Developmental screening--expecting the impossible?

In this issue of Pediatrics, Meisels addresses a topic that has received considerable attention within the child development literature—the validity of the Denver Developmental Screening Test (DDST). The author summarizes data from 13 studies to document the limited sensitivity of the test. However, several of the studies cited by Meisels are themselves weakened by methodologic problems. For example, in four of the so-called replication studies, applications were actually examined for which the DDST was not originally designed, such as identifying developmental delay among biologically vulnerable infants, screening for speech and language problems, and identifying children with moderate to severe delays.