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Related Experiment Videos

Are overreferrals on developmental screening tests really a problem?

F P Glascoe1

  • 1Department of Pediatrics, College of Medicine, The Pennsylvania State University, 25 Bragg Dr, East Berlin, PA 17316, USA. Frances.P.Glascoe@Vanderbilt.edu

Archives of Pediatrics & Adolescent Medicine
|February 15, 2001
PubMed
Summary
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Children with false-positive developmental screening results often have lower scores in key areas and may benefit from diagnostic testing. This testing can identify needs for early intervention programs, improving developmental outcomes.

Area of Science:

  • Developmental Psychology
  • Pediatric Health
  • Educational Assessment

Background:

  • Developmental screening tests identify children needing further evaluation but generate significant false-positive results.
  • False positives can lead to unnecessary referrals, increased costs, and parental anxiety.

Observation:

  • A national sample of 512 children (7 months to 8 years) underwent screening and diagnostic testing.
  • Children with false-positive screening results were compared to true negatives on cognitive, language, and academic measures.

Findings:

  • False positives scored significantly lower (9-14 points) on diagnostic measures of intelligence, language, and academics compared to true negatives.
  • Children with false positives had a higher risk (2.6-6.7 times) of scoring in the lowest quartile across key developmental domains.

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  • 70% of false positives scored below the 25th percentile in at least one area, versus 29% of true negatives.

    • Implications:

    • Over-referred children are an at-risk group, and diagnostic testing is a beneficial service, not an unnecessary expense.
    • Diagnostic evaluation can help target interventions like Head Start or speech therapy for children with developmental delays.
    • Testing identifies needs for services that improve language, cognitive, and academic skills, supporting school readiness.