Published online July 1, 2005
PEDIATRICS Vol. 116 No. 1 July 2005, pp. 174-179 (doi:10.1542/peds.2004-1809)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Web of Science (39)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Sand, N.
Right arrow Articles by O'Connor, K. G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Sand, N.
Right arrow Articles by O'Connor, K. G.
Related Collections
Right arrow Office Practice
Social Bookmarking
 Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

Pediatricians' Reported Practices Regarding Developmental Screening: Do Guidelines Work? Do They Help?

Nina Sand, MD*, Michael Silverstein, MD, MPH{ddagger}, Frances P. Glascoe, PhD, Vidya B. Gupta, MD, MPH§, Thomas P. Tonniges, MD|| and Karen G. O'Connor

* Neurodevelopmental Center, Akron Children's Hospital, Akron, Ohio
{ddagger} Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
§ Department of Pediatrics, New York Medical College, Valhalla, New York
|| Department of Community Pediatrics
Division of Health Policy Research, American Academy of Pediatrics, Elk Grove Village, Illinois
Dr. Glascoe is an independent consultant in Nashville, TN

Background. In 2001, the American Academy of Pediatrics (AAP) adopted a policy that all infants and young children should be screened for developmental delays at regular intervals. The policy statement promoted the use of valid reliable instruments. It is unknown, however, what proportion of pediatricians follow this recommendation and whether such a practice is associated with improved identification of children with developmental difficulties.

Objectives. To describe the use of developmental screening tests among board-certified pediatricians practicing general pediatrics and to determine the association between standardized screening and the self-reported identification of children with developmental difficulties.

Methods. We mailed a survey to a random sample of AAP members. We used multivariate logistic/linearregression analyses to determine the association between standardized screening and the self-reported identification of children with developmental disabilities.

Results. Of the 1617 surveys mailed, 894 were returned, for a response rate of 55%. Of the respondents, 646 practiced general pediatrics and were included in the analysis. Seventy-one percent of those pediatricians indicated that they almost always used clinical assessment without an accompanying screening instrument to identify children with developmental delays. Only 23% indicated that they used a standardized screening instrument. The most commonly used instrument was the Denver II. Logistic regression modeling demonstrated odds ratios between 1.71 and 1.90 for a >10% rate of identification of developmental problems among patients of pediatricians reporting standardized screening. Each adjusted odds ratio bordered on statistical significance. Linear-regression models estimating the difference in mean proportions of children identified with developmental problems across screening groups failed to show a statistically or clinically significant difference in physician-reported identification rates.

Conclusions. Our findings indicate that, despite the AAP policy and national efforts to improve developmental screening in the primary care setting, few pediatricians use effective means to screen their patients for developmental problems. It is uncertain whether standardized screening, as it is practiced currently, is associated with an increase in the self-reported identification of children with developmental disabilities.


Key Words: developmental screening • early intervention • screening tests • developmental surveillance

Abbreviations: AAP, American Academy of Pediatrics


Accepted Nov 11, 2004.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
PediatricsHome page
T. Turner, W. L. Cull, B. Bayldon, P. Klass, L. M. Sanders, M. P. Frintner, M. A. Abrams, and B. Dreyer
Pediatricians and Health Literacy: Descriptive Results From a National Survey
Pediatrics, November 1, 2009; 124(Supplement_3): S299 - S305.
[Abstract] [Full Text] [PDF]


Home page
PediatricsHome page
L. Sices, T. Stancin, H. L. Kirchner, and H. Bauchner
PEDS and ASQ Developmental Screening Tests May Not Identify the Same Children
Pediatrics, October 1, 2009; 124(4): e640 - e647.
[Abstract] [Full Text] [PDF]


Home page
PediatricsHome page
L. Sices, L. Egbert, and M. B. Mercer
Sugar-coaters and Straight Talkers: Communicating About Developmental Delays in Primary Care
Pediatrics, October 1, 2009; 124(4): e705 - e713.
[Abstract] [Full Text] [PDF]


