Abstract

BackgroundEncouraging early child development and the early identification of developmental difficulties is a priority. The Ministry of Health in the Australian State of New South Wales (NSW), has recommended a program of developmental surveillance using validated screening questionnaires, namely, the Parents’ Evaluation of Development Status (PEDS) and Ages and Stages Questionnaire (ASQs), however, the use of these tools has remained sub-optimal. A longitudinal prospective birth cohort “Watch Me grow” study was carried out in the South Western Sydney (SW) region of NSW to ascertain the uptake as well as the strategies and the resources required to maximise engagement in the surveillance program. This paper reports on a qualitative component of the study examining the attitudes, enablers and barriers to the current developmental surveillance practices, with reference to screening tools, amongst health professionals.MethodsQualitative data from 37 primary health care providers in a region of relative disadvantage in Sydney was analysed.ResultsThe major themes that emerged from the data were the “difficulties/problems” and “positives/benefits” of surveillance in general, and “specificity” of the tools which were employed. Barriers of time, tool awareness, knowledge and access of referral pathways, and services were important for the physician providers, while the choice of screening tools and access to these tools in other languages were raised as important issues by Child and Family Health Nurses (CFHN). The use of these tools by health professionals was also influenced by what the professionals perceived as the parents’ understanding of their child’s development. While the PEDS and ASQs was utilised by CFHNs, both General Practitioners (GPs) and paediatricians commented that they lacked awareness of developmental screening tools and highlighted further training needs.ConclusionsThe results highlight the practical challenges to, and limited knowledge and uptake of, the use of recommended screening tools as part of developmental surveillance. There is a need for further research regarding the most effective integrated models of care which will allow for a better collaboration between parents and service providers and improve information sharing between different professionals such as CFHNs GPs, Practices nurses and Paediatricians involved in screening and surveillance programs.

Highlights

  • Encouraging early child development and the early identification of developmental difficulties is a priority

  • Ethics The study was approved by the Human Research Ethics Committees (HREC) of South Western Sydney Local Health District (SWSLHD) and the University Of New South Wales (UNSW)

  • Individuals interviewed in the current study included three nurse managers, one Out-of-Home Care coordinator, two General Practitioners (GPs) practice nurses, five Child and Family Health Nurses (CFHN), six GPs, seven paediatricians and one senior child health medical officer

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Summary

Introduction

Encouraging early child development and the early identification of developmental difficulties is a priority. An Australian Early Development Census (AEDC) has revealed that 22% of children are developmentally vulnerable in one or more domains in their first year of formal schooling, with the potential to negatively impact on their long-term capacity to learn [1]. This situation is not confined to Australia and is of particular concern due to the known importance of the early years for child development [2]. Developmental surveillance involves longitudinal elicitation of parental concerns, obtaining an informed developmental history, performing skilled observations of children, and soliciting information from child care providers when concerns regarding a child’s development become evident

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