DEVELOPMENTAL ASSESSMENTS IN THE PEDIATRIC OFFICE Neal Halfon, Michael Regalado, Harvinder Sareen, Moira Inkelas, Colleen Peck, Frances P. Glascoe, Lynn Olson Pediatrics, UCLA, Los Angeles, CA; Pediatrics, Cedars-Sinai Medical Center, Los Angeles, CA; Community Health Sciences, UCLA, Los Angeles, CA; Foundation for Accountability, Portland, OR; Pediatrics, Vanderbilt University, Nashville, TN; Practice and Research, American Academy of Pediatrics, Elk Grove Village, IL

BACKGROUND: AAP and Bright Futures guidelines recommend that young children's development be assessed at each child visit. The extent to which physicians actually conduct developmental assessments (DA) and parents recall DAs is not known. This is important if parent reports are used to rate quality in consumer surveys.

OBJECTIVE: To determine the proportion of children 4-35 months ever receiving DAs and identify disparities by demographic and healthcare factors.

DESIGN/METHODS: The National Survey of Early Childhood Health (NSECH) is a telephone survey of 2,068 parents of children 4 to 35 months old. It includes FACCT-PHDS measures of preventive care, PEDS for parent concerns about developmental risk, and CAHPS measures of satisfaction. Children were classified as having received a DA in response to two questions - whether their child's providers ever told them that they were doing a "developmental assessment" and/or they recalled explicit components of a DA, such as stacking blocks or throwing a ball.

RESULTS: About 57% of parents say their child ever received a DA. Receipt of DA was not associated with health insurance or usual source of care. Parents of children who ever received a DA give more positive reports of family centered care (mean 71.9 vs 60.6, p<.01), higher satisfaction with check-ups (mean 88.9 vs 84.3, p<.01), more frequently report having "adequate" time in the most recent well child visit (60 vs 31%, p<.01), and reported longer visits with the provider (mean 19 vs 16 mins, p<.01). Logistic regression shows that odds of ever having a DA increases with child age and with higher maternal education (only hs OR 1.5, CI 1.02-2.25; more than hs OR 1.6, CI 1.06-2.43) but not with parent concerns about developmental risk. Receipt of DA is independently predictive of satisfaction with well-child care (p<.01) and positive reports of family centered care (p<.01) in OLS regression controlling for demographic and health system factors.

CONCLUSIONS: Although guidelines endorse routine provision of DAs, parents of many children do not report DAs. Parents of young children who report DAs also report higher family centered care and greater overall satisfaction.