Screening for Developmental Delay & Autism

Feb 28, 2020 admin NHI KHOA 0

Screening for Developmental Delay & Autism

Source: Book: Clinical Guidelines for Advanced Practice Nursing 3e

Regular surveillance and routine screening at recommended intervals help identify children at risk for multiple types of developmental delay (behavioral, developmental, and emotional problems), refer them for diagnostics tests and early intervention services. Valid and reliable screening tests can help identify children whose development has changed or whose developmental milestones have regressed (e.g., autism).

Recommended intervals for surveillance & screening

  • The AAP recommends surveillance to be included in every well-child visit and standardized screening to be included in well-child visits at 9, 18, 24, and 30 months of age.
  • Developmental surveillance alone, without screening, captures only 30% of children with delays and disabilities before the age of 5 years.
  • Autism screening is recommended for all children before they are 24 months of age ( Johnson & Myers, 2007; Robins, 2008).
  • Figure 9-1a Developmental Surveillance and Screening Algorithm for Pediatric Primary Care

Types of developmental delay (behavioral, developmental, and emotional problems)

At least one in eight children has a developmental concern at some point during their childhood. Twelve to 17% of all children have:

  • Speech or language delay
  • Mental retardation
  • Learning disability
  • Hearing loss
  • Emotional or behavioral concern
  • Delay in growth or development

The prevalence of autism spectrum disorders is estimated at about 1 in 68. The prevalence differs for boys (1 in 42) compared to girls (1 in 189) (Autism and Developmental Disabilities Monitoring Network Surveillance Year 2010 Principal Investigators, 2014).

Screening Instruments (Forms)

  • Screening forms, e.g. ASQ-3, BASC-2, Brigance Screen II, CDI, ECDI, PDI, Dencer II Developmental Screening Test, PEDS, ASQ-SE, BITSEA, PSC, PSC-Y, PPSC, PBKS-2, SWYC, BPSC, POSI, SEEC
  • Autism Screening (M-CHAT-R/F)

A. General development, including socioemotional tools
1. Ages and Stages Questionnaires, Third Edition (Squires & Bricker, 2009)
2. Behavior Assessment System for Children, Second Edition (Reynolds & Kamphaus, 2004)
3. Brigance Screens II (Glascoe, 2002, 2005b)
4. Child Development Inventories (Doig, Macias, Saylor, Craver, & Ingram, 1999; Ireton, 1992)
5. Denver-II Developmental Screening Test* (Frankenburg, Camp, & Van Natta, 1971; Glascoe et al., 1992)
6. Parents’ Evaluation of Developmental Status (Glascoe, 2006)
*The Denver-II lacks adequate validation and overrefers or underdetects problems (Glascoe, 2005a).

B. Socioemotional screening tools
1. Ages and Stages Questionnaire: Social-Emotional (Squires, Bricker, & Twombly, 2002)
2. Brief Infant/Toddler Social Emotional Assessment (Briggs-Gowan, Carter, Irwin, Wachtel, & Cicchetti, 2004)
3. Pediatrics Symptom Checklist ( Jellinek et al., 1999)
4. Preschool and Kindergarten Behavior Scales—Second Edition (Allin, 2004)
5. Survey of Well-being of Young Children (SWYC), Preschool Pediatric Symptom Checklist (Sheldrick et al., 2012), Baby Pediatric Symptom Checklist (BPSC)
6. Vineland Social-Emotional Early Childhood Scales (Sparrow, Balla, & Cicchetti, 1998)

C. Autism screening tools
1. Modified Checklist for Autism in Toddlers—Revised with Follow-Up (M-CHAT-R/F) (Robins et al., 2014)
2. Pervasive Developmental Disorders Screening Test (Siegel, 2004)
3. In combination with a standardized screening tool, the following Diagnostic and Statistical Manual IV criteria for autism spectrum disorders can be applied for children younger than 3 years of age ( Johnson, 2008; Johnson & Myers, 2007):

a. Impairment in social interaction
i. Lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., lack of pointing and showing)
ii. Marked impairment in the use of multiple nonverbal behaviors, such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
iii. Lack of social and emotional reciprocity
b. Impairments in communication. Delay in or total lack of the development of spoken language (not accompanied by attempt to compensate using gestures or mime)
c. Restricted repetitive and stereotyped patterns of behavior, interests, and activities

 

 

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