title: Disorders of childhood growth and development: screening and evaluation of the child who misses developmental milestones.
abstract: The family physician is one of the few individuals from whom families receive feedback about their children's development; this makes early identification of potential delays an important responsibility. The American Academy of Pediatrics recommends formal developmental screening for all children at the 9-, 18-, and 24- and/or 30-month well-child visits as well as developmental surveillance at every office visit through age 5 years. A formal screening measure is recommended, taking into account administration time and cost, characteristics of the patient population (eg, availability of screening tool in numerous languages), and psychometrics (eg, reliability, sensitivity, specificity). In the case of abnormal screening results, family physicians must determine the need for further medical evaluation (eg, by a developmental pediatric subspecialist or a pediatric neurology, genetics, or physiatry subspecialist) and/or further developmental evaluation (eg, by a physical therapy [PT], occupational therapy [OT], speech/language pathology, psychology, or audiology subspecialist). Knowledge of early intervention and early childhood programs is necessary for directing parents to evaluation and treatment sources. In treating patients with developmental delays, family physicians must possess knowledge regarding traditional modalities (eg, speech/language therapy, OT, PT) as well as newer treatments with less research support (eg, gluten-free/casein-free diet, hyperbaric oxygen therapy, neurodevelopmental treatment) that families may consider.
authors.affiliation: Hofstra North Shore-LIJ School of Medicine Family Medicine Residency Program, Bay Shore, NY 11706-8458, USA. mgrissom@nshs.edu
authors.forename: Maureen
authors.initials: M
authors.lastname: Grissom
mesh_terms: D002657:Child Development; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000628:therapy*; D042241:Early Diagnosis; D006801:Humans; D007223:Infant; D008297:Male; D008403:Mass Screening / Q000379:methods*; D014481:United States