Quantitative evaluation of content and age concordance across developmental milestone checklists
Open accessAbstract
Objective: Clinicians and caregivers rely on milestone checklists as tools for tracking a child's development. In addition, medical students and residents use milestone checklists to learn about normal child development. However, there are multiple published milestone checklists that vary qualitatively in structure and content, hindering their effective use in developmental surveillance and medical education. This project systematically evaluated the consistency and variability between commonly used milestone checklists. Methods: A team of child psychologists and developmental pediatricians reviewed a total of 1094 milestones derived from 4 published checklists (2 developed for providers, 2 developed for caregivers) to create a comprehensive set of 728 discrete developmental observations, with each observation mapped to corresponding milestones. This observation-milestone relational database was then used to determine the degree of content overlap and milestone age range concordance across milestone checklists. Results: Of the 728 discrete developmental observations, 40 (5.5%) were mapped to milestones in all 4 milestone checklists, and an additional 90 (12.4%) were mapped to 3 checklists. Among these 40 “universal” observations, most (42.5%) were in the motor domain. Of those 130 observations mapped to milestones in at least 3 of the 4 checklists, 26.9% (35/130) were mapped to milestones that were discordant in their associated age range. Conclusion: Four commonly used developmental milestone checklists were found to have limited overlap in content, and those that overlapped were inconsistent in their associated age ranges. The resulting observation-milestone relational database could be used to further validate age estimates of milestones and facilitate milestone surveillance through the electronic health record.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Milestones within checklists would represent milestones above the 50th percentile to ensure that most children would achieve the milestone by a given age.
“Second, milestones within checklists would represent milestones above the 50th percentile3,4,7,8 to ensure that most children would achieve the milestone by a given age.”
From Evidence-Informed Milestones for Developmental Surveillance Tools (2022) · cites this paper as [3]
The Introduction (Variability; page unavailable) says the majority of sources place milestones at the 50th percentile, not above it; only some use the 75th or 90th percentile. The Discussion likewise says two of the four checklists studied explicitly use the 50th percentile, while the other two do not specify a percentile. This contradicts the claim that checklist milestones would generally be set above the 50th percentile. (LLM, conf=0.85)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredVariability across surveillance resources, including the CDC's, can create confusion regarding what constitutes a concern and when developmental screening between recommended ages might be warranted.
“However, variability across surveillance resources, including the CDC’s, can create confusion regarding what constitutes a concern and when developmental screening between recommended ages might be warranted.3,4,38,76”
From Evidence-Informed Milestones for Developmental Surveillance Tools (2022) · cites this paper as [3]
The Introduction’s “Variability” section says differing milestone timelines can confuse providers and parents about when to be concerned and when to refer; the paper also includes the CDC checklist among the resources analyzed (Discussion, “Limitations”). It does not specifically say this variability causes confusion about whether developmental screening is warranted between the recommended screening ages. (LLM, conf=0.85)
Experimental — accuracy not yet measuredAges specified for individual developmental milestones are inconsistent across sources.
“Moreover, ages specified for individual milestones are inconsistent across sources.3,4”
From Evidence-Informed Milestones for Developmental Surveillance Tools (2022) · cites this paper as [3]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Pediatrics, S. O. D. B. (2006) · PEDIATRICS · doi:10.1542/peds.2006-1231 · Cited by 1,436 · see citing works
Sand, N., Silverstein, M., Glascoe, F. P., Gupta, V. B., Tonniges, T. P., & O'Connor, K. G. (2005) · Pediatrics · doi:10.1542/peds.2004-1809 · Cited by 344 · see citing works
Siu, A. L., and the US Preventive Services Task Force (USPSTF), Bibbins-Domingo, K., Grossman, D. C., Baumann, L. C., Davidson, K. W., Ebell, M., García, F. A. R., Gillman, M., Herzstein, J., et al. (2016) · JAMA · doi:10.1001/jama.2016.0018 · Cited by 261 · see citing works
Development of the Logical Observation Identifier Names and Codes (LOINC) Vocabulary
Huff, S. M., Rocha, R. A., McDonald, C. J., Moor, G. J. E. D., Fiers, T., Bidgood, W. D., Forrey, A. W., Francis, W. G., Tracy, W. R., Leavelle, D., et al. (1998) · Journal of the American Medical Informatics Association · doi:10.1136/jamia.1998.0050276 · Cited by 235 · see citing works
Trends in the Use of Standardized Tools for Developmental Screening in Early Childhood: 2002–2009
Radecki, L., Sand-Loud, N., O'Connor, K. G., Sharp, S., & Olson, L. M. (2011) · PEDIATRICS · doi:10.1542/peds.2010-2180 · Cited by 235 · see citing works
Effectiveness of Developmental Screening in an Urban Setting
