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Forty years of referrals and outcomes to a UK Child Development Centre (CDC): Has demand plateaued?
A N Williams1, B Mold1, L Kilbey1
1Virtual Academic Unit, CDC, Northampton General Hospital, Northampton, UK.
Insights
Over 40 years, Child Development Centres (CDCs) saw increased referrals for behavioral and social communication issues, reflecting greater awareness of neurodevelopmental disorders. Services must adapt to evolving diagnostic criteria and rising demand.
Area of Science:
- Pediatrics
- Developmental Pediatrics
- Child Psychology
Background:
- The Child Development Centre (CDC) at Northampton General Hospital has provided services for 40 years.
- Understanding long-term trends in child development assessments is crucial for service planning.
Purpose of the Study:
- To analyze 40 years of activity and outcomes at the Child Development Centre (CDC) from 1974 to 2014.
- To identify changes in referral patterns and assessment outcomes over four decades.
Main Methods:
- Data were compiled from three sources: a 1974-1999 report, a 2001-2004 audit, and 2005-2014 data.
- Medical notes of children assessed in 2014 and referral data from the preceding 10 years were reviewed.
Main Results:
- 3,786 children were assessed between 1974 and 2014.
- Referrals for behavioral difficulties rose from 10% (1999-2004) to 17.8% (2014).
- Referrals for social/communication problems increased 2.5-fold (10% to 26.7%), while 'developmental delay' referrals halved (22.2% to 12%).
Conclusions:
- A significant increase in referrals and demand for assessments of social interaction and behavioral difficulties was observed.
- This trend reflects increased awareness and evolving diagnostic criteria for neurodevelopmental disorders, including Autistic Spectrum Disorder.
- Implications for service development within Child Development Centres and Teams are considerable, necessitating adaptation to changing needs.
Aims:
To explore 40 years of Child Development Centre (CDC) activity and outcomes at Northampton General Hospital 1974-2014.
Methods:
The study comprises 3 data sets: a published report from 1974 to 1999, an internal audit from 2001 to 2004, and more recent data collected from 2005 to 2014. The medical notes of all children who were assessed by the CDC in 2014 were reviewed, along with referral data collected by the CDC manager from this year and the preceding 10 years.
Results:
From January 1, 1974 to December 31, 2014, 3,786 children were assessed. The male to female ratio is 2.8:1 from 2005 to 2014. Referrals for behavioural difficulties increased from 10% (10/100 referrals) in 1999-2004 to 17.8% (18/101 referrals) in 2014. Similarly, referrals for social and communication problems, "interaction" increased two and a half fold from 10% (10/100 referrals) in 1999-2004 to 26.7% (27/101 referrals) in 2014. Between 2004 and 2014, numbers of referrals for "developmental delay" halved (22.2% to 12%).
Conclusion:
We are aware of no other comparable extant UK CDC database. Services should plan for a referral rate of 6.5 per 1,000 preschool children. Between 1974 and 2014, there has clearly been a change in recorded assessment outcomes. From the mid-1980s, this reflects the change to a preschool assessment role and a shift away from purely educational outcome to include medical conditions. Covering 1974-2014, we demonstrate a clear increase in the number of referrals together with an increasing demand for assessments for social interaction and behavioural difficulties. This reflects the increased awareness of these neurodevelopmental difficulties and the changing diagnostic criteria which will now more likely result in an Autistic Spectrum Disorder diagnosis than previously. Together, these two features are most likely to have considerable implications for service development within Child Development Centres (CDCs) and Child Development Teams (CDTs).
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