The COVID-19 pandemic has had a significant effect on many factors, including healthcare. A recent government analysis based on data from the Centers for Medicare and Medicaid Services highlighted a decline in services used by children covered by Medicaid and the Children’s Health Insurance Program. Specifically, there were 44% fewer child screening services that assess physical and cognitive development in March through May of 2020 compared to 2019.

The American Academy of Pediatrics (AAP) in collaboration with the Centers for Disease Control and Prevention (CDC) conducted 9 key informant interviews with emerging pediatric practices to identify innovative strategies to continue conducting developmental surveillance, screening, referral, and follow-up during the COVID-19 pandemic.


An online emerging practice application was disseminated via AAP networks to solicit applications for participation in key informant interviews with AAP project staff. Over 30 applications were received, and 9 practices were selected based on a pre-determined review criteria to participate in a one-hour telephone key informant interview. Following the interviews, notes were transcribed and coded for emerging themes.


Practices described numerous innovations and challenges to conducting developmental surveillance, screening, referral and follow-up during the COVID-19 pandemic. Practices were able to implement innovative strategies to continue to reach their patient population, including restructuring clinic hours and appointments, modifying staff roles, implementing telehealth for appointments, and identifying new referral agencies while continuing to remain a source of trusted information during a global pandemic. Practices noted challenges observing patients and disseminating screening tools during telehealth visits. Referrals were challenging due to the virtual nature of therapies during the COVID-19 pandemic.


Practices demonstrated resilience and innovative strategies to continue to reach their patient population during a difficult and unprecedented public health emergency. Telehealth options for patients provided an important modality to increase access to care for many patients and improve health equity. Lessons learned and highlights from the interviews will help inform future educational materials and resources to assist other pediatric practices apply innovations in providing essential services moving forward.

Emerging Practice Interview Results

Learn what practices did in order to continue to conduct and deliver developmental surveillance, developmental screening, referral, and follow-up during the COVID-19 pandemic.

Emerging Practice Repository

Last Updated



American Academy of Pediatrics