Pediatric Quality Measures in Developmental Screening and Follow-Up

CONTEXT: Timely identification and management of developmental problems are essential for children. OBJECTIVE: To summarize quality measures for developmental screening and follow-up among children in the United States. DATA SOURCES: PubMed, Embase, CINAHL, Cochrane Library, and PsychINFO from 2009 to December 7, 2024. Gray literature sources recommended by experts. STUDY SELECTION: Systematic reviews, primary studies, and gray literature sources. DATA EXTRACTION: Two reviewers extracted information on measure definitions, study characteristics, barriers, and research gaps. RESULTS: We included 11 systematic reviews, 36 studies, and 11 gray literature sources and identified 67 developmental screening measures and 61 follow-up measures. Measures focused on early childhood in clinic settings. We found evidence for reliability, validity, and usability in 29, 25, and 30 screening measures, respectively, and 34, 39, and 36 follow-up measures, respectively, with evidence both for and against feasibility of measures. Eighteen studies showed improvement in measures with use of specific tools or implementation practices for developmental screening and follow-up. Differences in use of measures by state, population, institution, or clinician type were infrequently described. Barriers to measure implementation related to electronic health record data extraction, resource limitations, and burden of data collection and reporting. We found little evidence on reduced disparities associated with measure implementation. LIMITATIONS: We excluded information from other countries, from before 2009, or about measures for behavioral, social, or emotional screening. CONCLUSION: Many pediatric developmental screening and follow-up measures have evidence of reliability, validity, and usability, but feasibility is a concern. Future research should focus on feasibility, standardization, and stratification.