Frances Page Glascoe, Ph.D.
At some point in your childŐs life, you may find you have concerns about learning and development. Often these concerns focus on speech, language, and behavior but may also include social skills, school performance, self-help, or muscle coordination. What do these concerns mean? Is something wrong? Should your child be tested further? Do you just need advice about how to handle things? What, if anything, should you do next?
In the last 20 years, there has been much research on ways to test the progress of childrenŐs development. This work has produced a range of tests that perform well at sorting out the children that are at risk for developmental problems. Some of these tests check the childŐs progress against a comprehensive set of developmental milestones. For example, the Ages and Stages Questionnaire, which is now being used by childrenŐs doctors in place of the previously popular, but sadly underperforming, Denver II test. Other tests apply what science has learned about the meaning of parentsŐ concerns about how their children are coming along. What is now understood is that some parentsŐ concerns reflect typical development while other concerns indicate difficulties now and in the future. Some concerns require action but others donŐt and this depends on the childŐs age.
This relationship between parentsŐ concerns and their childŐs development is sufficiently complex that it must be built into screening tests that use information gathered from the parent. An example of such a test is the ParentsŐ Evaluation of Developmental Status (PEDS), which has been developed to alert health care providers when a parentŐs concerns are significant. PEDS then guides the health care provider towards the best course of action.
Unfortunately, not many doctors use quality screening tools to decide how best to help you help your child. Most of the older developmental checklists have been shown to perform little better than a coin toss at identifying kids with these problems. This means that serious concerns are sometimes not addressed well or soon enough. Indeed, most children with language or other difficulties are not detected before they reach school. Ideally, problems should be detected before kindergarten so that children can receive needed intervention that may reduce or eliminate problems.
So what can you do if you are a concerned parent? Your first step should be your childŐs doctor, who should be ready to use one of the screening measures that meet the American Academy of PediatricsŐ guidelines. But often your visit to the doctorŐs office is crowded with necessary routine shots, weighings and physical examinations that leave little or no time for subtler concerns about development. So the challenge for the parent is getting enough time during the encounter to have your concerns properly evaluated. You can do this by carrying out a screening test ahead of the visit (some doctors send out forms to allow you to do this). Even if your childŐs doctor doesnŐt do routine screening, you can do some of these tests yourself and present the results to your childŐs doctor at your childŐs next routine visit. The PEDS test is available on the Internet and others may be following soon.
The results of the screening test will either assure you that all is well or help you connect you to the resources for the kind of concerns you raised and the type of problems, if any, your child may be experiencing. These resources may include sources for free testing and screening services, links to parenting information or training sites, and how to reach other parents with similar concerns.
When you are concerned about your child, it is best not to wait and see. Rather, it is important to find out what your concerns really mean and what is the best thing to do for your child and how to rally the resources to prevent many minor problems from becoming larger ones.
Resources:
PEDS Online www.forepath.org
First Signs www.firstsigns.org
PEDS for Professionals www.pedstest.com
Ages and Stages Questionnaires www.pbrookes.com
Battelle Developmental Inventory-2 www.riverpub.com
Brigance Screen www.curriculumassociates.com
Other Child Development Information www.dbpeds.org
Dr. Frances Page Glascoe is a pediatric educator and researcher. Her studies have appeared in various publications of the American Academy of Pediatrics. She is also the author of PEDS, which meets the guidelines of the American Academy of Pediatrics for an effective proven screening tool.
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