Community perspectives on developmental screening of American Indian and Alaska Native children

Children are highly regarded and treasured as the future of American Indian and Alaska Native (AIAN) communities. Developmental disorders, however, are more frequently undiagnosed and untreated in AIAN children compared to others in the United States. Developmental screening can help communities ensure that their children reach their full potential, but lack of culturally sensitive and valid screening measures complicates screening among AIAN children. This can, in turn, delay access to early intervention and undermine the ability of AIAN communities to support children's optimal development. This study explored families' and professionals' perceptions of screening systems and processes in AIAN communities and to identify gaps and opportunities. A total of 53 interviews and 23 focus groups were conducted with 157 parents and early childcare professionals in four AIAN communities. A conceptual framework to describe systems of screening for young children was developed by AIAN early childhood program partners and early childhood researchers working together on a Tribal Early Childhood Research Center Community of Learning; this framework guided study design and interview guides. Transcripts were coded for themes in alignment with the conceptual framework; 13 key themes and 81 subthemes were identified. Findings are discussed in terms of implications for enhancing screening efforts in Tribal communities.