Pediatricians do a good job of screening children for developmental delays, but too rarely refer children with suspected delays for further treatment, new research indicates.

Under guidelines instituted by the American Academy of Pediatrics in 2006, pediatricians are advised to screen children at 9, 18 and 24 months of age for developmental delays. Children who fail a screening should then be referred to a specialist and an early intervention program.

But the process is not as seamless as it ought to be, researchers report in a study to be published in the February issue of the journal Pediatrics.

An analysis of screening and referrals at 17 pediatrics offices in 15 states found that since the guidelines were established screening rates increased from 68 percent to 85 percent. But only 61 percent of children with suspected developmental delays were referred for further testing and therapy.

Even in cases where a pediatrician did make a referral, researchers found that many families failed to act on the doctor’s advice, in some cases because they did not understand the need for further steps. What’s more, patients who were referred elsewhere by a doctor were often told to go to a specialist or an early intervention program rather than both.

“The ultimate goal of screening is to improve outcomes for children with developmental delays, but in our study we found that many pediatricians did not act properly even when serious red flags were present,” said Tracy King, a pediatrician at Johns Hopkins Children’s Center who led the research. “This is where we should focus our efforts: making sure that more children with suspected delays get referred for testing and therapy.”

Researchers recommend that pediatricians arrange for referrals directly rather than simply providing patients with a phone number and that they routinely follow up to ensure that children are getting the treatment they need.

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