The Importance of Developmental Screening
When it comes to our children, we want to do everything possible to ensure that they are healthy and growing as expected. One way to do...
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All-in-One Screening
The SWYC is an age specific, comprehensive, first-level screening instrument that combines what is traditionally “developmental” with traditionally “behavioral” screening, and adds screening for autism, parental depression and other family risk factors.
There are 12 SWYC forms—one for each pediatric well-child visit. They can be completed by any caregiver, including parents and grandparents, who have enough knowledge about the child to be able to answer the SWYC questions reliably.
Don’t worry if your baby is not doing all of the things this questionnaire asks about —most children can’t do every skill described. The questions are just a way for your doctor to get a sense of what things you should talk about in more detail.
Development Section.
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Developmental Milestones
The Developmental Milestones questions include indicators of fine and gross motor, language, social, and cognitive development.
Most children will not be able to do all the skills listed at any particular age. It was designed this way to provide parents with some idea of what skills they may see their children doing next.
The first few items on each screening are “easier” skills that most children will be doing. As the list goes on, the skills become more challenging.
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Autism screening — POSI (Parent's Observations of Social Interactions). Children ages 16-18 months.
POSI’s sensitivity (83%) is higher than that of the M-CHAT autism screening (50%). On the other hand, MCHAT is more specific than the POSI. Both screenings are available in the Pathfinder Health app.
Emotional/Behavioral Section.
With the typical ups and downs of young children’s emotions and behavior, delays or problems can be easily missed.
Today, as more children are increasingly exposed to risk factors such as poverty or toxic stress, the likelihood of depression, anxiety, and anti-social behavior increases.
Early identification of social-emotional challenges can make all the difference to a young child. The earlier a behavioral concern is identified, the greater the chance a child has of reaching his or her full potential in life.
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2-18 months — The Baby Pediatric Symptom Checklist (BPSC). ~10–15% of 1-2-year-old children experience social/emotional problems. Early behavior patterns can also affect the quality of parent-infant interactions.
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18-60 months — The Preschool Pediatric Symptom Checklist (PPSC). ~10–15% of preschool children experience social/emotional problems that cause significant suffering. Most mental health disorders in adulthood have their roots in childhood, early identification may reduce long term disability.
Family Questions.
This section is what sets the SWYC apart from other instruments.
Children with unmet basic needs—such as food insecurity or housing instability, being subject to structural racism, exposure to smoking and substance misuse—are at greater risk for chronic health conditions, developmental delays, behavioral problems, and poor educational outcomes.
Addressing children’s unmet social needs requires identifying and addressing the needs of parents and guardians in addition to those of the child.
Family Questions are used to measure symptoms of postpartum or long-term depression, alcohol and drug abuse, domestic violence, and other psychosocial risk factors that affect parents' and children's well-being.
A positive score on the SWYC indicates concern, not diagnosis.
The screening is very sensitive and will pick up some false positives, but it also means that children with real issues are less likely to be missed. Some children who screen positive on the Survey of Wellbeing of Young Children (SWYC) will, upon further conversation with their physician, actually turn out to be doing just fine.
If it was relatively hard to score positive, that would mean that the only children who score positive would have very concerning scores and almost certainly have a real problem but children with less extreme scores who might need just a little help to catch up would be missed.
If it was relatively easy to score positive, the SWYC would probably not miss many children with real issues.
However, this would also mean that it would detect more false positives – children who score positive, but are really doing fine.
Ready to get started?
We recommend:
01/
Have fun!
Try all the activities together with your child if you haven't already seen them do some of the things.
02/
Relax!
Think about all the special memories you've created with your child and take time to reflect on each question and answer them as accurately as possible.
03/
Take a breath!
Every child develops at their own pace, so if they aren't doing some things, no need to get scared. We'll let you know how they're doing and what to do next.
Disclaimer: The SWYC and the information on this site are not designed to and do not provide medical advice, professional diagnosis, or treatment. The information is NOT intended to replace consultation with a qualified medical professional.
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