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Overview
What is developmental
screening?
Developmental screening is a procedure designed to
identify children who should receive more intensive assessment or
diagnosis, for potential developmental delays. It can allow for earlier
detection of delays and improve child health and well-being for
identified children.
Why is developmental screening
important?
Many children with behavioral or developmental
disabilities are missing vital opportunities for early detection and
intervention.
Many children with developmental delays are not being
identified early.
In the United States, 17% of children have a developmental or behavioral
disability such as autism,
mental retardation, and
Attention-Deficit/Hyperactivity Disorder.
In addition, many children have delays in language or other areas, which
also impact school readiness. However, less than 50% of these children
are identified as having a problem before starting school, by which time
significant delays may have already occurred and opportunities for
treatment have been missed.
Early identification and
intervention for children with developmental delays is mandated
The
Individuals with Disabilities Education Act (IDEA) Amendments of 1990 to
1997 require states to provide early identification and provision of
services to infants and toddlers with 1) developmental delays, 2)
established conditions that are associated with developmental delays,
and, 3) at the state’s option, children at risk for developmental delays.
States that do not serve the at-risk population are encouraged to track
and monitor these children’s development, so that they may be referred in
the future if needed. IDEA also mandates that states refer children, free
of charge, for a comprehensive, multidisciplinary evaluation by a team
who, with the family, decides on which services are needed for the child
(via the Individualized Family Service Plan). Furthermore, it mandates
states to implement coordinated, family-centered, and culturally
competent community-based systems of care, to provide early intervention
services for children identified with developmental problems. The
National Early Childhood
Technical Assistance Center, lists early intervention programs by
state and provides their contact information for interested parents and
professionals.
Parents are interested in
knowing more about their child’s development and pediatric practitioners
need to be better prepared for this.
Recent surveys indicate that parents want information and
guidance from their health care provider about their child’s development.
However, studies sponsored by the American Academy of Pediatrics show
that about 65% of pediatricians feel inadequately trained in assessing
children’s developmental status.
Who provides developmental
screening services?
Developmental screening can be done by various
professionals in healthcare, community, or school settings. The role of
health professionals has become particularly important, because of the
greater emphasis placed on early identification of children with delays.
Through well-child visits, health professionals have regular contact with
children 0 to 3 years-of-age, allowing them an opportunity to monitor
development through periodic developmental screening. This has led
healthcare professional organizations, such as the American Academy of
Pediatrics (AAP) and the American Academy of Neurology, to recommend that
all infants and young children be screened for developmental delays
periodically in the context of office-based primary care.
Special topics
Today, a number of good screening tools are available
designed for a variety of settings, ages, and purposes.
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Milestones which may be used as part of developmental
screening
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0 to 1 years— infants (link already on our website)
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1 to 2 years—toddlers (link already on our website)
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2 to 3 years—toddlers (link already on our website)
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3 to 5 years—preschoolers (link already on our
website)
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Barriers to integrating developmental screening into
pediatric practice
(When reviewing the results of these surveys it is
important to note that the response rate of most of them is about 60%)
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State and national efforts
Significant efforts (for example, by the American
Academy of Pediatrics Committee on Children with Disabilities, the
Commonwealth Fund, or the Department of Education) have been made, over
an extended period of time, to address the issue of developmental
screening. This has allowed for the implementation of several national
and multistate programs. However, there are currently no national datasets that track this
practice and how it is integrated into primary care. There are a few
datasets that are particularly relevant to developmental screening and there are several that
cover
related topics.
The National Center on Birth Defects and
Developmental Disabilities, CDC, invited experts in the field of
developmental screening and some key stakeholders, to determine how CDC
can best contribute to the goal of promoting optimal child development
within public and private health systems. The focus of the meeting was on
creating a change in the way general pediatricians address and manage the
developmental needs of children. Meeting Notes
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CDC recommendation for Developmental Screening
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References to some relevant articles
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Committee on Children and Disabilities, American
Academy of Pediatrics. Developmental surveillance and screening for
infants and young children. 2001;108(1):192-6.
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Boyle CA, Decoufle P, Yeargin-Allsopp M. Prevalence
and health impact of developmental disabilities in US children.
Pediatrics 1994;93(3):399-403.
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Dawson G, Osterling J. Early intervention in
autism. In: Guralnick MJ, editor. The effectiveness of early
intervention. Baltimore (MD): Paul H. Brookes; 1997.
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Glascoe, FP. Early detection of developmental and
behavioral problems. Pediatrics in Review 2000; 21(8):272-280.
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Halfon N, Hochstein M, Sareen H, O'Connor KG,
Inkelas M, Olson LM. Pediatric Academic Societies periodic survey of
fellow: barriers to the provision of developmental assessments during
pediatric health supervision [abstract]. 2001 May. Available from URL:
http://www.aap.org/research/ps46pas4.htm.
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Lavigne JV, Binns HJ, Christoffel KK, Rosenbaum D,
Arend R, Smith K, Hayford JR, Mc Guire PA, Pediatric Practice Research
Group. Behavioral and emotional problems among preschool children in
pediatric primary care: prevalence and pediatricians' recognition.
Pediatric Practice Research Group. Pediatrics 1993;91(3):649-55.
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National Research Council, Committee on Educational
Interventions for Children with Autism, Division of Behavioral and
Social Sciences and Education. Educating children with autism.
Washington, DC: National Academy Press; 2001.
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Regalado M, Halfon N. Primary care services
promoting optimal child development from birth to age 3 years. Archives
of Pediatrics and Adolescent Medicine 2001;155:1311-1322.
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Resources and links to those involved in
developmental screening and related efforts
DISCLAIMER: We
have no control over the content on outside Web sites. Links to
these sites are included for information only. The views and
opinions expressed there are not necessarily those of CDC, the
Department of Health and Human Services (HHS), or the U.S. Public
Health Service (PHS). |
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Date: September 20, 2005
Content source: National Center on Birth Defects and Developmental
Disabilities
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