Ask For ASQ: The Importance of Early Developmental Screening
The relationships that children have with their parents and caretakers are vital in enabling them to reach their full developmental potential. While our genes may lay down the foundation, it is the experiences that children have that are the true building blocks and the mortar for them to be able to establish important connections within the brain and grow. Children who may be developmentally delayed can be significantly helped by important state-regulated programs that can target areas of need and maximize important skills during a vital period of brain development and growth.
Serve and Return
Executive Functioning is the brain’s ability to filter, prioritize, and focus one’s thinking. According to the Center for the Developing Child at Harvard University, the experiences and interactions that children have during a crucial window of development help shape their executive functioning for the rest of their lives. The “Serve and Return Interaction”, described by the Center, is one of the primary ways that children’s brains become molded and shaped to activate and develop neuronal connections that will become continual. For example, young children “serve” by gazing and focusing on a specific object, and adults “return” this attentive behavior by saying and repeating the name of the object. In due time the child will make connections in her brain which will enable her to instantaneously recall the name of the object.
Autism is a neurodevelopmental disorder in which executive functioning of a child may be impaired. A 2006 study by the CDC indicated that most children who have an autism spectrum disorder, showed features of developmental issues before the age of three, however the formally ascribed diagnosis was on average not made until five years of age. Waiting until that point to receive full developmental services can significantly delay the maximization of care during that fleeting window of brain development. Research has shown that the earlier health professionals intervene, the better the developmental outcome for the child.
Surveillance and screening during routine pediatric visits are essential in being able to catch developmental delays early and act on them in an expeditious manner. The typical screening months for developmental delay are during the 9,18, and the 24 or 30 month visits for general developmental screening and 18 and 24 months for autism specific screening. The ASQ (Ages and Stages Questionnaire) is recommended by the American Academy of Pediatrics to be used for developmental assessment starting from as young as 1 month of age and extending to 5 1/2 years of age. The questionnaire is a simple and effective screening tool that you and your pediatrician can go through together.
There are wonderful resources in place to support children when a delay is identified. One of the most dynamic and important resources is a state funded program called Early Intervention, which provides family centered plans geared to help children with developmental delays. In addition to the integral speech, occupational, and physical therapy, there are also social workers, nutritional therapists, and both nurses and physicians who provide their services to this fantastic program. These services are provided at no cost to the family.
Parental Empowerment: Asking for ASQ
While developmental screens are firmly recommended by the American Academy of Pediatrics, the reality is they are not always done in all pediatric settings.
Although many pediatricians believe that developmental screening is imperative, a study conducted by the National Survey of Children’s Health detected that only 19.5% of patients had parent-filled questionnaires completed in the prior 12 month time span. Additionally, the 2.7% enrollment rate of Early Intervention falls far below the Center for Disease Control’s projected 8% prevalence rate of developmental delay in the community. Barriers to healthcare professionals conducting screens include brevity of their well-child visit, inadequate time during a sick visit when there are multiple other complaints to address, language barriers, concern about reimbursement rates, and lack of knowledge about appropriate referral resources.
When you go for your child’s well-visit or even if you are seeing your physician for a simple cold and the doctor did not have the chance to conduct a developmental screen during your last visit, you have the right to request a screen. When parents are empowered by the knowledge that early intervention can impact their child’s growth and future well being, more children who require these services can be supported.