title: Effectiveness of developmental screening in an urban setting.
abstract: OBJECTIVE
  To determine the effectiveness of developmental screening on the identification of developmental delays, early intervention (EI) referrals, and EI eligibility.
  
  
  METHODS
  This randomized controlled, parallel-group trial was conducted from December 2008 to June 2010 in 4 urban pediatric practices. Children were eligible if they were <30 months old, term, without congenital malformations or genetic syndromes, not in foster care, and not enrolled in EI. Children were randomized to receive 1 of the following: (1) developmental screening using Ages and Stages Questionnaire-II (ASQ-II and Modified Checklist for Autism in Toddlers (M-CHAT) with office staff assistance, (2) developmental screening using ASQ-II and M-CHAT without office staff assistance, or (3) developmental surveillance using age-appropriate milestones at well visits. Outcomes were assessed using an intention-to-treat analysis.
  
  
  RESULTS
  A total of 2103 children were enrolled. Most were African-American with family incomes less than $30,000. Children in either screening arm were more likely to be identified with delays (23.0% and 26.8% vs 13.0%; P < .001), referred to EI (19.9% and 17.5% vs 10.2%; P < .001), and eligible for EI services (7.0% and 5.3% vs 3.0%; P < .001) than children in the surveillance arm. Children in the screening arms incurred a shorter time to identification, EI referral, and EI evaluation than children in the surveillance arm.
  
  
  CONCLUSIONS
  Children who participated in a developmental screening program were more likely to be identified with developmental delays, referred to EI, and eligible for EI services in a timelier fashion than children who received surveillance alone. These results support policies endorsing developmental screening.
authors.affiliation: PolicyLab, Center to Bridge Research, Practice, Policy, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania19104, USA. guevara@email.chop.edu
authors.forename: James P
authors.initials: JP
authors.lastname: Guevara
authors.forename: Marsha
authors.initials: M
authors.lastname: Gerdes
authors.forename: Russell
authors.initials: R
authors.lastname: Localio
authors.forename: Yuanshung V
authors.initials: YV
authors.lastname: Huang
authors.forename: Jennifer
authors.initials: J
authors.lastname: Pinto-Martin
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Minkovitz
authors.forename: Diane
authors.initials: D
authors.lastname: Hsu
authors.forename: Lara
authors.initials: L
authors.lastname: Kyriakou
authors.forename: Sofia
authors.initials: S
authors.lastname: Baglivo
authors.forename: Jane
authors.initials: J
authors.lastname: Kavanagh
authors.forename: Susmita
authors.initials: S
authors.lastname: Pati
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008403:Mass Screening / Q000379:methods*; D016896:Treatment Outcome; D014505:Urban Population