Screening for Developmental Disabilities

Abstract

Early identification and treatment of developmental disabilities that cause school-related problems is of considerable importance to practicing pediatricians. The motivation for early identification programs is: (1) to identify the barriers to children's participation in the educational process, (2) to assist these children and their families in finding medical, educational, or other appropriate services, and (3) to overcome or mitigate the adverse effects of the disability. The need for visual and auditory examinations to identify deficits in these areas is readily accepted. Use of these examinations is standard practice. However, use of preschool examinations for developmental problems, potential learning disabilities, and mental retardation needs to be encouraged. These disorders, which may be less obvious, may have a major impact on the physical and mental health of children and their families. Screening identifies most children who have or who are at risk of having developmental disabilities. Pediatricians have the opportunity to incorporate screening examinations in the context of well-child care and to refer their patients for confirmatory testing by an appropriate consultant, if indicated. The conduct of a scheduled health evaluation, as described in Academy guidelines,1 includes a systematic evaluation of development at all ages, commencing in the perinatal period. Simple instruments that identify developmental problems are readily available.2-4 These tests assure early identification of a range of developmental disabilities. Specific safeguards, including carefully developed guidelines and procedures, should accompany the application of such screening tests when practiced as part of a large community-based program, as well as in the pediatrician's office. Participation by pediatricians in the development and implementation of these screening procedures will assure that such efforts are comprehensive and effective.