Christina Bethell, Colleen Peck Reuland, Edward L. Schor, Melinda K. Abrams, Neal Halfon
Although experts in pediatric care recommend that all young children undergo screening for developmental problems, less than 20 percent of U.S. children under age 6 received a parent-completed screening at the request of a health care provider. High-risk children who are screened are more likely to receive early intervention services than their unscreened high-risk peers.
In 2006, the American Academy of Pediatrics recommended that pediatricians screen all young children for risk of developmental, behavioral, and social delays as a routine part of well-child care, and that the screenings include standardized questionnaires completed by parents. However, studies conducted a decade ago, including the 2000 American Academy of Pediatrics Periodic Survey of Fellows, pointed to significant gaps in developmental screening. To provide a more timely assessment of the use of standardized, parent-completed developmental screening (DS–PC), Commonwealth Fund–supported researchers analyzed findings from the 2007 National Survey of Children's Health.
The authors recommend continued promotion of developmental screening in pediatric care settings. State and federal policy can play an important role, they say. With only nine states exceeding the national screening average, a more systematic approach across the states is needed to better integrate screenings into routine well-child care. Higher screening rates in North Carolina, which has instituted a number of efforts over several years to promote screenings, suggest it is possible to improve.
The authors analyzed data from the 2007 National Survey of Children's Health, which is sponsored by the federal Maternal and Child Health Bureau. Among other questions, the survey included items to assess the prevalence of screening for risk of developmental, behavioral, and social delays in children ages 10 months to 71 months through the use of parent-completed questionnaires. Screening was assessed only for children who had had at least one health care visit in the previous 12 months.
Less than 20 percent of U.S. children under age 6 receive a parent-completed developmental screening as recommended in national guidelines. But wide variation across the country suggests states can successfully raise rates by instituting policies and implementing systematic improvement processes.