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Published on: June 20, 2020
Improved detection of developmental delays among young children in foster care
Sandra H Jee1, Moira Szilagyi, Claire Ovenshire
1601 Elmwood Ave, Box 777, Rochester, NY 14642, USA. sandra_jee@urmc.rochester.edu
Insights
Systematic developmental delay (DD) screening using the Ages and Stages Questionnaire (ASQ) in foster care was feasible. This method doubled the detection rate of DD in young children within a pediatric medical home setting.
Area of Science:
- Pediatric Health
- Developmental Pediatrics
- Child Welfare
Background:
- Children in foster care are at higher risk for developmental delays.
- Early detection and intervention are crucial for improving outcomes in this population.
- Current screening practices may not be systematic or consistently applied.
Purpose of the Study:
- To assess the feasibility of systematically screening children in foster care for developmental delay (DD).
- To determine if implementing the Ages and Stages Questionnaire (ASQ) improves DD detection rates.
- To evaluate the effectiveness of a pediatric medical home-based screening intervention.
Main Methods:
- A pre-post study design was employed with a practice intervention.
- Systematic screening for DD was implemented using the Ages and Stages Questionnaire (ASQ).
- Detection rates were compared between a baseline chart review group and a post-intervention screening group of children new to foster care (NFC).
Main Results:
- Screening demonstrated high feasibility, with 96% of visits resulting in a completed ASQ.
- The detection rate of DD in NFC children significantly increased from 29% at baseline to 58% after screening implementation (P < .001).
- Improved detection was observed across all age groups (infants, toddlers, preschoolers) and developmental domains.
Conclusions:
- Systematic screening for developmental delay (DD) using the ASQ is feasible in a pediatric medical home for children in foster care.
- This approach effectively doubled the detection rate of DDs.
- The findings support the integration of systematic developmental screening into routine care for children in foster care.
Objective:
Our goal was to determine if systematic use of a validated developmental screening instrument is feasible and improves the detection of developmental delay (DD) in a pediatric medical home for children in foster care.
Design And Methods:
This study had a pre-post study design, following a practice intervention to screen all children in foster care for DD by using the Ages and Stages Questionnaire (ASQ). The baseline detection rate was determined by medical chart review for all children aged 4 to 61 months who were new to foster care (NFC) during a 2-year period. After implementation of systematic screening, caregivers of young children who were NFC or already in foster care (IFC) completed the ASQ at preventive health care visits. We assessed the feasibility of systematic screening (the percentage of ASQs completed among the NFC and IFC groups). We compared the detection of DD among the baseline NFC group and the screening-NFC group by using bivariate and multivariable logistic regression.
Results:
Of 261 visits that occurred after initiation of screening, 251 (96%) visits had a completed ASQ form in the medical chart, demonstrating high feasibility. Among children who were NFC, the detection of DD was higher in the screening than baseline period for the entire population (58% vs 29%; P < .001), for each age group (infants: 37% vs 14%; toddlers: 89% vs 42%; preschool: 82% vs 44%; all P < or = .01), and for all developmental domains. On adjusted analyses, the detection of potential DD in toddler and preschool children was higher among the NFC screening group than the NFC baseline group.
Conclusion:
Systematic screening for DD using the ASQ was feasible and seemed to double the detection of DDs.
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