Cited by 251Child and Adolescent HealthHealth Policy Implementation ScienceAdolescent and Pediatric Healthcare

The DOI matches its Crossref record; 28 of the 28 references it cites were found in a registry or an index.

Implementing Developmental Screening and Referrals: Lessons Learned From a National Project

King, Tracy M., Tandon, S. Darius, Macias, Michelle M., Healy, Jill A., Duncan, Paula M., Swigonski, Nancy L., Skipper, Stephanie M., Lipkin, Paul H.·2010·Pediatrics

DOI 10.1542/peds.2009-0388

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Abstract

OBJECTIVES: To assess the degree to which a national sample of pediatric practices could implement American Academy of Pediatrics (AAP) recommendations for developmental screening and referrals, and to identify factors that contributed to the successes and shortcomings of these efforts. BACKGROUND: In 2006, the AAP released a policy statement on developmental surveillance and screening that included an algorithm to aid practices in implementation. Simultaneously, the AAP launched a 9-month pilot project in which 17 diverse practices sought to implement the policy statement's recommendations. METHODS: Quantitative data from chart reviews were used to calculate rates of screening and referral. Qualitative data on practices' implementation efforts were collected through semistructured telephone interviews and inductively analyzed to generate key themes. RESULTS: Nearly all practices selected parent-completed screening instruments. Instrument selection was frequently driven by concerns regarding clinic flow. At the project's conclusion, practices reported screening more than 85% of patients presenting at recommended screening ages. They achieved this by dividing responsibilities among staff and actively monitoring implementation. Despite these efforts, many practices struggled during busy periods and times of staff turnover. Most practices were unable or unwilling to adhere to 3 specific AAP recommendations: to implement a 30-month visit; to administer a screen after surveillance suggested concern; and to submit simultaneous referrals both to medical subspecialists and local early-intervention programs. Overall, practices reported referring only 61% of children with failed screens. Many practices also struggled to track their referrals. Those that did found that many families did not follow through with recommended referrals. CONCLUSIONS: A diverse sample of practices successfully implemented developmental screening as recommended by the AAP. Practices were less successful in placing referrals and tracking those referrals. More attention needs to be paid to the referral process, and many practices may require separate implementation systems for screening and referrals.

