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Evidence-Informed Milestones for Developmental Surveillance Tools

Jennifer M Zubler1,2, Lisa D Wiggins1, Michelle M Macias3

  • 1National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.

Pediatrics
|February 8, 2022
PubMed

Insights

The Centers for Disease Control and Prevention (CDC) revised developmental surveillance checklists with the American Academy of Pediatrics (AAP). New criteria ensure milestones are evidence-informed, reducing and replacing older checklists for better child development tracking.

Area of Science:

  • Pediatrics
  • Developmental Psychology
  • Public Health

Background:

  • Developmental surveillance is crucial for early identification of developmental delays.
  • Existing checklists from the Centers for Disease Control and Prevention (CDC) required updates based on current evidence.
  • The American Academy of Pediatrics (AAP) collaborated with the CDC to enhance developmental milestone tracking.

Purpose of the Study:

  • To revise the CDC's developmental surveillance checklists using evidence-informed milestones.
  • To establish clear age-expectations for developmental milestones, discouraging a "wait-and-see" approach.
  • To support clinical judgment in developmental screening between recommended ages.

Main Methods:

  • An expert working group convened by the AAP established 11 criteria for milestone selection.
  • Milestones were chosen based on normative data, ease of observation, and achievement by at least 75% of children by specific ages.
  • A database of normative data, screening tools, and clinical opinion informed the revisions.

Main Results:

  • Revised CDC checklists feature a 26.4% reduction and 40.9% replacement of previous milestones.
  • One-third of retained milestones were moved to different ages, mostly older ages.
  • Approximately 80% of final milestones had supporting normative data, with gaps noted in social-emotional and cognitive domains.

Conclusions:

  • The revised criteria and checklists enhance developmental surveillance and clinical judgment.
  • The updates aim to improve the accuracy and timeliness of developmental screening.
  • Further research is needed to address data gaps, especially in social-emotional and cognitive development.

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