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![Parent holding an infant's foot](graphics/foot.jpg)
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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