Prevalence and factors associated with parental concerns about development detected by the<i>Parents’ Evaluation of Developmental Status (PEDS)</i>at 6-month, 12-month and 18-month well-child checks in a birth cohort

Woolfenden, Susan; Eapen, Valsamma; Jalaludin, Bin; Hayen, Andrew; Kemp, Lynn; Dissanyake, Cheryl; Hendry, Alexandra; Axelsson, Emma; Overs, Bronwyn; Eastwood, John; Črnčec, Rudi; Beasley, Deborah; Murphy, Elisabeth; Williams, Katrina

doi:10.1136/bmjopen-2016-012144

Cited by 25 publications

(33 citation statements)

References 31 publications

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“…This aligns with the theoretical frameworks of cumulative risk and intersectionality of risk factors in relation to early childhood development 18–20. Yet, while health service patterns according to socioeconomic disadvantage and developmental vulnerability have been described separately,2 3 12 the combined effect on the use of health services by a preschool-aged child of being developmentally vulnerable and socioeconomic disadvantaged has not been examined.…”

Section: Introductionsupporting

confidence: 56%

“…Around one in five Australian preschool children have physical, socioemotional and learning difficulties that require additional support for school success—that is, they are ‘developmentally vulnerable’ 1–4. Children who developmentally vulnerable are more likely to have poor educational outcomes in primary school and early high school 5 6.…”

Section: Introductionmentioning

confidence: 99%

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Use of health services by preschool-aged children who are developmentally vulnerable and socioeconomically disadvantaged: testing the inverse care law

Woolfenden

Galea

Badland

et al. 2020

J Epidemiol Community Health

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AimThe inverse care law suggests that those with the greatest need for services are least likely to receive them. Our aim of this study was to test the inverse care law in relation to the use of health services by children aged 4–5 years in Australia who were developmentally vulnerable and socioeconomically disadvantaged.MethodCross-sectional data were collected from the Longitudinal Study of Australian Children birth cohort when the children were aged 4–5 years. Children were grouped according to the combination of developmental vulnerability (yes, no) and socioeconomic disadvantage (lower, higher), resulting in four groups (reference group: developmentally vulnerable and disadvantaged). Multivariate regression was used to examine the impact of the combination of developmental vulnerability and disadvantage on health service use, adjusting for other sociodemographic characteristics.Results3967 (90%) of children had data on developmental vulnerability at 4–5 years. A third of children (32.6%) were classified as developmentally vulnerable, and 10%–25% of these children had used health services. Non-disadvantaged children who were developmentally vulnerable (middle need) had 1.4–2.0 times greater odds of using primary healthcare, specialist and hospital services; and non-disadvantaged children who were not developmentally vulnerable (lowest need) had 1.6–1.8 times greater odds of using primary healthcare services, compared with children who were developmentally vulnerable and disadvantaged (highest need).ConclusionWe found some evidence of the inverse care law. Equity in service delivery remains a challenge that is critically important to tackle in ensuring a healthy start for children.

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Section: Introductionsupporting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Use of health services by preschool-aged children who are developmentally vulnerable and socioeconomically disadvantaged: testing the inverse care law

Woolfenden

Galea

Badland

et al. 2020

J Epidemiol Community Health

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“…Only a small minority (14%) of carers of all children aged 4-5 years reportedly saw a MCHN in the previous year. This is consistent with the drop off in attendance after 18 months reported in Australia (3). This represents a missed opportunity in detection of this developmental vulnerability and referral for early intervention in the 12 months prior to school which may impact on school readiness particularly for children who are developmentally vulnerable and disadvantaged.…”

Section: Use Of Any Health Services By Developmental Vulnerability Ansupporting

confidence: 83%

The intersection of developmental vulnerability and socioeconomic disadvantage on access to health care for preschool aged children: evidence for the inverse-care law

