Feature Story

December 13, 2007

Developmental Screening in Primary Care: The Effectiveness of Current Practice and Recommendations for Improvement

The Commonwealth Fund:

For this report, a literature review was conducted to determine the effectiveness of current efforts by primary care providers to detect developmental delays in early childhood.

While the prevalence of developmental delays is at least 10 percent, early intervention programs aimed at addressing these concerns serve only 2.3 percent of children under age 3.

Use of validated developmental screening tools is supported by American Academy of Pediatrics guidelines, but these instruments are neither widely nor systematically used in pediatric practice.

The report makes several recommendations to strengthen developmental surveillance and screening, and thereby improve outcomes for young children and families.

Early developmental delays are markers for later developmental conditions such as autism, intellectual disability, hearing or vision impairment, cerebral palsy, speech and language disorders, and learning disabilities.

Risk factors such as family poverty, parents' mental illness, and child neglect and abuse increase the likelihood of developmental delays.

The tremendous adaptability of the brain in the first three years of life means that early treatment of delays leads to improved outcomes, whereas later intervention is less effective.

For this report, a literature review was conducted to determine the effectiveness of current efforts by primary care providers to detect developmental delays in early childhood and to consider ways to improve.

Validated developmental screening tools that could increase identification of developmental delays exist, but most physicians do not use them systematically to screen all patients.

Resources are needed to develop high-quality screening tools that are available in the public domain and are compatible with electronic medical records.

This is already occurring through the ABCD Screening Academy, jointly sponsored by National Academy for State Health Policy and The Commonwealth Fund.