ArticleEvidence-Based Early Detection of Developmental-Behavioral Problems in Primary Care: What to Expect and How to Do It
Section snippets
Participants and Settings
Of 127 practices administering quality developmental/behavioral screening via an online screening service, 79, reflecting a range of practice types (e.g., private practice and public health centers) were selected for data analysis. Practice selection criteria were: (a) frequent use of screening tools, that is, at least several times per day; (b) use of online screening for at least 1 year; (c) provision of care to families of diverse socioeconomic status and language backgrounds; and (d)
Demographics
The 20,941 families participating in screening had elevated psychosocial risk factors and were disproportionately poor, ethnic minorities, non-English speaking, and had lower than average high school graduation rates (compared with U.S. Census Bureau population parameters, www.census.gov, accessed March 2014). Of parents, only 69% had completed high school (compared with 84% nationally); 30% had incomes below poverty guidelines (versus 24% nationally); 34% were non-English speaking (compared
Discussion
The results of this study will help clinicians know what to expect from an evidence-based screening initiative: (a) more than one out of five children can be expected to fail screening tests, at least in a sample serving families at elevated psychosocial risk; (b) the risk of failing screening tests increases with children's age; (c) children are less likely to attend well-child visits the older they are; and (d) children who do not arrive within 1 month of the well-child visit schedule are
Frances Page Glascoe, Professor of Pediatrics, Vanderbilt University, Nashville, TN.
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Frances Page Glascoe, Professor of Pediatrics, Vanderbilt University, Nashville, TN.
Conflicts of interest: Dr. Glascoe is the author/co-author of several screening tests used in this study and may receive royalties on their use.