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“According to King et al. (2010) there should be a system of referral-tracking as many families do not follow through with referrals and often do not understand why they are being referred.”
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Developmental and Behavioral Surveillance and Screening Within the Medical Home
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“For example, the Ages and Stages Questionnaire (ASQ) is often used in diverse medical practices to detect problems with general development, but a study by King et al. (2010) suggests physicians only referred those who failed the ASQ 61% of the time.”
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“…a g e Volume 2(2) ▪ Spring 2022 Developmental screening has proven to be an effective practice in identifying children at risk for developmental delays (Council on Children with Disabilities et al., 2006; Earls & Shackelford Hay, 2006; Hix-Small et al., 2007; King et al., 2010; Sand et al., 2005).”
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O conceito de identifi cação no processo de escolha profi ssional
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Macy, M. G., Glascoe, F. P., Ji, Y., Macy, R., & Zhang, B. (2017) · Current Developmental Disorders Reports · doi:10.1007/s40474-017-0123-0 · Cited by 3
Developmental and Behavioral Surveillance and Screening Within the Medical Home
Macias, M. M., & Lipkin, P. H. (2018) · American Academy of PediatricsItasca, IL eBooks · doi:10.1542/9781610021357-9 · Cited by 3
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Dahl, S. H., Jones, A. E., & Lynch, B. A. (2012) · Pediatric Annals · doi:10.3928/00904481-20120206-12 · Cited by 2
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Grañana, N. E., & Otálvaro, A. M. R. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-817988-8.00028-2 · Cited by 3
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“Of great concern is that fewer than 30% of children under 6 years of age ever receive a developmental screening [8] – and only 60% of these children screened receive a referral for further diagnostic evaluation and/or early intervention services when warranted [9].”
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Developmental Screening: What Every Nurse Practitioner Needs to Know
Gellasch, P. (2016) · The Journal for Nurse Practitioners · doi:10.1016/j.nurpra.2016.04.012 · Cited by 2
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Mardiyanti, M., & Case, A. (2021) · Belitung Nursing Journal · doi:10.33546/bnj.1480 · Cited by 2
“Many studies recommend ASQ as a standardised screening tool to be used during well-child visits in any clinical settings either in urban or rural settings (Hamilton, 2006; Rydz et al., 2006; Rybski & Wilder, 2008; Burns et al., 2009; King et al., 2010; Guevara et al., 2013).”
Method
Latinx Mothers' Experiences With Linkage to Early Intervention
Quebles, I., Perrigo, J. L., Bravo, R., Gera, M. P., Poulsen, M. K., Wheeler, B. Y., & Williams, M. E. (2022) · Infants & Young Children · doi:10.1097/iyc.0000000000000220 · Cited by 2
“For example, a national study that examined implementation and outcomes of developmental screenings among 17 pediatric practices across 15 states found that only 61% of children whose screening indicated a possible delay were referred to EI services (King et al., 2010).”
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Early Identification of Risk, Developmental Delay, or Disability in Young Children: Connecting Families with Services During a Global Health Crisis
Macy, M. G. (2022) · Educating the young child · doi:10.1007/978-3-030-96977-6_12 · Cited by 3
Exploring parent-engaged developmental monitoring of young children before and during the COVID-19 pandemic, Porter Novelli Styles 2019 and 2021
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Implementierung einer neuen Versorgungsform zur Früherkennung und Prävention emotionaler und Verhaltensauffälligkeiten bei Kindern im kinderärztlichen Setting: Qualitative Interviews mit Kinderärzt*innen, Praxispersonal und Sorgeberechtigten
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When and how to Screen!
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Assessing the Healthy People 2020 Objective to Expand Early Treatment Receipt Among a National Sample of Children with Autism Spectrum Disorder
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“Although specialists fill a substantial role in facilitating diagnosis of ASD after parents express concerns, there are barriers to expanding this to all families, including PCP referral, limited provider networks, and availability of specialists and mental health providers in local communities.(25,28,29) Efforts to a…”
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Exploring home visitors’ use and perceptions of developmental monitoring: A mixed methods study
Behrens, S., Lawson, L. A. M., Bigelow, K. M., Dean, E. E., Zhang, A., Foster, L. H., & Bridges, M. S. (2024) · Early Childhood Research Quarterly · doi:10.1016/j.ecresq.2024.11.011 · Cited by 5
Examining Sociodemographic Factors Related to Autism Screening Rates of Children in Early Intervention
Harrison, A. J., Bowman, K. L., Bub, K. L., Brown, J. A., Lieberman‐Betz, R. G., & Vail, C. O. (2025) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-025-07154-7 · Cited by 1

Authors: King, T. M., Tandon, S. D., Macias, M. M., Healy, J. A., Duncan, P. M., Swigonski, N. L., Skipper, S. M., & Lipkin, P. H.
Affiliations: Johns Hopkins University (US)
Medical University of South Carolina (US)
American Academy of Pediatrics (US)
University of Vermont (US)
Indiana University Indianapolis (US)
Kennedy Krieger Institute (US)
ORCID: Tandon, S. Darius
Macias, Michelle M.
Swigonski, Nancy L.
Lipkin, Paul H.
Venue: Pediatrics
Publisher: American Academy of Pediatrics (AAP)
Published: 2010-02-01
Volume: 125
Issue: 2
Pages: 350-360
ISSN: 0031-4005 (ISSN-L)
1098-4275
DOI: 10.1542/peds.2009-0388
OpenAlex: W2067299533
Cited by: 251
References: 28
Citations by year: 2026: 9 · 2025: 6 · 2024: 7 · 2023: 9 · 2022: 13 · 2021: 19 · 2020: 30 · 2019: 23 · 2018: 17 · 2017: 16 · 2016: 23 · 2015: 10 · 2014: 21 · 2013: 11 · 2012: 16
FWCI: 25.56
Type: journal article
Language: en
Open access: closed
Locations: PEDIATRICS (publishedVersion)
PubMed (publishedVersion)
Funders: National Center for Research Resources (KL2RR025006, K12RR017627)
Topics: Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Child and Adolescent Health
Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Adolescent and Pediatric Healthcare
Keywords: developmental screening, child development monitoring, pediatric practice, American Academy of Pediatrics policy statement, early intervention programs, referral tracking, implementation barriers, employee turnover
MeSH terms: Algorithms, Child Development, Developmental Disabilities, Child, Preschool, Humans, Infant, Infant, Newborn, Mass Screening, Pediatrics, Primary Health Care, Referral and Consultation, United States, Practice Guidelines as Topic, Guideline Adherence

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Implementing Developmental Screening and Referrals: Lessons Learned From a National Project

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