Breaking News
July 17, 2018 - Celgene and Acceleron Announce Luspatercept Achieved Primary and All Key Secondary Endpoints in Phase III ‘BELIEVE’ Study in Adults with Transfusion-Dependent Beta-Thalassemia
July 17, 2018 - Roots of leukemia reveal possibility of predicting people at risk
July 17, 2018 - Summer med program embraces low-income students’ potential
July 17, 2018 - New research lays foundation to create standards for RNA sequencing
July 17, 2018 - CRISPR/Cas9 gene editing can cause greater genetic damage than previously thought
July 17, 2018 - Democrats rally against threats to the ACA to block Trump’s Supreme Court nominee
July 17, 2018 - Staggering prices slow insurers’ coverage of CAR-T cancer therapy
July 17, 2018 - How proteins involved in neurodegeneration enter cells
July 17, 2018 - New super-resolution ‘nanoscope’ provides insight into progression of Alzheimer’s disease
July 17, 2018 - FDA Advisory Committee Endorses the Effectiveness and Safety of Single-Dose Tafenoquine for the Radical Cure of P. vivax Malaria
July 17, 2018 - Uncovering the evolutionary history of IBD-associated colorectal cancer
July 17, 2018 - Is nutrition research dependable? Stanford’s John Ioannidis weighs in
July 17, 2018 - New machine learning framework predicts effects of genetic mutations in ‘dark matter’ regions
July 17, 2018 - Plant-based products fail to have positive impact on blood pressure during clinical studies
July 17, 2018 - Electronic system to speed up facial pain diagnosis may improve quality of life and save money
July 17, 2018 - Study delves into the role played by Protein Kinase C in synaptic plasticity
July 17, 2018 - Women Often Unaware of Their Hospital’s Religious Affiliation
July 17, 2018 - New AASM guideline recommends use of actigraphy for sleep disorders
July 17, 2018 - CRISPR editing reduces repetitive behavior in mice with a form of autism
July 17, 2018 - Scientists use magnets to detect cancer
July 17, 2018 - Microfluidic chip to detect sepsis proves successful in clinical study
July 17, 2018 - Research provides better understanding of mechanisms underlying memory storage
July 17, 2018 - A Multi-Modal Approach for the Early Detection of Breast Cancer
July 17, 2018 - Mailing colorectal cancer tests to patients increases screening rates, report researchers
July 17, 2018 - Scientists find possible sources of medicinal and antimicrobial drugs
July 17, 2018 - Molecules formed when the body metabolizes omega-3 fatty acids may inhibit cancer
July 17, 2018 - Efficient communication between hospitals improves patient safety and reduces mortality
July 17, 2018 - Study highlights potential of fetal gene therapy to prevent lethal neurodegenerative disease
July 17, 2018 - For Americans, in Science They Trust
July 17, 2018 - Combating HIV/AIDS | NIH MedlinePlus the Magazine
July 17, 2018 - Study shows minorities widely underrepresented in autism diagnoses
July 17, 2018 - Multigene testing replacing BRCA tests for breast cancer risk | News Center
July 17, 2018 - Pre-clinical pilot study shows promising results of ‘concussion pill’
July 17, 2018 - Researchers reduce size of tumors in mice by artificially activating the brain’s reward system
July 17, 2018 - New study documents symptoms of people before they acquire multiple sclerosis
July 17, 2018 - Researchers discover why CRISPR gene editing sometimes fails
July 17, 2018 - New finding may hold key to better understand the complexities of neurological disorders
July 17, 2018 - The Current issue of “The view from here” is concerned with Novel Targets.
July 17, 2018 - Fighting the Flu with a Universal Vaccine
July 17, 2018 - Key social reward circuit in the brain impaired in kids with autism | News Center
July 17, 2018 - Insight into causes, types and treatment of aphasia
July 16, 2018 - Quark Pharmaceuticals, Inc Announces First Patient Dosed in Phase 3 Clinical Trial of QPI-1002 for Prevention of Acute Kidney Injury Following Cardiac Surgery
