Early Developmental Screening for Children in Foster Care

Abstract

Limited data exist about the ideal timing of developmental screening for young children entering foster care, and current best practice recommends screening by 1 month into care to prioritize resources for evaluation. Therefore, we aimed to: (1) compare detection rates for potential developmental delay (DD) at foster care entry before and after implementation of a developmental screen and (2) examine accuracy of developmental screening when performed at entry and 1 month into care. Charts of 124 children \6 years evaluated for an initial foster care health assessment (IFCHA) were reviewed to determine baseline detection rates for potential DD. The Parents' Evaluation of Developmental Status (PEDS) screening tool was then prospectively administered to 167 children \6 years during their IFCHA to determine detection rates. One month following the IFCHA, caregivers were recontacted, and the screen was re-administered. Accuracy of the initial PEDS screen was compared to the 1 month PEDS screen by calculation of sensitivity and specificity. At baseline, potential DD was detected in 34 % of children at the IFCHA compared to 46 % after implementation of the PEDS (P = 0.041). Compared to the 1 month screen, the early screen had a sensitivity of 75 % and specificity of 88 %. Use of a developmental screening tool at foster care entry increased detection of potential DD, and the results remained consistent with screening 1 month later. These results support use of a developmental screen for children in foster care and suggest that screening be performed as early as possible to expedite necessary evaluations and referrals.

Early detection of developmental delays in vulnerable children by community care workers using an mHealth tool

“…The significantly lower referral rate of the PEDS rescreen (27%) compared to the PEDS screen (35%) may be ascribed to the possible elimination of false positives (Hodges, Landin, Nugent, & Simpson, 2016). This warrants the need to closely monitor these children to prevent possible under referrals, but also to ensure that only true cases of concern are identified.…”

Youths in foster care with language delays: Prevalence, causes, and interventions

“…Current research suggests that even when developmental delays are identified, most children in foster care do not receive the services that they need (Hodges, Landin, Nugent, & Simpson, ; Stahmer et al., ). Within the zero to 5 age group, infants and toddlers are much less likely to receive interventions than preschool‐aged children.…”

“…This lack of access to services, especially for the youngest population, greatly affects the long‐term impact of language delays. Many children in foster care with language delays do not receive services until they reach school age, making it much more difficult to intervene as the critical period for language development is rapidly closing by the beginning of kindergarten (Conti‐Ramsden & Durkin, ; Hodges et al., ; Stock & Fisher, ).…”

“…As a universal intervention, the use of developmental screening for children when entering into the foster care system provides a way to identify children with language delays as quickly as possible, and therefore provide access to services and interventions as close to the linguistic critical period as possible. Currently, about 95% of children entering foster care are screened for physical health symptoms, but only about 58% receive a developmental screening upon entrance (Hodges et al., ; Leslie et al., ). An example program that provides these types of universal screening services is the Developmental Screening and Enhancement Program in San Diego County, CA.…”

“…Hodges et al. ()) found that the use of PEDS increased detection of developmental delays at the entry of foster care. They also found that this early screening was consistent with screening conducted 1 month into care.…”