How can we ensure all children are properly screened for developmental delays?

Michelle Sioson Hyman

Michelle Sioson Hyman
Senior Early Learning Officer
Center for Early Learning, SVCF

When I was pregnant with my first child, I had the advantage of years of experience in the early childhood field. I knew it was important to interview prospective pediatricians, and I was prepared with questions, such as:

  • How long have you been practicing?
  • What if my baby gets sick when the office is closed?
  • Will you discuss my child’s general growth and issues such as behavior and social development?

All three pediatricians I spoke with answered these questions easily and thoroughly, but when I asked, “Which developmental screening tool do you use?” not one had a clear answer. One doctor said, “I don’t know what you mean. I’m a doctor. I will examine your child during appointments and will tell you if s/he is developing on track. I’ve been doing this for 25 years. That’s how I know.”

According to the Centers for Disease Control, one in four children in the United States under the age of 6 is at risk for a developmental delay – so screening for developmental milestones is critical, and pediatricians play an important role.

It turns out that many pediatricians – like the one I mentioned above – rely on observations during 15-minute checkups as the primary method of measuring whether children are reaching crucial developmental milestones as they grow.

But the results of several studies over the past decade have prompted the American Academy of Pediatrics to recommend that all pediatricians use a developmental screening test or tool during well-child visits, instead of relying solely on observations. And the AAP recommends that the screening tools be used during 9-month, 18-month and 30-month well-child visits, if not more frequently.

Developmental Screening

California Pediatrician Survey on Early Childhood Developmental Screening

The Center for Early Learning at SVCF conducted an online survey of California pediatricians to understand the current landscape of pediatricians’ use of developmental screenings during well-child visits.

We found that 95 percent of pediatricians surveyed said that using a formal screening tool or test is important. However, pediatricians are not routinely screening children.

  • Only 37 percent of pediatricians indicated that they use a validated or evidence-based screening tool to identify the majority of developmental concerns
  • Only 29 percent of pediatricians universally* screen 6-month-old patients
  • Only 36 percent of pediatricians universally* screen 30-month-old patients
  • Sixty-nine percent of pediatricians universally* screen 18-month-old patients because the age is associated with a well-established autism screening tool

*”Universal” screening is defined as screening at least 95 percent of children

The short screening tests recommended by the AAP identify if a child is learning basic skills when he or she should. The questions in these tests aim to uncover any delays in talking, playing, learning, physical movements and overall behavior. A delay in any of these areas could be a sign of a problem that the pediatrician could address or refer to a specialist. Many developmental delays can be remedied through intervention services if they are identified early, and treatment can great improve a child’s development and later success in school and beyond.

To better understand how all young children can receive reliable, consistent screenings that support their development and growth, SVCF’s Center for Early Learning is conducting conversations with pediatricians throughout 2017. Findings from the online survey and community conversations will be compiled into a comprehensive report which will help identify needed resources and polices that better support the development of children.

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