Screening tools to identify developmental delay in healthy young children not beneficial

March 29, 2016

The Canadian Task Force on Preventive Health Care recommends against using a screening tool to identify developmental delay in children aged 1 to 4 years who have no apparent signs or parental concerns, according to a new guideline published in CMAJ (Canadian Medical Association Journal).

Developmental delay is characterized by delay in age-appropriate functioning, including motor skills, speech and language, social skills, daily living activities and/or cognition. Risk factors for developmental delay may include low birth weight, premature birth and birth complications, family history and other factors.

This recommendation applies to children with no visible signs of developmental delay. Screening differs from developmental surveillance, in which a physician regularly monitors a child's development, parental concerns and risk factors, and from case finding, which identifies cases of developmental delay in children with one or more risk factors.

"Clinicians should perform developmental surveillance on an ongoing basis and consider the possibility of developmental delay in children with signs that may suggest a delay in a developmental domain, those whose parents, caregivers or clinicians have concerns about their development, or those with significant risk factors," states Dr. Patricia Parkin, a pediatrician at The Hospital for Sick Children (SickKids) and member of the developmental delay guideline working group, with coauthors.

The guideline found no evidence from randomized controlled trials (RCTs) indicating that use of a screening tool for developmental delay in primary care improves outcomes for children. Most screening tools are standardized parent-completed checklists.

"The lack of RCT evidence demonstrating any clinical benefits associated with screening for developmental delay and the relatively poor diagnostic properties of available screening tools warrant a strong recommendation against population-based screening," write the authors.

In addition, screening tools for developmental delay are not accurate, and can lead to a high number of false-positive results that can cause parental anxiety as well as incorrect labeling of children who are developing normally. These false-positive results would likely lead to further testing, referral and diagnosis that might be better focused on children with true developmental delay.

"Primary care providers should remain vigilant in monitoring a child's development at each clinical encounter (i.e., developmental surveillance) and should focus on confirming the diagnosis of developmental delay among children in whom it is suspected," the task force concludes.
The guideline and knowledge translation tools are available at

The Canadian Task Force on Preventive Health Care has been established to develop clinical practice guidelines that support primary care providers in delivering preventive health care. The mandate of the task force is to develop and disseminate clinical practice guidelines for primary and preventive care, based on systematic analysis of scientific evidence.

Canadian Medical Association Journal

Related Children Articles from Brightsurf:

Black and Hispanic children in the US have more severe eczema than white children
A presentation at this year's virtual American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting reveals the disparities that exist for Black and Hispanic children when it comes to Atopic Dermatitis (AD), commonly known as eczema.

Black children with cancer three times less likely to receive proton radiotherapy than White children
A retrospective analysis led by investigators from Brigham and Women's Hospital has found racial disparities in the use of the therapy for patients enrolled in trials.

The Lancet Child & Adolescent Health: First Europe-wide study of children confirms COVID-19 predominately causes mild disease in children and fatalities are very rare
Children with COVID-19 generally experience a mild disease and fatalities are very rare, according to a study of 582 patients from across Europe published today in The Lancet Child & Adolescent Health journal.

Children not immune to coronavirus; new study from pandemic epicenter describes severe COVID-19 response in children
- While most children infected with the novel coronavirus have mild symptoms, a subset requires hospitalization and a small number require intensive care.

How many children is enough?
Most Russians would like to have two children: a boy and a girl.

Preterm children have similar temperament to children who were institutionally deprived
A child's temperament is affected by the early stages of their life.

Only-children more likely to be obese than children with siblings
Families with multiple children tend to make more healthy eating decisions than families with a single child.

Children living in countryside outperform children living in metropolitan area in motor skills
Residential density is related to children's motor skills, engagement in outdoor play and organised sports. that Finnish children living in the countryside spent more time outdoors and had better motor skills than their age peers in the metropolitan area.

Hispanic and black children more likely to miss school due to eczema than white children
In a study that highlights racial disparities in the everyday impact of eczema, new research shows Hispanic and black children are more likely than white children to miss school due to the chronic skin disease.

Children, their parents, and health professionals often underestimate children's higher weight status
More than half of parents underestimated their children's classification as overweight or obese -- children themselves and health professionals also share this misperception, according to new research being presented at this year's European Congress on Obesity (ECO) in Glasgow, UK (April 28-May 1).

Read More: Children News and Children Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to