice is unparalleled.

•Kids’ Health (www.kidshealth.org/)

From the Nemours Foundation, this site has excellent information on health and safety, emotional and social development and positive parenting, focused on teens and younger children.

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•Early Childhood Connections (www.rch.org.au/ecconnections)

This website has sections for parents and professionals interested in devel-opmental and behavioral issues in early childhood. It houses parent information sheets (Adobe Reader is required) in various languages including Arabic, Bosnian, Chinese, Croatian, Somali, Spanish, Turkish, Vietnamese and English.

•Tufts University has a site housing downloadable handouts in various Asian languages on health, child-rearing and disabilities (http://spiral.tufts.edu/topic.html).

•The U.S. Department of Education website houses information for Spanish-speaking families on how to pro- mote child development, help school age children, etc. (www.ed.gov/parents/academic/help/partnership.html).

•California First Five has child-rearing guidance for Spanish speaking par-ents (www.ccfc.ca.gov/parentinfo.htm).

So, what do users say about PEDS?

”I am amazed at the unexpected benefits, which we are logging and will report. The amount of discussion about child development, the realization that we are not aware of parent perspective, the excitement of the staff and administrators to raise the quality of our care is thrilling.

And this is in the first 4 days!!!!”Alison Schonwald, MD - Instructor in Pediatrics, Harvard Medical School

“One other benefit of using PEDS is that I am able to tailor the well child visit to the parent’s concerns. That saves a lot of time, and I think

the parents leave the office more satisfied.”Vince K. Yamashiroya, MD. Private Pediatric Practice, Honolulu, Hawaii

“PEDS has similar psychometric properties to any screening instru-ment in general use, except it is simpler, takes far less time, and most

importantly, involves parents in the process.”Prof. Frank Oberklaid, University of Melbourne, Queensland, Australia

“PEDS definitely wins my “saved from the grenade” award. The grenade of course is that last concern, usually behavioral, that par-ents throw at you as you are finishing a well baby check. In my ex-perience, this concern is usually the most important part of the visit. Well, my delight with the PEDS is that parents fill it out and ex-press those concerns before I even get in the room. It totally chang-es the focus of my visit, and makes more efficient use of time.”

Stephen Kundell MD, FAAP, Thousand Oaks Pediatrics

How will you implement screen-ing in your practice?

These sites can help:

www.developmentalscreening.org (Harvard University) has helpful guidance on working with reluc-tant providers and overloaded staff. There is an excellent video on the process.

www.commonwealthfund.org/ (Commonwealth Fund in New York City) covers the ABCD project and has implementation guides, work flow models, etc.

www.pedstest.com has an imple-mentation slide show, videos, a discussion list, training informa-tion, etc.

Item Description What do I need to order?What is PEDS? PARENTS’ EVALUATION OF DEVELOPMENTAL STATUS

PEDS

•is a 10 question, validated, accurate screen eliciting parents’ concerns, in their own words, about their child’s development and behavior. It takes about 5 minutes for parents to complete, and 1- 2 to for clinician to score.

•reveals whether to refer, give advice, provide watchful waiting, screen further or reassure.

•reduces “oh by the way” con-cerns, increases attendance at well-visits.

•can be used with children of any age from birth until 8 years of age.

•includes a Brief Guide to Ad-ministration, a Response Form, a longitudinal Score /Interpretation Form, and an optional Manual for case examples, how to explain re-sults to families, parent education handouts, etc..

•First Timers: Order #705-PEDS Complete Set (Brief Guide, 1 pad of 50 PEDS Response Forms, 1 pad of 50 Score/Interpretation Forms). This is enough material to screen 50 children). It is a good idea to also order #500 the manual, “Collaborating with Parents.” See order form for information on foreign language translations and electronic applications.

•Reorders-Small Clinics: Each clinician using PEDS should have a #300-Brief Guide and each clinic should have a copy of #500-“Collaborating with Par-ents.” Reorder equal amounts of #700-PEDS Response Forms (pads of 50) and #720-PEDS Score/Interpreta-tion Forms (pads of 50). (See order form for Spanish or Vietnemese versions of PEDS forms.)

