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A longitudinal study of developmental and behavioral screening and referral in North Carolina's Assuring Better Child
Marian F Earls1, Joseph E Andrews, Sherry S Hay
1Guilford Child Health, Inc, Greensboro, NC27405, USA. mearls@gchinc.com
Insights
Routine developmental screening during well-child visits identifies at-risk children. The Ages and Stages Questionnaire (ASQ) was used in North Carolina
Area of Science:
- Pediatrics
- Developmental Psychology
- Public Health
Background:
- Developmental and behavioral screening is crucial in primary care.
- Well-child visits offer a prime setting for parental engagement and screening.
- Early identification of developmental delays is essential for timely intervention.
Purpose of the Study:
- To assess the implementation and rates of developmental screening in North Carolina.
- To analyze developmental trajectories and risk patterns in screened children.
- To examine referral practices for children identified with potential delays.
Main Methods:
- Retrospective review of 526 children screened from 6 months old.
- Utilized the Ages and Stages Questionnaire (ASQ) at scheduled well-child visits.
- Data collected from August 2001 to November 2003.
Main Results:
- Determined screening rates and their changes over time.
- Observed developmental patterns and risk trajectories across five domains.
- Analyzed referral rates and physician referral patterns.
Conclusions:
- Routine screening using ASQ is feasible in primary care.
- Understanding screening patterns informs practice improvement.
- Further research on referral effectiveness is warranted.
Abstract:
Screening children for developmental and behavioral delays is an important part of primary care practice. Well-child visits provide an ideal opportunity to engage parents and to do periodic screening. Screening identifies children who may be at risk and need further evaluation. In North Carolina's Assuring Better Child Health and Development project best-practices process, screening was incorporated as a routine part of well-child visits regardless of payor. The schedule of screenings, using the Ages and Stages Questionnaire, was 6, 12, 18 or 24, 36, 48, and 60 months. From the practices' population, a cohort of 526 children, screened from the age of 6 months during August 2001 through November 2003, was retrospectively reviewed. The main objectives of this descriptive study were to determine the number of children who were screened and whether this rate improved with time, observe patterns and trajectories for children identified at risk in 1 or more of the 5 developmental domains, and examine referral rates and physician referral patterns.
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