Abstract
Early detection of developmental difficulties is universally considered a necessary public health measure, with routine developmental monitoring an important function of primary healthcare services. This study aimed to describe the developmental monitoring practice in two remote Australian Aboriginal primary healthcare services and to identify gaps in the delivery of developmental monitoring services. A cross-sectional baseline medical record audit of all resident children aged less than 5 years in two remote Aboriginal health centres in the Northern Territory (NT) in Australia was undertaken between December 2010 and November 2011. A total of 151 medical records were audited, 80 in Community A and 71 in Community B. Developmental checks were more likely among children who attended services more regularly. In Community A, 63 (79%) medical records had some evidence of a developmental check and in Community B there were 42 (59%) medical records with such evidence. However, there was little indication of how assessments were undertaken: only one record noted the use of a formal developmental screening measure. In Community A, 16 (16%) records documented parent report and 20 (20%) documented staff observations, while in Community B, the numbers were 2 (3%) and 11 (19%), respectively. The overall recorded prevalence of developmental difficulties was 21% in Community A and 6% in Community B. This is the first study to describe the quality of developmental monitoring practice in remote Australian Aboriginal health services. The audit findings suggest the need for a systems-wide approach to the delivery and recording of developmental monitoring services. This will require routine training of remote Aboriginal health workers and remote area nurses in developmental monitoring practice including the use of a culturally appropriate, structured developmental screening measure.
Highlights
Detection of developmental difficulties is universally considered a necessary public health measure, with routine developmental monitoring an important function of primary healthcare services
Developmental monitoring is a longitudinal process to enable early detection of children who may be at risk of developmental delays and more generally to promote healthy child development
A clinical audit of remote Australian Aboriginal primary healthcare services revealed that 37% of children aged less than 5 years had a record of a developmental service in the previous 12 months[22]
Summary
Detection of developmental difficulties is universally considered a necessary public health measure, with routine developmental monitoring an important function of primary healthcare services. Developmental monitoring is a longitudinal process to enable early detection of children who may be at risk of developmental delays and more generally to promote healthy child development. During this process, health practitioners may utilise developmental screening instruments in addition to discussing parent concerns, obtaining a history of risks and making clinical observations. Health practitioners may utilise developmental screening instruments in addition to discussing parent concerns, obtaining a history of risks and making clinical observations This is not a oneoff screen; rather, it is a process of following a child’s
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