of Developmental Status and Denver Developmental Screening Test.
At the nine-month visit, motor delays are often identified. Language
and communication delays are often more evident at the 18-month
visit, as well as mild motor delays that were not detected at the nine-
month visit. Most motor, language and cognitive delays have been
identified by the 30-month visit, thus the AAP has incorporated
into the recommendations a final screen at this time. If screening
identifies risk, then diagnostic developmental evaluation is war-
ranted through a specialist including a developmental pediatrician,
speech-language pathologist or occupational therapist.
Additionally, the AAP is now including autism-specific screening
tools into the recommendations at the 18-month and 24-month well
care visits. An example of a screening tool for autism is the Mod-
ified Checklist for Autism in Toddlers. For children with autism,
early interventions can improve core deficits, including social and
language delays.
As a pediatrician, I currently follow Bright Futures and Guide-
lines for Health Supervision to make sure all surveillance, screening
and diagnostic evaluations are being completed per AAP recom-
mendations, and to better identify those children who would benefit
from early interventions. Early intervention provides support to
caregivers and enhances learning opportunities for the child. First
Steps is a great resource in Louisville for children identified as “at
risk” for developmental and/or behavioral problems and who are
KIDS' STUFF
under the age of three. First Steps can offer comprehensive services
including physical therapy, occupational therapy and/or speech
therapy. Additional therapies can be incorporated into medical
home treatment plans depending on the individual child’s needs. For
more information on the First Steps program, call at 877-417-8377.
We live in a digital era of medicine. I direct parents who are
interested in following their child’s development closely to two free
internet resources. The first is healthychildren.org. Under the “Ages
and Stages” section, parents can read about different milestones for
their child’s specific age group and even look forward to what they
may be achieving in the future. Additionally, brightfutures.aap.org
is a good resource for parents and health care providers. Bright
Futures offer handouts that discuss the child’s health, development
and safety, and can be provided to caregivers at preventative well
care visits.
One of my greatest joys as a pediatrician is watching a child grow
and reach new milestones. The most important time for learning and
development is early in life. Through surveillance and screening, we
are able to identify delays earlier, and start therapies sooner so a child
can reach his or her potential. Health care providers can directly
improve a child’s long-term development and social behaviors.
Dr. Krease practices Pediatric Medicine at All Children Pediatrics.
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