Screening for developmental delay

Area of Science:

• Pediatrics
• Developmental Psychology
• Primary Care Medicine

Background:

• 12-16% of US children experience developmental delays, with up to 50% unidentified by kindergarten.
• Late detection of developmental delays can impede early intervention opportunities.
• Clinical recommendations for developmental delay screening in primary care are inconsistent and insufficient.

Purpose of the Study:

• To review the literature on developmental delay screening in primary care.
• To identify barriers to screening and effective strategies for overcoming them.
• To provide guidance for family physicians on screening tools and practices.

Main Methods:

• Systematic review of empirical literature on developmental delay screening.
• Analysis of clinical recommendations and barriers to screening in primary care.
• Evaluation of validated screening tools, particularly parent-completed questionnaires.

Main Results:

• Validated screening tools, used at regular intervals during well-child visits alongside physician surveillance, are recommended.
• Parent-completed tools, such as the Parents' Evaluation of Developmental Status (PEDS) and Ages and Stages Questionnaire (ASQ), are supported by evidence.
• Office-based systems for screening and referrals can overcome physician-related barriers.

Conclusions:

• Family physicians need to be aware of the strengths and limitations of available screening tools.
• Regular, repeated screening using validated parent-completed tools is essential for early identification of developmental delays.
• Prompt additional evaluation and referrals are necessary when developmental delay is suspected or identified.