The Time and Practice Challenges of Developmental-Behavioral Pediatrics: An Australian National Study

Roberts, Gehan; Efron, Daryl; Price, Anna; Wake, Melissa

doi:10.1097/dbp.0b013e31821bd07e

Cited by 9 publications

(10 citation statements)

References 22 publications

(24 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the current study, paediatricians (more so than any other profession) highlighted that the availability of intervention services was just as important, if not more important, than a sole focus on screening. Their views that developmental screening activities require more time for consultations, and result in greater referrals to early intervention and allied health services have also been shown in earlier study [ 40 ].…”

Section: Discussionsupporting

confidence: 54%

“…A clinical report from paediatricians as to their strategies for identifying children with developmental delays, diagnostic formulation and further management plan including referrals and monitoring pathways is a standard practice in Australia. But the challenges for GPs and paediatricians include the waiting lists for diagnostic developmental services when children with delays are identified, and sometimes limited access to allied health professionals for early intervention [ 40 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Health professional perceptions regarding screening tools for developmental surveillance for children in a multicultural part of Sydney, Australia

Garg

Eastwood

et al. 2018

BMC Fam Pract

View full text Add to dashboard Cite

BackgroundEncouraging early child development and the early identification of developmental difficulties is a priority. The Ministry of Health in the Australian State of New South Wales (NSW), has recommended a program of developmental surveillance using validated screening questionnaires, namely, the Parents’ Evaluation of Development Status (PEDS) and Ages and Stages Questionnaire (ASQs), however, the use of these tools has remained sub-optimal. A longitudinal prospective birth cohort “Watch Me grow” study was carried out in the South Western Sydney (SW) region of NSW to ascertain the uptake as well as the strategies and the resources required to maximise engagement in the surveillance program. This paper reports on a qualitative component of the study examining the attitudes, enablers and barriers to the current developmental surveillance practices, with reference to screening tools, amongst health professionals.MethodsQualitative data from 37 primary health care providers in a region of relative disadvantage in Sydney was analysed.ResultsThe major themes that emerged from the data were the “difficulties/problems” and “positives/benefits” of surveillance in general, and “specificity” of the tools which were employed. Barriers of time, tool awareness, knowledge and access of referral pathways, and services were important for the physician providers, while the choice of screening tools and access to these tools in other languages were raised as important issues by Child and Family Health Nurses (CFHN). The use of these tools by health professionals was also influenced by what the professionals perceived as the parents’ understanding of their child’s development. While the PEDS and ASQs was utilised by CFHNs, both General Practitioners (GPs) and paediatricians commented that they lacked awareness of developmental screening tools and highlighted further training needs.ConclusionsThe results highlight the practical challenges to, and limited knowledge and uptake of, the use of recommended screening tools as part of developmental surveillance. There is a need for further research regarding the most effective integrated models of care which will allow for a better collaboration between parents and service providers and improve information sharing between different professionals such as CFHNs GPs, Practices nurses and Paediatricians involved in screening and surveillance programs.

show abstract

Section: Discussionsupporting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Health professional perceptions regarding screening tools for developmental surveillance for children in a multicultural part of Sydney, Australia

Garg

Eastwood

et al. 2018

BMC Fam Pract

View full text Add to dashboard Cite

show abstract

“…1 Australian data estimate that 20-34% of new consultations address developmental-behavioural problems. [2][3][4] However, despite mandatory training requirements, many Australian paediatricians report that their developmental education is inadequate, 1-3 with training described as variable and site dependent. 1 Recognised barriers to effective learning include inadequate resources 5 and limited accessibility to education.…”

Section: What This Paper Addsmentioning

confidence: 99%

“…An understanding of child development is integral to paediatric practice . Australian data estimate that 20–34% of new consultations address developmental–behavioural problems . However, despite mandatory training requirements, many Australian paediatricians report that their developmental education is inadequate, with training described as variable and site dependent .…”

mentioning

confidence: 99%

‘Beyond Milestones’: A randomised controlled trial evaluating an innovative digital resource teaching quality observation of normal child development

Connolly

Cunningham

Sinclair

et al. 2013

J Paediatrics Child Health

View full text Add to dashboard Cite

Aims The study aimed to create and evaluate the educational effectiveness of a digital resource instructing paediatric trainees in a systematic approach to critical and quality observation of normal child development. Methods A digital educational resource was developed utilising the skills of an expert developmental paediatrician who was videoed assessing normal early child development at a series of critical stages. Videos illustrated aspects of language, sophistication of play and socialisation, cognition, and motor progress. Expert commentary, teaching text and summaries were used. A randomised controlled trial evaluated the resource. Paediatric trainees were recruited from The Sydney Children's Hospitals Network. Outcome measures were repeated at three time points (pre‐teaching, immediate‐post and 1 month) and included self‐rated attitudes, knowledge of markers of development and observational expertise. Qualitative data on teaching usefulness were obtained through open‐ended questions. Results Fifty‐six paediatric trainees (registrar 79%, women 82%; mean age 31 years) completed the pre‐assessment, 46 the immediate‐post and 45 the 1‐month follow‐up (20% attrition). Compared with the Control group, the Teaching group scored higher over time on markers of development (P = 0.006), observational expertise (P < 0.0001), confidence (P = 0.035) and satisfaction (P < 0.0001). Teaching participants valued the video and expert commentary and reported improvement in confidence and understanding and acquiring a more structured approach. Conclusions The ‘Beyond Milestones’ free online resource for medical professionals improves knowledge, increases confidence and is useful, providing a structured approach to developmental assessment. The techniques taught can be applied to every paediatric consultation.

show abstract

“…Clinical problems with a child's development, learning, behaviour and mental health are highly prevalent and constitute a major societal health and social burden . These conditions are prominent in the clinical life of general paediatricians as well as subspecialists in community child health . In an Australian survey of general paediatricians, conditions involving challenging behaviour, psychological disturbance or family dysfunction were identified as the most difficult clinical conditions to deal with .…”

mentioning

confidence: 99%

Clinical competence in developmental‐behavioural paediatrics: Raising the bar

O'Keeffe

2013

J Paediatrics Child Health

View full text Add to dashboard Cite

For our specialist paediatric workforce to be suitably equipped to deal with current childhood morbidity, a high level of competence in developmental-behavioural paediatrics (DBP) is necessary. New models of training and assessment are required to meet this challenge. An evolution of training in DBP, built around the centrepiece of competency-based medical education, is proposed. Summative assessment based upon entrustable professional activities, and a menu of formative workplace-based assessments specific to the DBP context are key components. A pilot project to develop and implement these changes is recommended.

show abstract

The Time and Practice Challenges of Developmental-Behavioral Pediatrics: An Australian National Study

Cited by 9 publications

References 22 publications

Health professional perceptions regarding screening tools for developmental surveillance for children in a multicultural part of Sydney, Australia

Health professional perceptions regarding screening tools for developmental surveillance for children in a multicultural part of Sydney, Australia

‘Beyond Milestones’: A randomised controlled trial evaluating an innovative digital resource teaching quality observation of normal child development

Clinical competence in developmental‐behavioural paediatrics: Raising the bar

Contact Info

Product

Resources

About