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
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.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
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?
In the citing paper
“In some settings, screening programs have been criticized for identifying children with high likelihood of developmental delays without being able to ensure timely follow-up evaluation and services (e.g., King et al., 2010).”
From Navigating the Challenges: A Commentary on Barriers to Autism Screening in Childcare Centers (2026) · cites this paper as King et al., 2010
Citations
Cites
Why Don't Physicians Follow Clinical Practice Guidelines?: A Framework for Improvement
Cabana, M. D., Rand, C. S., Powe, N. R., Wu, A. W., Wilson, M. H., Abboud, P.-A. C., & Rubin, H. R. (1999) · JAMA · doi:10.1001/jama.282.15.1458 · Cited by 6,677
From Neurons to Neighborhoods: The Science of Early Childhood Development
(2000) · doi:10.17226/9824 · Cited by 4,484
Enhancing the quality and credibility of qualitative analysis.
(1999) · PubMed Central · Cited by 4,133
From Neurons to Neighborhoods: The Science of Early Childhood Development
Carey, W. B. (2001) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/00004703-200104000-00011 · Cited by 2,678
Pediatrics, S. O. D. B. (2006) · PEDIATRICS · doi:10.1542/peds.2006-1231 · Cited by 1,472
(1997) · Europe PMC (PubMed Central) · Cited by 1,226
Qualitative methods: what are they and why use them?
Sofaer, S. (1999) · PubMed · Cited by 866
The Effectiveness of Early Intervention.
Guralnick, M. J. (1997) · Cited by 495
Internists' Attitudes about Clinical Practice Guidelines
Tunis, S., Hayward, R. S. A., Wilson, M. C., Rubin, H. R., Bass, E. B., Johnston, M., & Steinberg, E. P. (1994) · Annals of Internal Medicine · doi:10.7326/0003-4819-120-11-199406010-00008 · Cited by 440
Luckey, D. W., & Pett, M. A. (1998) · Journal of the American Statistical Association · doi:10.2307/2669654 · Cited by 394
Research works printed but not linked: 5
- Bricker, 1999, Ages & Stages Questionnaires: A Parent-Completed, Child-Monitoring System
- Glascoe, 1997, Parents' Evaluations of Developmental Status
- Frankenburg, 1996, DENVER II Technical Manual
- Frankenburg, 1998, Prescreening Developmental Questionnaire (PDQ II)
- Nelson, 2006, Screening for speech and language delay in preschool children: systematic evidence review for the US Preventive Services Task Force [published correction appears in Pediatrics. 2006;117(6):2336–2337], Pediatrics, 117
Cited by
Sorted by citations
Items 201–251 of 251
Implementing Developmental Screening
McBride, D. (2010) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2010.04.001 · Cited by 1
“…screening for suspected delays. of the 2006 American Academy in Pediatrics (AAP) policy on the early identification of infants and children with developmental disorders in primary care practice found wide variation in screening practices and subspecialist referrals (King et al., 2010).”
BackgroundYockelson, S. J., Linder, C., & Asman, R. (2016) · Journal of Intellectual Disability - Diagnosis and Treatment · doi:10.6000/2292-2598.2015.03.04.6 · Cited by 1
“Furthermore, pediatricians who use screening instruments do not consistently refer the children for evaluation or services [47].”
BackgroundLevinson, C. (2011) · OhioLink ETD Center (Ohio Library and Information Network) · Cited by 1
Addressing Barriers and Limitations of Developmental Screening in Community Contexts
Silver, R. B., Beers, M., Godoy, L., & Dickstein, S. (2019) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780199837182.013.20 · Cited by 1
Ben‐Sasson, A., Jacobs, K., & Ben‐Sasson, E. (2023) · Health Informatics Journal · doi:10.1177/14604582231164695 · Cited by 1
“14 It is, therefore, clear that an ef fi cient, scalable, digital screening platform is needed to complement preventive pediatric care, 15 for parental education and to encourage quicker follow-up with healthcare providers.”
BackgroundGuevara, J. P. (2024) · Journal of Pediatric Advance Research · doi:10.46889/jpar.2024.3101 · Cited by 1
“On both the national and the state level, this percentage of infants and toddlers in EI has been increasing from previous years, though many children and especially those in urban environments still fail to receive services they are eligible for [3,4].”
Combining Two Developmental Screening Tests to Improve Predictive Accuracy
Camp, B. W., & Bonnell, L. N. (2019) · Academic Pediatrics · doi:10.1016/j.acap.2019.06.010 · Cited by 1
Family-Centered Management of Birth Defects Diagnosis and Referral in Hospital Settings in Florida
Marshall, J. T., Falope, O. O., Vijayakumar, N., Tanner, J. P., Salemi, J. L., & Kirby, R. S. (2020) · Maternal and Child Health Journal · doi:10.1007/s10995-020-02914-6 · Cited by 1
“When the diagnosis occurs during an inpatient admission, there are a range of health professionals who meet with the parents and provide diagnosis (Dent and Carey 2006; Gooding et al. 2011; King et al. 2010).”
