Examining Antecedents of Caregivers’ Access to Early Childhood Developmental Screening: Implications for Campaigns Promoting Use of Services in Appalachian Ohio

Abstract

Although developmental delays are common in the United States, only about one third of developmental delays are identified before a child enters school. As challenging as use of developmental screening is on a national basis, the Appalachian region faces extreme lack of screening, diagnosis, and treatment for developmental delay. Local health care providers attribute this lack to poor parent understanding and have called for communication interventions to educate caregivers. This investigation sought to understand the antecedents of Appalachian caregivers' intentions to access developmental screening and services for their children as formative research for a communication-based intervention. The investigation was grounded by the health belief model. Surveys completed by 366 caregivers were used to model antecedents to behavioral intention. Perceived severity, perceived benefits, and self-efficacy were found to be the strongest predictors of intention to access developmental screening. Implications for a communication-based intervention are provided.

Comparison of Gross Motor Outcomes Between Children With Cerebral Palsy From Appalachian and Non-Appalachian Counties

“…This is because infants from Appalachia have a higher prevalence of prematurity and low birth weight,1,2,4 are from rural counties of habitancy,6 and are more likely to come from a family of low socioeconomic status, which are all risk factors for CP 6. They may also have limited access to medical care, which may prevent early diagnosis of CP and subsequent early rehabilitation services for optimal motor outcomes 9…”

“…6 They may also have limited access to medical care, which may prevent early diagnosis of CP and subsequent early rehabilitation services for optimal motor outcomes. 9 The primary purpose of this study was to evaluate gross motor outcomes between children with CP from non-Appalachian and Appalachian counties in Ohio who were seen at a single pediatric hospital. The secondary purposes of this study were to (1) compare gestational age and birth weight, and (2) evaluate the age of the participant when CP was first noted in their electronic medical record (EMR) between children with CP from non-Appalachian and Appalachian counties.…”

Human genetics and clinical aspects of neurodevelopmental disorders

“…With this in mind, the sequencing of whole genomes on a large scale promises to enable the discovery and prediction of disease in some people. The ability to sequence an infant at birth and to be able to predict a higher probability of certain phenotypes, such as developmental delay, would allow for educational and behavioral interventions to influence the phenotype, thus altering the trajectory of that phenotype (Bates et al, 2013; McIntyre, 2008; Rickards et al, 2007, 2009; Salem et al, 2012; Velleman and Mervis, 2011). One recent study of chromosomal microarray (CMA) testing found that “among 1792 patients with developmental delay (DD), intellectual disability (ID), multiple congenital anomalies (MCA), and/or autism spectrum disorders (ASD), 13.1% had clinically relevant results, either abnormal (n = 131; 7.3%) or variants of possible significance (VPS; n = 104; 5.8%).…”

Human Genetics and Clinical Aspects of Neurodevelopmental Disorders

“…With this in mind, the sequencing of whole genomes on a large scale promises to enable prediction of disease in some individuals. The ability to sequence an infant at birth and to be able to predict a higher probability of certain phenotypes, such as developmental delay, would allow for educational and behavioral interventions to influence the phenotype, thus altering the trajectory of that phenotype [227][228][229][230][231][232]. One recent study of chromosomal microarray (CMA) testing found that "among 1792 patients with developmental delay (DD), intellectual disability (ID), multiple congenital anomalies (MCA), and/or autism spectrum disorders (ASD), 13.1% had clinically relevant results, either abnormal (n = 131; 7.3%) or variants of possible significance (VPS; n = 104; 5.8%).…”