Literature DB >> 15995049

Pediatricians' reported practices regarding developmental screening: do guidelines work? Do they help?

Nina Sand1, Michael Silverstein, Frances P Glascoe, Vidya B Gupta, Thomas P Tonniges, Karen G O'Connor.   

Abstract

BACKGROUND: In 2001, the American Academy of Pediatrics (AAP) adopted a policy that all infants and young children should be screened for developmental delays at regular intervals. The policy statement promoted the use of valid reliable instruments. It is unknown, however, what proportion of pediatricians follow this recommendation and whether such a practice is associated with improved identification of children with developmental difficulties.
OBJECTIVES: To describe the use of developmental screening tests among board-certified pediatricians practicing general pediatrics and to determine the association between standardized screening and the self-reported identification of children with developmental difficulties.
METHODS: We mailed a survey to a random sample of AAP members. We used multivariate logistic/linearregression analyses to determine the association between standardized screening and the self-reported identification of children with developmental disabilities.
RESULTS: Of the 1617 surveys mailed, 894 were returned, for a response rate of 55%. Of the respondents, 646 practiced general pediatrics and were included in the analysis. Seventy-one percent of those pediatricians indicated that they almost always used clinical assessment without an accompanying screening instrument to identify children with developmental delays. Only 23% indicated that they used a standardized screening instrument. The most commonly used instrument was the Denver II. Logistic regression modeling demonstrated odds ratios between 1.71 and 1.90 for a >10% rate of identification of developmental problems among patients of pediatricians reporting standardized screening. Each adjusted odds ratio bordered on statistical significance. Linear-regression models estimating the difference in mean proportions of children identified with developmental problems across screening groups failed to show a statistically or clinically significant difference in physician-reported identification rates.
CONCLUSIONS: Our findings indicate that, despite the AAP policy and national efforts to improve developmental screening in the primary care setting, few pediatricians use effective means to screen their patients for developmental problems. It is uncertain whether standardized screening, as it is practiced currently, is associated with an increase in the self-reported identification of children with developmental disabilities.

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Mesh:

Year:  2005        PMID: 15995049     DOI: 10.1542/peds.2004-1809

Source DB:  PubMed          Journal:  Pediatrics        ISSN: 0031-4005            Impact factor:   7.124


  49 in total

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Journal:  Dtsch Arztebl Int       Date:  2012-06-15       Impact factor: 5.594

2.  Developmental Surveillance and Referral in a Traditionally Medically Underserved Border Community.

Authors:  Eugenia C Gonzalez; Connie Summers; Vanessa Mueller; Anne Hernandez; Gilda Gil-Lopez; Danielle C Garcia; Maritza E Lopez
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3.  Screening for autism spectrum disorders in primary care settings.

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Journal:  Autism       Date:  2008-09

4.  Autism and developmental screening in a public, primary care setting primarily serving Hispanics: challenges and results.

Authors:  Gayle C Windham; Karen S Smith; Nila Rosen; Meredith C Anderson; Judith K Grether; Richard B Coolman; Stephen Harris
Journal:  J Autism Dev Disord       Date:  2014-07

5.  Nipissing District Developmental Screen: patterns of use by physicians in Ontario.

Authors:  Marjolaine M Limbos; David P Joyce; G Jane Roberts
Journal:  Can Fam Physician       Date:  2010-02       Impact factor: 3.275

6.  Caretaker Awareness of Health Care Provided Developmental Screening: Increases from 2007 to 2012.

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7.  Trajectories and predictors of the development of very young boys with fragile X syndrome.

Authors:  Jane E Roberts; Jean B Mankowski; John Sideris; Barbara Davis Goldman; Deborah D Hatton; Penny L Mirrett; Grace T Baranek; J Steven Reznick; Anna C J Long; Donald B Bailey
Journal:  J Pediatr Psychol       Date:  2008-12-12

8.  Sociodemographic Barriers to Early Detection of Autism: Screening and Evaluation Using the M-CHAT, M-CHAT-R, and Follow-Up.

Authors:  Meena K Khowaja; Ann P Hazzard; Diana L Robins
Journal:  J Autism Dev Disord       Date:  2015-06

9.  Disparities in the prevalence of cognitive delay: how early do they appear?

Authors:  Marianne M Hillemeier; George Farkas; Paul L Morgan; Molly A Martin; Steven A Maczuga
Journal:  Paediatr Perinat Epidemiol       Date:  2009-01-14       Impact factor: 3.980

Review 10.  Language development and affecting factors in 3- to 6-year-old children.

Authors:  Nuray Bayar Muluk; Birgül Bayoğlu; Banu Anlar
Journal:  Eur Arch Otorhinolaryngol       Date:  2013-05-30       Impact factor: 2.503

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