The nurse and the early identification of young children at risk

Abstract

Early identification of young children at developmental risk has long been thought to be important (Zadig and Cracker, 1975). Research into the value of early intervention aimed at the alleviation of some handicapping conditions has caused increased emphasis to be placed on the need for preschool screening (Brazelton, 1977). Recent legislation in the U.S.A. (94-142) has further re-emphasized the importance of already existing federal and state laws mandating preschool screening programs. A review of the literature on existing preschool screening tools reflects that a tool that is both comprehensive and effective is unavailable (Erickson, 1976; Meier, 1973). There exists a clear need for developing an operational theoretical framework for large scale preschool screening which will be both effective and efficient (Hass and Scovell, 1977; Dept. of H.E.W., 1976). The study reported in this paper was conducted in response to such needs.* Experience with the already existing preschool screening programs, coupled with a thorough literature survey, led to the conclusion that certain aspects of the child’s development were neglected. For instance, the literature did not reveal a simple head-to-toe physical screening tool, and none of the available developmental screening tools adequately covered physical development. Also, almost all of the screening tools were binary in nature; that is, they are pass or fail, referral or no referral (Gomes and Nuttal, 1975). Thus, these tools lacked the finer mesh screening capability to deal with a variety of referral types (Sahin, 1978). Furthermore, the medical and educational approaches to screening were found to be disparate and called for conflicting screening strategies (Bailey, 1975; Barnard, 1976). In order to assess the ‘whole’ child, and also because of the multiple nature of ‘special-needs’ presented, an e@ort was made to combine the medical and educational approaches to screening. Further, it was felt that the nurse was in an optimum position to facilitate this interface.