Skip to main content
Top
Published in: BMC Health Services Research 1/2024

Open Access 01-12-2024 | Research

Access to child developmental assessment services in culturally and linguistically diverse metropolitan Sydney: a retrospective cohort analysis

Authors: Sibella E. Bentley, Pankaj Garg, Ori Gudes, Romy Hurwitz, Sinthu Vivekanandarajah, Lydia Y.L. So

Published in: BMC Health Services Research | Issue 1/2024

Login to get access

Abstract

Background

Despite the increasing prevalence of neurodevelopmental disorders (NDD), data regarding access to child development services have remained limited globally. Long wait times are a major barrier to developmental assessments, impacting on care and outcomes. The aim is to retrospectively analyse the demographic profile and prioritisation of patients seen at a child developmental assessment service (CDAS) in a vulnerable region of Sydney, and explore factors affecting wait times.

Methods

Data was collated and analysed for 2354 patients from 2018 to 2022. Socio-Economic Indexes for Areas (SEIFA) were collated from the Australian Bureau of Statistics. Descriptive statistics were used for demographic data and various statistical methods were used to analyse the relationships and impact of factors likely to affect wait lists.

Results

The median age was 51 months (IQR41-61) and males comprised 73.7% of the cohort. 64% of children were from culturally and linguistically diverse backgrounds (CALD) and 47% lived in the most disadvantaged suburbs. The median wait time was 302.5 days (IQR175-379) and 70% of children were seen within 12 months. CALD patients and children over 5-years had shorter wait times. Most children with Global Developmental Delay (GDD) were from the lowest four SEIFA deciles and waited longer for an appointment. 42.6% were seen within the priority allocated time or sooner. Children with ASD and/or severe GDD were prioritised to be seen earlier. Overall, the study could not demonstrate any difference in the wait times according to the prioritisation groups.

