Under-referrals for Developmental Delays by Pediatricians: A Systematic Review

Developmental screenings for children have become increasingly popular, as early intervention has taken strides in providing services to children at risk for developmental delays. Thus, it has been suggested that developmental screenings be routinely used in early childhood, however, many children are not being detected until school entrance. A literature review was conducted to explore why there continues to be an inconsistency of children being screened for developmental delays. Using PsycInfo and PubMed databases, this review included 45 peer-reviewed journals published between 1990 and 2014 that studied the underlying issues of developmental screenings in pediatric care and the referral rates. Findings show that pediatricians are inconsistent in their referral patterns due to their reluctance to use developmental screenings because of time dependency and lack of resources. Furthermore, the literature suggests that parental concern on child development is exceedingly useful and can aid in reducing the amount of under-referrals. Limited research has also indicated that child-care providers have been shown to assist in providing knowledgeable feedback on children's developmental capabilities, and can be instrumental in providing a comprehensive evaluation. To conclude, routine visits with a pediatrician are critical opportunities for children to be screened for developmental delays and for the families to receive resources on obtaining intervention services. Therefore, in addition to implementing surveillance and routine developmental screenings, it is essential to focus on procedures that allow active collaboration between pediatricians, families, and childcare providers to help detect developmental delays early and reduce the amount of under-referrals.Ope