PEDIATRICS Vol. 81 No. 3 March 1988, pp. 468
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Early and Periodic Screening; Diagnosis, and Treatment Program

SAMUEL J. MEISELS EdD1 and LEWIS H. MARGOLIS MD, MPH1

1 The University of Michigan, Center for Human Growth and Development, 300 N Ingalls, Ann Arbor, MI 48109

In Reply.—

In reply to Dr Frankenburg's letter, we would like to note that we found (Pediatrics 1988;81:262-271) the DDST to be highly insensitive, underidentifying 48% of the children screened. Professor Frankenburg's response to this finding is to suggest that this underreferral rate was brought about by problems in the Michigan EPSDT program. We, too, were concerned about the accuracy of the administration and interpretation of the DDST and stated this in our paper. But we are left to ponder whether a false-negative rate of nearly 50% can be attributable solely to poor test administration.




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