Cited by 345Child and Adolescent HealthInfant Development and Preterm CareDevelopmental and Educational Neuropsychology

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Pediatricians’ reported practices regarding developmental screening: do guidelines work? Do they help?

Sand, Nina, Silverstein, Michael, Glascoe, Frances P., Gupta, Vidya B., Tonniges, Thomas P., O'Connor, Karen G.·2005·Pediatrics

DOI 10.1542/peds.2004-1809

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Abstract

Background. In 2001, the American Academy of Pediatrics (AAP) adopted a policy that all infants and young children should be screened for developmental delays at regular intervals. The policy statement promoted the use of valid reliable instruments. It is unknown, however, what proportion of pediatricians follow this recommendation and whether such a practice is associated with improved identification of children with developmental difficulties. Objectives. To describe the use of developmental screening tests among board-certified pediatricians practicing general pediatrics and to determine the association between standardized screening and the self-reported identification of children with developmental difficulties. Methods. We mailed a survey to a random sample of AAP members. We used multivariate logistic/linearregression analyses to determine the association between standardized screening and the self-reported identification of children with developmental disabilities. Results. Of the 1617 surveys mailed, 894 were returned, for a response rate of 55%. Of the respondents, 646 practiced general pediatrics and were included in the analysis. Seventy-one percent of those pediatricians indicated that they almost always used clinical assessment without an accompanying screening instrument to identify children with developmental delays. Only 23% indicated that they used a standardized screening instrument. The most commonly used instrument was the Denver II. Logistic regression modeling demonstrated odds ratios between 1.71 and 1.90 for a >10% rate of identification of developmental problems among patients of pediatricians reporting standardized screening. Each adjusted odds ratio bordered on statistical significance. Linear-regression models estimating the difference in mean proportions of children identified with developmental problems across screening groups failed to show a statistically or clinically significant difference in physician-reported identification rates. Conclusions. Our findings indicate that, despite the AAP policy and national efforts to improve developmental screening in the primary care setting, few pediatricians use effective means to screen their patients for developmental problems. It is uncertain whether standardized screening, as it is practiced currently, is associated with an increase in the self-reported identification of children with developmental disabilities.

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Glascoe FP, Macias MM. How can you implement the AAP's new policy on developmental and behavioral screening?Contemp Pediatr. 2003;4:85–104

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Comparative study of the cognitive sequelae of school-aged victims of Shaken Baby Syndrome
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Ocular Manifestations of Child Abuse
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“However, 83 % of pediatricians report time limitations as a barrier to conducting standardized behavioral, emotional, and developmental screenings for young children (Sand et al. 2005).”
Implementation of a Routine Developmental Follow-up Program for Children with Congenital Heart Disease: Early Results
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“Despite AAP recommendations, screening rates for ASDs in pediatric practices remain low (DosReis et al., 2006; Radecki et al., 2011; Sand et al., 2005).”
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“Moreover, prior research suggests that health and mental health providers in community settings typically rely on their clinical skill rather than standardized tools to conduct developmental and mental health screening, even when formal guidelines and standardized methods are available (Romer & McIntosh, 2005; Sand et…”
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Language development and affecting factors in 3- to 6-year-old children
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Missed, Misused, or Mismanaged
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Developmental screening: is there enough time?
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Infants and Toddlers Left Behind
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Low adherence to national guidelines for thyroid screening in Down syndrome
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Autism and Pervasive Developmental Disorders
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Early Childhood Screening Practices and Barriers: A National Survey of Primary Care Pediatricians
Coker, T. R., Gottschlich, E. A., Burr, W. H., & Lipkin, P. H. (2024) · PEDIATRICS · doi:10.1542/peds.2023-065552 · Cited by 37
Investigating the ‘latent’ deficit hypothesis: Age at time of head injury, implicit and executive functions and behavioral insight
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Language Development Survey Provides a Useful Screening Tool for Language Delay in Preterm Infants
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Engaging Pediatricians in Developmental Screening: The Effectiveness of Academic Detailing
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“…average age of identification of autism in children has been shown to vary from 3.1 years (Mandell et al. 2005) to 5.7 years, (Shattuck et al. 2009) and for other developmental delays, reports show (Sand et al. 2005) that only 20–30% of children with delays are identified before entering school.”
BackgroundInfluential
Screening Practices of Family Physicians and Pediatricians in 2 Southern States
Gillis, J. L. (2009) · Infants & Young Children · doi:10.1097/iyc.0b013e3181bc4e21 · Cited by 35
“Earlier reports (Sand et al., 2005; Sices, Feudtner, McLaughlin, Drotar, & Williams, 2003) identified similar reasons for failure to screen (ie, most pediatricians do not consistently use developmental screening tools, given the time constraints).”
BackgroundMethodResultInfluential
Developmental disabilities across the world: A scientometric review from 1936 to 2020
Carollo, A., Bonassi, A., Lim, M., Gabrieli, G., Setoh, P., Dimitriou, D., Aryadoust, V., & Esposito, G. (2021) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2021.104031 · Cited by 35
The “Cough Trick:” A Brief Strategy to Manage Pediatric Pain From Immunization Injections
Wallace, D. P., Allen, K. D., Lacroix, A. E., & Pitner, S. L. (2010) · PEDIATRICS · doi:10.1542/peds.2009-0539 · Cited by 34
Comparison of Systematic Developmental Surveillance With Standardized Developmental Screening in Primary Care
Thomas, S. A., Cotton, W. H., Pan, X. J., & Ratliff-Schaub, K. L. (2011) · Clinical Pediatrics · doi:10.1177/0009922811420711 · Cited by 34

Authors: Sand, N., Silverstein, M., Glascoe, F. P., Gupta, V. B., Tonniges, T. P., & O'Connor, K. G.
Affiliations: Akron Children's Hospital (US)
Boston University (US)
Dr. Glascoe is an independent consultant in Nashville, TN
New York Medical College (US)
Department of Community Pediatrics
Division of Health Policy Research, American Academy of Pediatrics, Elk Grove Village, Illinois
ORCID: Silverstein, Michael
Venue: Pediatrics
Publisher: American Academy of Pediatrics (AAP)
Published: 2005-07-01
Volume: 116
Issue: 1
Pages: 174-179
ISSN: 0031-4005 (ISSN-L)
1098-4275
DOI: 10.1542/peds.2004-1809
OpenAlex: W2121239228
Cited by: 344
References: 31
Citations by year: 2026: 3 · 2025: 5 · 2024: 7 · 2023: 12 · 2022: 10 · 2021: 9 · 2020: 10 · 2019: 42 · 2018: 12 · 2017: 15 · 2016: 19 · 2015: 21 · 2014: 20 · 2013: 12 · 2012: 25
FWCI: 41.28
Type: journal article
Language: en
Open access: closed
Locations: PEDIATRICS (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Child and Adolescent Health
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
Keywords: developmental screening, developmental delay, American Academy of Pediatrics policy, Denver II, clinical evaluation, developmental disabilities, guideline adherence, primary care, infants and young children
MeSH terms: Developmental Disabilities, Child, Preschool, Data Collection, Humans, Infant, Pediatrics, Practice Patterns, Physicians', Practice Guidelines as Topic, Guideline Adherence

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Pediatricians’ reported practices regarding developmental screening: do guidelines work? Do they help?

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