Referral patterns to a district Child Development Centre: 25 years experience

This study describes the changes in referral patterns to a district Child Development Centre over 25 y. Referral information was collected prospectively for all referrals seen at the Child Development Centre at Northampton, UK, from 1974 to 1998 inclusive. This unique data set records CDC usage over 25 y in the same district and was collected, until recently, by the same individual. Professional awareness and identification of complex developmental problems appeared to improve over the study period. The data show a gradual rise in referral rates to reach a plateau of between 5.5 and 7.2 referrals per 1000 children under 5 per annum. This level of referral achieves almost complete ascertainment of childhood disability needing statutory assessment by the age of 6 y. The increases in early referrals followed educational intervention with primary health care teams emphasising the importance of early identification and referral.