Breaking News
October 18, 2018 - Health Highlights: Oct. 15, 2018
October 18, 2018 - Largest study of ‘post-treatment controllers’ reveals clues about HIV remission
October 18, 2018 - Bad Blood in Silicon Valley: A conversation with John Carreyrou
October 18, 2018 - ANTRUK’s Annual Lecture sends out message on shortage of funds for antibiotic research
October 18, 2018 - NAM special publication outlines steps to ensure interoperability of health care systems
October 18, 2018 - Novel method uses just a drop of blood to monitor effect of lung cancer therapy
October 18, 2018 - New blood test could spare cancer patients from unnecessary chemotherapy
October 18, 2018 - Training young researchers to work with data volumes arising in the health sector
October 18, 2018 - New Metrohm IC method is reliable and convenient to use for zinc oxide assay
October 18, 2018 - Global AIDS, TB fight needs more money: health fund
October 18, 2018 - Understanding the forces that cause sports concussions
October 18, 2018 - Research points to new target for treating periodontitis
October 18, 2018 - New tool improves assessment of postpartum depression symptoms
October 18, 2018 - From Biopsy to Diagnosis
October 18, 2018 - Sexual harassment and assault linked to worse physical/mental health among midlife women
October 18, 2018 - Stumped by medical school? A Q&A with a learning specialist
October 18, 2018 - Targeting immune checkpoints in microglia could reduce out-of-control neuroinflammation
October 18, 2018 - FDA Approves Talzenna (talazoparib) for gBRCAm HER2-Negative Locally Advanced or Metastatic Breast Cancer
October 18, 2018 - Sleeping Beauty technique helps identify genes responsible for NAFLD-associated liver cancer
October 18, 2018 - Many U.S. adults confused about primary care, study shows
October 18, 2018 - UC researcher focuses on light-mediated therapies to target breast cancer
October 18, 2018 - With philanthropic gifts, Stanford poised to make major advances in neurosciences | News Center
October 18, 2018 - Mice study shows antibiotics are not always necessary to cure sepsis
October 18, 2018 - Researchers discover why heart contractions are weaker in individuals with HCM
October 18, 2018 - Participation in organized sport during childhood may have long-term skeletal benefits
October 18, 2018 - Probiotic/antibiotic combination could eradicate drug-resistant bacteria
October 17, 2018 - More Socioeconomic Challenges for Hispanic Women With HIV
October 17, 2018 - 49,XXXXY syndrome – Genetics Home Reference
October 17, 2018 - Scientists uncover possible new causes of Tourette syndrome
October 17, 2018 - Girl undergoes unusual heart surgery after compassionate-use exemption | News Center
October 17, 2018 - Health Issues That Are Sometimes Mistaken for Gluten Sensitivity
October 17, 2018 - Elective induction of labor at 39 weeks may be beneficial option for women and their babies
October 17, 2018 - New smart watch algorithms can accurately monitor wearers’ sleep patterns
October 17, 2018 - Researchers demonstrate epigenetic memory transmission via sperm
October 17, 2018 - FDA, DHS announce memorandum of agreement to address cybersecurity in medical devices
October 17, 2018 - Health Tip: Know the Risks of Chicken Pox
October 17, 2018 - Immunotherapy effective against hereditary melanoma
October 17, 2018 - Researchers reveal new mechanism for how animal cells stay intact | News Center
October 17, 2018 - Alzheimer's Goes Under the Cryo-Electron Microscope
October 17, 2018 - Medicare for all? CMS chief warns program has enough problems already
October 17, 2018 - Metrohm Raman introduces Mira P handheld Raman system
October 17, 2018 - Expanding the knowledge about hippocampus to better understand cognitive deficits in MS
October 17, 2018 - Study of Nigerian breast cancer patients reveals prevalence of aggressive molecular features
October 17, 2018 - Many healthy children may have metabolic risk factors, finds study
October 17, 2018 - A new antibiotic could be a better, faster treatment for tuberculosis
October 17, 2018 - “I will not become a Robot Doctor”: A medical student vows to practice compassion
October 17, 2018 - Study findings may explain sporadic outbreaks of C. difficile infections in hospitals
