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BMC Primary Care
Published in: BMC Primary Care 1/2018

Open Access 01-12-2018 | Research article

Health professional perceptions regarding screening tools for developmental surveillance for children in a multicultural part of Sydney, Australia

Authors: Pankaj Garg, My Trinh Ha, John Eastwood, Susan Harvey, Sue Woolfenden, Elisabeth Murphy, Cheryl Dissanayake, Katrina Williams, Bin Jalaludin, Anne McKenzie, Stewart Einfeld, Natalie Silove, Kate Short, Valsamma Eapen

Published in: BMC Primary Care | Issue 1/2018

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Abstract

Background

Encouraging 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.

Methods

Qualitative data from 37 primary health care providers in a region of relative disadvantage in Sydney was analysed.

Results

The 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.

Conclusions

The 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.
Literature
1.
2.
Deming D. Early childhood intervention and life-cycle skill development: evidence from head start. Am Econ J Appl Econ. 2009;3(1):111–134.CrossRef
3.
Blair M, Hall D. From health surveillance to health promotion: the changing focus in preventive children’s services. Arch Dis Child. 2006;91(9):730–5.CrossRefPubMedPubMedCentral
4.
Blair M, Macaulay C. The healthy child Programme: how did we get here and where should we go? Paediatr Child Health. 2014;24(3):118–23.CrossRef
5.
Woolfenden S, Eapen V, Williams K, Hayen A, Spencer N, Kemp L. A systematic review of the prevalence of parental concerns measured by the parents’ evaluation of developmental status (PEDS) indicating developmental risk. BMC Pediatr. 2014;14(1):1.CrossRef
6.
Goldfeld S, O'Connor M, Sayers M, Moore T, Oberklaid F. Prevalence and correlates of special health care needs in a population cohort of Australian children at school entry. J Dev Behav Pediatr. 2012;33(4):319.CrossRefPubMed
7.
Wake M, Sanson A, Berthelsen D, Hardy P, Misson S, Smith K, Ungerer J, Consortium LR: How well are Australian infants and children aged 4 to 5 years doing. Soc Policy Res Pap. 2008;36:1–103.
8.
Greenberg MT, Lengua LJ, Coie JD, Pinderhughes EE, Bierman K, Dodge KA, Lochman JE, McMahon RJ. Predicting developmental outcomes at school entry using a multiple-risk model: four American communities. Dev Psychol. 1999;35(2):403.CrossRefPubMedPubMedCentral
9.
Janus M, Duku E. The school entry gap: socioeconomic, family, and health factors associated with children's school readiness to learn. Early Educ Dev. 2007;18(3):375–403.CrossRef
10.
11.
Hagan JF, Shaw JS, Duncan PM. Bright futures: Guidelines for health supervision of infants, children, and adolescents. Elk Grove Village, IL: American Academy of Pediatrics; 2008.
12.
Majnemer A: Benefits of early intervention for children with developmental disabilities. Semin Pediatr Neurol. 1998;5(1):62–69.
13.
Drotar D, Stancin T, Dworkin PH, Sices L, Wood S. Selecting developmental surveillance and screening tools. Pediatr Rev. 2008;29(10):e52–8.CrossRefPubMed
14.
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
15.
Woolfenden S, Short K, Blackmore R, Pennock R, Moore M. How do primary health-care practitioners identify and manage communication impairments in preschool children? Aust J Prim Health. 2015;21(2):176–81.CrossRefPubMed
16.
Hix-Small H, Marks K, Squires J, Nickel R. Impact of implementing developmental screening at 12 and 24 months in a pediatric practice. Pediatrics. 2007;120(2):381–9.CrossRefPubMed
17.
King TM, Tandon SD, Macias MM, Healy JA, Duncan PM, Swigonski NL, Skipper SM, Lipkin PH. Implementing developmental screening and referrals: lessons learned from a national project. Pediatrics. 2010;125(2):350–60.CrossRefPubMed
18.
Wood R, Blair M. A comparison of child health Programmes recommended for preschool children in selected high-income countries. Child Care Health Dev. 2014;40(5):640–53.CrossRefPubMed
19.
20.
Coker TR, Windon A, Moreno C, Schuster MA, Chung PJ. Well-child care clinical practice redesign for young children: a systematic review of strategies and tools. Pediatrics. 2013;131(Supplement 1):S5–S25.CrossRefPubMedPubMedCentral
21.