BackgroundNavigating the Challenges: A Commentary on Barriers to Autism Screening in Childcare Centers
Wieckowski, A. T., Perez Liz, G., McGhee Hassrick, E., Koku, E., Frick, E., Austin, A., & Robins, D. L. (2026) · Behavioral Sciences · doi:10.3390/bs16010079
“In some settings, screening programs have been criticized for identifying children with high likelihood of developmental delays without being able to ensure timely follow-up evaluation and services (e.g., King et al., 2010).”
Teplin, S. W., Macias, M. M., Mansoor, E., & Murray, K. E. (2009) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0b013e31819cf544
Self-citationHumphreys, B. P. (2013) · Carolina Digital Repository (University of North Carolina at Chapel Hill) · doi:10.17615/nwgc-ky24
Bohjanen, S. L. (2016) · UA Campus Repository (The University of Arizona)
Early childhood developmental screenings: Predictors of screening referral completion
Jennings, D. J. (2012) · ProQuest LLC eBooks
King, T. M., Tandon, S. D., Macias, M. M., Healy, J. A., Swigonski, N. L., Skipper, S. M., Lipkin, P. H., & Mahon, M. (2010)
Self-citationEarly Childhood Education and Care for Children with Disabilities
Hauser‐Cram, P., Heyman, M., & Bottema‐Beutel, K. (2017) · Wiley eBooks · doi:10.1002/9781118937334.ch10
Challenges of Developmental Screening in Pediatric Practice
Stein, M. T. (2010) · Journal watch · doi:10.1056/pa201002240000004
Efforts must continue to improve developmental screening rates, payments
Lipkin, P. H. (2011) · AAP News · doi:10.1542/aapnews.2011328-15a
Self-citationIncreasing Pediatric Health Care Providers' Referrals to Early Intervention Services
Mason, I. M. (2017) · doi:10.23860/thesis-mason-irene-2017
“…speech therapy, and occupational therapy, as mandated by Part C of the IDEA have been shown to reduce children’s developmental disabilities (Raspa et al., 2015; King et al., 2010) and improve their developmental outcomes, resulting in increased preparedness to enter school (Jimenez et al., 2013).”
BackgroundInfluentialThakur, H. (2018) · Illinois Digital Environment for Access to Learning and Scholarship (University of Illinois at Urbana-Champaign)
One Key to Timely Diagnosis and Services? A Coordinated System of Care
Nelson, B. B. (2019) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2019.08.001
Autism Screening and Early Identification: If You See Something, Say Something
Iyama-Kurtycz, T. (2019) · Springer eBooks · doi:10.1007/978-3-030-26531-1_3
Developmental Screening in Community-Based Settings
Shahidullah, J. D., Forman, S. G., Harris, J. H., & Norton, A. M. (2020) · Springer eBooks · doi:10.1007/978-3-030-46295-6_4 · Cited by 1
Child Development Screening 18 months to 4 years old
Mascarenhas, S. S. (2020) · The Singapore Family Physician · doi:10.33591/sfp.46.5.u2
O’Connor, A. (2021) · UWA Profiles and Research Repository (University of Western Australia) · doi:10.26182/v5gm-1p57
Approaches of Early Detection of Autism Spectrum Disorders
Papaefstathiou, E. (2021) · Advances in early childhood and K-12 education · doi:10.4018/978-1-7998-8217-6.ch001
AVALIAÇÃO COGNITIVA E CRIATIVIDADE: ESTUDOS DE CASO DE CRIANCAS COM DIFICULDADE DE APRENDIZAGEM
Dias, T. L., Enumo, S. R. F., & Pedroza, C. (2005) · Revista da Faculdade de Educação
Teplin, S. W., Murray, K. E., Nyp, S. S., & Wassom, M. C. (2010) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0b013e3181e28329
Screening and Diagnostic Assessment
Volkmar, F. R., & Wiesner, L. (2017) · doi:10.1002/9781119426981.ch2
Poon, J. K., & Childers, D. O. (2018) · American Academy of PediatricsItasca, IL eBooks · doi:10.1542/9781610021357-6
Brown, M. (2021) · doi:10.31390/gradschool_theses.5487
“Regular developmental screeners are recommended to occur during pediatric visits to identify potential risks of ASD (King et al. 2010).”
