A Multidisciplinary Approach to the Assessment and Management of Pre-school Age Neuro-developmental Disorders: A Local Experience

Abstract

Background: Early and effective identifi cation of childhood neurodevelopmental disorders remains a critical task of all pediatric healthcare professionals, which is critical to the well-being of children and their families. Methods: A retrospective review of medical records of all preschool children referred to a Child Development Centre (CDC) in NorthWest England, over a six-month period between Sept 2014 and Feb 2015 was conducted. The local multi-professional approach to the clinical assessment and management of preschool children was described and the published literature on this topic was reviewed. Results: Twenty four different categories of professionals spanning the whole range of primary, secondary, and tertiary healthcare, social care and educational services were involved in the management of the patients. The largest group of professionals was the primary healthcare specialists. The ten different primary care professionals managed an average of 42% of the patients. The secondary healthcare providers were involved in the care of an average of 17%, tertiary care providers 10%, educational specialists 25% and social care professionals were involved with 5% of all the patients. The commonest diagnostic disorders were Speech/Language delay (56%), Global developmental delay (33%), Behavior diffi culties (26%), Social communication concerns (21%) and Autistic spectrum disorder (19%). Conclusion: The high number and specialties of various healthcare professionals at all levels of care indicates the high social and economic investment required in managing the affected preschool children in the region. Childhood neurodevelopmental disorders in the preschool age represents a high level of public health signifi cance.

An Integrated Care Strategy for Pre-schoolers with Suspected Developmental Disorders: The Optimus Co-design Project that has Made it to Regular Care

“…Furthermore, if the child was not referred to another service, but still in need of intervention, this was coordinated within the team with the intervention being tailored to meet the need of the child and families with a follow-up within the team after six months. This has the potential to reduce the burden on the healthcare services, as children with developmental problems are known to be heavy service users [4,7], each child needing multiple professionals [34]. It is also worth considering that the reduction in visits would have an impact on parents' time and work hours, known to be affected when parenting a child with a neurodevelopmental disorder [7,12].…”

Overcoming the barriers to care for children with neurodevelopmental disorders

“…Children and young people with NDDs are cared for and treated by multidisciplinary teams including therapists, pediatricians, psychologists, primary care professionals, educators, and allied healthcare professionals. The different types of care and treatments are delivered by these multiple professionals within a number of disciplines that include physiotherapy, speech therapy, ophthalmology, pediatrics, psychiatry, psychomotor therapy, occupation therapy, and neuropsychology, among others 2 …”

“…The different types of care and treatments are delivered by these multiple professionals within a number of disciplines that include physiotherapy, speech therapy, ophthalmology, pediatrics, psychiatry, psychomotor therapy, occupation therapy, and neuropsychology, among others. 2 Cloet et al 3 present the results of research commissioned by the Flemish authorities to improve the diagnostic evaluation of children in Flanders with a suspected NDD. These results are meaningful in terms of global health for professionals involved in NDD diagnostics, care, treatment, as well as for developing and strengthening health sectors to provide equitable, integrated, interdisciplinary, and holistic services.…”