July 16, 2018 - NSAIDs shown to have causal role in cardiovascular risk of patients with osteoarthritis
July 16, 2018 - PET scan tracer predicts success of cancer ‘vaccine’ | News Center
July 16, 2018 - Parents struggle with what to do when their child has headache, shows study
July 16, 2018 - Outrageous or overblown? HHS announces another round of ACA navigator funding cuts
July 16, 2018 - Weight loss surgery may impact individual’s risk of developing cancer, shows study
July 16, 2018 - Alexion Submits Application for Priority Review and Approval of ALXN1210 as a Treatment for Patients with Paroxysmal Nocturnal Hemoglobinuria (PNH) in the U.S.
July 16, 2018 - Restoring epigenetic balance reinstates memory in flies with Alzheimer’s disease symptoms
July 16, 2018 - Magnetized wire could be used to detect cancer in people | News Center
July 16, 2018 - Non-surgical management found to be feasible option for penetrating kidney trauma
July 16, 2018 - California clinic screens asylum seekers for honesty
July 16, 2018 - FDA Approves Xtandi (enzalutamide) for the Treatment of Men with Non-Metastatic Castration-Resistant Prostate Cancer (CRPC)
July 16, 2018 - Can nanotechnology help treat Alzheimer’s?
July 16, 2018 - Researchers identify protein essential for making stem cells | News Center
July 16, 2018 - Severe childhood infections linked with lower school achievement in adolescence
July 16, 2018 - Radiologist discusses causes, treatments of varicose veins
July 16, 2018 - Researchers develop nanostructured surface to accelerate wound healing after dental implants
July 16, 2018 - New non-invasive procedure to reposition kidney stones could benefit astronauts
July 16, 2018 - Attending Surgeon Influences Genetic Testing in Breast Cancer
July 16, 2018 - Medical doctors with addictions fear professional repercussions if they seek treatment
July 16, 2018 - 5 Questions: John Ioannidis calls for more rigorous nutrition research | News Center
July 16, 2018 - University of Illinois buys 3D-Bioplotter for regenerative biology, tissue engineering research
July 16, 2018 - Charité’s researchers integrate open-source platform into the ‘Human Brain Project’
July 16, 2018 - SUSU scientists develop rehabilitation device for people with lower limbs injuries
July 16, 2018 - Researchers find definite increase in scooter-related injuries
July 16, 2018 - Researchers solve mystery of final blood group system
July 16, 2018 - Researchers develop near-infrared fluorophores-based PDT to cure cancer with less side effects
July 16, 2018 - Traumatic brain injury biomarker could help predict patient prognosis
July 16, 2018 - Researchers to investigate role of hormones in mosquito’s ability to use human blood for egg production
July 16, 2018 - AHA: Doctor Makes Lifesaving House Call in His Own Home
July 16, 2018 - Nearsightedness – Genetics Home Reference
July 16, 2018 - Study shows biomarker panel boosts lung cancer risk assessment for smokers
July 16, 2018 - Researchers find link between bereavement during pregnancy, child’s mental health | News Center
July 16, 2018 - Legalizing same-sex marriage has meaningful effects on health care access for sexual-minority men
July 16, 2018 - New York to allow medical marijuana as substitute to opioids
July 16, 2018 - Reducing tapeworm infection could improve academic performance, reduce poverty | News Center
July 16, 2018 - Researchers describe key role of enzyme in regulating immune response against Chagas disease parasite
July 16, 2018 - Johnson & Johnson Announces Publication in The Lancet Highlighting Robust Immune Response to Janssen’s Mosaic-based Preventive Vaccine Regimen for HIV
July 16, 2018 - Do Racial and Gender Disparities Exist in Newer Glaucoma Treatments?
Study finds low developmental screening and surveillance rates in the U.S.

