Abstract
Background
Twenty per cent of Australian children enter primary school with at least one area of developmental vulnerability (Commonwealth of Australia. (2018). Australian early development census [AEDC]. Retrieved from https://www.aedc.gov.au/.). This statistic is in the context of Maternal and Child Health (MCH) services offering regular developmental screening up to 8 times between 2 weeks and 3.5 years of age.
Objectives
This study investigated: (1) enablers and barriers influencing MCH nurses in identifying children from birth to school age at risk of developmental delay. This focused on their experience, knowledge, attitudes and skills regarding the use of developmental screening tools. And (2) strategies to support MCH nurses and parents to identify children at risk of delay.
Method
This mixed-methods study combined an online questionnaire and three focus groups and participants were MCH Nurses (N = 19) from one Australian municipality.
Results
MCH nurses surveyed (N = 19) reported more confidence in screening older children compared to children younger than 12 months. 15 of 19 nurses did not have accurate knowledge and skill in using PEDS and Brigance screens. In the focus group interviews (N = 16), time restraints, language used in developmental screening tools, and excessive waiting time for referral were raised as key barriers to identifying children at risk.
Limitations
While the study provides rich insight, caution needs to be exercised when making generalisations from the findings given the small number of participants from one municipality.
Conclusion
Recommendations for practice, service management, and further research are provided to improve the process of early detection.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ali, S. S. (2013). A brief review of risk-factors for growth and developmental delay among preschool children in developing countries. Adv Biomed Res, 2, 91. https://doi.org/10.4103/2277-9175.122523.
Australian Bureau of Statistics. (2017a). 2024.0—census of population and housing: Australia revealed, 2016. Retrieved from https://www.abs.gov.au/ausstats/abs@.nsf/mf/2024.0.
Australian Bureau of Statistics. (2017b). Census of population and housing 2016. Retrieved from http://www.abs.gov.au.
Berry, A. D., Garzon, D. L., Mack, P., Kanwischer, K. Z., & Beck, D. G. (2014). Implementing an early childhood developmental screening and surveillance program in primary care settings: lessons learned from a project in Illinois. Journal of Pediatric Health Care, 28(6), 516–525. https://doi.org/10.1016/j.pedhc.2014.04.008.
Centre for Community Child Health (CCCH). (2015). PEDS brief administration and scoring guide. Melbourne: CCCH. Available at https://www.rch.org.au/ccch/peds/materials/.
Centre for Community Child Health. (2018a). Place-based collective impact: an Australian response to childhood vulnerability. Policy Brief, 30. Retrieved from https://www.rch.org.au/uploadedFiles/Main/Content/ccchdev/1807-CCCH-PolicyBrief-30.pdf.
Centre for Community Child Health. (2018b). The first thousand days—our greatest opportunity. Policy Brief Number 28. Murdoch Children’s Research Institute/The Royal Children’s Hospital, Parkville, Victoria. https://doi.org/https://doi.org/10.25374/MCRI.5991184.
Commonwealth of Australia. (2018). Australian early development census [AEDC]. Retrieved from https://www.aedc.gov.au/.
Department of Education and Early Childhood Development (DEECD). (2014). Starting out strong: giving Victoria’s children a great start through better maternal and child health. East Melbourne, Victoria: DEECD.
Department of Education and Training, (DET). (2018a). MCH training. Retrieved from https://www.education.vic.gov.au/childhood/professionals/profdev/Pages/mchtraining.aspx#link74.
Department of Education and Training (DET). (2018b). KAS consultations. Available at: https://www.education.vic.gov.au/childhood/professionals/health/Pages/kasconsultations.aspx.
Department of Education and Training (DET). (2019a). School nurses. https://www.education.vic.gov.au/school/teachers/health/Pages/nurses.aspx.
Department of Education and Training (DET). (2019b). About early childhood intervention services. Retrieved from https://www.education.vic.gov.au/childhood/professionals/needs/Pages/ecisabout.aspx.
Department of Education and Training (DET). (2019c). Victorian early childhood intervention services guide (Project Code 718360). Retrieved as Victorian ECIS Guide from https://www.education.vic.gov.au/childhood/professionals/needs/Pages/ecisabout.aspx.
Department of Health and Human Services (DHHS). (2019). Maternal and child health service practice guidelines 2009. Retrieved from https://www2.health.vic.gov.au/primary-and-community-health/maternal-child-health/framework-mch.
French, B. (2014). Brigance screens III technical manual. Washington: Hawker Brownlow.
