Part I: Defining Your Practice's Screening Needs

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This section is designed to facilitate the selection of screening instruments by helping you define your practice's needs. It's important to first understand the context in which such instruments should be used. According to the 2006 American Academy of Pediatrics (AAP) policy statement, the application of developmental screening instruments should be part of a comprehensive approach to developmental surveillance.

What is developmental surveillance?

Developmental surveillance is defined as a flexible, longitudinal, continuous, cumulative process with the following components:

  • Documenting and maintaining the child's developmental history.
  • Making accurate and informed observations of the child's development.
  • Identifying the presence of risk and protective factors for developmental delay.
  • Documenting the process of ongoing developmental surveillance and screening activities.

When should developmental screening be performed as a part of surveillance?

  • Developmental screening is indicated whenever a problem is identified during developmental surveillance or when concerns are raised by parents, other caregivers, or child health professionals.
  • Standardized assessments of children's developmental status are much more accurate than clinical impressions. AAP recommended administration of standardized screening tools at targeted ages (9, 18, 24 or 30 months) to enhance the precision of developmental surveillance.

Why should developmental screening be conducted at multiple time points?

  • Repeated developmental screening is more valid and accurate than a single assessment.
  • Developmental screening at multiple time points is necessary to document children's developmental progress over time.


Questions to Consider When Choosing an Instrument

Available data on scientific validity are a critical consideration when selecting a developmental screening instrument.

Our review of developmental screening has found that there is no "one-size-fits-all" instrument. Screening instruments are likely to function differently (i.e., more accurately) with different patients and in different settings. To make an informed decision about the specific instrument that best suits your practice, we recommend that you consider the following questions, each of which is considered in depth on the following pages:

See Part II: Guides to Facilitate Your Choice and Use of Screening Instruments

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