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Impact of a "No Mobile Device" Policy on Developmental Surveillance in a Pediatric Clinic
Paul A Regan1, Benjamin N Fogel1, Steven D Hicks1
11 Penn State, Hershey, PA, USA.
Insights
Prohibiting mobile device use during pediatric visits did not improve developmental surveillance accuracy. Instead, allowing devices may enhance parent-provider interaction and fine motor skill observation.
Area of Science:
- Pediatric healthcare
- Developmental surveillance
- Technology in medicine
Background:
- Children frequently use mobile devices during pediatric appointments.
- This usage may negatively impact patient-provider communication and the precision of developmental assessments.
- The effect of mobile device policies on developmental surveillance accuracy is not well understood.
Purpose of the Study:
- To investigate whether a policy restricting mobile device use in a pediatric clinic enhances the accuracy of developmental surveillance.
- To compare the accuracy of pediatricians' developmental assessments with standardized questionnaire results under different mobile device policies.
Main Methods:
- A randomized, provider-blinded, controlled trial was conducted with children aged 18 to 36 months.
- Participants were assigned to either a device-prohibited (intervention) or device-allowed (control) group.
- Developmental surveillance was assessed using the Ages and Stages Questionnaire (ASQ-3) and compared with pediatrician clinical assessments.
Main Results:
- Provider-ASQ discrepancies were more frequent in the group where mobile device use was prohibited (P = .025).
- Pediatricians missed more ASQ-3 "delayed" developmental scores in the device-prohibited group (P = .005), especially in fine motor skills (P = .018).
- The policy restricting mobile device use did not improve the accuracy of developmental surveillance.
Conclusions:
- Banning mobile devices during well-child visits does not enhance the accuracy of pediatricians' developmental surveillance.
- Mobile devices might facilitate child engagement, allowing more time for parent-provider discussions and observation of fine motor skills.
- Current findings suggest that mobile devices may play a beneficial role in the pediatric visit context.
Abstract:
Children commonly use mobile devices at pediatric office visits. This practice may affect patient-provider interaction and undermine accuracy of developmental surveillance. A randomized, provider-blinded, controlled trial examined whether a policy prohibiting mobile device use in a pediatric clinic improved accuracy of pediatricians' developmental surveillance. Children, aged 18 to 36 months, were randomized to device-prohibited (intervention; n = 58) or device-allowed (control; n = 54) groups. After a 30-minute well-visit, development was evaluated as "normal," "borderline," or "delayed" in 5 categories using the Ages and Stages Questionnaire (ASQ-3). ASQ-3 results were compared with providers' clinical assessment in each category. Provider-ASQ discrepancies were more common for intervention participants ( P = .025). Providers "missed" more ASQ-3 "delayed" scores ( P = .005) in the intervention group, particularly in the fine motor domain ( P = .018). Prohibiting mobile device use at well-visits did not improve accuracy of providers' developmental surveillance. Mobile devices may entertain children at well-visits, allowing opportunities for parent-provider discussion, or observation of fine motor skills.