Enhancing the algorithm for developmental-behavioral surveillance and screening in children 0 to 5 years

Area of Science:

• Pediatric Developmental-Behavioral Health
• Child Development Surveillance
• Early Intervention Services

Background:

• The 2006 American Academy of Pediatrics (AAP) algorithm guides developmental surveillance and screening.
• Clinician's ability to perform developmental-behavioral surveillance in children aged 0-5 years requires investigation.
• Existing protocols may not adequately address the complexities of early detection and intervention.

Purpose of the Study:

• To evaluate the adequacy of the 2006 AAP developmental surveillance and screening algorithm.
• To identify areas for revision to optimize developmental care.
• To assess the effectiveness of current screening and referral pathways.

Main Methods:

• A comprehensive literature search was performed.
• The search focused on clinician practices in developmental-behavioral surveillance for children 0-5 years.
• Analysis of existing data on screening, referral, and early intervention (EI) outcomes.

Main Results:

• Pediatricians should refer children with suspected delays, even with typical broad-band screens, and be more vigilant with seemingly asymptomatic children.
• Periodic screening improves early detection and eligibility for early intervention (EI).
• Challenges exist in consistent referral, EI eligibility determination, and tracking at-risk children, despite numerous risk factors in referred children.

Conclusions:

• Revisions to the current algorithm are necessary for optimizing early detection, prevention, and monitoring of developmental delays.
• Increased focus on developmental-behavioral promotion and improved referral care coordination is essential.
• Enhanced strategies are needed to ensure children receive timely and appropriate early intervention services.