This meta-analysis of 37 PEDS® studies included a total of 210,242 children/parents. The studies were conducted in the US, Canada, Australia, Thailand, The Philippines, Indonesia, Spain, India and Tanzania. Dr. Woolfenden and colleagues found that parental concerns indicating high developmental risk were associated with multiple risk factors: male gender, low birth weight, poor/fair child health rating, poor maternal mental health, lower socioeconomic status (SES), minority ethnicity, not being read to, a lack of access to health care and not having health insurance. Thus PEDS® ensures both developmental-behavioral screening plus psychosocial risk assessment, i.e., surveillance. The authors conclude, “given [that] the prevalence of parental concerns increased with biological and psychosocial adversity, the service response needs to be one of proportionate universalism where the greater the disadvantage, the more services available.”