The American Academy of Pediatrics (AAP) released a statement recommending that primary care providers perform developmental screening with a standardized instrument for all 9-, 18-, 24-, or 30-month well-child visits. Despite evidence-based recommendations by the AAP, numerous pediatric practices do not currently use a standardized instrument for well-child visits. This quality improvement project aimed to determine the feasibility of implementing the Ages and Stages Questionnaire (ASQ), a validated developmental screening tool, at a pediatric primary care practice. In order to accurately assess implementation barriers and benefits, this feasibility study would have determined if the ASQ was the right fit for this pediatric practice. The first phase of implementation would have begun with the 9-month well-child visits and using the same process, later expanded to include the 18- and 24-month visits. The Plan-Do-Study-Act (PDSA) method would have provided the implementation framework for this project and the project would have been written utilizing the SQUIRE (Standards for Quality Improvement Reporting Excellence) guidelines. However, due to unforeseen complications, this project was unable to be completed as planned. Instead, this project discusses outcomes of the DNP project without data, and provides guidance and points of consideration for future implementation in pediatric primary care settings.

Much emphasis has been placed on early detection of developmental delays and disabilities due to increased knowledge regarding the important role early intervention can play in a young child's development. The American Academy of Pediatrics (AAP) published policy statements in 2001 and 2006 describing the role of pediatricians in the process of developmental surveillance and screenings. This study seeks to determine the current developmental surveillance and screening practices of pediatricians and family physicians in the southern nine counties of Illinois. Specifically the study aims at looking at to what extent pediatricians/family physicians use standardized developmental screening tools to screen infants and toddlers as described in the AAP recommendations. What methods are pediatricians currently utilizing to screen infants and toddlers (standardized instruments, self made checklists, clinical judgment) In addition, this study looks at to what extent do pediatricians/family physicians follow the AAP's recommendation process for referrals of infants and toddlers identified as at-risk for developmental delays?

Thesis (M.S.)--University of Michigan, 1985. / "A research report submitted in partial fulfillment of the requirements for the degree ..."

Thesis (M.S.)--University of Michigan, 1985. / "A research report submitted in partial fulfillment of the requirements for the degree ..."

Thesis--Wisconsin. / Includes bibliographical references (leaves 139-144).

The importance of early recognition and intervention for developmental delays is increasingly acknowledged, yet high rates of under-enrollment and 1-3 year delays in entry to the public early intervention system continue. Much research has examined developmental screening in health and child care settings, but less well understood is what prompts parents to identify problems and seek help for their children. This mixed methods study rooted in the Health Belief Model and Social Support Theory examined child, parent, family, and community level factors related to parent recognition (awareness and concern) and response (help-seeking and enrollment in services), including formal and informal sources of appraisal, informational, instrumental, and emotional support. Phase 1 examined responses from 27,566 parents of children ages 0-5 using the 2007 NSCH to quantify the type and number of parent concerns regarding their child's development in eight developmental domains, rates of enrollment in public intervention or private therapy, and factors associated with increased or decreased likelihood of concern or services enrollment. Regression analyses indicated that the likelihood of parent developmental concern and enrollment in public or private services differed by: child age, sex, health status, and type of developmental delay; parent and family characteristics (e.g. maternal race/primary language, reading to the child, etc.); pediatrician inquiry about concerns; insurance type; and child care type. Maternal age, education, marital status, and family structure and income were controlled for in all three models, but did not consistently contribute to likelihood of concern or services across outcomes. Phase 2 of the study utilized purposive, convenience, quota sampling via community agencies to invite 6 Spanish and 17 English speaking parents of high and low socioeconomic status to share their experiences in recognizing and responding to developmental concerns in their children (ages 2 weeks-4 ½ years) via 18 interviews and 2 focus groups. Participants also completed demographic, developmental status (PEDS), and knowledge of infant/child development (KIDI) questionnaires. About half of participants reported behavior (54%), social (50%), or speech concerns (54%); over a third had academic (38%), receptive language (42%), or self-help concerns (33%); and roughly 15% reported fine motor (17%) or gross motor (13%) concerns. Parents described in detail observations that first sparked developmental concerns, their decision-making processes in help-seeking and timelines for services; types and sources of social support; and facilitators and barriers related to recognition and help-seeking. The average score on the infant questionnaire was 50% correct and 65% on the prekindergarten questionnaire (range 32-91%). The results of this study describe child (sex, age, health status, type of delay), parent (age, education, race, ethnicity, home language, perception of susceptibility and severity of child delay), family (siblings, income, reading to the child, relative child care, social support), and community (pediatric practices, source of medical care, insurance, community support and referral coordination)factors related to early identification of developmental delays and access to public early intervention and private therapy services. Findings can be used to inform and improve community education, developmental screening, and Child Find outreach efforts. This study also contributes to our understanding of how parents interface with early intervention systems and both formal and informal parenting supports in the community, and identifies triggers for parental recognition and help-seeking for developmental delays and preferred entry points and pathways to assessment services. Recommendations include additional research on the causes, risk factors, co-morbidities, onset, and stability of diagnosis for developmental delays; continued development and universal implementation of valid and reliable screening and assessment tools, particularly for infants and toddlers; education campaigns to increase provider, parent, and public knowledge about developmental expectations, the importance of early intervention, and intervention options; further expansion of free, culturally appropriate programs to support child development for children with and without developmental delays and to strengthen formal and informal social supports for parents; improved referral coordination and timelines; and ongoing evaluation research to further demonstrate the efficacy of a variety of intervention service delivery models.

