Multicountry review: developmental surveillance, assessment and care by outpatient paediatricians

Nadia Coscini; Priya Heyes; Helen Bedford; Eyal Cohen; Anita D'Aprano; Sharon Goldfeld; Dougal Hargreaves; Sarah Loveday; Sahar Nejat; Gehan Roberts; Anna Sarkadi; Natasha Ruth Saunders; Susan Woolfenden; Kate Milner

doi:10.1136/archdischild-2021-322799

Multicountry review: developmental surveillance, assessment and care by outpatient paediatricians

Arch Dis Child. 2023 Mar;108(3):153-159. doi: 10.1136/archdischild-2021-322799. Epub 2022 Jun 28.

Authors

Nadia Coscini^{1

2}, Priya Heyes³, Helen Bedford⁴, Eyal Cohen^{5

6}, Anita D'Aprano^{7

8}, Sharon Goldfeld^{7

9}, Dougal Hargreaves¹⁰, Sarah Loveday¹¹, Sahar Nejat¹², Gehan Roberts^{7

9}, Anna Sarkadi¹³, Natasha Ruth Saunders^{5

6}, Susan Woolfenden^{14

15}, Kate Milner^{16

17}

Affiliations

¹ Centre for Community Child Health, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia nadia.coscini@gmail.com.
² Health Services Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
³ Department of Child Development Service, Government of Western Australia Child and Adolescent Health Service, Perth, Western Australia, Australia.
⁴ Population, Policy and Practice Department, University College London Institute of Child Health, London, UK.
⁵ Department of Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.
⁶ Department of Paediatrics, University of Toronto Institute of Health Policy Management and Evaluation, Toronto, Ontario, Canada.
⁷ Centre for Community Child Health, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.
⁸ Department of Paediatrics, The University of Melbourne Melbourne Medical School, Melbourne, Victoria, Australia.
⁹ Population Health Theme, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.
¹⁰ Department of Primary Care and Public Health, Imperial College London, London, UK.
¹¹ Health Services Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.
¹² Department of Public Health and Caring Sciences, Uppsala Universitet Institutionen for euroasiatiska studier, Uppsala, Sweden.
¹³ Department of Public Health and Caring Sciences, Uppsala Universitet, Uppsala, Sweden.
¹⁴ School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia.
¹⁵ Department of Community Child Health, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia.
¹⁶ Department of Neurodevelopment and Disability, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.
¹⁷ Neurodisability and Rehabilitation Research Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia.

PMID: 35764409
DOI: 10.1136/archdischild-2021-322799

Abstract

Background: Care of young children with neurodevelopmental disorders (NDD) is a major component of paediatric outpatient practice. However, cross-country practice reviews to date have been limited, and available data demonstrate missed opportunities for early identification, particularly in vulnerable population subgroups.

Methods: Multicountry review of national paediatric body guidance related to developmental surveillance, early identification and early childhood intervention together with review of outpatient paediatrician practices for developmental assessment of children aged 0-5 years with/at risk of NDDs. Review included five countries with comparable nationalised universal child healthcare systems (ie, Australia, Canada, New Zealand, Sweden and the UK). Data were collected using a combination of published and grey literature review, supplemented by additional local sources with descriptive review of relevant data points.

Results: Countries had broadly similar systems for early identification of young children with NDDs alongside universal child health surveillance. However, variation existed in national paediatric guidance, paediatric developmental training and practice, including variable roles of paediatricians in developmental surveillance at primary care level. Data on coverage of developmental surveillance, content and quality of paediatric development assessment practices were notably lacking.

Conclusion: Paediatricians play an important role in ensuring equitable access to early identification and intervention for young children with/at risk of NDDs. However, strengthening paediatric outpatient care of children with NDD requires clearer guidance across contexts; training that is responsive to shifting roles within interdisciplinary models of developmental assessment and improved data to enhance equity and quality of developmental assessment for children with/at risk of NDDs.

Keywords: Child Development; Child Health Services; Health services research; Infant Development.

Publication types

Review

MeSH terms

Australia
Child
Child, Preschool
Humans
Neurodevelopmental Disorders*
Outpatients*
Pediatricians
Risk Assessment