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Pediatricians’ reported practices regarding developmental screening: do guidelines work? Do they help?
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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Meta-Analysis of Diagnostic Accuracy of M-CHAT by Categorical Rank of Clinical Diagnosis
Olmstead, J. (2022) · Digital Archive @ GSU · doi:10.57709/17621674 · Cited by 1
Shevell, M. I. (2007) · PEDIATRICS · doi:10.1542/peds.2006-3730 · Cited by 1
Pelletier, J., & Kenney, G. M. (2010) · PsycEXTRA Dataset · doi:10.1037/e687652011-001 · Cited by 1
Quinoy, A. M. (2015) · VCU Scholars Compass (Virginia Commonwealth University) · doi:10.25772/aq7c-a807
“Evidence demonstrates that lack of provider education and/or training gets in the way of proper assessment and diagnosis of mental health issues and may contribute to low levels of comfort amongst providers in treating these issues (Sand et al., 2005; Bitar et al., 2009; Gardner et al., 2003).”
BackgroundInfluentialImplications for Pediatric Practice and Public Policy
Crane, J., & Winsler, A. (2007)
Early Intervention: A Crash Course for Pediatricians
Shulman, L. H., Meringolo, D., & Scott, G. (2007) · Pediatric Annals · doi:10.3928/0090-4481-20070801-07
Issues With the New Developmental Screening and Surveillance Policy Statement: In Reply
Lipkin, P. H. (2007) · PEDIATRICS · doi:10.1542/peds.2006-3770
O'Brien, G. (2008) · Developmental Neurorehabilitation · doi:10.1080/17518420802581222
Metadata
- 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
- 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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