Enablers and Barriers to Identifying Children at Risk of Developmental Delay: A Pilot Study of Australian Maternal and Child Health Services

Sheeran, Leanne; Zhao, Lin; Buchanan, Kerrie; Xenos, Sophia

doi:10.1007/s10995-020-03077-0

Cited by 7 publications

(5 citation statements)

References 8 publications

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“…Despite the framework being inclusive of infant social, emotional, and relational considerations (DH, 2019b), the MCH nurses’ focus on physical parameters was identified as impeding the inclusion of IMH considerations. This finding aligns with previous studies identifying the limited consultation time as a barrier to practice (Bryant et al., 2016; Sheeran et al., 2021). Evident in the findings were the ways MCH nurses gave voice to the infant's behaviors and expressions of their inner world, to draw the caregiver into reflecting on the infant's experiences, communication, and capacities.…”

Section: Discussionsupporting

confidence: 92%

How do maternal and child health nurses incorporate infant mental health promotion into their clinical practice? Experiences of an Australian municipality

Stevens,

Sheeran,

Buist

2024

Infant Mental Health Journal

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The field of infant mental health (IMH) has offered valuable insights into the critical importance of social–emotional development, including the enduring influence of early experiences throughout life. Maternal and Child Health (MCH) nurses are ideally placed to facilitate knowledge sharing with parents. This Australian‐based qualitative exploratory descriptive study explored how MCH nurses incorporate IMH in their clinical practice, and how they share this information with caregivers. Ten community‐based MCH nurses participated in voluntary, semi‐structured interviews which were transcribed verbatim and analyzed thematically. Findings identified five themes that characterized how MCH nurses incorporated IMH concepts into their practice. These themes were: prioritizing physical health promotion activities, highlighting infant communications, variations in knowledge and application of IMH concepts, workplace time schedules, and the relational nature of the work. Recommendations include encouraging IMH as a health promotion activity, facilitating IMH assessment, further education, reflective supervision, and extension of predetermined appointment times to enable knowledge and skill sharing. Further research is also recommended to provide additional insights into how nurses with IMH training promote and share IMH concepts with caregivers. Adoption of these recommendations would further enhance the care given to families and the role of the MCH nurses.

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Section: Discussionsupporting

confidence: 92%

How do maternal and child health nurses incorporate infant mental health promotion into their clinical practice? Experiences of an Australian municipality

Stevens,

Sheeran,

Buist

2024

Infant Mental Health Journal

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“…Providers' interest in more training and support for comprehensive services corresponds to our previous study with early intervention providers, which identified the value of connecting children with SCD to other follow‐up care, such as early intervention services 33 . Developmental screening and referring to intervention has been a consistent challenge, with caregivers often being responsible for supporting the process 34–36 . To our knowledge, children with SCD are not automatically eligible for early intervention services in most states 32 .…”

Section: Discussionmentioning

confidence: 69%

“…33 Developmental screening and referring to intervention has been a consistent challenge, with caregivers often being responsible for supporting the process. [34][35][36] To our knowledge, children with SCD are not automatically eligible for early intervention services in most states. 32 To increase screening and intervention for all children, as emphasized in Healthy People 2030, 11,37 .…”

Section: Discussionmentioning

confidence: 99%

“Everyone screens to some extent”: Barriers and facilitators of developmental screening among children with sickle cell disease: A mixed methods study

Hoyt,

Luo,

Rice

et al. 2024

Pediatric Blood & Cancer

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BackgroundDevelopmental delays are common among children with sickle cell disease (SCD). Existing guidelines support consistent screening to increase the identification of deficits and support referral to rehabilitative interventions, yet adherence remains variable. This study sought to assess current practices and identify barriers and facilitators to improve developmental screening for children 0–3 years with SCD.ProcedureA mixed methods approach, guided by the Exploration and Preparation stages of the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework, assessed developmental screening practices among primary care providers and hematologists. Phase 1 included the SCD Developmental Surveillance and Screening Guideline and Practice Survey. Phase 2 included the SCD Developmental Screening Organizational Survey alongside semi‐structured interviews. Descriptive and qualitative methods summarized the findings.ResultsThirty‐three providers from general pediatrics and hematology completed phase 1. Use of standardized developmental screening measures was variable, with the most frequently used being the Modified Checklist for Autism in Toddlers (77%) and the Ages and Stages Questionnaire (55%). Fifteen providers participated in phase 2, and reported they were most likely to engage in changes to improve their practice (mean = 4.4/5) and least likely to support spiritual health and well‐being (mean = 3.5/5). Three themes emerged:(i) developmental screening is not standardized or specific to SCD, (ii) children with SCD benefit from a multidisciplinary team, and (iii) healthcare system limitations are a barrier.ConclusionsDevelopmental screening is inconsistent and insufficient for young children with SCD. Providers are interested in supporting children with SCD, but report a lack of standardized measures and consistent guidance as barriers.

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“…Nevertheless, time-pressures in Australian general practice may mean that clinicians prioritise healthcare according to clinical urgency. Time-pressures have also been raised as barriers to developmental screening by CFHNs [ 25 ] and were reported in our previous study that implemented PEDS only during vaccine visits [ 17 ]. In that study PNs commented that if something urgent came up they would put the score sheet aside to address later and, whilst influenza vaccine-clinics were operating, receptionists stopped handing out PEDS altogether [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Routine developmental screening in Australian general practice: a pilot study

Alexander

Mazza

2023

BMC Prim. Care

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Background Parents’ Evaluation of Developmental Status, (PEDS), is a validated screening tool designed for primary health care clinicians to assess child development. Despite widespread use by local government child-nurse services, PEDS has not been tested in Australian general practice. We examined the effect of an intervention that aimed to use PEDS to improve documented assessment of child developmental status during routine general practice consultations. Methods The study took place in a single general practice in Melbourne, Australia. The intervention included training of all general practice staff regarding PEDS processes and provision of PEDS questionnaires, scoring and interpretation forms. Mixed methods incorporated audits of clinical records of young children (1 to ≤ 5 years) before and after the intervention, and written questionnaires and a focus group (informed by the Theoretical Domains Framework and COM-B model) with receptionists, practice nurses and general practitioners. Results Documented developmental status more than doubled after the intervention with almost one in three (30.4%) records documenting the PEDS tool. Overall, staff responses to questionnaires indicated that PEDS processes had been successfully implemented, half of the staff felt PEDS had developed their professional skills and clinicians expressed confidence using the tool (71%). Thematic analysis of the focus group transcript revealed divided reactions to PEDS screening with most barriers arising from general practitioners’ motivation to use PEDS tools and perceptions of environmental constraints. Conclusions A team-practice intervention that applied PEDS training and implementation, more than doubled documented rates of child developmental status during routine visits. Solutions to underlying barriers could be incorporated into a revised training module. Future studies need to test the tool in more methodologically robust studies that include analysis of the outcomes of developmental surveillance and long-term sustainability of PEDS use in practices.

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Enablers and Barriers to Identifying Children at Risk of Developmental Delay: A Pilot Study of Australian Maternal and Child Health Services

Cited by 7 publications

References 8 publications

How do maternal and child health nurses incorporate infant mental health promotion into their clinical practice? Experiences of an Australian municipality

How do maternal and child health nurses incorporate infant mental health promotion into their clinical practice? Experiences of an Australian municipality

“Everyone screens to some extent”: Barriers and facilitators of developmental screening among children with sickle cell disease: A mixed methods study

Routine developmental screening in Australian general practice: a pilot study

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