Developmental screening on the rise, but has room to improve

Screening for developmental issues in children is a key way to ensure that those who are at risk are referred for early intervention or subspecialist care. However, the use of developmental screening has been slow to catch on, and a new study in Pediatrics indicates that there is still much room to improve.¹

The researchers looked at American Academy of Pediatrics (AAP) Periodic Survey data from 2002 (response rate=58%; N=562), 2009 (response rate=57%; N=532), and 2016 (response rate=47%, N=469). The survey asked questions about knowledge, attitude, and practices for screening and referring children for developmental issues.

They found that utilization of a developmental screening tool had increased from just 21% in 2002 to 63% in 2016 (P<0.001). Fifty-nine percent of at-risk patients were referred for early intervention in 2016, which is an increase from the 41% in 2002 (P<0.001). Clinicians also were more likely to report being “very likely” to refer patients who had global developmental delay, sensory impairment, motor delay, family concern, language delay, and milestone loss to early intervention in 2016 than they were in 2002.

Barriers still exist for standardized screenings

The investigators noted there were some reasons for the increased screening, but that barriers still exist. In response to worries about time constraints, some practices have used other office staff to administer the tool (60%). Interpreting the results of the screen is still the responsibility for almost all respondents (96%). Although time as a barrier to the screen had decreased from 80% in 2002 to 57% in 2016, the respondents still said that time should be considered an issue. Lack of treatment options following a positive screen was considered a barrier by 21% of pediatricians in 2016, which was an increase from 9% in 2002. Improved access to treatments options is needed.

Additionally, 24% of clinicians in 2002 and 30% in 2016 reported that inconsistency in the quality of early intervention programs was a barrier to referrals. A lack of feedback from the programs was reported as a major barrier by 34% of respondents in 2002 versus 38% in 2016.

The increased number of standardized developmental screenings and referrals for additional care is a sign of positive progress, which ensures that more children are now getting the necessary care. However, there is still room for growth and a focus on enhancing referral systems, improving existing early intervention programs, increasing the communication between pediatricians and local early intervention specialists, and better tracking of outcomes could lead to even greater overall improvement.

References:

1. Lipkin PH, Macias MM, Baer Chen B, et al. Trends in pediatricians’ developmental screening: 2002–2016. Pediatrics. 2020;145(3):e20190851.