NSW Minsitry of Health. Maternal and child health primary health care policy. Sydney: NSW Department of Health; 2009.
22.
Garg P, Ha M, Eastwood J, Harvey S, Woolfenden S, Murphy E, Dissanayake C, Jalaludin B, Williams K, Mckenzie A, et al. Explaining culturally and linguistically diverse (CALD) parents’ access of healthcare services for developmental surveillance and anticipatory guidance: qualitative findings from the ‘watch me grow’ study. BMC Health Serv Res. 2017;17:228. https://​doi.​org/​10.​1186/​s12913-017-2143-1.​ CrossRefPubMedPubMedCentral
23.
Ou L, Chen J, Hillman K. Health services utilisation disparities between English speaking and non-English speaking background Australian infants. BMC Public Health. 2010;10(1):182.CrossRefPubMedPubMedCentral
24.
Britt H, Miller GC, Charles J, Henderson J, Valenti L, Harrison C, Zhang C, Chamber T, Pollack AJ, Bayram C, et al. A decade of Australian general practice activity2002–03 to 2011–12. General practice series no. 32. Sydney: Sydney University Press; 2012.
25.
Jeyendra A, Rajadurai J, Chanmugam J, Trieu A, Nair S, Baskaran R, Schmied V. Australian general Practitioners' perspectives on their role in well-child health care. BMC Fam Pract. 2013;14(1):2.CrossRefPubMedPubMedCentral
26.
27.
Alexander KE, Mazza D. The healthy kids check-is it evidence-based. Med J Aust. 2010;192(4):207–10.PubMed
28.
Oberklaid F. Prevention and early detection in young children: challenges for policy and practice. Med J Aust. 2014;201:369–70.CrossRefPubMed
29.
Alexander K, Mazza D. Scrapping the healthy kids check: a lost opportunity. Med J Aust. 2015;203(8):321–2.CrossRefPubMed
30.
Glascoe FP, Macias MM, Wegner LM, Robertshaw NS. Can a broadband developmental-behavioral screening test identify children likely to have autism spectrum disorder? Clin Pediatr. 2007;46(9):801–5.CrossRef
31.
Squires J, Bricker D, Potter L. Revision of a parent-completed developmental screening tool: ages and stages questionnaires. J Pediatr Psychol. 1997;22(3):313–28.CrossRefPubMed
32.
Brothers KB, Glascoe FP, Robertshaw NS. PEDS: developmental milestones—an accurate brief tool for surveillance and screening. Clin Pediatr. 2008;47(3):271–9.CrossRef
33.
Limbos MM, Joyce DP. Comparison of the ASQ and PEDS in screening for developmental delay in children presenting for primary care. J Dev Behav Pediatr. 2011;32(7):499–511.CrossRefPubMed
34.
Armstrong MF, Goldfeld S. Systems of early detection in Australian communities: the use of a developmental concern questionnaire to link services. Aust J Adv Nurs. 2008;25(3):36.
35.
Jeyaseelan DC, Sawyer MG. Developmental literacy: a universal intervention to help children with developmental disorders. J Paediatr Child Health. 2017;53(2):101–4.CrossRefPubMed
36.
NSW Ministry of Health. Child personal health record (blue book), release of revised version 2012/13, information bulletin. Sydney: NSW Kids and Families; 2013.
37.
NSW Minstry of Health. Centre for Epidemiology and Evidence. 2009-2010 Summary Report from the New South Wales Child Health Survey. Sydney: NSW Ministry of Health, 2012. North Sydney: NSW Minitsry of Health; 2012.
38.
39.
40.
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
41.
Eapen V, Woolfenden S, Williams K, Jalaludin B, Dissanayake C, Axelsson EL, Murphy E, Eastwood J, Descallar J, Beasley D. " are you available for the next 18 months?"-methods and aims of a longitudinal birth cohort study investigating a universal developmental surveillance program: the ‘watch me Grow’study. BMC Pediatr. 2014;14(1):1.CrossRef
42.
Woolfenden S, Eapen V, Axelsson E, Hendry A, Jalaludin B, Dissanayake C, Overs B, Descallar J, Eastwood J, Einfeld S. Who is our cohort: recruitment, representativeness, baseline risk and retention in the “watch me grow” study? BMC Pediatr. 2016;16(1):1.CrossRef
43.
Woolfenden S, Eapen V, Jalaludin B, Hayen A, Kemp L, Dissanyake C, Hendry A, Axelsson E, Overs B, Eastwood J. Prevalence and factors associated with parental concerns about development detected by the parents’ evaluation of developmental status (PEDS) at 6-month, 12-month and 18-month well-child checks in a birth cohort. BMJ Open. 2016;6(9):e012144.CrossRefPubMedPubMedCentral
44.
