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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Background
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Method
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“Clinicians continue to cite lack of staffing, time limitations, and lack of reimbursement as ongoing barriers to screening (Lipkin et al., 2020b; King et al., 2010; Sand et al., 2005).”
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Merle, J. L., Carroll, A. J., Mohanty, N., Berkel, C., Scherr, C. L., Davis, M. M., Wakschlag, L. S., & Smith, J. D. (2023) · Journal of Child Health Care · doi:10.1177/13674935231163362 · Cited by 11
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Shahshahani, S., Vameghi, R., Sajedi, F., & Biglarian, A. (2016) · Iranian Journal of Pediatrics · doi:10.5812/ijp.6179 · Cited by 9
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The use by Alabama pediatricians of genetics consultation in the evaluation of developmental delay
Chen, M., Holt, C. L., Lose, E. J., & Robin, N. H. (2008) · American Journal of Medical Genetics Part A · doi:10.1002/ajmg.a.32150 · Cited by 10
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Behavioral Health Screening among Massachusetts Children Receiving Medicaid
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Screening Measures in Integrated Behavioral Health and Primary Care Settings
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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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