Screening for developmental delay among children aged 1-4 years: a systematic review
Rachel Warren1, Meghan Kenny1, Teresa Bennett1
1Evidence Review and Synthesis Centre, and Offord Centre for Child Studies, McMaster University, Hamilton, Ont.
CMAJ Open
|May 27, 2016
Summary
Screening young children for developmental delay has mixed results. While one tool increased early intervention referrals, long-term academic outcomes showed no difference, indicating inconclusive evidence for current screening practices.
Area of Science:
- Pediatric developmental screening
- Early childhood development research
- Systematic review methodology
Background:
- Current guidelines for screening young children (under 5) for developmental delay lack consistency.
- This systematic review synthesizes existing literature on the effectiveness and potential harms of developmental delay screening in asymptomatic children aged 1-4 years.
Purpose of the Study:
- To evaluate the effectiveness of developmental delay screening in asymptomatic children aged 1-4 years.
- To assess the harms associated with developmental delay screening in this population.
- To provide evidence to inform guidelines on developmental delay screening for young children.
Main Methods:
- Systematic literature search of MEDLINE, Embase, and PsychINFO up to June 16, 2015.
- Inclusion of studies on children aged 1-4 years, without high risk for developmental delay, screened in primary care.
- Consideration of randomized trials and controlled cohort studies for benefits; no design restrictions for harms review.
Main Results:
- One study using the Ages and Stages Questionnaire II showed significantly more referrals to early intervention in screened groups.
- The same study indicated a 64-70% shorter time to referral for early intervention with screening.
- Another study using the VroegTijdige Onderkenning Ontwikkelingsstoornissen Language Screening instrument found no difference in academic outcomes at age 8.
Conclusions:
- Evidence regarding the effectiveness and harms of developmental delay screening in asymptomatic 1-4 year olds is currently inconclusive.
- Further research focusing on longer-term outcomes is necessary to guide decisions on screening practices and intervals.
- The findings highlight the need for more robust evidence to support developmental screening recommendations.
