Many Pediatricians Aren't Testing Tots for Developmental
MONDAY, June 27 (HealthDay News) -- Although there's been some
improvement in the number of pediatricians checking toddlers for
developmental delays, more than half still don't routinely do so, a
new study finds.
In 2002, just 23 percent of pediatricians reported always or
almost always using one or more standardized developmental
screening tools for infants and toddlers up to 35 months of age. By
2009, that number had risen to just under 48 percent, reported the
Early detection of developmental issues such as autism or
impaired hearing is key to initiating early and effective
treatment, experts said.
"There's more and more evidence that starting early intervention can make a big difference in developmental outcomes than if we wait," explained study co-author Dr. Nina Sand-Loud, an assistant professor of pediatrics and a developmental-behavioral pediatrician at Dartmouth-Hitchcock Medical Center and Dartmouth Medical School in Hanover, N.H.
The new study, published in the July issue of
Pediatrics, "is a follow-up to a study done in 2002 looking at the number of pediatric providers doing standardized screening on their patients," she said. "At that time, the number was pretty low. But, since that time, a lot of specific recommendations have been made about screening, so we looked to see if there was a change in practice."
Prior research has found that more than 40 percent of parents
have at least one or more concerns about their young child's
physical, behavioral or social development, according to the
The current study included a national, random sample of
pediatricians. Almost 900 pediatricians responded in 2002, while
927 responded in 2009.
The researchers asked about a number of standardized screening
tests for children under 3 years of age, such as the Denver
Developmental Screening Test, Ages & Stages Questionnaires, or
whether or not the pediatrician had developed their own checklist
to use during well-child visits.
While more than twice as many pediatricians reported in 2009
that they were doing at least one developmental screening than in
2002, more than half still weren't participating in standardized
Time was probably the biggest reason that doctors gave for not
doing formal developmental screenings, said Sand-Loud.
Also, some doctors may feel that they can spot any developmental
problems by simply watching the child during the visit and talking
to the parents, she said. "But that still misses a big portion of
kids with developmental delays," Sand-Loud said.
Dr. Andrew Adesman, chief of developmental and behavioral
pediatrics at Steven and Alexandra Cohen Children's Medical Center
in New Hyde Park, N.Y., agreed. "Even though parental concerns will
often help pediatricians identify most children with developmental
problems, the goal of developmental screening is also to identify
children with less severe, but nonetheless significant
developmental delays that may not be recognized by parents or
pediatricians without formal screening."
He said that he thinks more pediatricians will soon be using
formal developmental screenings. Electronic medical records and
recent changes in insurance company reimbursements will likely help
more pediatricians add these tests to their practices, he
Sand-Loud said current recommendations call for developmental
screening at nine, 18 and either 24 or 30 months during well-child
But if parents have any concerns, they should let their
pediatrician know, she said.
Parents may notice emerging issues with their children, but may
"let others reassure them that it's nothing, or they may
rationalize it themselves. But it's worthwhile to be proactive.
Your family doctor or pediatrician is a good resource, and families
should feel comfortable bringing up developmental concerns," she
said, adding, "It's better to go and make sure everything's
Visit the American Academy of Pediatrics' Healthy Children Web
site to learn what
developmental milestones to expect from a 12 month
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