Components of developmental surveillance
- eliciting and attending to parental concerns
- documenting and maintaining a developmental history
- observing the child
- identifying risks and protective factors
- maintaining an accurate record of findings over time, which includes input from others (childcare providers, schools, etc.)
Research has shown that parental concerns are important indicators of problems, soliciting parents’ input is critical to developmental surveillance. Properly employed, developmental surveillance is family-focused, accurate, and efficient and can guide clinical decision-making.
Utilization of specific screening instruments complements developmental surveillance. It has been shown that child health providers are extremely accurate in identifying children with developmental delays, but that they could identify children who would benefit from intervention services earlier if they used standardized screening tools.
The American Academy of Pediatrics recommends that, in addition to performing developmental surveillance at every well-child visit, pediatricians use standardized screening tools at the 9, 18 and 30 (or 24) month visits. Several screening instruments have been standardized across the child population and are especially easy to integrate into pediatric primary care settings. Two screening tools that are widely used are the Ages and Stages Questionnaire (ASQ3) and Ages and Stages Social Emotional Questionnaire (ASQ:SE) both of which engage parents in developmental monitoring of their children and are an integral part of Help Me Grow.
Developmental surveillance is a flexible, continuous process in which knowledgeable professionals perform observations of children while providing care. Development is continuously monitored within the context of overall well-being, rather than viewed in isolation during a testing session. Developmental surveillance is broader in scope than screening and occurs at every well child visit. Developmental screening is performed at selected ages or when concerns arise using standardized tools such as parent-completed questionnaires and professionally administered tests. The periodic use of such tools enhances the effectiveness of ongoing surveillance.