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Missed well-child visits lead to delays in diagnosing developmental disorders

March 1, 2022

Editor's note: As the COVID-19 pandemic enters its third year, Arwa K. Nasir, M.B.B.S., M.Sc., M.P.H., FAAP, is one of six pediatricians reflecting on what keeps her going, the lessons she's learned along the way and she hopes for the future. To read all six reflections, click here.

Two years into the pandemic, Arwa K. Nasir, M.B.B.S., M.Sc., M.P.H., FAAP, is preparing for yet another challenge, this one affecting her youngest patients.

Due to concerns about exposure to the SARS-CoV-2 virus, some parents skipped well-child appointments — visits Dr. Nasir said are critical to screen young children for developmental issues.

“What I noticed in the past couple years is we are seeing some children who were between 1 to 3 years old where the medical care had been interrupted by the COVID pandemic,” said Dr. Nasir, professor in the Division of General Pediatrics at University of Nebraska Medical Center. “… Because of that, some kids who had emerging developmental delays which we usually catch during that period got missed because they hadn’t seen a doctor for that year.”

As a result, children who were diagnosed with delays later must now play catch-up.

“Although we are not delivering COVID-19 vaccines, we are delivering this very, very critical screening for developmental delay,” said Dr. Nasir, a member of the AAP Section on Developmental and Behavioral Pediatrics. “The interventions are much more effective when those kids are still small, so a delay in those diagnoses is usually not very good.”

Dr. Nasir said the first three years of life are “a window of opportunity” when interventions for speech, fine motor, gross motor or physical issues can lead to better outcomes for children.

“If you get those basic skills early on, kids can move on, but if you don’t get the basic skills, it’s really difficult to teach them later on,” Dr. Nasir said. “When you’re so behind, all those subsequent skills don’t get built. Really, it compounds the situation.”

Dr. Nasir said she and her team remain committed to ensuring patients and families can access the resources they need.

“We feel what we do makes a difference in people’s lives and families’ lives,” she said. “We just do one patient at a time, but if I can pick up just one of those kids and make sure they get the services they want and support that family, that is a huge achievement. The belief in the importance of this work is what keeps us coming back.”

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