Child and Adolescent Health Measurement Initiative, Department of Pediatrics, School of Medicine, Oregon Health & Science University, 707 SW Gaines Ave, Mailcode CDRC-P, Portland, OR 97219, USA.
Pediatrics. 2011 Jul;128(1):146-55. doi: 10.1542/peds.2010-0424. Epub 2011 Jun 6.
In 2006, the American Academy of Pediatrics recommended developmental screening of young children with a standardized screening tool as a routine component of well-child care.
To assess the national and state prevalence of standardized, parent-completed developmental screening (DS-PC) in the previous 12 months and evaluate associations between screening and receipt of an early-intervention plan or mental health services for children at higher risk.
Data from the 2007 National Survey of Children's Health were used. Nested t tests were used to compare each state to national prevalence. Logistic and multilevel regression models evaluated variations and associations with DS-PC.
Nationally, 19.5% of children received a DS-PC in the previous 12 months, although the figure varied from 10.7% to 47% across the United States. Prevalence did not rise above 26.7% for any socioeconomic subgroup of children and was highest for younger, black, and publicly insured children and lowest for uninsured children and children with gaps in insurance coverage. Equally high-risk children varied twofold in their probability of receiving early intervention or needed mental health services according to whether they had received a DS-PC.
There is a significant gap between the developmental screening that is recommended and what is reported nationally. When children are not screened consistently, opportunities for early identification, intervention, and treatment may be delayed. Gaps in screening and wide variations across states present considerable opportunities for cross-state learning to improve quality on this critical component of preventive pediatric care. Measurement systems for assessing prevalence and impact of screening require continued evaluation and development.
2006 年，美国儿科学会建议对幼儿进行标准化筛查，将其作为常规儿童保健的一部分。
评估全美和各州在过去 12 个月内使用标准化、家长完成的发育筛查（DS-PC）的情况，并评估筛查与为高风险儿童提供早期干预计划或心理健康服务之间的关系。
使用 2007 年全国儿童健康调查的数据。嵌套 t 检验用于比较每个州与全国的流行率。逻辑和多层次回归模型评估了 DS-PC 的变化和关联。
全国范围内，19.5%的儿童在过去 12 个月内接受了 DS-PC，尽管美国各地的这一数字从 10.7%到 47%不等。任何儿童社会经济亚组的流行率都没有超过 26.7%，而年龄较小、黑人、公共保险的儿童的流行率最高，没有保险的儿童和保险覆盖有缺口的儿童的流行率最低。同样高风险的儿童，根据他们是否接受过 DS-PC，接受早期干预或需要心理健康服务的可能性相差两倍。
建议的发育筛查与全国报告的情况之间存在显著差距。当儿童不能持续接受筛查时，早期发现、干预和治疗的机会可能会延迟。筛查方面的差距和各州之间的广泛差异为改善预防儿科保健这一关键组成部分的跨州学习提供了巨大机会。评估筛查的流行率和影响的测量系统需要不断评估和发展。
