Court come true--for better or for worse?

Bowie, Cameron; Jones, Alex

doi:10.1136/bmj.289.6454.1322

Cited by 6 publications

(5 citation statements)

References 4 publications

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“…Assuming that the results of BMJ VOLUME 300 5 MAY 1990 1 Flat feet preschool developmental screening should be related to the child's later educational achievement, why did we do so poorly?…”

Section: Discussionmentioning

confidence: 99%

How good is general practice developmental screening?

Dearlove

Kearney

1990

BMJ

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All developmental screening in Somerset is performed by general practitioners and health visitors. A retrospective review of a cohort of 1504 7 year old children living in semirural Somerset found that the development assessment by a health visitor at age 31/2 years had a sensitivity of 45% for identifying the 103 children with special educational needs, whereas the sensitivity of the preschool examination by a general practitioner was 56%. There was no relation between results of preschool developmental assessment and later reading ability. Of the 23 children in special schools, 22 had been identified independently of the developmental screening programme before starting school. Intervention was started at a mean age of 1 year 5 months (range 2 months to 3 years) for children with severe learning difficulties, and 3 years 9 months (2 years 3 months to 6 years 6 months) for children with moderate learning difficulties. The preschool medical examination revealed fairly minor medical problems: 29 of 81 children referred for specialist opinions were shown to be medically normal, and for only seven of the medically abnormal children was information about their conditions given to their teachers. In Somerset screening the development of all children at predetermined ages has not been very useful.

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Section: Discussionmentioning

confidence: 99%

How good is general practice developmental screening?

Dearlove

Kearney

1990

BMJ

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“…Instead, most physicians rely on clinical observation, review of milestones and informal checklists. Unfortunately, such approaches seem to contribute to the finding that the majority of children with serious emotional problems, developmental disabilities and sensory impairments are not identified before school entrance ( Bowie & Parry 1984; Rona et al 1989 ; Dearlove & Kearney 1990; Lavigne et al 1993 ; Ni Bhrolchain 1994; Palfrey et al 1994 ; Corrigan et al 1996 ; Parving & Salomon 1996).…”

Section: Introductionmentioning

confidence: 99%

Evidence‐based approach to developmental and behavioural surveillance using parents’ concerns

Glascoe

2000

Child

214

164

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Half of all children with disabilities are not identified before school entrance, which precludes their participation in early intervention programs. Such programs have known value in reducing high school drop-out rates, increasing employment, delaying child-bearing and reducing criminal behaviour. Although there are many screening tests that can greatly improve detection rates, these have not been popular in primary care due to test length, difficulty managing children's behaviour, etc. An alternative is to carefully elicit and interpret parents' concerns. Research shows that parents' concerns are as accurate as quality screening tests and that parents are equally able to raise important concerns regardless of differences in education and child-rearing experience. Parents' concerns can be elicited quickly and 92% of parents can answer questions in writing while in exam or waiting rooms. Unlike screening tests, use of parents' concerns facilitates an evidenced-based approach to comprehensive surveillance and aids in making a range of other important decisions about children's developmental and behavioural needs. These include when to: offer suggestions on developmental promotion; watch children more vigilantly; screen for emotional and behavioural problems; advise families about behaviour management; offer reassurance and routine monitoring of development that is likely normal; administer a second screening test; or refer for additional testing and the kinds of testing needed.

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“…Instead, most physicians rely on informal methods of early identification. Unfortunately such approaches seem to contribute to the finding that the majority of children with emotional problems and mild to moderate learning difficulties are not identified before school entry 11 –18…”

mentioning

confidence: 99%

“…Unfortunately such approaches seem to contribute to the finding that the majority of children with emotional problems and mild to moderate learning difficulties are not identified before school entry. [11][12][13][14][15][16][17][18] Under-detection is understandable given the subtle and emerging nature of children's problems. However, it is also unfortunate because early detection followed by early intervention offers substantial benefits to children with disabilities and those likely to experience school failure due to psychosocial risk factors.…”

mentioning

confidence: 99%

The value of parents’ concerns to detect and address developmental and behavioural problems

Glascoe

1999

J Paediatrics Child Health

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Half of all children with disabilities are not identified before school entry. This precludes their participation in early intervention programs that have known benefit. Although screening tests can greatly improve detection rates, these have not been popular in primary care due to test length and time constraints, and difficulty managing children's behaviour. An alternative is to rely on information from parents. This review describes existing research on parents’ concerns about children's development and behaviour. Hand‐ and electronic‐searches were made of journals indexed in the EMBASE, Medline and Psych‐lit data bases between 1980 and 1998. Key words included ‘parents’ concerns’ and ‘parents’ complaints’. These terms were intersected with ‘development’ and ‘behaviour’. The search identified 30 articles which were grouped into the following categories: frequency of concerns, concerns about development/behavioural/emotional status, the meaning of concerns, influences on concerns including children's ages, health, and parents’ mental health status, eliciting concerns, how parents’ respond to concerns questions, and the accuracy of parents’ concerns. Parents, regardless of differences in education, socioeconomic status, and child‐rearing experience, are able to raise concerns that accurately reflect children's developmental and behavioural status. However, concerns must be carefully and systematically elicited and interpreted according to available evidence. When this occurs, concerns have a high degree of accuracy in detecting developmental and behavioural problems and do so at levels that represent a substantial improvement over disability detection rates usually found in medical settings.

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Court come true--for better or for worse?

Cited by 6 publications

References 4 publications

How good is general practice developmental screening?

How good is general practice developmental screening?

Evidence‐based approach to developmental and behavioural surveillance using parents’ concerns

The value of parents’ concerns to detect and address developmental and behavioural problems

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