Model Collaboration — Meeting Milestones Initiative

We are working with all Grand County healthcare and childcare providers to ensure that all children are screened three times by the age of three. 

Grand County Rural Health Network, Grand Beginnings / Rural Resort Region NE Early Childhood Council, Colorado’s ABCD Project, and Patient Tools, Inc. as well as Grand County’s primary care providers and early childhood programs make up this public / private collaboration.

Our problem was that both healthcare and early childhood providers were screening children using different tools. The result was multiple screenings for each child, often confusing the parents. No provider was communicating with other providers on the child’s screening results—especially if a potential delay was found—resulting in providers’ untimely access to results and the child’s untimely access to follow-up services. Referrals were not getting to the right places, and information given to the parents often varied based on who gave which screening. Together, the Grand County collaborative worked to solve the problem.

Our solution, or community model, involves:

  • Implementing Ages and Stages Questionnaire 3 (ASQ3, the standardized developmental screening tool chosen by the community) in all settings (successful—100% of healthcare practices and early childhood programs use the tool);
  • Creating a consistent referral policy for healthcare and childcare providers based on the results of the screening;
  • Implementing online ASQ3 with a provider interface in primary care offices and childcare centers;
  • Creating a master ID unique to each child to track child- and aggregate-level data;
  • Creating a communication model to ensure a high level of consistent communication between healthcare and childcare providers, Horizons Specialized Services / Early Intervention Colorado, Child Find, and any other providers chosen by the family.
Early and Middle Childhood in Healthy Grand County 2020 Plan


Document and track population-based measures of health and well-being for early and middle childhood populations over time in the United States.


There is increasing recognition in policy, research, and clinical practice communities that early and middle childhood provide the physical, cognitive, and social-emotional foundation for lifelong health, learning, and well-being. Early childhood, middle childhood, and adolescence represent the 3 stages of child development. Each stage is organized around the primary tasks of development for that period.

  • Early childhood (usually defined as birth to year 8) is a time of tremendous physical, cognitive, and socio-emotional development.
  • Middle childhood (usually defined as ages 6 to 12) is a time when children develop skills for building healthy social relationships and learn roles that will lay ground work for a lifetime.


Increase the proportion of parents who receive information from their doctors or other healthcare professionals when they have a concern about their children’s learning, development, or behavior.

Assuring Better Childhood Development Program (ABCD). The Network and Grand Beginnings / Early Childhood Council Rural Resort Region Northeast have been partnering for the past year to implement the ABCD program in healthcare and childcare provider settings. ABCD requires the use of one consistent tool (in this case Ages and Stages) on all children with the goal that all children are screened minimally three times by the age of three. We have been extremely successful in this initiative.