Breaking News
August 18, 2018 - Researchers describe promising strategy to remove melanoma’s most powerful defenses
August 18, 2018 - Women with polycystic ovary syndrome dissatisfied with medical care
August 18, 2018 - Research discoveries reveal insights behind neurological degeneration
August 18, 2018 - Researchers win multi-million Euro award to conduct research into liver disease
August 18, 2018 - Survey highlights variations in practice of airway management in pediatric intensive care units
August 18, 2018 - UK students win sponsorship from Promega Corporation
August 18, 2018 - Janssen Reports Positive Topline Results for ATLAS Phase III Study of a Novel, Long Acting Injectable Two-Drug Regimen for the treatment of HIV-1
August 18, 2018 - PSD as a molecular platform for understanding synapse formation and plasticity
August 18, 2018 - Improved visual communication could help patients to make informed health-care decisions
August 18, 2018 - New algorithm helps identify and manage diabetic patients at increased fracture risk
August 18, 2018 - Microscopic insect odour detecting mechanisms discovered
August 18, 2018 - Researchers develop new approach to study how tuberculosis infects people
August 18, 2018 - FDA Approves Kalydeco (ivacaftor) for Cystic Fibrosis in Children Ages 12 to
August 18, 2018 - An ion channel differentiates newborn and mature neurons in the adult brain
August 18, 2018 - Socio-economic position associated with pregnant women’s exposure to environmental hazards
August 18, 2018 - Voters to settle dispute over ambulance employee break times
August 18, 2018 - AGA urges policymakers and stakeholders to improve affordability of drugs
August 18, 2018 - Increasing dietary protein may lower risk of diabetes in people with NAFLD
August 18, 2018 - New HIV therapy suppresses viral replication and increases immune cells in drug-resistant patients
August 18, 2018 - Broad Genetic Testing for NSCLC May Not Improve Survival
August 18, 2018 - Discovery opens door for synthetic opioids with less addictive qualities
August 18, 2018 - Transgenic rice plant extracts could help stop the spread of HIV
August 18, 2018 - Hologic’s Cynosure division partners with Porter Instrument to distribute nitrous oxide and oxygen system
August 18, 2018 - Two thyroid medications recalled by FDA
August 18, 2018 - Forecast Sees Abnormal Heat Worldwide Through 2022
August 18, 2018 - Childhood absence epilepsy – Genetics Home Reference
August 18, 2018 - Fearing hard Brexit, UK drugmakers stockpile to protect lives
August 18, 2018 - Discovery may help broaden the scope of defenses against HPV
August 18, 2018 - When they start thinking green, they see green
August 18, 2018 - Scientists introduce microfluidics-based chip for manipulation and analysis of single cells
August 18, 2018 - Researchers design new way to grow nose cells for treating spinal cord injuries
August 18, 2018 - New light shed on relationship between calorie-burning fat and muscle function
August 18, 2018 - Surgery Saturday Instagram series takes you inside Stanford’s OR
August 18, 2018 - Researchers uncover surprising new role for inhibition in the cerebellum
August 18, 2018 - Children have better nutrition when they live near forests, global study shows
August 18, 2018 - OHSU professor conducts clinical trial with artificial pancreas using Xeris’ liquid glucagon
August 18, 2018 - HSS takes young patients with physical challenges on a surfing trip
August 18, 2018 - Study shows electronic health records leave doctors and patients unsatisfied
August 18, 2018 - Study uncovers mechanism that affects multiplication of dengue virus lineage
August 18, 2018 - Theravance Biopharma Reports Positive Top-Line Four-Week Data from Phase 2 Trial of TD-9855 for the Treatment of Symptomatic Neurogenic Orthostatic Hypotension
August 18, 2018 - Animations prove effective in accurately measuring pain
August 18, 2018 - Three faculty members appointed to endowed positions | News Center
August 18, 2018 - New technique detects, measures, analyzes unevenly charged biomolecules
August 18, 2018 - Brief exposures to stressors can be beneficial to cells, shows study
August 18, 2018 - UTHealth-led survey shows much work remains to increase safety of e-health records
August 18, 2018 - Researchers use super-resolution microscope to unravel secrets of deadly Nipah virus
August 18, 2018 - Scientists identify pathways that reveal insights into mechanism of lung cancer etiology
August 18, 2018 - Rush’s health care IT leaders reach White House
August 18, 2018 - FDA approves marketing of brainsway deep transcranial magnetic stimulation system for OCD
August 17, 2018 - OUHSC gets $20 million grant to advance research and patient care for Oklahomans
August 17, 2018 - Sperm morphology differs depending on qualities of male bird
August 17, 2018 - Texas A&M researchers develop clay-based platform to grow blood vessels
August 17, 2018 - FDA Approves Expanded Indication for Orkambi (lumacaftor/ivacaftor) in Children Ages 2-5 Years
August 17, 2018 - Caring for Concussions | NIH News in Health
August 17, 2018 - Team explores diabetes drug’s ability to treat RSV infection
August 17, 2018 - New imaging technique can spot tuberculosis infection in an hour | News Center
August 17, 2018 - PolyU researchers design new self-fitting scaffold to induce bone regeneration
August 17, 2018 - CartiHeal and LSU Health successfully enroll first two patients in Agili-C IDE pivotal study
August 17, 2018 - Less-invasive options are slowing disease progression in glaucoma patients
August 17, 2018 - Researchers discover new promising target point for cancer and diabetes therapies
August 17, 2018 - Podcast: KHN’s ‘What the Health?’ See you in court!
August 17, 2018 - New mobile phone application enables early detection of cerebral ictus
August 17, 2018 - AJMC addresses role of community pharmacies in boosting adult vaccination rates
August 17, 2018 - UK’s leading sight loss charity invites applications from brightest minds in ophthalmic research
August 17, 2018 - Alternative devices can help when autoinjectors are unavailable
August 17, 2018 - Researchers produce artificial placenta model that closely resembles natural organ
August 17, 2018 - Study offers possibility of squelching a focal epilepsy seizure before symptoms appear
August 17, 2018 - FDA Alert: Temporary Total Artificial Heart Companion 2 Driver System by SynCardia Systems: Letter to Health Care Providers
August 17, 2018 - New statewide program in North Dakota aims to stem opioid misuse
August 17, 2018 - Researchers discover why sepsis from a staph infection causes organ failure
August 17, 2018 - Stony Brook University’s new medical students start a transformative journey
August 17, 2018 - Revealed: The molecular mechanism underlying hypertrophic cardiomyopathy | News Center
August 17, 2018 - New modeling studies highlight urgent need for effective drug policy reforms to prevent HIV
August 17, 2018 - Research explores relationship between personal history of infectious fever and cancer risk
August 17, 2018 - Study finds rise in cases of progressive massive fibrosis among U.S. coal miners
August 17, 2018 - NEDBELS project examines impact of neurodiversity concept on legal systems
August 17, 2018 - Seeking solutions to treat scleroderma
August 17, 2018 - Statins may improve conditions of people with rare lung disease
August 17, 2018 - Study finds why some people with brain markers of Alzheimer’s never develop dementia
August 17, 2018 - Life Biosciences contributes $100,000 to fund its biomedical innovation course on aging
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