NYMC Faculty Publications

Developmental Surveillance and Screening Practices in a Pediatric Oncology Clinic: Initial Progress of a Quality Improvement Study

Author Type(s)

Faculty, Resident/Fellow

DOI

10.1002/pon.6348

Journal Title

Psycho Oncology

Document Type

Letter to the Editor

Publication Date

5-1-2024

Department

Pediatrics

Keywords

cancer, developmental disabilities, health care quality, access, and evaluation, integrative oncology, oncology, pediatric psychology, psycho-oncology, quality improvement

Disciplines

Medicine and Health Sciences

Abstract

Background: Pediatric cancer patients’ oncology teams regularly take on a primary care role, but due to the urgent nature of cancer treatment, developmental screenings may be deprioritized. This leaves patients at risk of developmental diagnoses and referrals being delayed. Aims: Clarify the current developmental surveillance and screening practices of one pediatric oncology team. Materials and methods: Researchers reviewed charts for patients (n = 66) seen at a pediatric oncology clinic in a suburban academic medical center to determine engagement in developmental screening (including functioning around related areas such as speech, neurocognition, etc.) and referrals for care in these areas. Results: Developmental histories were collected from all patients through admission history and physical examination (H&P), but there was no routinized follow-up. Physicians did not conduct regular developmental screening per American Academy of Pediatrics guidelines for any patients but identified n = 3 patients with needs while the psychology team routinely surveilled all patients seen during this time (n = 41) and identified n = 18 patients as having delays. Discussion: Physicians did not routinely screen for development needs beyond H&P and were inconsistent in developmental follow-up/referrals. Integrated psychologists were key in generating referrals for developmental-based care. However, many oncology patients were not seen by psychologists quickly or at all, creating a significant gap in care during a crucial developmental period. Conclusion: The case is made for further routinization of ongoing developmental screening in pediatric oncology care.

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