Information for Professionals

Have you ever...

  • Had a family who is continually missing or rescheduling well-child visits due to family stress or challenges such as transportation?
  • Been concerned about a parents or caregiver's stress or possible depression, but not been able to ask due to lack of time, screening tools, or referral resources?
  • Made a referral and been left wondering, "Did they make the call?" or "What was the outcome?"
  • Been concerned that parental issues may be negatively impacting the current and future social and emotional development of a child you are seeing?

Iowa's 1st Five Healthy Mental Development Initiative serves as a national model for continued investment in children's mental health. Research tells us that a significant portion of young children are not receiving adequate developmental surveillance and screening. 1st Five assists medical practices in implementing recommended surveillance and screening tools. When developmental or behavioral concerns, family stress or caregiver depression is identified by a child's primary care provider, the provider sends a referral to the local 1st Five Developmental Support Specialist, who then assists in linking the family to appropriate services. Once the family is connected to services, the developmental support specialist follows up with the referring physician regarding the status of the referral. Public and private providers partner to design a process for assessment, referral and follow-up that effectively and efficiently assures children receive needed services.


Early identification and intervention with developmental concerns and family risk factors lead to improved outcomes for the individual child and family, as well as considerable savings to society over the long term, with the biggest savings from decreased criminality in adulthood. Several national studies have demonstrated that every dollar invested in early childhood yields between $3-$17 in return. The RAND group estimated a government savings of $18,611 per child who underwent early intervention in the Elmira Prenatal / Early Infant Project, and a savings of $13,289 per child for individuals receiving intervention in the Perry Preschool Project (figures in 1996 dollars). For further information on the economic return from early childhood investments, see First Years First.

Resources for Implementing Developmental Surveillance and Screening