Better together: Developmental screening and monitoring best identify children who need early intervention.
Brian Barger, Catherine Rice, Rebecca Wolf and 1 others
PMID 29459217WHAT IT FOUND
Parents who reported both developmental monitoring and screening were more likely to say their child had an early intervention plan than parents reporting either alone or neither.
This was a link in parent reports, not proof the practices caused referral.
Key findings
01In both survey periods, children whose parents reported both developmental monitoring and screening had the highest estimated IFSP receipt percentage: 8.38% in 2007/2008 and 6.47% in 2011/2012, compared with 1.31% and 1.92% for neither, 2.74% and 2.70% for monitoring alone, and 3.59% and 3.09% for screening alone.
02After adjustment, children with both monitoring and screening were more likely to have an IFSP than children with neither, with reported adjusted odds ratios of 6.25 in 2007/2008 and 2.94 in 2011/2012.
03Across the survey periods, reported tandem monitoring and screening was 15% in 2007/2008 and 26% in 2011/2012, screening alone was 9% and 12%, monitoring alone was 36% and 29%, and neither was 39% and 33%.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The data are cross-sectional, so they cannot show whether monitoring and screening led to early intervention receipt or followed concerns that were already known. The study relies on parent reports of whether providers asked questions or filled out a screening questionnaire, which may not match clinical records. Developmental monitoring and screening were measured with single survey items, so they do not capture the full range of provider practices. The paper cannot separate the contribution of monitoring and screening from other factors such as child condition, insurance, household characteristics, and state eligibility rules. The outcome is receipt of an Individualized Family Service Plan, not developmental or therapy outcomes. Estimates may differ from official Part C counts because caregiver report and a last-year recall window were used.
Declared interests
The authors declared no conflicts of interest. The surveys were funded by the Maternal and Child Health Bureau of the Health Resources and Services Administration and administered by the National Center for Health Statistics.
The easy way to misread this
Do not conclude that using developmental monitoring and screening together causes more children to receive early intervention. These are parent-reported cross-sectional associations, and the paper says the temporal relationship cannot be firmly established.