Reviewed for medical accuracy by Dr Evelyne Jonniaux, Medical Advisor
Last updated 17 September 2026
Only three screens carry an established net benefit in an asymptomatic child: newborn hearing, vision between 3 and 5 years, and obesity from age 6 with referral to intensive behavioural intervention. The others are graded insufficient evidence, which does not mean useless, but that no study allows the balance to be settled.
The questions we get asked
What does “insufficient evidence” mean?
A grade I from the US task force means the balance of benefit and harm cannot be determined for lack of studies. It is not an adverse opinion. For lead, the capillary test correctly identifies the children concerned; what is missing is evidence on the effectiveness of treatment in an asymptomatic child. The gap is about what is done with the result, not about the test.
Which screens have established benefit?
Newborn hearing, grade B. Vision between 3 and 5 years at least once, for amblyopia and its risk factors, grade B. Below 3 years the same recommendation falls back to insufficient evidence. Obesity from age 6, grade B, but with a condition that is often forgotten: referral to a behavioural intervention of at least 26 contact hours. Without that, screening alone has not demonstrated a benefit.
What about autism screening at 18 months?
Graded insufficient evidence, but the wording matters: the recommendation applies to children aged 18 to 30 months for whom no concern has been raised by parents or clinicians. It does not question the assessment of a child about whom a concern exists. The same qualification applies to speech and language.
Is universal hip ultrasound useful?
It is the best documented example of paediatric over-diagnosis. A randomised trial in 11,925 newborns compared general ultrasound, targeted ultrasound and clinical examination alone. The treatment rate rises from 1.8 to 3.4 percent, the additional follow-up rate from 0 to 13 percent, and the reduction in late dislocations is not statistically significant. A later Norwegian study titled its article: introducing universal ultrasound screening doubled the treatment rate.
Set against the benefit of waiting: in the Norwegian targeted programme, 3.3 percent of newborns normalised spontaneously under watchful waiting, without treatment.
And in continental Europe?
The French health authority identifies dedicated consultations at 4 months, 9 months, 2 years, 3 years, 4 years and 6 years, across six domains. One important difference from the US framework: those proposals are consensus-based and are not graded by level of evidence.
What the figures say
| Screen | Grade | Source |
|---|---|---|
| Newborn hearing | Established net benefit | USPSTF, Pediatrics, 2008 |
| Vision from 3 to 5 years | Established net benefit | USPSTF, JAMA, 2017 |
| Obesity from age 6, with a 26-hour intervention | Established net benefit | USPSTF, JAMA, 2017 |
| Autism, language, lipids, anaemia, lead, scoliosis, hip | Insufficient evidence | USPSTF, 2006 to 2024 |
| Hip treatment after universal ultrasound against clinical examination | 3.4 against 1.8 percent | Rosendahl et al., Pediatrics, 1994 |
| Hips that normalised spontaneously under watchful waiting | 3.3 percent of newborns | Laborie et al., Pediatr Radiol, 2014 |
What Noria Health does, and does not do
We organise a structured paediatric assessment with a specialist team near Brussels, matched to the child’s age and to the concerns raised, and we confirm feasibility within 24 to 48 hours.
We do not offer a routine battery of tests, we do not interpret any result by message, and we do not replace the child’s usual follow-up.
Who reviewed this page
Noria Health editorial team.
See also: all our articles on paediatrics.
Have your case reviewed. Noria Health arranges a specialist consultation near Brussels and confirms feasibility within 24 to 48 hours. Open a case.