Rates of detection of developmental problems at the 18‐month well‐baby visit by family physicians' using four evidence‐based screening tools compared to usual care: a randomized controlled trial

Abstract

Despite higher early detection rates in the evidence-based care group, there were no differences in referral rates between evidence-based and usual-care groups. This suggests that clinicians: (1) override evidence-based screening results with informal judgment; and/or (2) need assistance understanding test results and making referrals. Possible solutions are improve the quality of information obtained from the screening process, improved training of physicians, improved support for individual practices and acceptance by the regional health authority for overall responsibility for screening and creation of a comprehensive network.

Clinical utility of the Structured Observation of Motor Performance in Infants within the child health services

“…Studies have suggested that without using evidence-based assessment methods practitioners may have greater difficulties detecting mild delays or suspected deviations compared to not using an evidence-based assessment method[16,40,68–70]. A Swedish study reported that the average age for referral of children with CP from the CHS to rehabilitation services was 12 months[69].…”

“…To facilitate early detection of motor problems and developmental delays the use of standardized assessment methods is recommended[2,10,16]. Not only does assessment using standardized methods improve the accuracy of detection, it also provides valuable information compared to clinical judgment alone[16–19].…”

“…Not only does assessment using standardized methods improve the accuracy of detection, it also provides valuable information compared to clinical judgment alone[16–19]. Health professionals that rely only on their clinical judgment detect fewer children with developmental delays and do so at a later stage compared to professionals that apply a standardized assessment method[2,16,17,20–22]. To improve detection rates during infancy repeated assessments are recommended[23–26].…”

“…Parental concern is considered a significant marker for development disorders,[16,53,54] but this is not necessarily true when it comes to early motor problems. For instance, Ehrmann Feldman and colleagues showed that physicians are concerned significantly earlier than parents of younger children with neuromotor problems[55].…”

Rani Skrining Na Autizam U Primarnoj Pedijatrijskoj Službi

“…U 25 porodica procjena ranog razvoja vršila se "neformalno", a u 29 slučajeva upotrebom upitnika za čije popunjavanje nije trebalo više od 10 minuta. U prvoj grupi identifikovano je 4 % , a u drugoj 62 % djece sa mogućim razvojnim problemima (13).…”