The US Preventive Services Task Force Recommendations and Rationales
| Screenings | USPSTF recommendations | Rationales |
|---|---|---|
| Development | Inadequate evidence on the effectiveness of interventions, the accuracy of surveillance and screening instruments for speech and language delay.7 | Early detection can lead to early intervention and improved outcomes, and PEDS form shown to be acceptable for use in primary care.15 |
| Anemia | Inadequate evidence on the effect of routine screening for iron deficiency anemia in asymptomatic children aged 6 to 24 months on growth or child cognitive, psychomotor, or neurodevelopmental outcomes.8,9 | Iron deficiency anemia is associated with psychomotor and cognitive abnormalities in children, and it continues to be the highest among children from minority and poor backgrounds.16 |
| Lead | Good-quality evidence that interventions do not result in sustained decreases in blood lead levels10 | There is evidence that 25% of children live in housing with deteriorated lead-based paint and are at risk of lead exposure that can result in cognitive impairment and other sequelae.17 |
| Oral Health | Insufficient evidence to assess the balance of benefits and harms of routine screening for dental caries performed by primary care clinicians in children aged 0 to 5 years.11,12 | The prevalence of untreated dental caries at ages 2 to 5 years is almost 20% and early professional dental care complemented by risk assessment, anticipatory guidance, and periodic supervision can provide time-critical opportunities to reduce the risk of preventable dental or oral disease in children.18,19 |
| Vision | Recommended for all children at least once between the ages of 3 and 5 years (B recommendation); high certainty of a moderate net benefit and moderate certainty of a moderate-to-substantial net benefit.13 | Amblyopia prevalence in the United States is 1% to 4%, but on using available vision screening tests, early detection can prevent visual loss by ensuring effective interventions are given earlier. No obvious harms associated with vision screening were noted.13 |
| Hearing | Not published on hearing screening in infants and children. One study raises doubts about the usefulness of preschool hearing screening program in child care centers.14 | Failure to detect congenital or acquired hearing loss in childhood may result in lifelong deficits in speech and language acquisition, poor academic performance, social maladjustment, and emotional difficulties.20 |
USPSTF, US Preventive Services Task Force; PEDS, Parent's Evaluation of Developmental Status.