Early identification of children's special needs: A study in five metropolitan communities

Palfrey, Judith S.; Singer, J. David; Walker, Deborah Klein; Butler, John

doi:10.1016/s0022-3476(87)80238-x

Cited by 156 publications

(96 citation statements)

References 8 publications

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“…10 Results of previous studies have suggested that the earlier disabilities are identified, the more appropriate the response from the family, professionals, and the community. 96,97 Furthermore, diseasespecific health-disparity information may attract attention from clinicians who routinely care for children with the disease and contribute to the development of intervention strategies to reduce these disparities.…”

Section: Discussionmentioning

confidence: 99%

Health Inequity in Children and Youth With Chronic Health Conditions

et al. 2010

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BACKGROUND: Over the last decades, there have been great advances in health care delivered to children with chronic conditions, but not all children have benefitted equally from them. OBJECTIVES: To describe health inequities experienced by children with chronic health conditions. METHODS: We performed a literature review of English-language studies identified from the Medline, Centers for Disease Control and Prevention, National Cancer Institute, and Cystic Fibrosis Foundation Web sites that were published between January 1985 and May 2009, included children aged 0 to 18 years, and contained the key words “incidence,” “prevalence,” “survival,” “mortality,” or “disparity” in the title or abstract for the following health conditions: acute leukemia, asthma, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorders, cerebral palsy, cystic fibrosis, diabetes mellitus, Down syndrome, HIV/AIDS, major congenital heart defects, major depressive disorder, sickle cell anemia, spina bifida, and traumatic brain injury. RESULTS: Black children had higher rates of cerebral palsy and HIV/AIDS, were less likely to be diagnosed with ADHD, had more emergency department visits, hospitalizations, and had higher mortality rates associated with asthma; and survived less often with Down syndrome, type 1 diabetes, and traumatic brain injury when compared with white children. Hispanic children had higher rates of spina bifida from Mexico-born mothers, had higher rates of HIV/AIDS and depression, were less likely to be diagnosed with ADHD, had poorer glycemic control with type 1 diabetes, and survived less often with acute leukemia compared with white children. CONCLUSIONS: Serious racial and ethnic health and health care inequities persist for children with chronic health conditions.

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Section: Discussionmentioning

confidence: 99%

Health Inequity in Children and Youth With Chronic Health Conditions

et al. 2010

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“…The average child with cerebral palsy is not diagnosed until approximately 12 months of age, 3,15 and some experts have suggested that a definitive diagnosis should be deferred until 2 years of age. 3 When it becomes clear that a fixed pattern of altered movement, muscle tone, and reflexes is associated with weakness and delayed motor milestones, then a diagnosis of cerebral palsy is warranted.…”

Section: Diagnosis and Initial Counseling Of Familiesmentioning

confidence: 99%

Providing a Primary Care Medical Home for Children and Youth With Cerebral Palsy

Cooley¹

2004

Pediatrics

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ABSTRACT. Children and youth with cerebral palsy present pediatricians with complex diagnostic and therapeutic challenges. In most instances, care also requires communication and comanagement with pediatric subspecialists and pediatric surgical specialists, therapists, and community developmental and educational teams. The importance of family resilience to the patient's wellbeing broadens the ecologic scope of care, which highlights the value of a primary care medical home from which care is initiated, coordinated, and monitored and with which families can form a reliable alliance for information, support, and advocacy from the time of diagnosis through the transition to adulthood. This report reviews the aspects of care specific to cerebral palsy that a medical home should provide beyond the routine health maintenance, preventive care, and anticipatory guidance needed by all children. Pediatrics 2004;114:1106-1113; cerebral palsy, developmental disability, medical home, chronic illness, spasticity.

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“…1,[17][18][19] A number of factors have been implicated in exacerbating this delay, including the fact that many physicians have limited knowledge of the presentation, prognosis, and treatment of ASD 20 or other developmental disorders with polymorphous phenotypes. 21 They therefore often delay for extended periods of time before referring families of children with ASD to specialists for assessment. [22][23][24] Few studies have examined factors that may delay or expedite the diagnosis of ASD.…”

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confidence: 99%

Factors Associated With Age of Diagnosis Among Children With Autism Spectrum Disorders

2005

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Objective-Early diagnosis of children with autism spectrum disorders (ASD) is critical but often delayed until school age. Few studies have identified factors that may delay diagnosis. This study attempted to identify these factors among a community sample of children with ASD.Methods-Survey data were collected in Pennsylvania from 969 caregivers of children who had ASD and were younger than 21 years regarding their service experiences. Linear regression was used to identify clinical and demographic characteristics associated with age of diagnosis.Results-The average age of diagnosis was 3.1 years for children with autistic disorder, 3.9 years for pervasive developmental disorder not otherwise specified, and 7.2 years for Asperger's disorder. The average age of diagnosis increased 0.2 years for each year of age. Rural children received a diagnosis 0.4 years later than urban children. Near-poor children received a diagnosis 0.9 years later than those with incomes >100% above the poverty level. Children with severe language deficits received a diagnosis an average of 1.2 years earlier than other children. Hand flapping, toe walking, and sustained odd play were associated with a decrease in the age of diagnosis, whereas oversensitivity to pain and hearing impairment were associated with an increase. Children who had 4 or more primary care physicians before diagnosis received a diagnosis 0.5 years later than other children, whereas those whose pediatricians referred them to a specialist received a diagnosis 0.3 years sooner.Conclusion-These findings suggest improvements over time in decreasing the age at which children with ASD, especially higher functioning children, receive a diagnosis. They also suggest a lack of resources in rural areas and for near-poor families and the importance of continuous pediatric care and specialty referrals. That only certain ASD-related behaviors, some of which are not required to satisfy diagnostic criteria, decreased the age of diagnosis suggests the importance of continued physician education.Early diagnosis of autism spectrum disorders (ASD) is critical for a number of reasons, 1, 2 perhaps most important because interventions to improve the functioning of children with ASD may be more effective with younger children.3 -6 Evidence suggests that early treatment optimizes long-term prognosis, 7 and treatment yields diminishing returns as children get older. 8 Several studies have estimated that the gains in functioning associated with early treatment will result in considerable cost savings to both families of children with ASD and the systems in which they are served. [9][10][11]

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Early identification of children's special needs: A study in five metropolitan communities

Cited by 156 publications

References 8 publications

Health Inequity in Children and Youth With Chronic Health Conditions

Health Inequity in Children and Youth With Chronic Health Conditions

Providing a Primary Care Medical Home for Children and Youth With Cerebral Palsy

Factors Associated With Age of Diagnosis Among Children With Autism Spectrum Disorders

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