Home page
J Pediatr PsycholHome page
J. E. Roberts, J. B. Mankowski, J. Sideris, B. D. Goldman, D. D. Hatton, P. L. Mirrett, G. T. Baranek, J. S. Reznick, A. C. J. Long, and D. B. Bailey Jr
Trajectories and Predictors of the Development of Very Young Boys with Fragile X Syndrome
J. Pediatr. Psychol., September 1, 2009; 34(8): 827 - 836.
[Abstract] [Full Text] [PDF]


Home page
PediatricsHome page
D. B. Bailey Jr, M. Raspa, E. Bishop, and D. Holiday
No Change in the Age of Diagnosis for Fragile X Syndrome: Findings From a National Parent Survey
Pediatrics, August 1, 2009; 124(2): 527 - 533.
[Abstract] [Full Text] [PDF]


Home page
CLIN PEDIATRHome page
A. Schonwald, K. Horan, and N. Huntington
Developmental Screening: Is There Enough Time?
Clinical Pediatrics, July 1, 2009; 48(6): 648 - 655.
[Abstract] [PDF]


Home page
PediatricsHome page
A. Schonwald, N. Huntington, E. Chan, W. Risko, and C. Bridgemohan
Routine Developmental Screening Implemented in Urban Primary Care Settings: More Evidence of Feasibility and Effectiveness
Pediatrics, February 1, 2009; 123(2): 660 - 668.
[Abstract] [Full Text] [PDF]


Home page
CLIN PEDIATRHome page
M. K. Fagan and T. R. Montgomery
Managing Referrals for Children with Receptive Language Delay
Clinical Pediatrics, January 1, 2009; 48(1): 72 - 80.
[Abstract] [PDF]


Home page
PediatricsHome page
L. Sices, D. Drotar, A. Keilman, H. L. Kirchner, D. Roberts, and T. Stancin
Communication About Child Development During Well-Child Visits: Impact of Parents' Evaluation of Developmental Status Screener With or Without an Informational Video
Pediatrics, November 1, 2008; 122(5): e1091 - e1099.
[Abstract] [Full Text] [PDF]


Home page
Pediatr. Rev.Home page
D. Drotar, T. Stancin, P. H. Dworkin, L. Sices, and S. Wood
Selecting Developmental Surveillance and Screening Tools
Pediatr. Rev., October 1, 2008; 29(10): e52 - e58.
[Full Text] [PDF]


Home page
AutismHome page
D. L. Robins
Screening for autism spectrum disorders in primary care settings
Autism, September 1, 2008; 12(5): 537 - 556.
[Abstract] [PDF]


Home page
PediatricsHome page
K. N. Carroll, P. G. Arbogast, J. A. Dudley, and W. O. Cooper
Increase in Incidence of Medically Treated Thyroid Disease in Children With Down Syndrome After Rerelease of American Academy of Pediatrics Health Supervision Guidelines
Pediatrics, August 1, 2008; 122(2): e493 - e498.
[Abstract] [Full Text] [PDF]


Home page
J. Neurol. Neurosurg. PsychiatryHome page
L A Behan, J Phillips, C J Thompson, and A Agha
Neuroendocrine disorders after traumatic brain injury
J. Neurol. Neurosurg. Psychiatry, July 1, 2008; 79(7): 753 - 759.
[Abstract] [Full Text] [PDF]


Home page
PediatricsHome page
C. M. Lannon, K. Flower, P. Duncan, K. S. Moore, J. Stuart, and J. Bassewitz
The Bright Futures Training Intervention Project: Implementing Systems to Support Preventive and Developmental Services in Practice
Pediatrics, July 1, 2008; 122(1): e163 - e171.
[Abstract] [Full Text] [PDF]


Home page
CLIN PEDIATRHome page
K. B. Brothers, F. P. Glascoe, and N. S. Robertshaw
PEDS: Developmental Milestones--An Accurate Brief Tool for Surveillance and Screening
Clinical Pediatrics, April 1, 2008; 47(3): 271 - 279.
[Abstract] [PDF]


