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Monday, June 27, 2022

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As a parent, you want to ensure that your child is healthy, growing well and showing no signs of any problems that could interfere with her physical, mental, emotional, communicative and social development.

So, you’ll be relieved to learn that today all children, regardless of  race, nationality, language and culture can be checked or screened to reassure parents about healthy growth and development or to identify potential challenges early enough to get to work on eliminating or limiting their adverse impact on a child’s life.

A child’s development proceeds in a predictable sequence of stages.  Babies support their head, roll over and begin to crawl before they stand and walk. As preschoolers, they hop, skip and jump before they run, throw, join teams and raise trophies.  They suck before they coo and babble before they speak.  The same is true when it comes to the orderly progress children make in developing their fine motor skills, their ability to reason and solve problems and  their processing and expressing of feelings such as sympathy, empathy, generosity and friendship.  The combination of maturation, experience, practice and satisfying results motivates and enables children to outgrow their current abilities to achieve even more effective and efficient skills and accomplishments.

Because we can anticipate, predict and observe each successive set of skills as they emerge, we can design instruments to measure the timing, consistency and quality of every child’s course of development.    Today, a veritable industry helps pediatricians, teachers and parents apply the science of child development to constructing standardized, valid screening tools.

Some examine general abilities of children across multiple domains of behavior, thinking, communicating and relating.  Others focus on one line of functioning, for example, hearing, use of language or social skills.  And just as a child’s development progresses from emergent to mature, the instruments we use to identify normalcy, delay or deviance range from simple surveys to intensive evaluations.  All of them are meant to discover challenges early on when children’s brains and potentials are most able to respond to support and to recover successful trajectories.

Each instrument has a specific purpose and value.  Developmental screening is the first line of inquiry about how well a child is developing.  All children should be screened at regular intervals during early childhood to monitor progress in their physical, mental, emotional, social and communicative abilities.  Screening yields one of two results: either the child is developing well in all areas of functioning or one or more concerns were discovered.  The most widely used developmental screening instruments are very sensitive in their ability to catch children who have potential problems and they are also very specific to not label too many children with concerns when none exist.

If a concern is found by the screening instrument, the clinician who administered the test makes a referral to a developmental specialist who conducts a thorough assessment or evaluation, looking in depth and detail into the specific nature and extent of any challenges that may or may not require intervention.   Evaluation leads to diagnosis and intervention appropriate to the source of the problem and the functional disability.

Developmental screening can take a few minutes to administer or it can involve a comprehensive look at many abilities and issues.  The latter has been a model developed in Hillsborough County over the past 25 years as a community-based developmental screening program that coordinates, free of charge, the expertise and services of many professional individuals and organizations.

The Early Childhood Developmental Screening Program, recognized as a “Best  Practice” by the Florida Department of Education, provides free screening for delays or problems with speech and language development, motor skills, vision, hearing, cognition and behavior to any child from birth to age 5 in Hillsborough County.  The program has screened nearly 20,000 children during the past 25 years.  About 75 percent of children screened have been referred for further assessment/evaluation due to some type of developmental challenge.  That’s a huge number and suggests that parents know when to be concerned.

Many other young children get their screenings through a service of the county’s Early Learning Coalition.  Children participating in the School Readiness Program are screened twice a year.  If minor concerns arise, the coalition provides an Individual Learning Plan for the parent and teacher to address those concerns.  When warranted, an intervention team conducts further assessments.

Developmental delays and disabilities occur in children from every socioeconomic and cultural background.   Without screening, children often go undiagnosed until they begin elementary school, which is a disadvantage academically, socially and emotionally.  The chance to promote healthy development and prevent handicapping conditions is a resource no child should be denied.   In addition, early detection and intervention yields enormous cost savings in healthcare and special education.  Yet less than half of the pediatricians in the U.S. routinely perform standard developmental screening on children in their practices.  The Affordable Care Act will endorse, as standard of practice, the use of this simple key to a bright future.  It is within our means and our generous American spirit to enable every individual to reach and tap his or her potential.

For more information about Hillsborough County’s Early Childhood Developmental Screening Program, go to www.ecctampabay.org or call (813) 837-7723. For information about the Early Learning Coalition Screening Program, go to www.elchc.org or call (813) 202-1000.

Peter A. Gorski, M.D., M.P.A. is the director of research and innovation at the Children’s Board of Hillsborough County and professor of pediatrics, public health, and psychiatry at the University of South Florida. Stephen C. Martaus is executive director of the Early Childhood Council of Hillsborough County Inc.  Dave McGerald is the chief executive officer of the Early Learning Coalition of Hillsborough County.  

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