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Developmental screening in South Africa: comparing the national developmental checklist to a standardized tool
Jeannie van der Linde1, De Wet Swanepoel2, Frances Page Glascoe3
1Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa.
Insights
South Africa's Road to Health Booklet developmental checklist is ineffective for identifying at-risk infants due to low sensitivity. Improvements are needed to accurately screen children for developmental delays and disorders.
Area of Science:
- Child Development
- Public Health
- Pediatrics
Background:
- Over 200 million children globally face developmental delays or disabilities.
- South Africa utilizes the Road to Health Booklet (RTHB) as its sole national developmental screening tool.
Purpose of the Study:
- To assess the accuracy of the RTHB developmental checklist.
- To compare the RTHB checklist against the PEDS tools (PEDS and PEDS:DM).
Main Methods:
- A comparative cross-sectional within-subject design was used.
- 201 participants were recruited via convenience sampling at primary health care facilities in Tshwane, South Africa.
Main Results:
- The RTHB developmental checklist demonstrated low sensitivity but high specificity.
- It failed to identify over half of the infants who were actually at risk for developmental delays or disorders.
Conclusions:
- The RTHB developmental checklist is currently ineffective for identifying at-risk infants.
- Adaptation, validation, or replacement of the RTHB checklist is recommended to enhance early identification of developmental issues.
Background:
Worldwide, more than 200 million children in low- and middle-income countries have developmental delays and/or disabilities. In South Africa the only nationally implemented developmental 'screening' tool is integrated as part of 'The Road to Health Booklet (RTHB).
Method:
The study employed a comparative cross-sectional within-subject design to evaluate the accuracy of the RTHB developmental checklist against a standardized international tool i.e. the PEDS tools, consisting of the PEDS and PEDS:DM. A total of 201 participants were included through convenience sampling at primary health care facilities in Tshwane, South Africa.
Results:
Sensitivity of the RTHB developmental checklist is low, but specificity is high. The RTHB developmental checklist failed to identify more than half the infants at risk of delays or disorders. The nationally implemented developmental checklist is ineffective to identify at-risk infants. It should be adapted and validated or replaced in order to improve identification of at-risk infants.
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