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How good is general practice developmental screening?
1Yeovil District Hospital, Somerset.
Insights
Developmental screening by health visitors and general practitioners in Somerset showed low sensitivity for identifying children with special educational needs. Most children needing special education were identified before preschool screening, indicating limited program utility.
Area of Science:
- Child Development
- Public Health
- Educational Psychology
Background:
- Developmental screening is crucial for early identification of special educational needs.
- Current screening practices in Somerset involve general practitioners and health visitors.
- The effectiveness of these established screening programs requires evaluation.
Purpose of the Study:
- To assess the sensitivity of developmental assessments conducted by health visitors and general practitioners.
- To determine the relationship between preschool developmental assessments and later reading ability.
- To evaluate the overall utility of the Somerset developmental screening program.
Main Methods:
- Retrospective review of 1504 seven-year-old children in Somerset.
- Analysis of developmental assessment data from health visitors and general practitioners.
- Comparison of screening results with identification of children with special educational needs and school placement.
Main Results:
- Health visitor sensitivity was 45%, and general practitioner sensitivity was 56% for identifying special educational needs.
- No correlation found between preschool developmental assessment and later reading ability.
- 22 out of 23 children in special schools were identified independently of the screening program.
Conclusions:
- Developmental screening in Somerset demonstrated limited effectiveness in identifying children with special educational needs.
- The existing screening program did not significantly contribute to early identification or impact later academic outcomes.
- Alternative or improved methods for developmental screening may be necessary.
Abstract:
All developmental screening in Somerset is performed by general practitioners and health visitors. A retrospective review of a cohort of 1504 7 year old children living in semirural Somerset found that the development assessment by a health visitor at age 3 1/2 years had a sensitivity of 45% for identifying the 103 children with special educational needs, whereas the sensitivity of the preschool examination by a general practitioner was 56%. There was no relation between results of preschool developmental assessment and later reading ability. Of the 23 children in special schools, 22 had been identified independently of the developmental screening programme before starting school. Intervention was started at a mean age of 1 year 5 months (range 2 months to 3 years) for children with severe learning difficulties, and 3 years 9 months (2 years 3 months to 6 years 6 months) for children with moderate learning difficulties. The preschool medical examination revealed fairly minor medical problems: 29 of 81 children referred for specialist opinions were shown to be medically normal, and for only seven of the medically abnormal children was information about their conditions given to their teachers. In Somerset screening the development of all children at predetermined ages has not been very useful.