Glascoe F P
Child Development Center, Vanderbilt University, Nashville, Tennessee.
Pediatrics. 1991 Mar;87(3):317-22.
Pediatricians often rely on clinical judgment derived from observation or parental concern to identify children with developmental problems. The less popular but recommended alternative is to repeatedly administer standardized screening tests. Such tests are time consuming but, unlike clinical judgment, have known detection rates. Preliminary research concerning clinical judgment showed that clusters of parental concerns related to their childrens' performances on screening tests. In the present study, previous research was refined by assessment of the meaning of parents' concerns about their childrens' speech-language development. In this study of 157 families seeking pediatric care, 72% of children whose speech-language screening yielded positive results had parents who were concerned about their speech-language development. Of children with negative screening results, 83% had parents with no concerns about their speech-language development. Although standardized screening tests should be used occasionally in the developmental surveillance process, the findings show that the problems of most children with developmental problems were detected through clinical judgment based on parental concern.
儿科医生通常依靠从观察或家长的担忧中得出的临床判断来识别有发育问题的儿童。不太常用但被推荐的另一种方法是反复进行标准化筛查测试。此类测试耗时，但与临床判断不同，其检测率是已知的。关于临床判断的初步研究表明，家长的担忧与他们孩子在筛查测试中的表现相关。在本研究中，通过评估家长对其孩子语言发展的担忧的意义，对先前的研究进行了完善。在这项对157个寻求儿科护理的家庭的研究中，语言筛查结果呈阳性的儿童中，72%的家长对其孩子的语言发展表示担忧。筛查结果为阴性的儿童中，83%的家长对其孩子的语言发展不表示担忧。尽管在发育监测过程中应偶尔使用标准化筛查测试，但研究结果表明，大多数有发育问题的儿童的问题是通过基于家长担忧的临床判断发现的。
