PEDS: Developmental Milestones—An Accurate Brief Tool for Surveillance and Screening

Abstract

About 16% of children have developmental-behavioral disabilities but less than one-third of the children are detected by their health care providers, probably because of the use of informal milestones checklists. The goal of this study is to determine the reliability, validity, accuracy, and utility of a new tool, PEDS: Developmental Milestones (PEDS:DM). Data from a nationally representative sample of 1619 children administered developmental diagnostic measures were mined for items that best predicted performance in each developmental domain. A total of 112 met inclusion criteria, that is, sensitivity/specificity ≥ 70%. For each domain/age level (birth to 8 years of age), sensitivity to performance less than or equal to the 16th percentile on diagnostic measures was 83% and specificity was 84%. Reliability was high (test—retest, .98 to .99; interrater, .82 to .96; κ, .81). The readability level was 1.8 grades (range 1.1 to 2.6). The PEDS:DM appears to be a validated, accurate alternative to informal milestones checklists that are a probable contributor to underdetection of children with delays and disabilities.

Keywords

developmental screening behavioral screening developmental-behavioral disabilities developmental milestones early intervention

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References

American Academy of Pediatrics, Council on Children With Disabilities; Section on Developmental Behavioral Pediatrics; Bright Futures Steering Committee; 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;118:405-420.

US Department of Education. National Assessment of Title I: Interim Report to Congress. Available at: http:// www.ed.gov/rschstat/eval/disadv/title1interimreport/index.html. Published February 2006. Accessed April 17, 2007.

Foorman BR , Francis DJ , Fletcher JM , Schatschneider C. , Mehta P. The role of instruction in learning to read: preventing reading failure in at-risk children. J Educ Psychol. 1998;90:37-55.

Glascoe FP Teacher's global ratings and students' academic achievement. J Dev Behav Pediatr. 2001;22;163-168.

Pinto-Martin JA , Dunkle M. , Earls M. , Fliedner D. , Landes C. Developmental stages of developmental screening: steps to implementation of a successful program. Am J Public Health. 2005;95:1928-1932.

Earls MF , Hay SS Setting the stage for success: implementation of developmental and behavioral screening and surveillance in primary care practice—the North Carolina Assuring Better Child Health and Development (ABCD) Project. Pediatrics. 2006;118:183-188.

Rydz D. , Shevell MI , Majnemer A. , Oskoui M. Developmental screening. J Child Neurol. 2005 ;20:4-21.

Sand N. , Silverstein M. , Glascoe FP , Gupta VB , Tonniges TP , O'Connor KG

Pediatricians' reported practices regarding developmental screening: do guidelines work? Do they help?

Pediatrics. 2005;116:174-179.

Sices L. , Feudtner C. , McLaughlin J. , Drotar D. , Williams M. How do primary care physicians identify young children with developmental delays? A national survey. J Dev Behav Pediatr. 2003;24:409-417.

10.

Glascoe FP Parents' Evaluation of Developmental Status: An Evidence-Based Approach to Developmental-Behavioral Screening and Surveillance. Nashville, TN: Ellsworth & Vandermeer Press; 2007.

11.

Glascoe FP , Robertshaw NS PEDS: Developmental Milestones. Nashville, TN: Ellsworth & Vandermeer Press; 2007.

12.

Kemper KJ , Kelleher KJ Family psychosocial screening: instruments and techniques. Ambul Child Health. 1996; 4:325-339.

13.

Reznick JS , Schwartz BB When is an assessment an intervention? Parent perception of infant intentionality and language. J Am Acad Child Adolesc Psychiatry. 2001;40:11-17.

14.

Mendelsohn AL , Mogilner LN , Dreyer BP , et al. The impact of a clinic-based literacy intervention on language development in inner-city preschool children. Pediatrics. 2001;107:130-134.

15.

BRIGANCE® A. Inventory of Early Development—II. North Billerica, MA: Curriculum Associates; 2004.

16.

Glascoe FP Technical Manual of the BRIGANCE® Inventory of Early Development—II . North Billerica, MA: Curriculum Associates; 2004.

17.

BRIGANCE® A. Comprehensive Inventory of Basic Skills—Revised. North Billerica, MA: Curriculum Associates; 1999.

18.

Glascoe FP Standardization and Validation Manual for the BRIGANCE® Diagnostic Comprehensive Inventory of Basic Skills—Revised. North Billerica, MA: Curriculum Associates; 1999.

19.

Breese P. , Burman W. Readability of notice of privacy forms used by major health care institutions . JAMA. 2005;293:1593-1594.

20.

American Academy of Pediatrics, Committee on Children with Disabilities. Developmental surveillance and screening of infants and young children. Pediatrics. 2001;108:192-196.

21.

Sameroff AJ , Seifer R. , Barocas R. , Zax M. , Greenspan S. Intelligence quotient scores of 4-year-old children: social-environmental risk factors. Pediatrics. 1987;79:343-350.

22.

Blair M. , Hall DMB. From health surveillance to health promotion: the changing focus in preventive children's services. Arch Dis Child. 2006;91;730-735.

23.

Dobrez 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;108:913-922.

24.

Hix-Small H. , Marks K. , Squires J. , Nickel R. Impact of implementing developmental screening at 12 and 24 months in a pediatric practice. Pediatrics. 2007; 120: 381-389.