Effectiveness of Enhanced Developmental Screening at 18 Months to Identify Developmental Delays

Area of Science:

• Pediatrics
• Developmental Psychology
• Public Health

Background:

• Early identification of developmental delays is crucial for timely intervention.
• Standard 18-month well-baby visits often rely on surveillance rather than standardized screening tools.
• The effectiveness of enhanced well-baby visits in improving developmental delay detection requires further investigation.

Purpose of the Study:

• To compare the time to identification of developmental delays between enhanced 18-month well-baby visits with developmental screening and routine visits.
• To assess the impact of enhanced developmental monitoring on early detection rates.

Main Methods:

• A cohort study in Ontario included children aged 17-22 months receiving an 18-month well-baby visit between March 2020 and March 2022.
• Linked health administrative datasets were used to track developmental delay diagnoses up to September 2022.
• Piecewise Cox proportional hazards models analyzed the association between enhanced (n=83,554) versus routine (n=15,723) visits and early (within 6 months) or late (after 6 months) developmental delay identification.

Main Results:

• Children with enhanced visits were slightly older, less likely to be from deprived backgrounds, and more often seen by pediatricians.
• After adjustment, enhanced visits were associated with a higher likelihood of early developmental delay detection (aHR 1.19, 95% CI 1.11–1.28).
• No significant association was found for late detection of developmental delays following the 18-month visit.

Conclusions:

• Enhanced 18-month well-baby visits incorporating developmental screening tools are linked to earlier identification of developmental delays.
• These findings suggest that enhanced developmental monitoring can facilitate earlier recognition of developmental concerns in young children.
• Implementing screening tools during well-baby visits may improve developmental surveillance outcomes.