MODULE 2

Objectives

Overview

• Goals and Concerns
• Parent/Child Interactions
• Developmental Surveillance
• Screening

Key Components

• Self-Control
• Sleep
• Eating
• Toilet Learning
• Self-Care
• Managing Emotions
• A Moral Sense
• Positive Parent-Child Relationships
• Competence
• Socialization
• Sibling Rivalry
• The New Baby
• Friends
• Cooperation
• Aggression
• School Readiness

Developmental Checklist

Office Practices

Community Practices

Developmental Screening in Early Childhood

Few developmental tests are known to be culturally bias-free. When administering tests to members of culturally diverse groups, it is essential to be sensitive and well informed.

Be sure to:

• Become knowledgeable about the culture and language of the child being tested
• Respect the family's cultural values
• Consult the norming procedures that accompany the testing manual
• Ensure all tests, evaluation materials, and procedures are given in the native language of the child’s family or through other modes of communication (when feasible)

Recommendations

American Academy of Pediatrics and Bright Futures recommend screening all young children with a validated developmental screening tool at:

• 18 and 30 months
• Any time a parent raises concern

Validated Screening Tools

Identifying and monitoring developmental status is more accurate when providers use validated screening tools.

Parent-completed Tools

• Parents' Evaluation of Developmental Status (PEDS) (through 4 years)
• Ages & Stages Questionnaires (ASQ) (through 4 years) Note: ASQ is designed for use in the home, but may also be used in clinical settings.
• Ages & Stages Questionnaires: Social-Emotional (ASQ:SE) (through 4 years)
• Pediatric Symptom Checklist (PSC) (ages 2-4 years) Also available in English, Spanish, and Japanese from the Massachusetts General Hospital

Provider-administered Tools

• Battelle Developmental Inventory Screening Tool-2nd ed. (BDI-ST) (through 4 years)
• Bayley Infant Neurodevelopmental Screen (BINS) (through 24 months)
• Brigance Screens-II (through 4 years)

 

Autism Screening

American Academy of Pediatrics and Bright Futures recommend screening with an autism-specific tool at:

• 18 and 24 months
• Any time a parent raises concern

Centers for Disease Control and Prevention recommend screening all children for autism spectrum disorders during well-child visits at:

• 18, 24, and 30 months

Autism Screening Tools

• Modified Checklist for Autism in Toddlers (M-CHAT) (16-48 months)
• Pervasive Developmental Disorders Screening Test-II (PDDST-II), Stage 1-Primary Care Screener (12-48 months)

Resources for Providers

Identifying Infants and Young Children With Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening Area of Interest: Use of Clinical Screening Tools for Case Identification Clinical screening tools can increase the identification of psychosocial problems and mental disorders in primary care settings. Moreover, such tools can provide an important framework for discussing psychosocial issues with families. These screening tools can be grouped into three general categories: Broad psychosocial tools that assess overall functioning, family history, and environmental factors; deal with a wide range of psychosocial problems; and identify various issues for discussion with the child or adolescent and family. An example of this type of tool is the Pediatric Intake Form, which can be used to assess such issues as parental depression and substance use, gun availability, and domestic violence (Kemper and Kelleher, 1996a, 1996b). Tools that provide a general screen for psychosocial problems or risk in children and adolescents. An example of this type of tool is the Pediatric Symptom Checklist (Jellinek et al., 1988, 1999). Tools that screen for specific problems, symptoms, or disorders. The Conners’ Rating Scales for ADHD (Conners, 1997) and the Children's Depression Inventory (Kovacs, 1992) are examples of this type of screening tool. Often a broader measure such as the Pediatric Symptom Checklist is used first, followed by a more specific tool focused on the predominant symptoms for those that screen positive on the broader measure. (Some of the more specific tools may not be readily available to primary care health professionals or may require specialized training.) Source: Bright Futures in Practice: Mental Health,—Volume I, Practice Guide Developmental Screening for Health Care Providers