Woolfenden¹,

Galea²,

Badland³

et al. 2019

Preprint

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Aim. Children who are developmentally vulnerable have greater health needs. Socioeconomic disadvantage not only increases this risk of developmental vulnerability but can be associated with less access to health services. Our aim was to compare health services use in children aged 4-5 years in Australia with and without developmentally vulnerability and consider the intersection of socioeconomic disadvantage on this relationship. Method. Cross sectional data were collected from Wave 3 of the Longitudinal Study of Australian Children birth cohort when the children were aged 4-5 years. A composite variable for developmental vulnerability was designed by combining those children who were in the lowest 15% in the physical, socioemotional and/or learning outcome indices. Children were then subgrouped according to developmental vulnerability and disadvantage based on socioeconomic position (SEP) quintile (derived from parental education, occupation, household income). We defined SEP 1 the lowest quintile as ‘disadvantaged’ and SEP quintiles 2-5 as ‘not disadvantaged’. Multivariate regression was used to examine the intersection between health service use and developmental vulnerability and disadvantage using these composite variables. Results The total number of children with information on developmental vulnerability in Wave 3 was 3967 (90% of the sample). A total of 1292 (32.6%) children were classified as developmentally vulnerable. 30.6% of children who were developmentally vulnerable came from families who were disadvantaged. Overall children who were developmentally vulnerable were reported to use more specialist/hospital health services than those who were not developmentally vulnerable (10-25 % vs 5-16%). Children who were developmentally vulnerable and not disadvantaged were 1.4-2.0 times more likely to have reported using a GP, paediatrician, other specialist, and Emergency Department compared with children who were developmentally vulnerable and disadvantaged. Conclusion Preschool children who are developmentally vulnerable have a higher reported use of specialist and hospital services compared with those who are not developmentally vulnerable. There is evidence of an inverse care law; those who were not disadvantaged with and without developmental vulnerability are more likely to use health services compared with their counterparts who were disadvantaged.

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“…This also highlights a caregiver need for services that support children's speech and language and behaviour in ACCHs and mainstream services. Previous research using the PEDS in a culturally and linguistically diverse and low socioeconomic status cohort of children in Australia showed that developmental risk increased with the age [33]. Similarly, in our cohort, children in the older age group (4.5 to 8 years) had the highest prevalence of developmental risk.…”

Section: Discussionsupporting

confidence: 69%

“…Due to the amount of missing data we used multiple imputation to account for the missing values for the risk factors. Under the assumption that the missing data were missing at random, multilevel multiple imputation was performed using REALCOM-IMPUTE software [33]. We created 50 imputed data sets, which incorporated variability due to uncertainty in the exact values, with a burn-in period of 2500 iterations and 500 iterations between imputations.…”

Section: Discussionmentioning

confidence: 99%

Developmental risk among Aboriginal children living in urban areas in Australia: the Study of Environment on Aboriginal Resilience and Child Health (SEARCH)

et al. 2020

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Background: Most Australian Aboriginal children are on track with their development, however, the prevalence of children at risk of or with a developmental or behavioural problem is higher than in other children. Aboriginal child development data mostly comes from remote communities, whereas most Aboriginal children live in urban settings. We quantified the proportion of participating children at moderate and high developmental risk as identified by caregivers' concerns, and determined the factors associated with developmental risk among urban Aboriginal communities. Methods: Study methods were co-designed and implemented with four participating urban Aboriginal Community Controlled Health Services in New South Wales, Australia, between 2008 and 2012. Caregiver-reported data on children < 8 years old enrolled in a longitudinal cohort study (Study of Environment on Aboriginal Resilience and Child Health: SEARCH) were collected by interview. The Parents' Evaluation of Developmental Status (PEDS) was used to assess developmental risk through report of caregiver concerns. Odds ratios (OR) were calculated using multinomial logistic regression to investigate risk factors and develop a risk prediction model. Results: Of 725 children in SEARCH with PEDS data (69% of eligible), 405 (56%) were male, and 336 (46%) were aged between 4.5 and 8 years. Using PEDS, 32% were at high, 28% moderate, and 40% low/no developmental risk. Compared with low/no risk, factors associated with high developmental risk in a mutually-adjusted model, with additional adjustment for study site, were male sex (OR 2.42, 95% confidence intervals 1.62-3.61), being older (4.5 to < 8 years versus < 3 years old, 3.80, 2.21-6.54), prior history of ear infection (1.95, 1.21-3.15), having lived in 4 or more houses versus one house (4.13, 2.04-8.35), foster care versus living with a parent (5.45, 2.32-12.78), and having a caregiver with psychological distress (2.40, 1.37-4.20). Conclusion: In SEARCH, 40% of urban Aboriginal children younger than 8 years were at no or low developmental risk. Several factors associated with higher developmental risk were modifiable. Aboriginal community-driven programs to improve detection of developmental problems and facilitate early intervention are needed.

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Prevalence and factors associated with parental concerns about development detected by theParents’ Evaluation of Developmental Status (PEDS)at 6-month, 12-month and 18-month well-child checks in a birth cohort

Cited by 25 publications

References 31 publications

Use of health services by preschool-aged children who are developmentally vulnerable and socioeconomically disadvantaged: testing the inverse care law

Use of health services by preschool-aged children who are developmentally vulnerable and socioeconomically disadvantaged: testing the inverse care law

The intersection of developmental vulnerability and socioeconomic disadvantage on access to health care for preschool aged children: evidence for the inverse-care law

Developmental risk among Aboriginal children living in urban areas in Australia: the Study of Environment on Aboriginal Resilience and Child Health (SEARCH)

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