Since the early identification of developmental and behavioral disorders is critical to the well-being of children and their families, screening should be an integral function of the primary care medical home.  The American Academy of Pediatrics recommends that parents of children be given screening questionnaires at 9, 18, and 30 months, but many doctors choose to instead screen at 24 months since the 30-month visit is not often reimbursable by third party payers. 

Here are 7 reasons why developmental screening is important at 9, 18, 24/30 months and when surveillance shows risk at other visits:

1. To celebrate milestones and recognize developmental promotion of all children. By checking the child’s abilities, parents will learn what is fun for the young child at a particular stage of development and may find tasks that are enjoyable activities that could promote positive parent-child relationships and deepen the parent-child bond. 
2. Developmental and behavioral screening can lead to an earlier diagnosis allowing for early treatment and supportive services. Studies show early intervention can greatly improve a child’s development and help them make the most of their abilities. Early intervention also provides support for parents and siblings of children with special needs and can help build a more caring and nurturing environment for the entire family.
3. Clinical observation only detects 30% of children with significant delays. Developmental and behavioral screenings can lead to the diagnosis of Autism Spectrum Disorder, emotional disturbances, and speech and language disorders that often go undetected until children enter school.
4. Delayed diagnosis and interventions cost the children, families and society money, time, and worry. Late diagnosis forces states, schools, and taxpayers to foot the bill for expensive special education fixes when early intervention may have minimized the cost.
5. Delays and/or deficits in one area of a child’s development or health can affect the development of other abilities as well. For instance, newborn and early childhood hearing screening can lead to a diagnosis which can alert the physician and parent to seek a remedy. Continued hearing loss can cause language, communication and socio-emotional growth issues.
6. Both the Center for Disease Control and the American Academy of Pediatrics strongly recommend developmental, behavioral and health screening. In addition, the Individuals with Disabilities Education Act (IDEA) Amendments of 1997 mandate early identification of, and intervention for, developmental disabilities through the development of community-based systems.
7. States are required to provide comprehensive and preventative health care services for children under age 21 who are enrolled in Medicaid under the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) regulations.

Most screening for developmental delays and behavioral and health issues is fairly simple and can be done through paper and pencil questionnaires administered in the doctor’s office or can be done online in the comfort of the parent’s home using CHADIS on a computer, tablet, or smartphone. These screens are paid for by Medicaid and most insurers using code 96110.  Regardless of how screening is performed, the future of children’s abilities is at stake.

Click here or more information about CHADIS or the Bright Futures Schedule  

CHADIS is a unique screening, decision support and patient engagement system designed to streamline and optimize healthcare by providing Clinicians with evidence-based data that improves diagnosis and management of health, emotional, developmental and behavioral concerns.

Ask your physician for any of the many resources CHADIS has on child development.

 Source:
American Academy of Pediatrics; Council on Children With Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee and Medical Home Initiatives for Children With Special Needs Project Advisory Committee.Identifying Infants and Young Children With Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening. Pediatrics. 2006;118(1):405-420.
Additional DSS Information
Pediatrics Article (2010): Implementing Developmental Screening and Referrals: Lessons Learned From a National Project
Pediatrics Article (2011): Trends in the Use of Standardized Tools for Developmental Screening in Early Childhood: 2002–2009 andAbstract Presented at 2010 PAS Meeting
AAP News (2006): AAP policy, algorithm assist in early developmental screens
AAP News (2011): Pediatricians’ use of developmental screening tools on the rise 
AAP News (2011): Efforts must continue to improve developmental screening rates, payment