Child Development: Interventions : Part 3

by CDC

(Page 3 of 3)

National Survey of Early Childhood Health (NSECH)

From the parents or guardians who are primarily responsible for the health of a child in the home, NSECH recently collected information on a random sample of young children (ages 4 through 35months). This survey is a module of the State and Local Area Integrated Telephone Survey (SLAITS). It collects information mostly on the health-related concerns and needs of parents and children, the quality of developmental and psychosocial care received, factors associated with quality pediatric care, and home health behaviors.

Sample Finding Only 35% of surveyed parents reported that their child had been asked by their health care provider to pick up small objects or do related tasks that would suggest that a developmental assessment was done.

Promoting Healthy Development Survey (PHDS-PLUS)

By interviewing parents of children four years-of-age and under, this survey, by the Foundation for Accountability, seeks to measure how well pediatric clinicians provide child development health care services.

Sample Finding Only 46% of parents who reported potentially serious concerns to their healthcare provider also reported getting the information they needed to address these concerns.

Gaps in our knowledge on Developmental Screening

Although the above datasets have provided, and continue to provide, important information on developmental screening, there is no survey that follows children from screening to intervention. Therefore, we are lacking data on the effects of screening for further assessment and intervention implementation. This leaves us with little data on the outcomes of developmental screening.

Other gaps in our knowledge relate to meeting the requirements of federally mandated services, such as EPSDT, Child Find, and early interventions. Better evaluation of these programs is needed to identify the barriers and increase accountability for providing more eligible children services.

Facts about Developmental Screening Tools

What screening tools can do

Screening tools are designed to help identify children who might have developmental delays. Screening tools can be specific to a disorder (for example, autism), an area (for example, cognitive development, language, or gross motor skills), or they may be general, encompassing multiple areas of concern.

What screening tools cannot do

Screening tools do not provide conclusive evidence of developmental delays and do not result in diagnoses. A positive screening result should be followed by a thorough assessment. Screening tools do not provide in-depth information about an area of development.

What to consider when selecting a screening tool

Domain or domains the screening tool covers. That is, what are the questions that need to be answered? What types of delays or conditions do you want to detect?

Psychometric properties. These have to do with the overall ability of the test to do what it is meant to do. The sensitivity of a screening tool is the probability that it will correctly identify children who exhibit developmental delays or disorders. The specificity of a screening tool is the probability that it will correctly identify children who are developing normally.

Characteristics of the children. For example, age and presence of risk factors. Setting in which the screening tool will be administered (for example, physician office, daycare setting, community screening). Screening can be performed by professionals, such as nurses, or teachers or by trained paraprofessionals.

Myths about Developmental Screening Tools

Myth: There are no adequate screening tools for preschoolers.

Fact: While this may have been true decades ago, today sound screening measures exist. Many screening measures have sensitivities and specificities over 70%.

Myth: It takes a great deal of training to administer screening correctly

Fact: Training requirements are not extensive for most screeners. Many can be administered by paraprofessionals.

Myth: Screening takes a lot of time.

Fact: Many screening instruments take less than 15 minutes to administer, and some require only about 2 minutes of professional time.

Myth: Tools that incorporate information from the parents are not valid.

Fact: Parents' concerns are generally valid and are predictive of developmental delays. Research has shown that parental concerns detect 70% to 80% of children with disabilities.

Today, a number of good screening tools are available that are designed for a variety of settings, ages, and purposes. Some screening tools are used primarily in pediatric practices, while others are used by school systems or in other community settings.

About the Author

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The Centers for Disease Control and Prevention (CDC) is one of the 13 major operating components of the Department of Health and Human Services (HHS), which is the principal agency in the United States government for protecting the health and safety of all Americans and for providing essential human services, especially for those people who are least able to help themselves.