Systematic Screening for Developmental Delay in Early Childhood: Problems and Possible Solutions

Early identification of children with developmental delay is a longstanding goal in pediatric research and practice, and a large number of screening and assessment tools have been developed to this end. Unfortunately, these measures are problematic: Definitions of “delay” are not consistent, thresholds are somewhat arbitrary, some scoring systems are affected by systematic error, and the natural variability in the timing of development may limit the accuracy they can achieve. Significantly, the ability of early screening to predict longer-term functional problems has proven to be very limited. False positive results are also not harmless, and the effectiveness of early interventions is in some doubt. The benefits of early screening using existing instruments and interventions are therefore doubtful. Some improvements may be possible, however, by making use of more information sources, by using variable thresholds, and by making more rigorous use of cost-benefit analysis. © 2016, Springer International Publishing Switzerland.