Background: Early identification and intervention for infants and young children with developmental delays may negate or minimise the negative effect of a disability on a child's development. Poor follow-up on early detection referrals, however, undermines the effectiveness of early intervention programmes. Objectives: To identify factors, including text message reminders, that influence follow-up adherence for early intervention after developmental screening in primary health care. A secondary objective surveyed reasons for follow-up default. Methods: The PEDS Tools was used to screen 247 high-risk children. A risk assessment questionnaire was completed with caregivers whose children were referred for speech-language and/or occupational therapy (n=106, 43%). A quasi-experimental study was employed to identify risk factors for defaulting on appointments. A thematic analysis of telephonic interviews was also employed to determine reasons for follow-up defaults. Results: Follow-up adherence was 17%. Participants who were divorced, widowed or never married were 2.88 times more likely to attend a follow-up appointment than those who were married or living together (95%, CI 0.97- 8.63). Text message reminders did not significantly improve follow-up. More than half (58%) of participants who defaulted on appointments could be reached for telephonic interviews. During the telephonic interviews 87% of participants did not report concern about their child's development. Reasons for defaulting were employment, logistical issues, other responsibilities and forgetfulness. Conclusions: Detecting possible developmental delays did not lead to acceptable follow-up adherence for early intervention services at primary health care levels. Increased awareness and education regarding the importance of development for educational success is needed. / Dissertation (M Communication Pathology)--University of Pretoria, 2016. / Speech-Language Pathology and Audiology / MCommunication Pathology / Unrestricted

MSc (Med), Child Health Neurodevelopment, Faculty of Health Sciences, University of the Witwatersrand / Background The early identification of developmental disorders facilitates early intervention, improving childhood outcomes. Parent-administered questionnaires have been recommended for this purpose. The PEDS COMBINED, which includes the Parents Evaluation of Developmental Status (PEDS) and PEDS Developmental Milestones (PEDS:DM), and the Ages and Stages Questionnaire (ASQ) are parent-administered questionnaires with good psychometric properties. It has not been determined if they identify the same infants at-risk for developmental delays however. It is also not know how South African paediatricians monitor childhood development. Objective To compare the ASQ, PEDS COMBINED and South African paediatricians’ subjective assessment (PSA) of neonatal intensive care graduates at 6-months corrected age. To identify trends in developmental screening practices, including the knowledge and use of parentadministered screening tools, in a diverse group of paediatricans working in Gauteng, South Africa. Methods Developmental screening and referral practices of paediatricians were ascertained by analysis of a short questionnaire sent to participating paediatricians. Concordance between the questionnaires and PSA was determined using the kappa coefficient (κ) and Test of Symmetry (κ ≤ 0.4 indicating poor agreement; κ ≥ 0.75 indicating excellent agreement). Results Concordance between the ASQ and PEDS COMBINED was 90.7% (κ = 0.82, ρ = 0.05). The PSA showed poor concordance with both PEDS COMBINED and ASQ (κ = 0.28, ρ = 0.03 and κ= 0.26, ρ = 0.01 respectively). The ASQ and PEDS COMBINED identified 40% and 42% of the cohort with developmental concerns and the PSA identified 6%. Only 13% of paediatricians used specific guidelines for developmental assessment and none used, or could name any parent-administered questionnaire. Conclusion There is excellent agreement between the ASQ and PEDS COMBINED in identifying the same children with developmental concerns. Paediatricians identified significantly fewer infants and showed statistically significant poor agreement with both questionnaires. Most paediatricians in Gauteng, South Africa are not using standardized screening tools to detect developmental delay and have poor knowledge regarding these tools.

The psychometric properties of a parent-completed developmental questionnaire for children at 6 years of age were investigated. Currently, few developmental screening instruments for 6-year-old children have been validated, and most available instruments are designed to be completed by teachers or professionals, who may not witness an optimal sample of child behavior. Thus a screening tool with robust psychometric properties is needed that can be completed by parents or caregivers who see the child across settings and time. A total of 169 children participated in this research. Data collection included online and paper completion during well child visits, in clinics, at preschool programs, and in parents' homes. A random subsample was asked to participate in reliability and convergent validity studies. Cronbach's alpha coefficient was used to measure internal consistency reliability. Results indicated a Cronbach alpha of agreement with the Child Development Inventory was used. A Confirmatory Factor Analysis with categorical data confirmed the 6-Year Ages and Stages Questionnaire domains, e.g., communication, personal social, fine motor, gross motor, and problem solving. Limitations of the current study and directions for future research are discussed. / 10000-01-01

Neuropsychological developmental screening (NES) is a German tool (published in 2005) for assessing eight fields of development of children aged 3 to 24 months. It is designed for pediatritians, early intervention specialists and psychologists. This thesis builds on A. Klapetek's thesis and aims to verify and check accurancy of Czech translation of the tool by administring the test to a group of Czech children. A. Klapetek conducted a pilot study of the tool. 50 children (10 for every age group) were administred the translation which was being refined during the field research. She also planned further steps to applying NES. Literature review of the thesis deals with developmental characteristics of infants and toddlers. Psychological assessment of young children and its uses and risks are described. The thesis also persues developmental scales, their history and present state. Theoretical concept of the Neuropsychological developmental screening (NES) is introduced. During the field research a group of 50 children was assessed by Czech translation of the tool, and the same group was tested by Developmental screening (Kovařík). Results of the testing were used to discuss existing norms of the tool, to identify problematic exercises (both too difficult and too easy) and to statistically analyse...