Conclusion

This study provides insights into the profile, prioritisation processes and wait lists of children seen by CDAS in South Western Sydney with high rates of social vulnerability and presents an argument to discuss benchmarking targets with service providers. It identifies the need to prioritise children living in suburbs with socioeconomic disadvantage and refine prioritisation and data collection processes to improve wait times.
Appendix
Available only for authorised users
Literature
1.
go back to reference Sapiets SJ, Totsika V, Hastings RP. Factors influencing access to early intervention for families of children with developmental disabilities: a narrative review. J Appl Res Intellect Disabil. 2021;34(3):695–711.CrossRefPubMed Sapiets SJ, Totsika V, Hastings RP. Factors influencing access to early intervention for families of children with developmental disabilities: a narrative review. J Appl Res Intellect Disabil. 2021;34(3):695–711.CrossRefPubMed
2.
go back to reference Miller AR, Armstrong RW, Masse LC, Klassen AF, Shen J, O’Donnell ME. Waiting for child developmental and rehabilitation services: an overview of issues and needs. Dev Med Child Neurol. 2008;50(11):815–21.CrossRefPubMed Miller AR, Armstrong RW, Masse LC, Klassen AF, Shen J, O’Donnell ME. Waiting for child developmental and rehabilitation services: an overview of issues and needs. Dev Med Child Neurol. 2008;50(11):815–21.CrossRefPubMed
3.
go back to reference McGill N, McLeod S, Crowe K, Wang C, Hopf SC. Waiting lists and prioritization of children for services: Speech-language pathologists’ perspectives. J Commun Disord. 2021;91:106099.CrossRefPubMed McGill N, McLeod S, Crowe K, Wang C, Hopf SC. Waiting lists and prioritization of children for services: Speech-language pathologists’ perspectives. J Commun Disord. 2021;91:106099.CrossRefPubMed
4.
go back to reference Huber J, Loh A, Monga S, Esufali J, Shouldice M. Development of a Novel Multi-disciplinary Specialised Care Service for children and adolescents with Autism Spectrum Disorder and/or Intellectual/Developmental Disability in a Tertiary Children’s hospital setting. Child - MDPI. 2022;10(1):57.CrossRef Huber J, Loh A, Monga S, Esufali J, Shouldice M. Development of a Novel Multi-disciplinary Specialised Care Service for children and adolescents with Autism Spectrum Disorder and/or Intellectual/Developmental Disability in a Tertiary Children’s hospital setting. Child - MDPI. 2022;10(1):57.CrossRef
5.
go back to reference Roberts G, Efron D, Price A, Hiscock H, Wake M. The time and practice challenges of developmental-behavioral pediatrics: an Australian national study. J Dev Behav Pediatr. 2011;32(5):368–74.CrossRefPubMed Roberts G, Efron D, Price A, Hiscock H, Wake M. The time and practice challenges of developmental-behavioral pediatrics: an Australian national study. J Dev Behav Pediatr. 2011;32(5):368–74.CrossRefPubMed
6.
go back to reference Hiscock H, Danchin MH, Efron D, Gulenc A, Hearps S, Freed GL, et al. Trends in paediatric practice in Australia: 2008 and 2013 national audits from the Australian Paediatric Research Network. J Paediatr Child Health. 2017;53(1):55–61.CrossRefPubMed Hiscock H, Danchin MH, Efron D, Gulenc A, Hearps S, Freed GL, et al. Trends in paediatric practice in Australia: 2008 and 2013 national audits from the Australian Paediatric Research Network. J Paediatr Child Health. 2017;53(1):55–61.CrossRefPubMed
7.
go back to reference Sices L, Feudtner C, McLaughlin J, Drotar D, Williams M. How do primary care physicians manage children with possible developmental delays? A national survey with an experimental design. Pediatrics. 2004;113(2):274–82.CrossRefPubMed Sices L, Feudtner C, McLaughlin J, Drotar D, Williams M. How do primary care physicians manage children with possible developmental delays? A national survey with an experimental design. Pediatrics. 2004;113(2):274–82.CrossRefPubMed
8.
go back to reference Garg P. Building a theoretical model of well-child care using a realist mixed-method study for early identification of developmental delays in the context of rising prevalence of autism spectrum disorders. University of New South Wales; 2019. Garg P. Building a theoretical model of well-child care using a realist mixed-method study for early identification of developmental delays in the context of rising prevalence of autism spectrum disorders. University of New South Wales; 2019.
9.
go back to reference Mittal R, Sciberras E, Sewell J, Efron D. Assessment of children with learning and behavioural problems: comparison of a multidisciplinary and sole paediatrician model. J Paediatr Child Health. 2014;50(2):135–40.CrossRefPubMed Mittal R, Sciberras E, Sewell J, Efron D. Assessment of children with learning and behavioural problems: comparison of a multidisciplinary and sole paediatrician model. J Paediatr Child Health. 2014;50(2):135–40.CrossRefPubMed
10.
go back to reference Royal Australasian College of Physicians. Position Statement: Early Intervention for Children with Developmental Disabilities. 2013. Royal Australasian College of Physicians. Position Statement: Early Intervention for Children with Developmental Disabilities. 2013.
11.
go back to reference Gordon M, Vaz Carneiro A, Patricio M, Gibbs T. Missed opportunities in health care education evidence synthesis. Med Educ. 2014;48(6):644–5.CrossRefPubMed Gordon M, Vaz Carneiro A, Patricio M, Gibbs T. Missed opportunities in health care education evidence synthesis. Med Educ. 2014;48(6):644–5.CrossRefPubMed
12.
go back to reference Morin M, Rivard M, Morin D, Mello C, Coulombe P. Parents’ satisfaction with a Canadian pilot clinic to reduce waiting lists for the assessment and diagnosis of autism spectrum disorder and intellectual disability in young children. J Appl Res Intellect Disabil. 2022;35(5):1186–98.CrossRefPubMed Morin M, Rivard M, Morin D, Mello C, Coulombe P. Parents’ satisfaction with a Canadian pilot clinic to reduce waiting lists for the assessment and diagnosis of autism spectrum disorder and intellectual disability in young children. J Appl Res Intellect Disabil. 2022;35(5):1186–98.CrossRefPubMed