Gellasch, P. (2017). The developmental screening behaviours, skills, facilitators, and constraints of family nurse practitioners in primary care. A Dissertation presented to the Faculty of the College of Nursing Villanova University. Ann Arbor: Proquest LLC/ Available at: https://primo-direct-apac.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_sciversesciencedirect_elsevierS0891-5245(18)30586-8&context=PC&vid=RMITU&lang=en_US&search_scope=Books_articles_and_more&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,patricia%20gellasch&mode=Basic.
Glascoe, F. P. (1998). Collaborating with parents: using parents evaluation of developmental status to detect and address developmental and behavioral problems. Nashville, TN: Ellsworth and Vandermeer.
Glascoe, F. P. (2003). Parents’ evaluation of developmental status: how well do parents’ concerns identify children with behavioral and emotional problems? Clinical Pediatrics (Phila), 42(2), 133–138. https://doi.org/10.1177/000992280304200206.
Glascoe, F. P. (2015). Evidence-based early detection of developmental-behavioral problems in primary care: what to expect and how to do it. Journal of Pediatric Health Care , 29(1), 46–53. https://doi.org/10.1016/j.pedhc.2014.06.005.
Goldfeld, S. & Oberklaid, F. (2007). Building early detection systems for child development problems. Community Paediatric Review, 16(1), 1–4. Retrieved from https://www.rch.org.au/uploadedFiles/Main/Content/ccch/CPRVol16No1.pdf.
Grove, S. K., Gray, J. R., & Burns, N. (2015). Understanding nursing research: building an evidence base practice (6th ed.). St Louis: Elsevier Saunders.
Hawker Brownlow Education. (2014). Brigance early childhood screens standardisation and validation: research highlights. United States of America: Hawker Brownlow Education .
Krupic, F., Hellstrom, M., Biscevic, M., Sadic, S., & Fatahi, N. (2016). Difficulties in using interpreters in clinical encounters as experienced by immigrants living in Sweden. Journal of Clinical Nursing, 25(11–12), 1721–1728. https://doi.org/10.1111/jocn.13226.
Moore, T.G., McDonald, M., Sanjeevan, S. and Price, A. (2012). Sustained home visiting for vulnerable families and children: a literature review of effective processes and strategies. Prepared for Australian Research Alliance for Children and Youth. Parkville, Victoria: Murdoch Childrens Research Institute and The Royal Children’s Hospital Centre for Community Child Health. Retrieved from https://www.rch.org.au/uploadedFiles/Main/Content/ccch/resources_and_publications/Home_visiting_lit_review_RAH_processes_final.pdf.
Morelli, D. L., Pati, S., Butler, A., Blum, N. J., Gerdes, M., Pinto-Martin, J., & Guevara, J. P. (2014). Challenges to implementation of developmental screening in urban primary care: a mixed methods study. BMC Pediatrics, 14, 16. https://doi.org/10.1186/1471-2431-14-16.
Myers, D. G., & DeWall, C. N. (2015). Psychology (11th ed.). New York: Worth Publishers.
Royal Childrens Hospital (RCH). (2019). Parents evaluation of developmental status (PEDS) For clinicians. Available at: https://docs.google.com/document/d/1H1KzRCwBcT5LLCAcCl-AIpaoV6YtV-LnLtZpAeajk8s/edit#heading=h.m93bl1l0cw5d.
Singh, A., Yeh, C., & Blanchard, S. (2017). Ages and stages questionaire: a global screening tool. Boletin Medico del Hospital Infantil de Mexico, 74(1), 5–12. https://doi.org/10.1016/j.bmhimx.2016.07.008.
The Royal Australasian College of Physicians. (2013). Position statement: early intervention for children with developmental disabilities. Retrieved from https://www.racp.edu.au/docs/default-source/advocacy-library/early-intervention-for-children-with-developmental-disabilities.pdf.
Vameghi, R., Sajedi, F., Shahshahani, S., & Biglarian, A. (2015). Validity and reliability determination of parents evaluation of developmental status (PEDS) in 4–60 months old children in Tehran. Iranian Rehabilitation Journal, 13(2), 62–67.
Author information
Authors and Affiliations
Corresponding author
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Sheeran, L., Zhao, L., Buchanan, K. et al. Enablers and Barriers to Identifying Children at Risk of Developmental Delay: A Pilot Study of Australian Maternal and Child Health Services. Matern Child Health J 25, 967–979 (2021). https://doi.org/10.1007/s10995-020-03077-0
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10995-020-03077-0