Contemporary Pediatrics - November 2009 - (Page 76)
DEVE LOPM E NTAL SCRE E NI NG PAGE 75 CONTINUED FROM related office visits, written care plans, explicit comanagement with medical and nonmedical specialists, appropriate patient education, and care coordination via an effective monitoring and tracking system. Many families need communitybased support services, including respite care, parent-to-parent programs, and advocacy organizations. Parent organizations such as Family Voices and condition-specific organizations (eg, Autism Speaks, the Autism Society of America, Autism Research Centre) can provide valuable family support, assistance, and information. Depending on the child and the state, additional benefits may be available including Supplemental Social Security income, public insurance, waiver programs, and state programs for children with special healthcare needs.15 • When chronic conditions are identified, deploy the medical home guidelines regarding the management of children with developmental behavioral disorders. R E F E R E N C E S Putting policy into practice • Use standardized DS tools when surveillance raises developmental concerns and at regular preventive-care visits at 9, 18, and 24 or 30 months, as well as annually thereafter. • Administer autism-specific screens at 18- and 24-month visits (in addition to general screens). • Problematic screens should always prompt an immediate referral to IDEA services, either early intervention or public school programs (depending on the child’s age). These programs offer free diagnostic testing and also have federal mandates for swift initiation of special services. • Providers should remember that a diagnosis is not required before referring to IDEA programs. Intervention referrals should never be postponed while physicians are waiting for results of genetic, autism-specific, or other subspecialty care evaluations. • Because DS can identify risk factors associated with emerging but not yet manifest delays, it should be part of every preventive care visit. DS should include measurement of parents’ concerns, psychosocial risk and resilience factors, and a medical evaluation. • DS also means addressing any problems detected with a range of tailored in-office interventions or appropriate referrals for more specialized services.C O N T E M P O R A R Y P E D I AT R I C S 1. American Academy of Pediatrics, Council on Children With Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee, Medical Home Initiatives for Children With Special Needs Project Advisory Committee. Identifying infants and young children with developmental disorders in the medical home: An algorithm for developmental surveillance and screening. Pediatrics. 2006;118(1):405-420. 2. Sand N, Silverstein M, Glascoe FP, et al. Pediatricians’ reported practices regarding developmental screening: Do guidelines work? Do they help? Pediatrics. 2005;116(1):174-179. 3. Bethell C, Reuland CP, Halfon N, Schor EL. Measuring the quality of preventive and developmental services for your children: National estimates and patterns of clinicians’ performance. Pediatrics. 2004;113(6 suppl 1):1973-1983. 4. Johnson CP, Myers SM; the American Academy of Pediatrics Council on Children With Disabilities. Identification and evaluation of children with autism spectrum disorders. Pediatrics. 2007;120(5):1183-1215. 5. Committee on Practice and Ambulatory Medicine. Recommendations for preventive pediatric health care. Pediatrics. 2000;105(3):645-646. 6. Shevell M, Ashwal S, Donley D, et al; Quality Standards Subcommittee of the American Academy of Neurology; Practice Committee of the Child Neurology Society. Practice parameter: Evaluation of the child with global developmental delay: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2003;60(3):367-379. 7. Curry CJ, Stevenson RE, Aughton D, et al. Evaluation of mental retardation: Recommendations of a Consensus Conference. Am J Med Genet. 1997;72(4):468-477. 8. Flint J, Wilkie AO. The genetics of mental retardation. Br Med Bull. 1996;52(3):453-464. 9. Shevell MI, Majnemer A, Rosenbaum P, Abrahamowicz M. Etiologic yield of single domain developmental delay: A prospective study. J Pediatr. 2000;137(5):633-637. 10.Filipek PA, Accardo PJ, Ashwal S, et al. Practice parameter: Screening and diagnosis of autism: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Child Neurology Society. Neurology. 2000;55(4):468-479. 11.Schaefer GB, Mendelsohn NJ; Professional Practice and Guidelines Committee. Clinical genetics evaluation in identifying the etiology of autism spectrum disorders. Genet Med. 2008;10(4):301-305. Erratum in: Genet Med. 2008;10(6):464. 12.McPherson M, Arango P, Fox H, et al. A new definition of children with special health care needs. Pediatrics. 1998;102(1 pt 1):137-140. 13.American Academy of Pediatrics Council on Children With Disabilities. Care coordination in the medical home: Integrating health and related systems of care for children with special health care needs. Pediatrics. 2005;116(5):1238-1244. 14.American Academy of Pediatrics Council on Children With Disabilities, Duby JC. Role of the medical home in family-centered early intervention services. Pediatrics. 2007;120(5):1153-1158. 15.Committee on Children With Disabilities. American Academy of Pediatrics: The continued importance of Supplemental Security Income (SSI) for children and adolescents with disabilities. Pediatrics. 2001;107(4):790-793. NOVEMBER 2009 VOL. 26 NO. 11
Table of Contents for the Digital Edition of Contemporary Pediatrics - November 2009
Contemporary Pediatrics - November 2009
Editorial Advisory Board
Dermatology: What's Your DX?
Then and Now: ADHD Treatments
Cardiovascular Risk in ADHD Pharmacotherapy
Transitioning Adolescents to Adult Care and Adulthood: Is it Time Yet? Part 1 of 2
A Pragmatic Approach to ALTEs
Developmental Surveillance and Screening Part 1 of 3
Contemporary Pediatrics - November 2009
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