What is developmental screening?

Answer 1

Developmental screening involves the administration of brief, accurate tests in order to decide whether a child probably has a problem or probably does not. Results of such measures are not diagnostic and do not determine the nature of any difficulties. Rather, results are used to decide whether more testing is needed.

Health care providers are encouraged to use screening tests at each well visit. Many, however, confuse informal approaches (e.g., items drawn from lengthy tools, informal milestones checklists, etc.) with developmental screening. Informal approaches are ineffective and thought to miss more than 50% of children with problems. That only 1/4th of children with problems are identified and enrolled in early intervention, attests to the need to use quality screening tools. Such measures are known to detect at least 70% to 80% of children with difficulties, with minimal over-referrals.

Examples of quality screens include the Ages and Stages Questionnaire, Parents' Evaluation of Developmental Status, and PEDS:Developmental Milestones. Adjuncts are "narrow-band" tools focused on detecting specific conditions (e.g., autism spectrum disorder). Adjuncts should never be used in isolation because they fail to detect children with other (often more common) types of problems. Rather narrow-band tools should be used to hone referrals to specialty services. Even so all children with probable problems should be referred first to early intervention or, if older, public school services. Specialty evaluations often have long waiting lists and children should receive public services in the interim.