•Re-orders-Large Clinics: You’ll probably want to re-quest a #740-Discounted Bulk Order (a 25% discount from individual pads) consisting of 20 Brief Guides, 20 pads of 50 Response Forms and 20 pads of 50 Score/In-terpretation Forms. This will screen 1000 children.

•Re-orders-HMOs, Clinic Network: If you need 50 or more bulk orders (screens for 50,000 children or more during a year or so) and are willing to have them sent to a single address, please email evpress@pedstest.com. We have a discount schedule that can save you 30% to 50%.

What is the PEDS:DM? PEDS:Developmental Milestones PEDS:DM for Pediatric and Public Health Encounters

THE PEDS:DM•is a 6-8 items per visit focused

on children’s skills in each de-velopmental domain: fi ne motor, gross motor, expressive language, receptive language, self-help, so-cial-emotional, and for older chil-dren preschool and school skills. The questions take about 5 min-utes to complete and 1 minute to score.

•is designed for children at any age from birth until age 8, the measure consists of a laminated book of questions upon which parents mark answers with a dry erase marker. Marks are wiped off in preparation for re-use with the next family. To score, a single tem-plate is placed over the completed page to reveal each milestone not met.

•replaces informal milestones checklists (known to miss 70% of children with problems) with proven, validated, and accurate items.

800-PEDS:DM for Pediatric and Public Health En-counters (starter kit) Includes: PEDS:DM Family Book (in English or Spanish) consisting of reusable laminated forms; 100 longitudinal PEDS:DM Recording Forms; and a Binder Case housing the scoring template and storage for the Family Book, manual, dry erase marker, and clip to secure the correct page. The starter kit also includes the PEDS:DM Professional Manual.

•First Timers: Order #800-PEDS:DM for Pediatric and Public Health Encounters starter kit (see order form for Spanish or Vietnamese versions of PEDS Forms).

•Small Clinic: Order #800-PEDS:DM for Pediatric and Public Health Encounters starter kit plus enough #810-Family Books (or #815 Family Book in Spanish) for each well visit scheduled at the same time.

•Large Clinic: Order enough of the above #800 starter kits for each nurses’ station, plus enough #810-Family Books (or #815 Family Book in Spanish) for each well visit scheduled at the same time.

•Re-orders: Reorder #820-PEDS:DM Recording Forms.

ORDERING INFORMATION FOR PEDS and the PEDS:DM

PEDS:Developmental Milestones

Family Book in Spanish

[Hitos Del Desarrollo De Los Niños

Libro Para Las Familias]

Frances Page GlascoeNicholas S. Robertshaw

Ellsworth & Vandermeer Press, LLC

Item Description What do I need to order?What is the PEDS:DM (cont’d)? THE PEDS:DM FOR EARLY CHILDHOOD AND NICU

THE PEDS:DM (CONT’D)

•includes a developmental promotion component by encouraging parents, once they’ve completed the questions, to read a short story to their children about age-appropriate parent-child interactions. Online applications are coming soon. See www.pedstest.com for updates.

•the PEDS:DM Recording Form is used to record answers and can be re-used with each child to produce a graph of progress over time.

•the PEDS:DM manual contains infor-mation on parenting, billing and coding, and directions for using the PEDS:DM alone, in combination with PEDS, or with screens of parent-child interactions, psychosocial risk, resilience, ADHD, and autism spectrum disorders, along with parent information handouts, case ex-amples, and training guides.

•For NICU follow-up and early child-hood settings, the assessment level version of the PEDS:DM presents more items at once and produces age-equiva-lent scores.

