Selecting Developmental Surveillance and Screening Tools

Dennis Drotar; Terry Stancin; Paul H. Dworkin; Laura Sices; Susan Wood

doi:10.1542/pir.29-10-e52

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Dennis Drotar, PhD*
Terry Stancin, PhD^†
Paul H. Dworkin, MD^‡
Laura Sices, MD^§
Susan Wood**

^*Professor of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
^†Professor of Pediatrics, Psychiatry and Psychology, Case Western Reserve University and Metro Health Medical Center, Cleveland, Ohio
^‡Professor of Pediatrics, University of Connecticut School of Medicine, Farmington, Conn
^§Assistant Professor of Pediatrics, Boston University School of Medicine, Boston, Mass
^**Coordinator, Division of Behavioral and Developmental Pediatrics, Rainbow Babies & Children's Hospital, Cleveland, Ohio

Introduction

The importance of surveillance and screening for developmental problems in primary care has been well recognized in scholarly reviews and practice guidelines. (1) The need for early detection of developmental problems in infants and young children in primary pediatric care settings stems from the high prevalence of such problems and the potential for early intervention for the child and family. Frequent longitudinal contact with young children and their families at critical times in their early development provides pediatricians and other practitioners with important opportunities to conduct developmental surveillance and screening to detect clinically significant developmental problems and institute early intervention. (1)(2)(3)(4) Early identification and referral to early intervention programs can ameliorate the negative consequences of developmental problems on children, families, and society. (3) However, studies have indicated consistently that many infants and young children who have clinically significant developmental delays are not detected in pediatric primary care. (1)(3)(4) As a consequence, critical opportunities for early intervention for young children who are at risk for developmental problems may be lost. (2)(5)(6)(7)

To address this need, the American Academy of Pediatrics (AAP) developed a policy statement for identifying infants and young children who have developmental delays and disorders. (8) This statement is a significant advance in the clinical application of developmental screening in several respects. One is the recommendation to address parental concerns about development as one of several health topics in routine pediatric preventive care visits throughout the first 5 years after birth. Developmental surveillance, defined as a flexible, longitudinal, continuous, and cumulative process, is recommended for inclusion at every pediatric visit.

The five components of developmental surveillance described in the AAP statement include: 1) eliciting and attending to the parent's concerns about his …