Sharmila B Mukherjee1, Satinder Aneja, Vibha Krishnamurthy, Roopa Srinivasan. 1. Department of Pediatrics, Lady Hardinge Medical College and associated Kalawati Saran Childrens Hospital, New Delhi, India; and Ummeed Child Development Center, Mumbai, India. Correspondence to: Dr Sharmila B Mukherjee, Department of Pediatrics, Kalawati Saran Childrens Hospital, Bangla Sahib Road, New Delhi 110 001, India. theshormi@gmail.com.
Abstract
CONTEXT: Developmental concerns voiced by parents need to be responded to by structured developmental screening. Screening is the use of validated developmental screening tools to identify children with high risk of developmental delay out of an apparently normal population, while surveillance is the process of monitoring children identified as high risk by screening. Absence of routine screening can be attributed to problems at the level of parents, pediatricians or National policies. Hence vulnerable children are not detected early, and are denied benefit from appropriate developmental interventions. There are no definite guidelines for screening or for suitable tools for screening and surveillance. OBJECTIVES: To review existing developmental screening and monitoring tools for children validated in Indian under-five children, and provide a proposed practice paradigm for developmental screening in office practice. EVIDENCE ACQUISITION: Scientific papers were retrieved by an electronic database search using MeSH terms 'screening tool', 'developmental delay', and filter of 'children under 5 years'. Those relevant to office practice and validated internationally or in Indian children were reviewed. RESULTS: Screening tools applicable to Indian office practice have been compared and certain tools have been recommended according to the level of risk of developmental delay. An algorithmic approach to screening has been given along with strategies for incorporation. CONCLUSIONS: Screening and surveillance for high risk of developmental delay are essential components of child health care. It is possible to incorporate both into routine practice.
CONTEXT: Developmental concerns voiced by parents need to be responded to by structured developmental screening. Screening is the use of validated developmental screening tools to identify children with high risk of developmental delay out of an apparently normal population, while surveillance is the process of monitoring children identified as high risk by screening. Absence of routine screening can be attributed to problems at the level of parents, pediatricians or National policies. Hence vulnerable children are not detected early, and are denied benefit from appropriate developmental interventions. There are no definite guidelines for screening or for suitable tools for screening and surveillance. OBJECTIVES: To review existing developmental screening and monitoring tools for children validated in Indian under-five children, and provide a proposed practice paradigm for developmental screening in office practice. EVIDENCE ACQUISITION: Scientific papers were retrieved by an electronic database search using MeSH terms 'screening tool', 'developmental delay', and filter of 'children under 5 years'. Those relevant to office practice and validated internationally or in Indian children were reviewed. RESULTS: Screening tools applicable to Indian office practice have been compared and certain tools have been recommended according to the level of risk of developmental delay. An algorithmic approach to screening has been given along with strategies for incorporation. CONCLUSIONS: Screening and surveillance for high risk of developmental delay are essential components of child health care. It is possible to incorporate both into routine practice.