Development of a Shelter-based Pediatric Behavioral and Developmental Health Screening Program Through Community Partnerships

Children experiencing homelessness face elevated risks for behavioral health disorders and developmental delays, including autism spectrum disorder (ASD), yet access to screening and early intervention is limited. This column describes the establishment of a pediatric behavioral health and ASD screening program at two Philadelphia homeless shelters through a partnership with JeffHOPE, a student-run free clinic at Thomas Jefferson University. The program illustrates how student-run clinics can function as flexible, community-based platforms for early identification and referral. Screenings utilized the Pediatric Symptom Checklist (PSC-17) for school-aged children and the Modified Checklist for Autism in Toddlers (M-CHAT-R/F) for toddler-age children, offered in multiple formats to accommodate family preferences and literacy levels, and were integrated into routine clinic workflow. Families received resource handouts and discharge summaries to support follow-up with pediatricians and community services. The program benefited from partnerships with faculty, community behavioral health providers, shelter administrators, and families, which informed trauma-informed implementation, workflow integration, and ongoing program refinement. Key strengths included feasibility without external funding, adaptability to family needs, and the ability to build trust and engagement with families over time. Challenges included ensuring continuity across volunteer transitions and maintaining follow-up in a transient population. This experience provides a practical model for student-run clinics seeking to implement behavioral health and developmental screening initiatives in shelter settings. By emphasizing collaboration, flexibility, and responsiveness to family needs, similar programs can improve access to care for children who are often underserved by traditional healthcare systems.