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
Developmental
Screening Tools
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
-
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%)
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.
Notes from Working Group on Developmental Screening
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
photo by:
Leonid Mamchenkov 
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