Guevara, J. P., Gerdes, M., Localio, R. A., Huang, Y.-S. V., Pinto‐Martin, J. A., Minkovitz, C. S., Hsu, D., Kyriakou, L., Baglivo, S. J., Kavanagh, J. E., et al. (2012) · PEDIATRICS · doi:10.1542/peds.2012-0765 · Cited by 231 · see citing works
Prevalence and variation of developmental screening and surveillance in early childhood
Hirai, A. H., Kogan, M. D., Kandasamy, V., Reuland, C., & Bethell, C. (2018) · JAMA Pediatrics · doi:10.1001/jamapediatrics.2018.1524 · Cited by 195 · see citing works
How Do Primary Care Physicians Identify Young Children with Developmental Delays? A National Survey
SICES, L., FEUDTNER, C., MCLAUGHLIN, J., DROTAR, D., & WILLIAMS, M. (2003) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/00004703-200312000-00002 · Cited by 176 · see citing works
Scharf, R. J., Scharf, G., & Stroustrup, A. (2016) · Pediatrics in Review · doi:10.1542/pir.2014-0103 · Cited by 175 · see citing works
Trends in the Use of Standardized Tools for Developmental Screening in Early Childhood: 2002-2009
(2011) · PEDIATRICS · doi:10.1542/peds.2010-2180d · Cited by 164 · see citing works
Lorentzen, S. S., Papoutsakis, C., Myers, E. F., & Thoresen, L. (2018) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2018.02.006 · Cited by 117 · see citing works
Recommendations on screening for developmental delay
Canadian Task Force on Preventive Health Care (2016) · Canadian Medical Association Journal · doi:10.1503/cmaj.151437 · Cited by 101 · see citing works
Siu, A. L. (2015) · Pediatrics · doi:10.1542/peds.2015-1711 · Cited by 99 · see citing works
Sices, L. (2007) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0b013e31803084c6 · Cited by 96 · see citing works
Barger, B., Rice, C., Wolf, R., & Roach, A. (2018) · Disability and Health Journal · doi:10.1016/j.dhjo.2018.01.002 · Cited by 77 · see citing works
Use of a Computerized Decision Aid for Developmental Surveillance and Screening
Carroll, A. E., Bauer, N. S., Dugan, T. M., Anand, V., Saha, C., & Downs, S. M. (2014) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/jamapediatrics.2014.464 · Cited by 58 · see citing works
Baorto, D. M., Cimino, J. J., Parvin, C. A., et al. (1998) · International Journal of Medical Informatics · doi:10.1016/s1386-5056(98)00089-6 · Cited by 51 · see citing works
Implementing Electronic Health Record-Based Quality Measures for Developmental Screening
Jensen, R. E., Chan, K. S., Weiner, J., Fowles, J., & Neale, S. (2009) · Pediatrics · doi:10.1542/peds.2008-3091 · Cited by 36 · see citing works
Developmental Milestones: Cognitive Development
Wilks, T., Gerber, R. J., & Erdie-Lalena, C. R. (2010) · Pediatrics in Review · doi:10.1542/pir.31-9-364 · Cited by 34 · see citing works
Developmental Milestones: Cognitive Development
Wilks, T., Gerber, R. J., & Erdie-Lalena, C. R. (2010) · Pediatrics in Review · doi:10.1542/pir.31.9.364 · Cited by 22 · see citing works
Developmental Milestones 3: Social-Emotional Development
Gerber, R. J., Wilks, T., & Erdie-Lalena, C. R. (2011) · Pediatrics in Review · doi:10.1542/pir.32-12-533 · Cited by 15 · see citing works
Developmental Milestones 3: Social-Emotional Development
Gerber, R. J., Wilks, T., & Erdie-Lalena, C. R. (2011) · Pediatrics in Review · doi:10.1542/pir.32.12.533 · Cited by 10 · see citing works
Flagged first, then by citations
Research works printed but not linked: 3
- [10]Hagan J, Shaw J, Duncan P. Bright Futures: Guidelines for Health Supervision of Infants, Children and Adolescents. 3rd edition Elk Groove Village, IL American Academy of Pediatrics; 2008.
- [12]American Academy Of Pediatrics. Caring for Your Baby and Young Child, Revised Edition. 5th Editio. (Shelov SP, Altmann TR, eds.). American Academy of Pediatrics; 2009.
- [28]Current Procedural Terminology. https://www.ama-assn.org/amaone/cpt-current-procedural-terminology.
Cited by
Sorted by citations
Evidence-Informed Milestones for Developmental Surveillance Tools
Zubler, J. M., Wiggins, L. D., Macias, M. M., Whitaker, T. M., Shaw, J. S., Squires, J. K., Pajek, J. A., Wolf, R. B., Slaughter, K. S., Broughton, A. S., et al. (2022) · Pediatrics · doi:10.1542/peds.2021-052138 · Cited by 224 · see citing works
“Second, milestones within checklists would represent milestones above the 50th percentile 3,4,7,8 to ensure that most children would achieve the milestone by a given age.”
- Authors
- Wilkinson, C. L., Wilkinson, M. J., Lucarelli, J., Fogler, J. M., Becker, R. E., & Huntington, N.
- Affiliations
- Boston Children's Hospital (US)
- Corresponding author
- Wilkinson, Carol L.
- Venue
- Journal of Developmental & Behavioral Pediatrics
- Published
- 2019-09
- Volume
- 40
- Issue
- 7
- Pages
- 511-518
- ISSN
- 0196-206X (ISSN-L)
- PMC
- PMC6731149
- OpenAlex
- W2955244041
- Cited by
- 18
- References
- 22
- Citations by year
- 2025: 1 · 2024: 5 · 2023: 5 · 2022: 5 · 2021: 1 · 2020: 1
- FWCI
- 2.38
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Developmental & Behavioral Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (T32MH112510)
- Topics
- Health Sciences › Health Professions › General Health Professions › Child and Adolescent Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Social Sciences › Education › Health Education and Validation
- Keywords
- child development, child development monitoring, content overlap, developmental observation, motor development, electronic health records, medical education
- MeSH terms
- Child, Child Development, Developmental Disabilities, Psychology, Child, Child, Preschool, Humans, Infant, Pediatrics, Databases, Factual, Observation, Checklist
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
