This piece is part of Scientific American’s column The Science of Parenting. For more, go here.
As we strive to keep our kids safe, healthy and happy, detecting and treating developmental and other conditions early is essential. For this reason, pediatric care emphasizes the importance of screening for everything from developmental delays to emotional problems to autism. Unfortunately, screening results are not always reassuring. For example, when a screening questionnaire comes back “positive” for, say, autism, panic can set in. What does this result mean, and why does the doctor think your child is autistic?
It turns out these screening results don’t offer simple “yes” or “no” answers as to whether a child has a condition. Identification depends a lot on estimates of how common a condition is. Detecting uncommon conditions, such as autism, is a lot harder than anyone would like. Parents should know this when hearing about their child’s scores. Understanding why requires knowing a few basic facts about the science of screening.
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Simply put, a screening questionnaire is a standardized set of questions designed to identify or predict one or more conditions or potential health or quality of life issues. For example a screener for autism usually includes questions about behaviors that are known to be its early signs, often focusing on how children communicate. Typically each answer is scored—for example, a “yes” response may receive a 1, and a “no” response may receive a 0. Sometimes, particularly for developmental milestones, questions are scored by comparing a child’s results with those of same-aged children. Either way, answers are combined to generate a total score.
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