Study finds low developmental screening and surveillance rates in the U.S.

image_pdfDownload PDFimage_print

Only about one-third of young children in the U.S. receive recommended screenings or surveillance designed to catch developmental delays. Findings reveal wide variations in rates across states, with as few as 17 percent of children under three years old receiving developmental screening in the lowest performing state. The study was led by researchers at the Johns Hopkins Bloomberg School of Public Health, with colleagues at the federal Maternal and Child Health Bureau and Oregon Health & Sciences University.

The findings, published online July 9, 2018 in JAMA Pediatrics, highlight an area ripe for improvements, despite more than a decade of initiatives designed to promote these important programs.

Approximately 12 percent to 15 percent of American children experience developmental delays or disabilities. These include conditions that affect small motor skills, such as holding a crayon; large motor skills, such as walking; or social and behavioral skills, such as talking.

Identifying these issues early is critical to getting children and their families the help they need in order to advance developmental skills–particularly before school age, when problems can affect academic performance and have lifelong consequences, explains Christina Bethell, PhD, professor in the Department of Population, Family and Reproductive Health at the Bloomberg School and director of the School’s Child and Adolescent Health Measurement Initiative.

Since the American Academy of Pediatrics (AAP) first recommended developmental screening in 2001, a variety of initiatives at the state and federal levels have been implemented to promote screening, which often involves parents completing a standardized questionnaire at their child’s well visits, and developmental surveillance, which involves health care providers asking specific questions about concerns in learning, development or behavior.

However, explains Bethell, until now, it has been unclear how many providers are actually following these recommendations.

To answer this question, she and her colleagues used data from the 2016 National Survey of Children’s Health (NSCH), a nationally representative, parent-completed survey of U.S. children that has been administered periodically to thousands of families since 2003. The researchers focused on children ages 9 to 35 months, the target age for AAP guidelines for developmental screening and the focus for a variety of state and federal “birth-to-three” initiatives.

A child was considered to have received developmental screening if a parent or other caregiver responded affirmatively to validated questions in the survey about whether a doctor or other health care provider had them complete a questionnaire about developmental observations or concerns. A child was considered to have received developmental surveillance if a doctor or other health care provider had asked them about developmental concerns.

An analysis of this data showed that in 2016, nationally, only 30.4 percent of children in this age bracket had received a developmental screening in the past year. A slightly higher number, 37.1 percent, had received developmental surveillance. Less than 1 in 5 children had received both screening and surveillance, while just over half had received neither.

When the researchers broke down the numbers by state, Bethell says, they made a startling finding: the gap between the lowest and highest performing states stretched 40 percentage points for both screening and surveillance. While 17.2 percent of children in Mississippi received screening, 58.8 percent received it in Oregon. Similarly, 19.1 percent of children received surveillance in Mississippi, and 60.8 percent received it in Oregon.

Demographic characteristics, including primary household language, family structure, household education and income, had a slight effect on whether children received screening and surveillance. However, the only factor that significantly predicted both screening and surveillance was whether a child had health care that met the criteria for being a medical home–for example, having a usual source of care, having a personal physician or nurse, and receiving family-centered care.

Bethell notes that it’s difficult to determine why there is such a broad divide between states in administering developmental screening and surveillance. However, she adds, the research shows that it is possible to dramatically improve. Oregon had one of the lowest rates of developmental screening in 2007, Bethell explains, and has since doubled its rate to become the top performer in the nation. She and her colleagues suggest in their study that this success may be attributable to tracking and incentivizing quality improvement through pay-for-performance metrics in coordinated care organizations, established as part of a Medicaid demonstration waiver.

Performance incentives, new technology and other factors could help improve success rates in other states as well, Bethell says. The authors note that changes to the methods for the 2016 NSCH prevent direct comparison to prior years of the NSCH, making this study critical to establish a basis for further tracking improvements in screening and surveillance over time.

“We need to create comprehensive systems to optimize early child development in the first 1,000 days of life, which we know is dramatically important for child and population health,” says Bethell. “Even in the best states, only about half of children are receiving screening and surveillance. We still have a long way to go.”

“Developmental Screening and Surveillance in Early Childhood: Results from the 2016 National Survey of Children’s Health” was written by Ashley H. Hirai, PhD, Michael D. Kogan, PhD, Veni Kandasamy, MSPH, Colleen Reuland, MS, Christina Bethell, PhD.

Source:

https://www.jhsph.edu/news/news-releases/2018/developmental-screening-and-surveillance-rates-remain-low-new-study-suggests.html

About author

Related Articles