BackgroundMethods of Screening for Core Symptoms of Autism and Pervasive Developmental Disabilities
Brown, M., Matson, J. L., & Tevis, C. M. (2022) · Autism and child psychopathology series · doi:10.1007/978-3-030-88538-0_13
Rahman, M. S., Hoque, M., & Hafiz, P. (2022) · Research Square · doi:10.21203/rs.3.rs-2398588/v1
Hafiz, P., Hoque, M., & Rahman, M. S. (2023) · Research Square · doi:10.21203/rs.3.rs-2398588/v2
Ages and Stages Questionnaires: Feasibility of Online Survey for Postshunt Hydrocephalus Follow-Up
Dutta, H. K., Baruah, M., & Dutta, M. (2023) · Indian Journal of Neurosurgery · doi:10.1055/s-0043-1775972
“18 In the present study, ASQ-3 was chosen, as the ASQ can be administered to a wide age group and it has been validated against DASII, which is considered the gold standard for Indian children.”
MethodStransky, M. L., Kuhn, J., & Feinberg, E. (2023) · Child & Youth Care Forum · doi:10.1007/s10566-023-09773-6
“…& Twyman, 2014; Payakachat et al., 2018), low birth weight (Atkins et al., 2016; Wang et al., 2009), social-emotional problems (Brown et al., 2012), and having or at increased likelihood of developmental delays (Clements et al., 2006; King et al., 2010; Rosenberg et al., 2008; Tang et al., 2012).”
Volkmar, F. R., & Wiesner, L. (2021) · Wiley eBooks · doi:10.1002/9781394259007.ch2
Milojevich, H. M., Beasley, L. O., Fuller, S., Lane, O., & Bard, D. (2025) · Prevention Science · doi:10.1007/s11121-025-01794-y
“…screenings (Lipkin et al., 2020), with time constraints, training requirements, staff turnover, and beliefs that screening is not the role of pedia-tricians being cited as challenges to conducting developmental screenings in healthcare settings (King et al., 2010; Lipkin et al., 2020).”
Shared Understanding Between Parents and Clinicians Regarding Developmental Screening and Referrals
Schlichte-Seaberg, L., Vangala, S., Porras-Javier, L., Thompson, L. R., Chung, P. J., Nelson, B. B., & Dudovitz, R. (2025) · Academic Pediatrics · doi:10.1016/j.acap.2025.103121
Park, J., Cho, H. J., Yoo, S., & Song, M. (2025) · Annals of Medicine · doi:10.1080/07853890.2025.2525401
“Barrier reported a lack of reimbursement for the 30-month visit [20].”
Child life specialists in foster care: A case for child life in a nontraditional setting
Meyer, L. (n.d.) · ProQuest Demo Repository
Macy, M. G. (2025) · IGI Global eBooks · doi:10.4018/979-8-3373-3068-6.ch005
Shanley, D. C., Page, M., Shelton, D., Harbeck, E., Ware, R. S., Byrnes, J., Zimmer‐Gembeck, M. J., Towers, K., Brown, N. J., Marshall, J., et al. (2026) · BMC Health Services Research · doi:10.1186/s12913-025-13828-w
Brown, L. S., Bacon, A., Chappell, A., Pacey, V., Pates, N., & İlhan, E. (2026) · Physical & Occupational Therapy In Pediatrics · doi:10.1080/01942638.2026.2631557
“…delay (Sheldrick et al., 2020; van Dokkum et al., 2022), but the literature indicates that in some cases in developed countries, such as the United States of America, intervention services may be inadequately accessed (King et al., 2010) or provided to these children (Brian et al., 2019).”
Excluded Early: Barriers and Supports for Families of Infants and Toddlers with Disabilities
Movahedazarhouligh, S., & Myers, M. (2026) · Journal of Early Intervention · doi:10.1177/10538151261450186
“Despite 87% of pediatricians conducting developmental screening, fewer than 30% provide community program information beyond Part C referrals (King et al., 2010).”
Barriers to neurodevelopmental care: Caregiver pathways, stigma, and delayed presentation
Joshi, U., Sharma, I., & Dutta, K. P. (2026) · Journal of Neurosciences in Rural Practice · doi:10.25259/jnrp_10_2026
Gebeyehu, S., Mommers, M., Hussen, S., & Spigt, M. (2026) · PLoS ONE · doi:10.1371/journal.pone.0355686
“These findings are consistent with research from the United States, where inefficient systems of care were identified as major barriers [10,37].”
Roemhild, E., Sanford, K., Ronis, S. D., & Burkhart, K. M. (2026) · Journal of Primary Care & Community Health · doi:10.1177/21501319261488480
“19 This requires a more comprehensive, multidisciplinary approach 20,21 supported by an integrated model that allows for collaboration between behavioral health providers and primary care providers.”
Sayman, Ö. A., Çalışkan, D., Başarır, G., Turan, C. A., Alpaslan, S. Ö. Ö., & Gökçeoğlu, A. U. (2026) · Acta Medica Alanya · doi:10.30565/medalanya.1873067
Implementing a Developmental Screening Tool in Pediatric Primary Care Practice
Petrosino, M. K. (2015) · UA Campus Repository (The University of Arizona)
Metadata
- 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)
- 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
- 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
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