13.
go back to reference Bernie C, Mitchell M, Williams K, May T. Parent-directed intervention versus controls whilst their child waits for diagnostic assessment: a systematic review protocol. Syst Rev. 2021;10(1):67.CrossRefPubMedPubMedCentral Bernie C, Mitchell M, Williams K, May T. Parent-directed intervention versus controls whilst their child waits for diagnostic assessment: a systematic review protocol. Syst Rev. 2021;10(1):67.CrossRefPubMedPubMedCentral
14.
go back to reference Murphy K, Harrison E. The weight of waiting: the impact of delayed early intervention on parental self-efficacy. Br J Special Educ. 2022;49(1):84–101.CrossRef Murphy K, Harrison E. The weight of waiting: the impact of delayed early intervention on parental self-efficacy. Br J Special Educ. 2022;49(1):84–101.CrossRef
15.
go back to reference Lo BH, Klopper F, Barnes EH, Williams K. Agreement between concern about autism spectrum disorder at the time of referral and diagnosis, and factors associated with agreement. J Paediatr Child Health. 2017;53(8):742–8.CrossRefPubMed Lo BH, Klopper F, Barnes EH, Williams K. Agreement between concern about autism spectrum disorder at the time of referral and diagnosis, and factors associated with agreement. J Paediatr Child Health. 2017;53(8):742–8.CrossRefPubMed
16.
go back to reference Moore T, McDonald M, McHugh-Dillon H. Early childhood development and the social determinants of health inequities: a review of the evidence. Parkville, Victoria: Centre for Community Child Health at The Murdoch Childrens Research Institute and the Royal Children’s Hospital; 2015.CrossRef Moore T, McDonald M, McHugh-Dillon H. Early childhood development and the social determinants of health inequities: a review of the evidence. Parkville, Victoria: Centre for Community Child Health at The Murdoch Childrens Research Institute and the Royal Children’s Hospital; 2015.CrossRef
17.
go back to reference Woolfenden S, Posada N, Krchnakova R, Crawford J, Gilbert J, Jursik B, et al. Equitable access to developmental surveillance and early intervention–understanding the barriers for children from culturally and linguistically diverse (CALD) backgrounds. Health Expect. 2015;18(6):3286–301.CrossRefPubMed Woolfenden S, Posada N, Krchnakova R, Crawford J, Gilbert J, Jursik B, et al. Equitable access to developmental surveillance and early intervention–understanding the barriers for children from culturally and linguistically diverse (CALD) backgrounds. Health Expect. 2015;18(6):3286–301.CrossRefPubMed
18.
go back to reference Bates G. What impact does the child development assessment process have on parental self-efficacy? Adv Mental Health. 2019;18(1):27–38.CrossRef Bates G. What impact does the child development assessment process have on parental self-efficacy? Adv Mental Health. 2019;18(1):27–38.CrossRef
21.
go back to reference South Western Sydney Local Health District. Diagnostic Phase Findings and Recommendations: Paediatrics and Neonatology Clinical Redesign Developmental Assessment Diagnostic Services. Sydney; 2017. South Western Sydney Local Health District. Diagnostic Phase Findings and Recommendations: Paediatrics and Neonatology Clinical Redesign Developmental Assessment Diagnostic Services. Sydney; 2017.
22.
go back to reference Suarez E, Perez CM, Rivera R, Martinez MN. Polynomial regression models. Applications of regression models in Epidemiology. Wiley; 2017. p. 63. Suarez E, Perez CM, Rivera R, Martinez MN. Polynomial regression models. Applications of regression models in Epidemiology. Wiley; 2017. p. 63.
24.
go back to reference Foreman D, Hanna M. How long can a waiting list be? The impact of waiting time on intention to attend child and adolescent psychiatric clinics. Psychiatric Bull Camb Univ Press. 2000;24(6):211–3.CrossRef Foreman D, Hanna M. How long can a waiting list be? The impact of waiting time on intention to attend child and adolescent psychiatric clinics. Psychiatric Bull Camb Univ Press. 2000;24(6):211–3.CrossRef
25.
go back to reference The Community Network. Hidden waits: the lasting impact of the pandemic on children’s services in the community. 2022. The Community Network. Hidden waits: the lasting impact of the pandemic on children’s services in the community. 2022.
26.
go back to reference Huang HC-H, Ougrin D. Impact of the COVID-19 pandemic on child and adolescent mental health services. Br J Psychiatry Open. 2021;7(5):145.CrossRef Huang HC-H, Ougrin D. Impact of the COVID-19 pandemic on child and adolescent mental health services. Br J Psychiatry Open. 2021;7(5):145.CrossRef
27.
go back to reference Foley K, Maile E, Bottle A, Neale F, Viner R, Kenny S, et al. Impact of COVID-19 on primary care contacts with children and young people aged 0–24 years in England; longitudinal trends study 2015–2020. Br J Gen Pract. 2022;72(720):464–71.CrossRef Foley K, Maile E, Bottle A, Neale F, Viner R, Kenny S, et al. Impact of COVID-19 on primary care contacts with children and young people aged 0–24 years in England; longitudinal trends study 2015–2020. Br J Gen Pract. 2022;72(720):464–71.CrossRef
29.
go back to reference Malbon E, Carey G, Meltzer A. Personalisation schemes in social care: are they growing social and health inequalities? BMC Public Health 2019;19. Malbon E, Carey G, Meltzer A. Personalisation schemes in social care: are they growing social and health inequalities? BMC Public Health 2019;19.
Metadata
Title
Access to child developmental assessment services in culturally and linguistically diverse metropolitan Sydney: a retrospective cohort analysis
Authors
Sibella E. Bentley
Pankaj Garg
Ori Gudes
Romy Hurwitz
Sinthu Vivekanandarajah
Lydia Y.L. So
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2024
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-024-10800-y

Other articles of this Issue 1/2024

BMC Health Services Research 1/2024 Go to the issue