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Feasibility of screening young children in day care centers--a preliminary investigation
Insights
Day care staff can effectively screen young children for health issues with nurse training. This method identified numerous problems, proving feasible and acceptable for early detection in childcare settings.
Area of Science:
- Pediatric Health
- Childcare Services
- Health Screening
Background:
- Childhood health and developmental problems are prevalent.
- Early detection is crucial for timely intervention.
- Day care centers offer a unique setting for health screenings.
Purpose of the Study:
- To investigate the feasibility and acceptability of a health screening method in day care centers.
- To assess the effectiveness of trained day care staff in conducting screenings.
- To identify health and developmental problems in young children.
Main Methods:
- A nurse trained day care staff to screen 94 children (birth to 6 years) for health and developmental issues.
- Staff screenings were supervised, with questionable results re-screened by the nurse.
- Interrater reliability, referrals, follow-ups, and program assessments were conducted.
Main Results:
- 39 problems were identified in 33 children; 16 problems were verified after follow-up.
- Screenings led to 35 primary health care visits; parents were often unaware of verified issues.
- An overreferral rate of 47% was observed, with over 80% interrater agreement.
Conclusions:
- Health screenings in day care centers are feasible with modifications and acceptable to stakeholders.
- The method adequately identifies prevalent health problems in children under 6.
- Centers responded to identified needs but faced fiscal barriers to environmental or procedural changes.
Abstract:
A preliminary investigation of a method of providing health screening in day care centers was conducted. Ninety-four children, birth to 6 years, attending two day care centers were screened for health and developmental problems. A nurse trained day care staff to conduct the screenings, supervised their activities, rescreened children with questionable results, and conducted an interrater reliability study as well as referral and followup activities. The nurse also did assessments of environmental characteristics of the programs, their policies, procedures, and activities and assessed staff and parent information needs concerning child development, health practices, and health needs of children. Thirty-nine problems were identified in 33 children. Followups of 29 problems were completed, and 16 of these were verified. The 29 problems resulted in a total of 35 visits to primary health care providers. Among parents of children with verified problems, only three had been aware of the problem. The overreferral rate was 47 percent. Interrater percentages of agreement on most screenings were more than 80 percent. The findings suggested that the screenings were feasible with specific modifications. The screening activities were acceptable to parents, their physicians, and center staff. Centers were responsive to staff and parent needs identified in the screening process but not to recommendations for change within the environment and in operating procedures, partly because of fiscal implications. Screenings were adequate to identify a number of health problems prevalent in children under 6, and interrater reliabilities were acceptable.