Developmental Evaluation

1. Indications
   1. Periodic screening in all children at ages 9, 18, 24 and 30 months
   2. High risk for Disability
      1. Low income family
      2. Parents with limited education
      3. Parents with mental health concerns
      4. Single parent family
      5. Numerous siblings
      6. Parental unemployment
      7. Lack of parental concerns
2. Approach: Survey Parental Concerns
   1. Use standardized questionnaire (preferred for primary care)
      1. Example: Ages and Stages Questionnaire (ASQ) for age 4-60 months
      2. See Tools below for preferred options (ASQ, CDR/IDI or PEDS)
   2. Use Clinician Trigger Question (Glascoe)
      1. Ask Parent "Please tell me any concerns you have:"
         1. Learning
         2. Developing
         3. Behaving
3. Approach: Developmental Screening Tests for parental concerns
   1. Behavior (35%)
   2. Speech and Language (30%)
   3. Gross motor (less common)
   4. Fine motor
      1. Often reflects true developmental problems
   5. Global concerns
      1. Needs screening!
4. Tools
   1. Developmental Screening Tests ("Does a problem exist?")
      1. Preferred Options
         1. Ages and Stages Questionnaire (ASQ): 4-60 months
         2. Infant Development Inventory (IDI): 0-18 months
         3. Child Development Review (CDR): 18-60 months
         4. Parent's Evaluations of Developmental Status (PEDS): 0-8 years
      2. Other options
         1. Battelle Developmental Inventory
         2. Bayley Infant Neurodevelopmental Screen
         3. Brigance Screen
         4. CAT/CLAMS
         5. Denver Developmental Screening Test II (not recommended due to low efficacy)
         6. Minnesota Child Developmental Inventory (replaced by CDR and IDI)
   2. Developmental Assessment Tools (abnormal screening)
      1. Young children under age 3 years: Cognitive Test
         1. Bayley II Developmental Assessment
         2. McCarthy Scales of Children's Ability
      2. Children 3 years and older: Intelligence Testing
         1. Stanford-Binet Intelligence Scale
         2. Wechsler Intelligence Scale
   3. Behavioral Screening
      1. Eyberg Child Behavior Inventory
      2. Family Psychosocial Screening
      3. Pediatric Symptom Checklist
   4. Other Tests
      1. Language and communication
         1. Sequenced Inventory Communication Development
            1. Abbreviation: SICD
            2. Used in 4-48 months
      2. Adaptive and social Functioning
         1. Vineland Adaptive Behavior Scales
            1. Used in birth to 18 years
5. Resources
   1. Developmental and Behavioral Screening
      1. http://www.dbpeds.org/articles/dbtesting
6. References
   1. Mackrides (2011) Am Fam Physician 84(5): 544-9
   2. Hamilton (2006) J Fam Pract 55(5): 415-22
   3. Glascoe (2005) Ment Retard Dev Disabil Res Rev 11(3): 173-9
   4. Rydz (2005) J Child Neurol 20(1): 4-21