Developmental surveillance of infants and young children in pediatric primary care

King, Tracy M.; Glascoe, Frances Page

doi:10.1097/00008480-200312000-00014

Cited by 75 publications

(76 citation statements)

References 21 publications

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“…A number of studies suggest that more physicians rely on clinical judgment or a few questions more than on standardized measures. [46][47][48][49][50] Unless validated measures are implemented in a reliable manner, it may be more effective for physicians to rely on parental concern as a measure of need. 51,52 Limitations A number of study limitations should be considered.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated With Age of Diagnosis Among Children With Autism Spectrum Disorders

2005

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Objective-Early diagnosis of children with autism spectrum disorders (ASD) is critical but often delayed until school age. Few studies have identified factors that may delay diagnosis. This study attempted to identify these factors among a community sample of children with ASD.Methods-Survey data were collected in Pennsylvania from 969 caregivers of children who had ASD and were younger than 21 years regarding their service experiences. Linear regression was used to identify clinical and demographic characteristics associated with age of diagnosis.Results-The average age of diagnosis was 3.1 years for children with autistic disorder, 3.9 years for pervasive developmental disorder not otherwise specified, and 7.2 years for Asperger's disorder. The average age of diagnosis increased 0.2 years for each year of age. Rural children received a diagnosis 0.4 years later than urban children. Near-poor children received a diagnosis 0.9 years later than those with incomes >100% above the poverty level. Children with severe language deficits received a diagnosis an average of 1.2 years earlier than other children. Hand flapping, toe walking, and sustained odd play were associated with a decrease in the age of diagnosis, whereas oversensitivity to pain and hearing impairment were associated with an increase. Children who had 4 or more primary care physicians before diagnosis received a diagnosis 0.5 years later than other children, whereas those whose pediatricians referred them to a specialist received a diagnosis 0.3 years sooner.Conclusion-These findings suggest improvements over time in decreasing the age at which children with ASD, especially higher functioning children, receive a diagnosis. They also suggest a lack of resources in rural areas and for near-poor families and the importance of continuous pediatric care and specialty referrals. That only certain ASD-related behaviors, some of which are not required to satisfy diagnostic criteria, decreased the age of diagnosis suggests the importance of continued physician education.Early diagnosis of autism spectrum disorders (ASD) is critical for a number of reasons, 1, 2 perhaps most important because interventions to improve the functioning of children with ASD may be more effective with younger children.3 -6 Evidence suggests that early treatment optimizes long-term prognosis, 7 and treatment yields diminishing returns as children get older. 8 Several studies have estimated that the gains in functioning associated with early treatment will result in considerable cost savings to both families of children with ASD and the systems in which they are served. [9][10][11]

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Section: Discussionmentioning

confidence: 99%

Factors Associated With Age of Diagnosis Among Children With Autism Spectrum Disorders

2005

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“…247,248 However, parental concerns may not be shared if the PCP does not ask about the child's development, and lack of parental concern about development does not imply typical development. [247][248][249][250] Therefore, a systematic surveillance strategy must be used for all children. 246 Screening with a standardized developmental tool should be performed whenever concerns are raised through the ongoing surveillance process.…”

Section: General Developmental Surveillance and Screeningmentioning

confidence: 99%

Identification and Evaluation of Children With Autism Spectrum Disorders

Johnson

Myers²

2007

Pediatrics

1,679

1,038

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Autism spectrum disorders are not rare; many primary care pediatricians care for several children with autism spectrum disorders. Pediatricians play an important role in early recognition of autism spectrum disorders, because they usually are the first point of contact for parents. Parents are now much more aware of the early signs of autism spectrum disorders because of frequent coverage in the media; if their child demonstrates any of the published signs, they will most likely raise their concerns to their child's pediatrician. It is important that pediatricians be able to recognize the signs and symptoms of autism spectrum disorders and have a strategy for assessing them systematically. Pediatricians also must be aware of local resources that can assist in making a definitive diagnosis of, and in managing, autism spectrum disorders. The pediatrician must be familiar with developmental, educational, and community resources as well as medical subspecialty clinics. This clinical report is 1 of 2 documents that replace the original American Academy of Pediatrics policy statement and technical report published in 2001. This report addresses background information, including definition, history, epidemiology, diagnostic criteria, early signs, neuropathologic aspects, and etiologic possibilities in autism spectrum disorders. In addition, this report provides an algorithm to help the pediatrician develop a strategy for early identification of children with autism spectrum disorders. The accompanying clinical report addresses the management of children with autism spectrum disorders and follows this report on page 1162 [available at www.pediatrics.org/cgi/content/full/120/5/1162]. Both clinical reports are complemented by the toolkit titled “Autism: Caring for Children With Autism Spectrum Disorders: A Resource Toolkit for Clinicians,” which contains screening and surveillance tools, practical forms, tables, and parent handouts to assist the pediatrician in the identification, evaluation, and management of autism spectrum disorders in children.

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“…Notwithstanding, it is necessary to consider that NPMD primarily takes place during the first two years of life and therefore all of the children assessed were going through a critical period for monitoring and intervention of their process of overall development, as has already been pointed out (2,6) .…”

Section: Discussionmentioning

confidence: 99%

“…A good proportion of neuropsychomotor development (NPMD) is primarily achieved during the period form birth to around 2 years of age, and during this period children's cognitive and motor capacities grow, making them more susceptible to harm (2) . Although children are more vulnerable during this period, in view of the significant neuronal plasticity they have acquired it is also during this period that children respond best to treatment and to environmental stimuli and, if interventions are made early, they exhibit better prognosis at this age (3)(4)(5) .…”

Section: Introductionmentioning

confidence: 99%

Desenvolvimento infantil: concordância entre a caderneta de saúde da criança e o manual para vigilância do desenvolvimento infantil

Oliveira¹,

Costa²,

Requeijo³

et al. 2012

Rev. paul. pediatr.

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Developmental surveillance of infants and young children in pediatric primary care

Cited by 75 publications

References 21 publications

Factors Associated With Age of Diagnosis Among Children With Autism Spectrum Disorders

Factors Associated With Age of Diagnosis Among Children With Autism Spectrum Disorders

Identification and Evaluation of Children With Autism Spectrum Disorders

Desenvolvimento infantil: concordância entre a caderneta de saúde da criança e o manual para vigilância do desenvolvimento infantil

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