Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening

Abstract

Early identification and intervention for developmental disorders are critical to the well-being of children and are the responsibility of pediatric professionals as an integral function of the medical home. This report models a universal system of developmental surveillance and screening for the early identification of conditions that affect children's early and long-term development and achievement, followed by ongoing care. These conditions include autism, deafness/hard-of-hearing, intellectual and motor disabilities, behavioral conditions, and those seen in other medical conditions. Developmental surveillance is supported at every health supervision visit, as is as the administration of standardized screening tests at the 9-, 18-, and 30-month visits. Developmental concerns elicited on surveillance at any visit should be followed by standardized developmental screening testing or direct referral to intervention and specialty medical care. Special attention to surveillance is recommended at the 4-to 5-year well-child visit, prior to entry into elementary education, with screening completed if there are any concerns. Developmental surveillance includes bidirectional communication with early childhood professionals in child care, preschools, Head Start, and other programs, including home visitation and parenting, particularly around developmental screening. The identification of problems should lead to developmental and medical evaluations, diagnosis, counseling, and treatment, in addition to early developmental intervention. Children with diagnosed developmental disorders are identified as having special health care needs, with initiation of chronic condition management in the pediatric medical home.

A Two-Stage Screening Approach with I-TC and Q-CHAT to Identify Toddlers at Risk for Autism Spectrum Disorder within the Italian Public Health System

“…This model had an area under the receiver operating characteristic (ROC) curve (AUC) of 90.7% and a cut-off could be chosen with 100% sensitivity and 72% specificity ( Figure 2). At 18 months, the bivariate logistic regression analysis allowed us to identify 17 Q-CHAT items that were significantly associated to positivity to ASD or BAP (1,2,3,4,5,6,7,8,9,10,14,15,16,17,19, 20, 23 and 25; p < 0.05). Again, starting from these items, we carried out a multivariate logistic regression adopting a stepdown procedure and obtained a model with 4 significantly associated items: item 10 ("Does your child follow where you're looking?…”

“…Clear evidence exists that early detection and early intervention can lead to a better prognosis [2][3][4]. According to the latest revision of the American Academy of Pediatrics (AAP) guidelines about promoting optimal development in infants and young children, the early identification of developmental disorders should be conducted through developmental surveillance and periodic screening at each pediatric health visit [5]. The AAP recommends that specific screeners for ASD should be administered to all children at their 18-and 24-month visits because screening tests enhance the accuracy of the developmental surveillance process [6].…”

The Criterion Validity of the First Year Inventory and the Quantitative-CHecklist for Autism in Toddlers: A Longitudinal Study

“…Early intervention requires early identification of risk factors followed by early diagnosis, as recommended by the American Academy of Pediatrics [ 17 ]. Several authors [ 18 , 19 , 20 ] suggested that the accuracy of the screening procedure for autism is sufficiently reliable when the child is 18-24 months of age [ 20 , 21 , 22 , 23 ]; however, some recent studies [ 21 , 22 , 24 , 25 ] reported that children as young as 12 months of age may elicit behavioral markers for autism.…”

Establishment of Egyptian developmental screening chart for infants from birth up to 30 months

“…[15][16] BDST have been used in Egypt forinfants motor and mental developmentassessment, asa rapid,easy and valid test according to manystudies. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] So we found suitable to develop an Egyptian developmentalchart according to Egyptian norms.EDSC for infants from birth up to 30 months established to meet these criteria for early detection of developmental delay at this age category. Items of the Indian BDST are simple, applicable and convenient to Egyptian society.…”

“…It also recommends that performing repeated developmental screening is more accurate and reliable than single assessment. [4][5] One of the effective screening tests is the Baroda development screening test (BDST) by Phatak and Khurana. It is a simple, rapid, and cost-effective tool.…”