Screening Foster Care Children Doubles Detection Rate of Potential Developmental Problems

Inexpensive, brief questionnaire could bring early intervention to high-risk group

January 13, 2010

The addition of a simple and systematic screening among children in foster care doubled the detection rate of developmental disabilities in a population that is at high risk for developmental problems. The University of Rochester Medical Center (URMC) study published in Pediatrics this week shows that universal screening is feasible in a busy pediatric practice.

“We hope this study encourages other providers to institute these kinds of screenings so they can catch developmental issues early,” said Sandra Jee, M.D., M.P.H., author of the study, assistant professor of Pediatrics at URMC’s Golisano Children’s Hospital and research director of Starlight Pediatrics, the foster care clinic at which the study was conducted. “Children in foster care often have a lot of challenges. If we can get them the interventions they need earlier in life, we can help level the playing field for them.”

In 2007, Starlight Pediatrics changed its standard of care to include sending foster families a brief, non-diagnostic screening questionnaire (Ages and Stages Questionnaires) a week before well-child visits. When called to be reminded about their appointment, the families were also reminded to bring the completed questionnaire. The vast majority of the questionnaires were completed before or at the visit (96 percent), which researchers concluded meant it was feasible for families. It generally took providers less than five minutes to score and review the questionnaires with families during their visit.

More importantly, the questionnaires helped providers detect twice as many potential developmental disabilities as they found before the screening was implemented (58 percent versus 29 percent). The questionnaires also teased out more delays in problem-solving, personal-social and fine motor skills than had previously been detected.

Jee completed this research with colleagues Moira Szilagyi, M.D., Ph.D., Claire Ovenshire, R.N., Amy Norton, M.A., Anne-Marie Conn, M.A., Aaron Blumkin, M.S., and Peter Szilagyi, M.D., M.P.H., all of the Department of Pediatrics at URMC. This research was supported by the Halcyon Hill Foundation and the Robert Wood Johnson Physician Faculty Scholars Program.

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