Early Developmental Screening in High-Risk Communities: Implications for Research and Child Welfare Policy

Abstract

Early detection of developmental delays in children living in high-risk communities enables effective intervention and promotes positive outcomes. Until now, the mechanisms by which these risks and benefits arise and persist have yet to be documented from a synergistic perspective. We take a dynamic, ecological theoretical approach to examine the interplay between developmental surveillance, professional support and parental understanding of children's developmental progress. The Regional ASQ Developmental Screening Project* used geo-mapping to target the highest risk communities in three metropolitan Detroit counties. Statistical analyses using paired t tests compared screening results for 1,640 children in high-risk communities to results for 24,220 children living in surrounding communities. Children in high-risk communities had a substantially higher risk of developmental delay than the rest of Metro Detroit (43% vs. 28%). There were significant differences in the overall scores from the initial screens (M =2.38, SD = .788) to subsequent screens (M = 2.46, SD =.706): t (1,640) = -5.104 p < .05, suggesting that risk of delay decreases over time. There were statistically significant differences in the overall risk for developmental delay and within in the domain of fine motor development. These results 19 provide an empirical basis to develop prevention and intervention programs and child welfare policy. We suggest ways to build capacity at the individual, institutional, and societal levels. Future research should focus on exploring the unique interplay of community-level risk with family and child level risk and protective factors.