Home page
PediatricsHome page
I. O. Ertem, D. G. Dogan, C. G. Gok, S. U. Kizilates, A. Caliskan, G. Atay, N. Vatandas, T. Karaaslan, S. G. Baskan, and D. V. Cicchetti
A Guide for Monitoring Child Development in Low- and Middle-Income Countries
Pediatrics, March 1, 2008; 121(3): e581 - e589.
[Abstract] [Full Text] [PDF]


Home page
J Child NeurolHome page
J. Schatz, C. B. McClellan, E. S. Puffer, K. Johnson, and C. W. Roberts
Neurodevelopmental Screening in Toddlers and Early Preschoolers With Sickle Cell Disease
J Child Neurol, January 1, 2008; 23(1): 44 - 50.
[Abstract] [PDF]


Home page
CLIN PEDIATRHome page
F. P. Glascoe, M. M. Macias, L. M. Wegner, and N. S. Robertshaw
Can a Broadband Developmental-Behavioral Screening Test Identify Children Likely to Have Autism Spectrum Disorder?
Clinical Pediatrics, December 1, 2007; 46(9): 801 - 805.
[Abstract] [PDF]


Home page
PediatricsHome page
C. P. Johnson, S. M. Myers, and and the Council on Children With Disabilities
Identification and Evaluation of Children With Autism Spectrum Disorders
Pediatrics, November 1, 2007; 120(5): 1183 - 1215.
[Abstract] [Full Text] [PDF]


Home page
Arch Pediatr Adolesc MedHome page
E. B. Caronna, M. Augustyn, and B. Zuckerman
Revisiting Parental Concerns in the Age of Autism Spectrum Disorders: The Need to Help Parents in the Face of Uncertainty
Arch Pediatr Adolesc Med, April 1, 2007; 161(4): 406 - 408.
[Full Text] [PDF]


Home page
PediatricsHome page
P. H. Lipkin
Issues With the New Developmental Screening and Surveillance Policy Statement: In Reply
Pediatrics, April 1, 2007; 119(4): 862 - 863.
[Full Text] [PDF]


Home page
PediatricsHome page
D. Z. Kuo, K. G. O'Connor, G. Flores, and C. S. Minkovitz
Pediatricians' Use of Language Services for Families With Limited English Proficiency
Pediatrics, April 1, 2007; 119(4): e920 - e927.
[Abstract] [Full Text] [PDF]


Home page
PediatricsHome page
M. I. Shevell
Improving Developmental Screening: Combining Parent and Pediatrician Opinions With Standardized Questionnaires: In Reply
Pediatrics, March 1, 2007; 119(3): 656 - 657.
[Full Text] [PDF]


Home page
PediatricsHome page
D. Rydz, M. Srour, M. Oskoui, N. Marget, M. Shiller, R. Birnbaum, A. Majnemer, and M. I. Shevell
Screening for Developmental Delay in the Setting of a Community Pediatric Clinic: A Prospective Assessment of Parent-Report Questionnaires
Pediatrics, October 1, 2006; 118(4): e1178 - e1186.
[Abstract] [Full Text] [PDF]


Home page
PediatricsHome page
Council on Children With Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee, and Medical Home Initiatives for Children With Special
Identifying Infants and Young Children With Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening
Pediatrics, July 1, 2006; 118(1): 405 - 420.
[Abstract] [Full Text] [PDF]


Home page
PediatricsHome page
M. F. Earls and S. S. Hay
Setting the Stage for Success: Implementation of Developmental and Behavioral Screening and Surveillance in Primary Care Practice--The North Carolina Assuring Better Child Health and Development (ABCD) Project
Pediatrics, July 1, 2006; 118(1): e183 - e188.
[Abstract] [Full Text] [PDF]


Home page
PediatricsHome page
M. H. Pavan
Starting Small
Pediatrics, December 1, 2005; 116(6): 1611 - 1611.
[Full Text] [PDF]


Home page
PediatricsHome page
M. Silverstein and N. Sand
Starting Small: In Reply
Pediatrics, December 1, 2005; 116(6): 1611 - 1612.
[Full Text] [PDF]


Home page
AAP NewsHome page
Surveys explore part-time residency, developmental screening
AAP News, August 1, 2005; 26(8): 3 - 20.
[Full Text]