BACKGROUND: Existing guidelines on screening children less than 5 years of age for developmental delay vary. In this systematic review, we synthesized the literature on the effectiveness and harms of screening for developmental delay in asymptomatic children aged 1-4 years. METHODS: We searched MEDLINE, Embase and PsychINFO for relevant articles published to June 16, 2015. We identified studies that included children aged 1-4 years who were not at high risk of developmental delay, screened in a primary care setting. Randomized trials and controlled cohort studies were considered for benefits (cognitive, academic and functional outcomes); no restrictions on study design were imposed for the review of harms. RESULTS: Two studies were included. One used the Ages and Stages Questionnaire II for screening and reported significantly more referrals to early intervention in the intervention groups than in the control group (relative risk [RR] 1.95, 95% confidence interval [CI] 1.49-2.54, in the intervention group with office support and RR 1.71, 95% CI 1.30-2.25, in the intervention group without office support). The time to referral was 70% shorter in the intervention group with office support (rate ratio 0.30, 95% CI 0.19-0.48) and 64% shorter in the intervention group without office support (rate ratio 0.36, 95% CI 0.23-0.59), compared with the control group. The other study used the VroegTijdige Onderkenning Ontwikkelingsstoornissen Language Screening instrument to screen children aged 15 months at enrolment for language delay. It reported no differences between groups in academic performance outcomes at age 8 years. INTERPRETATION: The evidence on screening for developmental delay in asymptomatic children aged 1-4 years is inconclusive. Further research with longer-term outcomes is needed to inform decisions about screening and screening intervals.
BACKGROUND: Existing guidelines on screening children less than 5 years of age for developmental delay vary. In this systematic review, we synthesized the literature on the effectiveness and harms of screening for developmental delay in asymptomatic children aged 1-4 years. METHODS: We searched MEDLINE, Embase and PsychINFO for relevant articles published to June 16, 2015. We identified studies that included children aged 1-4 years who were not at high risk of developmental delay, screened in a primary care setting. Randomized trials and controlled cohort studies were considered for benefits (cognitive, academic and functional outcomes); no restrictions on study design were imposed for the review of harms. RESULTS: Two studies were included. One used the Ages and Stages Questionnaire II for screening and reported significantly more referrals to early intervention in the intervention groups than in the control group (relative risk [RR] 1.95, 95% confidence interval [CI] 1.49-2.54, in the intervention group with office support and RR 1.71, 95% CI 1.30-2.25, in the intervention group without office support). The time to referral was 70% shorter in the intervention group with office support (rate ratio 0.30, 95% CI 0.19-0.48) and 64% shorter in the intervention group without office support (rate ratio 0.36, 95% CI 0.23-0.59), compared with the control group. The other study used the VroegTijdige Onderkenning Ontwikkelingsstoornissen Language Screening instrument to screen children aged 15 months at enrolment for language delay. It reported no differences between groups in academic performance outcomes at age 8 years. INTERPRETATION: The evidence on screening for developmental delay in asymptomatic children aged 1-4 years is inconclusive. Further research with longer-term outcomes is needed to inform decisions about screening and screening intervals.
Authors: Leslea Peirson; James Douketis; Donna Ciliska; Donna Fitzpatrick-Lewis; Muhammad Usman Ali; Parminder Raina Journal: CMAJ Open Date: 2014-10-01
Authors: Leslea Peirson; James Douketis; Donna Ciliska; Donna Fitzpatrick-Lewis; Muhammad Usman Ali; Parminder Raina Journal: CMAJ Open Date: 2014-10-01
Authors: Daniel Messinger; Gregory S Young; Sally Ozonoff; Karen Dobkins; Alice Carter; Lonnie Zwaigenbaum; Rebecca J Landa; Tony Charman; Wendy L Stone; John N Constantino; Ted Hutman; Leslie J Carver; Susan Bryson; Jana M Iverson; Mark S Strauss; Sally J Rogers; Marian Sigman Journal: J Am Acad Child Adolesc Psychiatry Date: 2013-02-08 Impact factor: 8.829
Authors: James P Guevara; Marsha Gerdes; Russell Localio; Yuanshung V Huang; Jennifer Pinto-Martin; Cynthia S Minkovitz; Diane Hsu; Lara Kyriakou; Sofia Baglivo; Jane Kavanagh; Susmita Pati Journal: Pediatrics Date: 2012-12-17 Impact factor: 7.124
Authors: Heleen M E van Agt; Heleen A van der Stege; Hanneke de Ridder-Sluiter; Ludo T W Verhoeven; Harry J de Koning Journal: Pediatrics Date: 2007-12 Impact factor: 7.124
Authors: Meta van den Heuvel; Cornelia M Borkhoff; Christine Koroshegyi; Weeda Zabih; Sijmen A Reijneveld; Jonathon Maguire; Catherine Birken; Patricia Parkin Journal: CMAJ Open Date: 2016-10-19