With as many as 1 in 4 children at risk for developmental delay, universal early childhood screening provides an opportunity to identify delays early and intervene during the most critical period of development.1,2 Considering that standard developmental screenings may not reveal indications of autism spectrum disorder (ASD) nor social-emotional concerns, it is important to conduct ASD-specific and social-emotional screenings as well.3 However, approximately 40% of pediatricians do not consistently complete recommended developmental screenings.4
The AAP recommends conducting developmental surveillance at every health supervision visit and conducting developmental screening using formal, validated tools at 9, 18, and 30 months or whenever surveillance reveals a concern.5 In addition, the AAP recommends that all children be screened for autism spectrum disorder at 18 and 24 months.3 Furthermore, the AAP recommends that children are screened with formal, validated tools at regular intervals for behavioral and emotional problems beginning in the first year of life.
Click here to view tools to assess early childhood development and here for resources to implement a screening program in your practice.
Approximately 10 percent of women suffer from depression during the postpartum period, but it is estimated that fewer than half of cases are recognized.6 Children of mothers with depression are more likely to have cognitive, neurological, and motor delays and to have ongoing behavioral challenges.9
Screening for perinatal depression increases opportunities for intervention, thereby improving outcomes for both mothers and their children.7 Pediatric health care providers are well-positioned to screen women for postpartum depression due to their frequent contact with families during the child’s first year of life.
The AAP recommends integrating postpartum depression screening and surveillance at the 1-, 2-, 4-, and 6-month visits.7
Click here to view tools to assess maternal depression and here for resources to implement a screening program in your practice.
Social Determinants of Health
In the absence of protective relationships, exposure to toxic stress such as poverty and adverse childhood experiences can disrupt the architecture of a child’s developing brain, leading to long-term behavioral and health problems8. In addition, factors such as food insecurity, unsafe housing, and domestic or community violence pose a direct threat to the health of children.9
Nearly half of all children live in poverty or near poverty, and about a quarter of children have been impacted by at least one adverse childhood experience.10 As part of their role in supporting healthy development and providing anticipatory guidance, pediatric health care providers can identify toxic stress and refer families to services, as well as build protective factors in children and families to ameliorate the effects of these exposures.
The AAP recommends using a written screener or verbally asking family members questions about basic needs such as food, housing, and heat during patient encounters.10
Click here to view tools to assess these factors and here for additional resources to implement a screening program in your practice.