Survey asks parents to help screen for early child development delays.

Byline: THE HEALTH FILES By Tim Christie The Register-Guard

Pediatricians are always on the lookout for signs that their young patients may be lagging in their early development.

They question parents about a child's ability to walk and talk and solve problems and get along with others to get a "quick and dirty idea of how they're doing," said Eugene pediatrician Dr. Kevin Marks.

But pediatricians are busy, and they don't always catch little delays that, if not detected early in life, can cause huge problems by the time children reach school age and older, Marks said.

That's why groups such as the American Academy of Pediatrics, which estimates that 12 percent to 16 percent of American children have developmental or behavioral disorders, urge doctors to systematically check for developmental delays.

And it's why Marks and other PeaceHealth Medical Group doctors are working with University of Oregon researchers to enlist parents in screening for such delays.

So now, 18 pediatricians and two nurse practitioners at PeaceHealth Medical Group clinics in Eugene have begun giving a survey to parents when they bring their children for well-child check-ups at 1 and 2 years of age.

"Doctors think they're good at picking up developmental delays and in fact, we're not so good," said Marks, the lead physician on the project.

Pediatricians are good at detecting things like gross motor delays - difficulty walking, for instance - and speech delays, he said, "but my intuition tells me we're not as good at picking up subtle delays."

That's where the survey comes in. It's called the Ages and Stages Questionnaire, and was developed about 1980 at the UO by Diane Bricker, Jane Squires and colleagues. The ASQ has been translated into four or five languages and may be the most commonly used screening tool in the country, said Liz Twombly, senior research assistant at the UO's Early Intervention Program.

The survey doesn't diagnose developmental problems, but serves as an effective screening tool to identify children who should receive more detailed diagnosis or assessment, Twombly said.

It asks questions such as: When your child wants something, does she tell you by pointing; and does your child correctly use at least two words such as me, mine, I and you?

The survey can be time-consuming, and in a busy practice, doctors don't have time to go through it with parents, Marks said.

So the surveys will be sent home with parents, along with a pre-stamped envelope. The surveys will go to EC Cares, a program of the Oregon Department of Education that provides early childhood intervention and special education services. EC Cares officials will review the surveys to determine if a child is typical, questionable or needs further assessment.

Even if a child is not eligible for early intervention through EC Cares, the survey can identify children who would benefit from relatively easy changes that parents can do, Twombly said.

"Parents can have a huge impact on their child's development by providing opportunities for their children to practice skills in play and everyday activities," she said.

For instance, if a child is lagging with fine motor skills, parents can give the child more opportunities to manipulate small objects, like stacking blocks. Even little changes like that can make big differences, she said.

"If you wait, by the time you get into kindergarten, those delays become really big," she said. "It's much easier to work with them early. Oftentimes, we can completely cure them."

That's because children's brains undergo huge development in the first years of life.

"They're so ripe at that age," she said. "If you have kids and they're not receiving good stimulation, their brains are not developing in the same ways as kids with enhanced opportunities to learn."

A recent pilot study of 100 children suggested that in a year's time, 830 children seen by PeaceHealth Medical Group doctors will be identified in the questionable delay range, and another 580 would be identified as needing further assessment.

The UO researchers may use data from the PeaceHealth Medical Group project to study whether having pediatricians give parents the ASQ survey is an effective screening tool.

Getting parents to follow through and complete the survey is a matter of friendly urging by doctors and nurses, Marks said.

"What we're saying is, this is a fun thing to do," he said. "It gives you a better idea of where your child is developmentally and it focuses you on your child's development."

Tim Christie can be reached at 338-2572 or tchristie@ guardnet.com.