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

Abstract

BackgroundEncouraging 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.MethodsQualitative data from 37 primary health care providers in a region of relative disadvantage in Sydney was analysed.ResultsThe 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.ConclusionsThe 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.

Screening tools for early identification of children with developmental delay in low- and middle-income countries: a systematic review

“…Basic properties of ASQ and PEDS are stated in the online supplemental table S8. 76 Limitations Despite our best efforts, there were several limitations to this study. This study was limited to articles published in the English language only due to constraints in resources and time.…”

Child Development Screening 18 months to 4 years old

“…Parents are encouraged to complete the PEDS in the Blue book and discuss any concerns with the CFHNs or GPs during health checks or immunisation visits. 29,30 M -CHAT and Developmental Behaviour Checklist (DBC), a parent-completed questionnaire of emotional and behavioural problems that include an autism screening algorithm for child aged 18-48 months are also recommended. 31 In Canada (Ontario), developmental surveillance is recommended at every review.…”

General Practitioners' management of young people with mental health conditions in Australia

“…These may improve identification rates (Glascoe, ; Sanci, Lewis, Patton, ) and may hasten recovery due to more timely access to mental health supports (Sanci, Lewis, & Patton, ). However, use of such screening tools may be limited if GPs do not have the training to score and interpret the results (Garg et al, ). Other reports suggest that another potential barrier to engagement is when GPs are reluctant to label young people with a mental disorder due to a perceived lack of effective therapeutic options (Sanci, Lewis, Patton, ).…”