Overs B, Woolfenden S, Williams K, Jalaludin B, Axelsson E, Dissanayake C, Descallar J, Harvey S, Beasley D, Murphy E. Predictors of developmental surveillance completion at six months of age in south western Sydney. Child Care Health Dev. 2017;43(2):307–15.CrossRefPubMed
45.
Australian Bureau of Statistics. Census of population and housing: socio-economic indexes for areas (SEIFA). Canberra: ABS; 2004.
46.
Morgan K, Eastwood J, Faniran S: Families NSW.Headline population indicators Data report 2009, A report for the South West Sydney region on key statistics relating to the health and family well being of its children and families. In. Liverpool: Sydney South West Area Health Service; 2009.
47.
Harding A, McNamara J, Daly A, Tanton R. Child social exclusion: an updated index from the 2006 census. Aust J Labour Econ. 2009;12(1):41–64.
48.
49.
Oberklaid F, Baird G, Blair M, Melhuish E, Hall D. Children's health and development: approaches to early identification and intervention. Arch Dis Child. 2013;98(12):1008–11.CrossRefPubMed
50.
51.
Department of Community Paediatrics. Annual Report (2017). Liverpool: South Western Sydney LHD; 2017.
52.
South Western Sydney LHD: Health Improvement for Children,Young People and Families,2016–2025. In. Liverpool: Liverpool Hospital; 2016.
53.
Patton MQ. Qualitative research & evaluation methods. 3rd ed. Thousand Oaks, California: Sage Publications; 2002.
54.
QSR International Pty Ltd. NVivo qualitative data analysis software. Version 10 ed; 2012.
55.
Glaser B. Doing grounded theory: issues and discussions. Mill Valley, CA: Sociology Press; 1998.
56.
Eapen V, Garg P, Eastwood J, Harvey S, Overs B, Črncec R, Axelsson E: A grounded theory approach for understanding factors affecting universal developmental surveillance in NSW. In: Emerging Health Policy Research Conference: 15 August 2013; Menzies Centre for Health Policy. Sydney: University of Sydney; 2013.
57.
Sices L, Fund C: Developmental screening in primary care: the effectiveness of current practice and recommendations for improvement: Commonwealth Fund; 2007.
58.
Sand N, Silverstein M, Glascoe FP, Gupta VB, Tonniges TP, O'Connor KG. Pediatricians' reported practices regarding developmental screening: do guidelines work? Do they help? Pediatrics. 2005;116(1):174–9.CrossRefPubMed
59.
Woolfenden S, Posada N, Krchnakova R, Crawford J, Gilbert J, Jursik B, Sarkozy V, Perkins D, Kemp L. 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
60.
Kroening AL, Moore JA, Welch TR, et al. Developmental Screening of Refugees: A Qualitative Study. Pediatrics. 2016;138(3):e20160234.
61.
Kiing JS, Low PS, Chan YH, Neihart M. Interpreting Parents' concerns about their Children's development with the parents evaluation of developmental status: culture matters. J Dev Behav Pediatr. 2012;33(2):179.PubMed
62.
Bornstein MH, Cote LR. “Who is sitting across from me?” immigrant mothers’ knowledge of parenting and Children’s development. Pediatrics. 2004;114(5):e557–64.CrossRefPubMed
63.
64.
Dworkin PH. Towards a critical reframing of early detection and intervention for developmental concerns. J Dev Behav Pediatr. 2015;36(8):637–8.CrossRefPubMed
65.
66.
Briggs C. Nursing practice in community child health: developing the nurse–client relationship. Contemp Nurse. 2007;23(2):303–11.CrossRef
67.
Borrow S, Munns A, Henderson S. Community-based child health nurses: an exploration of current practice. Contemp Nurse. 2011;40(1):71–86.CrossRefPubMed
68.
Chen L, Magliano DJ, Balkau B, Colagiuri S, Zimmet PZ, Tonkin AM, Mitchell P, Phillips PJ, Shaw JE. AUSDRISK: an Australian type 2 diabetes risk assessment tool based on demographic, lifestyle and simple anthropometric measures. Med J Aust. 2010;192(4):197.PubMed
Metadata
Title
Health professional perceptions regarding screening tools for developmental surveillance for children in a multicultural part of Sydney, Australia
Authors
Pankaj Garg
My Trinh Ha
John Eastwood
Susan Harvey
Sue Woolfenden
Elisabeth Murphy
Cheryl Dissanayake
Katrina Williams
Bin Jalaludin
Anne McKenzie
Stewart Einfeld
Natalie Silove
Kate Short
Valsamma Eapen
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2018
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-018-0728-3

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