Early detection of developmental delays in vulnerable children by community care workers using an mHealth tool

Merwe, Maria N. van der; Mosca, Renata; Swanepoel, De Wet; Glascoe, Frances Page; Linde, Jeannie van der

doi:10.1080/03004430.2018.1480481

Cited by 22 publications

(44 citation statements)

References 69 publications

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“…Future research should focus on evaluating the cost–effectiveness and impact of detection and intervention on educational and psychosocial outcomes; the perceived acceptability of such screening programmes to parents and caregivers; and the potential integration of other mHealth services, for example, developmental delay screening, 39 towards a more comprehensive community-based service.…”

Section: Discussionmentioning

confidence: 99%

Hearing and vision screening for preschool children using mobile technology, South Africa

Eksteen

Launer

Kuper

et al. 2019

Bull. World Health Organ.

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103

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ObjectiveTo implement and evaluate a community-based hearing and vision screening programme for preschool children in the Western Cape, South Africa, supported by mobile health technology (mHealth) and delivered by community health workers (CHWs).MethodsWe trained four CHWs to provide dual sensory screening in preschool centres of Khayelitsha and Mitchells Plain during September 2017–December 2018. CHWs screened children aged 4–7 years using mHealth software applications on smartphones. We used logistic regression analysis to evaluate the association between screening results and age, sex and test duration, and, for hearing, excessive background noise levels.ResultsCHWs screened 94.4% (8023/10 362) of eligible children at 271 centres at a cost of 5.63 United States dollars per child. The number of children who failed an initial hearing and visual test was 435 (5.4%) and 170 (2.1%), respectively. Hearing test failure was associated with longer test times (odds ratio, OR: 1.022; 95% confidence interval, CI: 1.021–1.024) and excessive background noise levels at 1 kilohertz (kHz) (e.g. OR for left ear: 1.688; 95% CI: 1.198–2.377). Visual screening failure was associated with longer test duration (OR: 1.003; 95% CI: 1.002–1.005) and younger age (OR: 0.629; 95% CI: 0.520–0.761). Of the total screened, 111 (1.4%) children were diagnosed with a hearing and/or visual impairment.ConclusionmHealth-supported CHW-delivered hearing and vision screening in preschool centres provided a low-cost, acceptable and accessible service, contributing to lower referral numbers to resource-constrained public health institutions.

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Section: Discussionmentioning

confidence: 99%

Hearing and vision screening for preschool children using mobile technology, South Africa

Eksteen

Launer

Kuper

et al. 2019

Bull. World Health Organ.

Self Cite

103

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“…Parents report more developmental concerns for children older than three years than for their younger counterparts (Van der Merwe et al, 2019). This may be due to caregivers noticing that their children are not ready for the academic demands upon school entry (Willoughby et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

“…A 99% agreement rate between the caregiver-completed smartphone application and original paper-based PEDS tools was reported (Maleka et al, 2016). It was successfully implemented in a low-income South African community for children below the age of 36 months (Van der Merwe et al, 2019). The mHealth PEDS tools can be implemented within settings such as schools, clinics and during home visits, with the paper-based tools being validated for children up to the age of seven years, 11 months (Glascoe, 2013; Glascoe and Robertshaw, 2007).…”

Section: Introductionmentioning

confidence: 99%

“…Validating the mHealth PEDS tools for an older age cohort (42–83 months) in the South African context could enable quality developmental screening to vulnerable preschool children and their families in a decentralised service delivery model (Van der Merwe et al, 2019). A validated mHealth-based developmental screening tool may provide a viable alternative to time-consuming, paper-based developmental services for preschool children.…”

Section: Introductionmentioning

confidence: 99%

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mHealth developmental screening for preschool children in low-income communities

Toit

Linde

Swanepoel

2020

J Child Health Care

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Children are often only identified with a developmental delay when they enter primary school due to developmental delays hindering academic progress. Detection of at-risk children in low-income communities is typically unavailable due to several challenges. This study validated an mHealth-based developmental screening tool as a potential time- and cost-effective way of delivering services for preschool children. This cross-sectional within-subject study screened 276 preschool children from low-income communities using the mHealth Parents’ Evaluation of Developmental Status (PEDS) tools. The mHealth PEDS tools’ performance was then evaluated by comparing caregiver concerns according to the PEDS tools with results obtained using a reference standard assessment tool, the Vineland-3. The mHealth PEDS tools identified 237 (85.9%) of children at risk of developmental delay compared to 80.1% ( n = 221) of children identified with a developmental delay using the Vineland-3. Sensitivity of the PEDS tools was high (92.6%) with low specificity (22.5%) using US standardised criteria. Literacy skills were found to be most delayed, according to the PEDS: DM (89.3%; n = 142) and Vineland-3 (87.1%; n = 134). Low specificity of the prescribed criteria may require the implementation of adapted referral criteria within low socio-economic status (SES) settings. The mHealth PEDS tools may still be valuable for preschool developmental surveillance of children within low SES settings. It is recommended, however, that children who are identified with a developmental concern undergo a second screen to reduce false positives.

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“…Govender et al1 and Faruk et al10 in a systematic review highlight possible screening tools or tests for LMIC contexts. • Further education required for PHC workers Development screening as part of well-baby clinics regularly lack the knowledge to correctly identify and refer children with DD12…”

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confidence: 99%

Developmental delay in a resource-constrained environment: An approach to early intervention

Govender

Govender²,

Naidoo

2021

South African Family Practice

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With a reduction in mortality rates of children under 5 years, in low- and middle-income countries, the responsibility to provide quality care to the increased number of surviving children becomes essential. Many of these children present with developmental delay and the onus inevitably rest on the healthcare system. There is, therefore, the need for recognising timely intervention as routine care for these children, who may have potential for a better quality of life with intervention. The authors advocate for early referral and intervention, and provide a brief overview of a holistic approach to developmental delay in low resourced settings from their perspective.

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Early detection of developmental delays in vulnerable children by community care workers using an mHealth tool

Cited by 22 publications

References 69 publications

Hearing and vision screening for preschool children using mobile technology, South Africa

Hearing and vision screening for preschool children using mobile technology, South Africa

mHealth developmental screening for preschool children in low-income communities

Developmental delay in a resource-constrained environment: An approach to early intervention

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