The American Academy of Pediatrics recommends that infants and toddlers be screened for communication and cognitive difficulties. But until recently no tool had been developed for use in primary care. Because signs of communication and cognition development usually appear before speech, and because parents can reliably report them, the Screening for Communication and Cognition in Infants and Toddlers tool has been developed. An NP can use it by interviewing the parent while examining the child.

Screening questions focus on several developmental areas of the first two years of life, including feeding and swallowing, frequency of ear infections, responses to sound, and interaction with parents and toys, among others. Problems in these areas may indicate language or speech disorders, cognitive disorders, autism, hearing or visual impairment, or physical disabilities such as cerebral palsy. If a concern arises in three or more areas, the child should be referred for a thorough evaluation.

Fran Mennick, BSN, RN