Child Development

Facts about Developmental Screening Tools

What screening tools can do

Screening tools are designed to help identify children who might have developmental delays. Screening tools can be specific to a disorder (for example, autism), an area (for example, cognitive development, language, or gross motor skills), or they may be general, encompassing multiple areas of concern.

What screening tools cannot do

Screening tools do not provide conclusive evidence of developmental delays and do not result in diagnoses. A positive screening result should be followed by a thorough assessment. Screening tools do not provide in-depth information about an area of development.

What to consider when selecting a screening tool

• Domain or domains the screening tool covers. That is, what are the questions that need to be answered? What types of delays or conditions do you want to detect?

• Psychometric properties. These have to do with the overall ability of the test to do what it is meant to do.

  • The sensitivity of a screening tool is the probability that it will correctly identify children who exhibit developmental delays or disorders.

  • The specificity of a screening tool is the probability that it will correctly identify children who are developing normally.
     

• Characteristics of the children. For example, age and presence of risk factors.

• Setting in which the screening tool will be administered (for example, physician office, daycare setting, community screening). Screening can be performed by professionals, such as nurses, or teachers or by trained paraprofessionals.

Myths about Developmental Screening Tools

Myth: There are no adequate screening tools for preschoolers.
Fact: While this may have been true decades ago, today sound screening measures exist. Many screening measures have sensitivities and specificities over 70%.^1,2

Myth: It takes a great deal of training to administer screening correctly
Fact: Training requirements are not extensive for most screeners. Many can be administered by paraprofessionals.

Myth: Screening takes a lot of time.
Fact: Many screening instruments take less than 15 minutes to administer, and some require only about 2 minutes of professional time. ^2,3

Myth: Tools that incorporate information from the parents are not valid.
Fact: Parents’ concerns are generally valid and are predictive of developmental delays. Research has shown that parental concerns detect 70% to 80% of children with disabilities.^4,5

Today, a number of good screening tools are available that are designed for a variety of settings, ages, and purposes. Some screening tools are used primarily in pediatric practices, while others are used by school systems or in other community settings.

¹Committee on Children and Disabilities, American Academy of Pediatrics. Developmental surveillance and screening for infants and young children. 2001;108(1):192-6.
²Glascoe FP. Collaborating with Parents. Nashville, Tennessee: Ellsworth & Vandermeer Press, Ltd; 1998.
³Dobrez D, Sasso A, Holl J, Shalowitz M, Leon S, Budetti P. Estimating the cost of developmental and behavioral screening of preschool children in general pediatric practice. Pediatrics 2001; 108:913-22.
⁴Glascoe, F. P. Evidence-based approach to developmental and behavioral surveillance using parents’ concerns. Child: Care, Health, and Development, 2000; 26:137-49
⁵Squires J, Nickel R E, and Eisert D. Early detection of developmental problems: Strategies for monitoring young children in the practice setting. Journal of Developmental and Behavioral Pediatrics 1996;17:420-7..

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National Center on Birth Defects and Developmental Disabilities

The National Center on Birth Defects and Developmental Disabilities (NCBDDD) promotes the health of babies, children, and adults, and enhances the potential for full, productive living.  Our work includes identifying the causes of birth defects and developmental disabilities, helping children to develop and reach their full potential, and promoting health and well-being among people of all ages with disabilities.