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Developmental Testing

Many screening tools are available to the pediatrician; the ones described here are just a sample of some that are used commonly. Understanding the purpose and limitations of each screening measure, in terms of reliability, validity, sensitivity, specificity, and the population for which it was designed, will help the pediatrician use these tools effectively to identify children at risk for developmental delay. Most importantly, the pediatrician should view screening tests as one source of information to be used in an overall strategy of developmental surveillance that includes careful historical review, systematic clinical observations, and solicitation of parental concerns and attitudes.

Pediatricians play a central role in monitoring the development of infants and children during the course of providing well child care. Parents turn to pediatricians for help in determining whether their child has a temporary lag in development, a serious delay or disorder, or a significant behavior problem that should be addressed. With the passage of PL 99-457, pediatricians also play a key role in referring children at risk to early intervention services. By employing a strategy of developmental surveillance, with periodic developmental screening, the pediatrician can determine when a child should be referred for more extensive developmental or psychological testing, which will aid in the process of diagnosis and treatment of developmental disabilities and behavioral disturbances. Knowledge of the screening and testing measures used commonly, as well as their limitations, will result in more accurate interpretation of the data derived from such measures. Once delays are diagnosed and treatment is initiated, repeated assessments over time will serve to identify areas in need of continuing intervention while indicating gains made in specific areas of developmental functioning. Throughout this process, the pediatrician's role as advocate for the child and family serves as a bridge to other professionals and services, with the ultimate goal of facilitating the optimal development of the child.

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