Developmental Surveillance and Screening of Infants and Young Children

The AAP’s Committee on Children With Disabilities published a statement on developmental surveillance and screening.¹ In doing so, they have appropriately called attention to the need for continuous developmental surveillance using procedures that are simple, valid, standardized, and reliable, as well as culturally sensitive and appropriate to the population. This recommendation could be applied as well to the surveillance of growth, which is an essential aspect health maintenance. Where the recommendations on developmental surveillance differ is in the recommendation that the procedures be “sensitive” and “specific” in the identification of “developmental delays.” Sensitivity and specificity apply to specific disease entities and not to the broad concept of general development, which encompasses skills in such diverse areas as language, motor, intellectual, social, self help, etc.² It, therefore, is not surprising that there is no single universally agreed on definition of “developmental delay” (J. Shakelford, personal communication, April 10, 1992). Rather, developmental delay, like growth delay, is a subjective term based on many factors such as the child’s previous developmental pattern, the degree of delay, and the expectations of the parent and/or provider. In summary, screening should be valid, but sensitivity and specificity are not relevant to …

Address correspondence to William K. Frankenburg, MD, MSPH, Box 10247, Bainbridge Island, WA 98110. E-mail: wkfwilliamaol.com