805-PEDS:DM for Early Childhood and NICU fol-low-up (starter kit) Adds to the PEDS:DM starter kit the PEDS:DM Assessment Level (in Spanish or Eng-lish) which offers more items at each encounter and produces age-equivalent scores in 7 domains: fi ne motor, gross motor, expressive language, receptive language, self-help, social-emotional, and, for older children, pre-academic/academic skills. The Assess-ment Level includes the laminated PEDS:DM Family Book (with illustrations needed for the Assessment Level administration); 50 PEDS:DM Assessment Lev-el Booklet (reusable over time with the same child); and the Longitudinal Growth Chart (printed on the back of the Assessment Level booklet) for sharing re-sults with families. This version of the PEDS:DM can be mailed out, completed in waiting exam rooms, or administered directly to children by teachers, clini-cians, etc. For children less than 3 years of age, the PEDS:DM Assessment Level can also be adminis-tered via telephone interview.

•First Timers: Order #805-PEDS:DM for Early Child-hood and NICU follow-up starter kit.

•Small and Large Clinics: Order the #805 starter kit plus enough #810-Family Books and #840-Assess-ment Level Booklets (or #815 and #845 for Spanish) for each visit scheduled at the same time.

•Re-orders: Reorder #810-PEDS:DM Assessment Level Booklet (or #815 for Spanish booklet).

What is THE BEST APPROACH? TO USE BOTH PEDS AND THE PEDS:DM!

PEDS:DM PLUS PEDS THE BEST APPROACH

•adding PEDS to the PEDS:DM (both at the same time, or the PEDS:DM as needed) offers good compliance with American Academy of Pediatrics policy: eliciting and addressing parents’ con-cerns at each encounter, monitoring milestones, and screening with validated tools periodically.

•using PEDS and PEDS:DM together improves communication between fami-lies and providers, increases the likeli-hood of attendance at follow-up visits, and offers optimal program evaluation/research metrics.

850-PEDS:DM plus PEDS: The Best Approach for Pediatric and Public Health Encounters includes the PEDS:DM starter kit plus 100 PEDS Response Forms and the PEDS Brief Guide. The PEDS:DM Record-ing Form (100 supplied with each order) includes the PEDS Scoring/Interpretation Form that identifi es when the PEDS:DM is needed.

•First Timers: Order #850-PEDS:DM plus PEDS: The Best Approach for Pediatric and Public Health Encounters.

•Re-orders: Reorder #700-PEDS Response Forms (or 710 or 730 for Spanish or Vietnamese) and #820-PEDS:DM Recording Forms.

807-PEDS:DM and PEDS for Early Childhood and NICU follow-up: The Best Approach for NICU follow-up and Early Childhood includes with the PEDS:DM starter kit, 50 PEDS Response Forms and the PEDS Brief Guide.

•First Timers: Order #807-PEDS:DM and PEDS for Early Childhood and NICU follow-up.

•Re-orders: Reorder #700-PEDS Response Forms (#710 or #730 for Spanish or Vietnamese) and #720-PEDS Score/Interpretation Forms, and additional #840-Assessment Booklets (or #845 for Spanish).

PEDS Response Form Provider

#700PEDSv1-2008

…with brief adminis-tration instructions

and scoring template

PEDS:DM Binder Case

PEDS:DM Assessment Level Booklet

PEDS Response Form

…with directions, and parent and

professional education materials

PEDS:DM Profes-sional Manual

PEDS Brief Administra-tion and Scoring Guide

Includes the PEDS:DM Growth Chart and PEDS Score/Interpretation Form

PEDS:DM Recording forms

PEDS Family Book

…containing questions about parents’ concerns

English Spanish

Directions for eliciting and addressing parents’

concerns

12-page record bookletRe-usable for each child

English Spanish

…with laminated forms and supplementary measures

English Spanish

…for decision support and longitudinal

monitoring with PEDS

PEDS Score & Interpretation Form

}} } }}} }} }} }

ORDER FORM for the PEDS:DM

Item Price Quant. Total800-PEDS:DM for Pediatric and Public Health encounters (starter kit)

1 1pk

1001

$275.00

803-PEDS:DM for Pediatric and Public Health encounters (starter kit) (Spanish)

1 1pk

1001

$275.00

805-PEDS:DM for Early Childhood and NICU follow-up (starter kit) 1 1 25 1

$318.00

806-PEDS:DM for Early Childhood and NICU follow-up (Spanish)

