WITHDRAWN: Applicability of a Tool for Comprehensive Assessments: the Expanded Guide for Monitoring Child Development

Abstract

Background: Pediatricians globally are in critical need of tools enabling comprehensive information about children and families while also saving face-to-face time. This study examined the applicability of the expanded version of the Guide for Monitoring Child Development (GMCD), a free-of-charge tool used in over 30 countries.The Expanded GMCD is a written tool incorporating the biopsychosocial model of healthcare delivery, bioecological theory of child development, and two World Health Organization frameworks: International Classification of Functioning, Disability and Health, and Nurturing Care. Methods: Parents of children attending Ankara University Developmental Pediatrics Division, Turkey, were given or digitally sent the Expanded GMCD to complete before their first assessment. The completeness of the responses to the four Expanded GMCD domains and factors associated with full completion were ascertained using multivariate analyses. Results: Of 480 children, 57% were boys, median age was 17.0 (IQR: 9.0-27.0) months. Completion rates were 78%, 87% and 92% for all four, at least three and at least two domains, respectively. All four domains “body structures and functioning,” “health conditions,” “activities and participation,” and “environmental factors” had completion rates >80%. The Expanded GMCD provided holistic information: 87% of children had developmental difficulties and special needs; 60% had chronic conditions requiring follow-up; over 20% of parents reported stigmatization and maternal depression; over 10% unemployment and financial difficulties, not getting enough support from friends and relatives, paternal depression; and 5% intra-family conflict. In the logistic regression analyses, parents of children ≤ 6 months more likely completed <4 domains compared to parents of older children (OR: 2.24; 95% CI: 1.25-3.72); maternal education less than high school (OR: 1.38; 95% CI: 0.87-2.20) and having multiple children (OR: 1.48; 95% CI: 0.94-2.35) were not significantly associated with the full completion of the Expanded GMCD.Conclusion:The applicability of the Expanded GMCD in this study in children with diverse health conditions and families with different educational levels implies its potential for applicability in other settings. Using the free-of-charge Expanded GMCD in healthcare delivery including telemedicine may address the gaps in the implementation of the theory, model and framework-based comprehensive tools for children and their families.