New Resources - Standard Rotations: Developmental and Behavioral Pediatrics

  

Developmental Pediatrics 

Section Contributor: Cathy Scheiner MD 

References: Developmental Screening/Clinical evaluation of the child with developmental delay 

  1. Identifying Infants and Young Children With Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening. Pediatrics Vol. 118 No. 1 July 1, 2006;  405 -420 http://pediatrics.aappublications.org/content/118/1/405.full 

 

Brief Description of Resource: The AAP developed an algorithm for developmental surveillance and developmental screening to improve the identification of these children. In this 2006 policy statement they recommend developmental surveillance at all well child visits and formal screening at 9, 18 and 30 month visits, including the administration of an autism specific screening tool at 18 months.(PC1, 5; MK1; PBL 3; SBP 1) 

 

  1. Screening for Speech and Language Delay in Preschool Children: Systematic Evidence Review for the US Preventive Services Task Force. Pediatrics Vol. 117 No. 2 February 1, 2006; e298-e319 
    http://pediatrics.aappublications.org/content/117/2/e298.full 

 

Brief Description of Resource: The US Preventative Services Task Force (USPSTF) reviewed studies between 1996 and 2004 of speech and language screening. .(PC1, 5; MK1; PBL 3; SBP 1) 

 

 

  1. Motor Delays: Early Identification and Evaluation. Pediatrics Vol. 131 No. 6 June 1, 2013, e2016-2027 http://pediatrics.aappublications.org/content/131/6/e2016.full.pdf+html 

 

Brief Description of Resource: AAP clinical report to identify children with motor delays. It includes an algorithm for surveillance and screening. Describes a diagnostic approach to children with motor delays. .(PC1, 5; MK1; PBL 3; SBP 1) 

 

 

On line learning opportunities: Developmental Screening: 

  1. Developmental Screening Tool Kit for Primary Care Providers. http://www.developmentalscreening.org/ 

Brief description of resources: This site is for primary care providers considering or planning to start screening children for developmental needs using a validated tool. (PC1, 5; MK1; PBL 3; SBP 1) 

 

  1. AAP Section on Developmental Screening and Assessment. http://www2.aap.org/sections/dbpeds/screening.asp 

Brief description of resources. This Web page provides materials to support improvement in developmental and behavioral screening, surveillance, and identification of disabilities. (PC1, 5; MK1; PBL 3; SBP 1) 

 

 

 

Brief description of resources: Understand the pediatricians role in screening, diagnosing and managing/referring children with developmental delay 

  1. Developmental Surveillance: The American Academy of Pediatrics (AAP) encourages pediatricians to assume an active role in caring for children with developmental delay and disabilities. Part of this role is to identify developmental delay in children between birth and three years of age, in the primary care setting. The AAP has developed an algorithm for developmental surveillance and developmental screening to improve the identification of these children. In their 2006 policy statement they recommend developmental surveillance at all well child visits and formal screening at 9, 18 and 30 month visits, including the administration of an autism specific screening tool at 18 months. The AAP autism expert panel also recommended an autism specific screening tool at 24 months. In 2006 the AAP published a clinical report on the identification and evaluation of children with autism spectrum disorders, in which a surveillance and screening algorithm for autism is published. This clinical report builds upon the principals of the AAP 2006 policy statement.  

  1. Speech and language delay is the most common form of developmental delay. Approximately 15% of children at 24 months and 5%-8% of preschool children may meet criteria for speech and language delay, which often persists into the school age years and is associated with lower academic performance. The US Preventative Services Task Force (USPSTF) reviewed studies between 1996 and 2004 of speech and language screening. In their recommendation statement they concluded that there is insufficient data to recommend formal screening instruments in primary care to detect speech and language delay in children up to 5 years of age. Their review discusses the potential advantages (e.g. increased awareness of a childs development) and disadvantages (e.g. increased caregiver stress) of the screening process.   This recommendation is not inconsistent with the AAP recommendation on developmental screening, which endorses the use of broad developmental screening instruments.    

  1. Motor delays: In 2013 the AAP published a clinical report to identify children with motor delays. It includes an algorithm for surveillance and screening. The report recommends formal screening at 9, 18, 30 and 48 month well child visits. It describes a diagnostic approach to children with motor delay including key components of the history and the physical examination, neuroimaging and laboratory testing as well as management using a medical home model of care.