1 1 25$318.00

850-PEDS:DM plus PEDS: The Best Ap-proach for Pediatric and Public Health Encounters

1 1 2pad 100

pk 100

1$315.00

855-PEDS:DM plus PEDS: The Best Ap-proach for Pediatric and Public Health Encounters (Spanish)

1 1 2pad 100

pk 100

1$315.00

807-PEDS:DM and PEDS for Early Child-hood and NICU follow-up: The Best Approach

1 1 50 2pad50

pad50

1$399.00

808-PEDS:DM and PEDS for Early Child-hood and NICU follow-up: The Best Approach (Spanish)

1 1 50 2pad50

pad50

1$399.00

810-PEDS:DM Family Book (English) It is helpful to have a Family Book for each exam room or simultaneous appointment. Includes clip and dry erase marker

1 $110.00(10 or more:

$80.00)

815-PEDS:DM Family Book (Spanish)1

$110.00(10 or more:

$80.00)

830-PEDS:DM Professional Manual A Manual is recommended for each station where professionals administer the PEDS:DM

1 $40.00(10 or more:

$30.00)

820-PEDS:DM Recording Forms pk100 $32.00

840-PEDS:DM Assessment Level Booklet 25 $75.00

845-PEDS:DM Assessment Level Booklet (Spanish)

25$75.00

Electronic PEDS:DM and PEDS See www.pedstest.com for information Subtotal (add to total on next page)Volume discounts/bulk ($25k+) orders Please inquire: evpress@pedstest.com

EXTRA COPIES AND REFILLS

PEDS Printed Forms and Guides:PEDSTEST.com (Ellsworth & Vandermeer Press, LLC)1013 Austin Court, Nolensville, TN 37135phone: 615.776.4121 fax: 615.776.4119 web: www.pedstest.com email: evpress@pedstest.com

PEDS Electronic and Online:See www.pedstest.com for trials and information

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Item Description 705-PEDS Complete Set: 1 Brief Administration & Scoring Guide, 1 pad of 50 PEDS Response Forms, 1 pad of 50 PEDS Score & Interpretation Forms

300-Brief Administration & Scoring Guide (for English- and Spanish-speaking families) Volume discount (e.g., large clinics, teaching hospitals) orders of 20+

700-PEDS Response Forms for English-speaking parents (pad of 50)

720-PEDS Score & Interpretation Forms (pad of 50)

710-PEDS Response Forms for Spanish-speaking parents (pad of 50)

730-PEDS Response Forms for Vietnamese-speaking parents (pad of 50)

740-Discounted Bulk Order Package: 1000 Response Forms, 1000 Score & Interpretation Forms, 20 Brief Administration & Scoring Guides (substitutions available on request)

500-Comprehensive PEDS Manual, “Collaborating with Parents”

PEDS Forms are designed for ease of scanning completed Forms into image-based electronic records.For information on using PEDS in electronic health records go to www.pedstest.com and follow links to electronic records. For ordering enough material to screen 50,000 children during a single year contact: evpress@pedstest.com. 50% prepayment required.For versions in other languages, and research issues contact: research@pedstest.org.org. Examples, videos, downloadable training slide shows and research information are also available at www.pedstest.com.

Cost Quantity Total

$36.00

$4.00

$3.50

$18.00

$18.00

$18.00

$18.00

$600.00

$79.95

Subtotal PEDS Order

Subtotal of PEDS:DM Order

Sales Tax (TN residents)

International Shipping & orders over $2000:

Contact Us

US Shipping 9% of total, ($8.99 for all orders less than $83.00)

TOTAL****There is a 30 day limit for credit for a returned order. Returned orders, ifdamaged, will not be credited. Shipping costs plus a 10% restocking fee will be deducted from undamaged returned orders. Ifunsure what to order please read through this ordering guide carefully. Also helpful is the Q & A on www.pedstest.com.Please join our Early Detection Discussion List. Sign up at www.pedstest.com and post questions to other PEDS users.

ORDER FORM for PEDS FORMS AND GUIDES