October 17, 2018 - Purdue researchers develop new chemical process to find better drug ‘fits’ for patients
October 17, 2018 - Yale researchers develop way to attack RNA with small-molecule drugs
October 17, 2018 - New pragmatic study launched to understand the effectiveness of new type 2 diabetes drug
October 17, 2018 - Alnylam Announces Plan to Initiate Rolling Submission of a New Drug Application and Pursue Full Approval for Givosiran
October 17, 2018 - Nine cases of polio-like illness suspected in children in illinois
October 17, 2018 - Eisai enters into agreement with Eurofarma for development and sales of lorcaserin in 17 countries
October 17, 2018 - Patients once thought incurable can benefit from high-dose radiation therapy
October 17, 2018 - Researchers awarded grant to advance testing of experimental heroin vaccine
October 17, 2018 - Researchers examine SSRI use during pregnancy and major gestational malformations
October 17, 2018 - FDA grants Rare Pediatric Disease Designation for Immusoft’s Iduronicrin genleukocel-T
October 17, 2018 - Reliable Respiratory announces acquisition of Attleboro Area Medical Equipment
October 17, 2018 - Study reveals link between childhood abuse and higher arthritis risk in adulthood
October 17, 2018 - Research shows people over 65 are not performing enough physical activity
October 17, 2018 - FDA Approves Liletta (levonorgestrel-releasing intrauterine system) 52 mg to Prevent Pregnancy for up to Five Years
October 17, 2018 - Weight gain after smoking cessation linked to increased short-term diabetes risk
October 17, 2018 - Researchers find opportunity to control salt-sensitive hypertension without exercising
October 17, 2018 - Women not warned about cancer associated with breast implants
October 17, 2018 - Metrohm offers robust handheld Raman analyzer for Defense and Security
October 17, 2018 - Modeling Non-Numerical Data in Systems Biology
October 17, 2018 - Research aims to address health disparities in African-American men
October 17, 2018 - Human and cattle decoys trap outdoor-biting mosquitoes in malaria endemic regions
October 17, 2018 - High Circulating Prolactin Level Inversely Linked to T2DM Risk
October 17, 2018 - Study finds gene variant predisposes people to both Type 2 diabetes and low body weight
October 17, 2018 - Metrohm software products make it easy to comply with ALOCA and ALCOA+ guidelines
October 17, 2018 - Network of doctors identify the cause of 31 new conditions
October 17, 2018 - Notable improvement in brain cancer survival among younger patients but not much for elderly
October 17, 2018 - Scientists shed light on roles of transcription factors, TP63 and SOX2, in squamous cell carcinoma
October 17, 2018 - Costs of Medicare Diabetes Prevention Program may be higher than expected reimbursement
October 17, 2018 - Misuse of prescription opioids or benzodiazepines associated with suicidal thoughts
October 17, 2018 - New research seeks to address sex disparities in women’s health
October 17, 2018 - C-Section Rates Have Nearly Doubled Since 2000: Study
October 17, 2018 - Talking to Your Kids About STDs
October 17, 2018 - New classification of periodontal and peri-implant diseases and conditions
Developmental screening and surveillance rates remain low, new study suggests

Developmental screening and surveillance rates remain low, new study suggests

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 federal Health Resources and Services Administration, Johns Hopkins Bloomberg School of Public Health and Oregon Health & Science 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, an important 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 is now the top performer in the country with a rate that is more than double the national rate. 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.”

“Prevalence and Variation of Developmental Screening and Surveillance in Early Childhood” was written by Ashley H. Hirai, PhD, Michael D. Kogan, PhD, Veni Kandasamy, MSPH, Colleen Reuland, MS, Christina Bethell, PhD.


Explore further:
Screening tools to identify developmental delay in healthy young children not beneficial

Journal reference:
JAMA Pediatrics

Provided by:
Johns Hopkins University Bloomberg School of Public Health

About author

Related Articles