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Why Screen?

Both the American Academy of Pediatrics (AAP) and the American Academy of Neurology (AAN) exhort providers to engage in developmental surveillance. Surveillance is a longitudinal process that commences with routinely eliciting and addressing parents' concerns, followed by reviewing medical history, maintaining a record of developmental progress, making accurate and informed observations about the child and parent-child interactions, identifying risk and protective factors that often predict developmental risks or resilience, and ensuring that needed interventions are promptly delivered.

The AAP recognizes the benefits of early detection and thus earlier intervention. In its July, 2006 policy statement (Pediatrics, 2006), members of the Council on Children with Disabilities wrote:

"Early identification of developmental disorders is critical to the well-being of children and their families. It is an integral function of the primary care medical home and an appropriate responsibility of all pediatric health care professionals."

The AAN, in its Practice Parameter on diagnosis of autism (2000), stated:
"[Early detection] should be performed at all well-child visits from infancy through school-age, and at any age thereafter if concerns are raised about social acceptance, learning, or behavior."

Periodic use of quality screening tools is recommended to add evidence to the process of surveillance. The AAN specifically recommends tools with abundant psychometric support, i.e., national standardization, reliability (of several types), validation against criterion diagnostic tests, and accuracy, i.e., sensitivity and specificity of 70% or greater. Both societies suggest a periodicity schedule for surveillance and screening. Both agree that surveillance should occur at all well-child visits from infancy through school age.

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