Strong Start: Information for Early Care and Education Providers

female teacher playing with toy telephone held by child

Strong Start is a free and secure, online system that allows you to track and share developmental screening results.

Families, health care and early care and education providers can use Strong Start to enter completed screening results, no matter where they happened. Families will have an ongoing record they can share with providers like you. This will help ensure children get screenings when they need them and help families make informed decisions.

Strong Start can help you:

  • Support developmental monitoring. You can enter and view developmental screening results, including past screenings done elsewhere.
  • Track when children in your care need to be screened, what type of screen they need, and when it’s due.
  • Share records with families and authorized users.
  • Avoid duplicate screenings.

As more families and providers use Strong Start, we will be able to create reports that can show trends and gaps in developmental screening.

Note: The reports won’t contain any individual identifiable information. The data will help us better understand how many children are receiving developmental screenings and what resources are needed to support children and families in Washington.

Early Care and Education User Requirements

  • To gain access to Strong Start system you must be affiliated with a licensed site.
  • Your site director is required to complete a DOH Information Sharing Agreement (ISA).
  • DOH will review and approve the form before access is granted.

These steps are essential to ensure we protect confidential information and maintain the trust and integrity of our program and system.

Note: Only one ISA submission is required per site. Please make sure it is signed by either the director or the owner.

Need more information? Email StrongStart@doh.wa.gov

Getting Started

Ready to use Strong Start? Please make sure your DOH Information Sharing Agreement is approved. Follow the steps to set up your account.

Frequently Asked Questions for Early Care and Education Providers

What do you mean by “Early Care and Education Provider”?

Early care and education providers are professionals who provide early care, early learning, and supports to children. Examples would be licensed childcare providers, Head Start/Early Head Start, home visitors, Early Achievers, Early Childhood Education and Assistance Program (ECEAP), and Early Support for Infants and Toddlers (ESIT).

How can early care and education providers benefit from the Strong Start system?

Using Strong Start to view and record screening results, and any referrals for follow up, enables ECE providers to track screenings over time. It also supports shared decision-making with parents/families and, with parent permission, the child’s healthcare provider. Strong also has a feature for monitoring when a future screening is due.

Is Strong Start used to complete the screening?

No, Strong Start is for recording information from a screening that has already been completed. Records include the scores, whether there was a concern, and whether there was a referral for further evaluation or services.

What screening tools are included in the Strong Start system?

The information below provides high-level information on the tools in Strong Start. You can find additional information on each tool using the embedded hyperlinks.

ASQ-3: Ages and Stages Questionnaires, 3rd edition
Available in Spanish, Arabic, Chinese, French
Brookes Publishing

Numerical scores in 5 domains:

  1. Communication
  2. Gross motor
  3. Fine motor
  4. Problem solving
  5. Personal social

Scores grouped into:

  • Above cutoff
  • Near cutoff
  • Below cutoff

ASQ:SE-2: Ages & Stages Questionnaires: Social-Emotional, Second Edition
Available in Spanish, Arabic, French
Brookes Publishing

Numerical scores in 7 domains:

  1. Interaction with people
  2. Self-regulation
  3. Compliance
  4. Social communication
  5. Adaptive functioning
  6. Autonomy
  7. Affect

Scores grouped into:

  • Monitor
  • Above cutoff
  • Near cutoff
  • Below cutoff

SWYC: Survey of Wellbeing of Young Children
Includes autism-screening tool
Culturally sensitive, available in Spanish, Khmer, Burmese, Nepali, Portuguese, Haitian-Creole, Arabic, Somali and Vietnamese.
Tufts University

Numerical scores in 3 domains

  1. Developmental
  2. Emotional/behavioral
  3. Family context

Scores grouped into:

  • Further investigation needed
  • Below average range
  • Average range
  • Above average range

M-CHAT-R: Modified Checklist for Autism in Toddlers, Revised with Follow-up
Available in numerous languages, although validation of these translations is still underway.
©Robbins, et al

Numerical scores in 3 domains

  1. Communication
  2. Social
  3. Behavior

Identifies risk (not a diagnosis)

  • Low
  • Med
  • High
What are the recommended ages/intervals for developmental screening?

The American Academy of Pediatrics recommends developmental screening at 9, 18, and 24 or 30 months, and autism-specific screening at 18 and 24 months.

The conversation with parents/families can be sensitive. What resources are there to help early childhood partners with those conversations?

Yes, these conversations can be sensitive! Parents may wonder if they “did something wrong” when a developmental concern is identified. You can help reassure them. Below are some resources to help with those conversations:

Other questions? Please contact us at StrongStart@doh.wa.gov.

Other questions? Please contact us at StrongStart@doh.wa.gov.