Surveillance and Screening
Most pediatric health professionals practice developmental surveillance. Surveillance is a flexible, ongoing process where knowledgeable professionals perform skilled observations of children during the health care visit. The components of developmental surveillance include:
- Eliciting and attending to parental concerns;
- Maintaining a developmental history;
- Making accurate and informative observations of children;
- Identifying the presence of risk and protective factors
- Maintaining an accurate record of documenting the process and findings.1
Pediatricians and other health care providers often use age-appropriate developmental checklists to record milestones during preventive care visits as part of developmental surveillance. To be in compliance with EPSDT, clinicians should be doing this routinely and documenting this as part of the well child visit. The Developmental Milestones Checklist is one form that can be used during the visit to document developmental surveillance that has been performed during the patient visit.
Developmental screening, on the other hand, is a brief procedure, using a standardized validated tool, available either commercially or in the public domain, to determine whether a child requires further and more comprehensive evaluation. Developmental screening enhances surveillance. Screening may be a part of routine well child visit or it may be used during acute care visits in response to a specific concern about a child. The AAP recommends routine surveillance and using standardized developmental and behavioral screening at least 3 specific times: the 9, 18 and 24/30 month visits.2
For more information about developmental and behavioral screening tools, click on the link: Screening Tools
References
1. Council on Children With Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee and Medical Home Initiatives for Children With Special Needs, Project Advisory Committee. Identifying infants and young children with developmental disorders in the medical home: An algorithm for developmental surveillance and screening. Pediatrics 2006; 118: 405-420. http://www.pediatrics.org/cgi/content/full/118/1/405
2. Council on Children With Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee and Medical Home Initiatives for Children With Special Needs, Project Advisory Committee. Identifying infants and young children with developmental disorders in the medical home: An algorithm for developmental surveillance and screening. Pediatrics 2006; 118: 405-420. http://www.pediatrics.org/cgi/content/full/118/1/405
