Comparison of Systematic Developmental Surveillance With Standardized Developmental Screening in Primary Care

Abstract

Many physicians use surveillance questions to assess development; the American Academy of Pediatrics recommends screening at 9-, 18-, and 24-month health supervision visits (HSVs). There are no studies directly comparing surveillance with screening. The authors directly compared systematic surveillance with standardized screening using a cross-sectional observational study of children with no known delays. Surveillance questions were completed at each HSV. The Ages and Stages Questionnaire (ASQ) was administered following the 9-, 18-, or 24-month HSV. The authors compared detection of delays by surveillance with ASQ screening. Using surveillance, 11/95 subjects were identified as delayed. Using the ASQ, 15/95 subjects scored fail; 28/95 scored monitor. Among the 11 delayed surveillance subjects, 5 scored fail on the ASQ and 5 scored monitor. Ten of the 15 subjects scoring fail on the ASQ were not identified by surveillance. The study's findings support the American Academy of Pediatrics recommendations for periodic formal screening in addition to continued surveillance.

The Evaluation of Primary School Readiness Levels of the Children Aged 66 - 72 Months with the Denver II Test

“…Development monitoring is to follow any progression in the stages of child development (5). Developmental screening is defined as the identification of individuals at risk for the developmental delay with standardized tools.…”

The Efficacy of Arabic Version of the Developmental Assessment of Young Children Second Edition (DAYC-2) Scale in Detecting Developmental Delay among Jordanian Children Aged Birth to 71 Months

“…By reviewing these studies, we can deduce the crucial role of physicians in surveillance systems (Thomas et al, 2012;Earls et al, 2009) and the importance of parental concerns about their children's development (Chung et al, 2011). On the other hand, these studies results also indicated that physicians reliant solely on their clinical impressions and parents' concerns concentration on developmental areas more than others will leave many developmental delays cases undetected.…”

“…A cross-section observational study conducted by Thomas and colleagues (Thomas, Cotton, & Pan Ratliff-Schaub, 2012) compared between the systematic use of developmental surveillance (assessing child's development by administrating standard set of informal surveillance developmental questions for parents at the time of their child's 9-, 18-, or 24-month health supervision visit) with standardized scored screening methods for the detection of early child developmental delay. Results showed that (67%) of children were identified by screening were not identified by surveillance The study revealed that even with surveillance carried out in a systematic fashion, clinical judgment is ultimately used to determine a diagnosis of developmental delay.…”

Developmental Screening and Follow-up by Nurses

“…In response to this concern, in 2006 the American Academy of Pediatrics (AAP) recommended standardized developmental screening for children at 9, 18, and either 24 or 30 months and developmental surveillance at all other well-child visits (AAP Council on Children with Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee, & Medical Home Initiatives for Children with Special Needs Project Advisory Committee, 2006). Developmental screening using a standardized instrument has been shown to be more sensitive than surveillance questions at well-child visits (Thomas, Cotton, Pan, & Ratliff-Schaub, 2012). Standardized autism-specifi c screening at age 18 and 24 months was also recommended (Johnson, Myers, & AAP Council on Children with Disabilities, 2007).…”