To identify the root causes of problems and barriers related to early identification and referral in the community.
If, after reviewing the Community Readiness Assessment and results of the Scan of Current Screening Practices, the Community Implementation Team determines that fewer than desired programs are providing developmental screening for children birth to three, the next step is to begin developing a common understanding of the root causes of the lower than desired screening rates. The Five Whys exercise is a tool for identifying root causes of challenges, barriers, and problems. Identifying root causes is a foundational step that must occur prior to developing strategies to address barriers related to developmental screening.
The instructions for the Five Whys exercise are simple. Begin by stating the problem. Next, answer the question “Why is this a problem?” Continue asking “why?” four additional times, or until you feel you have identified the root cause. The root cause should identify a process that is not working well or does not exist. Keep in mind that “people do not fail, processes do.” If your answers point towards reasons such as inadequate time, resources, or staff, try to reframe the question from “why?” to “why did the process fail?”
There may be multiple barriers or problems related to developmental screening in your community. Some of these problems and barriers may be drawn from the Weakness and Threats identified through the SWOT analysis. Complete The Five Whys exercise for each problem to identify all root causes. After completing the exercise for each problem, copy each problem and associated root cause into the table provided for easy reference as you move through the planning process.