The role of well-child visits in detecting developmental delay in preschool children
M Moser1,2, C Müllner1,2, P Ferro1,2
1Child Development Center, University Children's Hospital Zurich, University of Zurich (UZH), Zürich, Switzerland.
Insights
Early detection of developmental delay (DD) in preschool children is crucial. Well-child visits are key for identification, but parental hesitancy can hinder early intervention (EI) access.
Area of Science:
- Pediatric Health
- Developmental Pediatrics
- Public Health
Background:
- Early detection of developmental delay (DD) in preschool children is critical for timely intervention.
- Effective identification strategies are needed to improve outcomes for children with DD.
- Parental counseling and support are essential components of early intervention (EI) services.
Purpose of the Study:
- To evaluate the role of primary care physicians (PCPs) in identifying developmental delay (DD) in preschool children.
- To assess the frequency and effectiveness of well-child visits for DD detection.
- To understand parental acceptance of diagnostic work-up and early intervention (EI).
Main Methods:
- Register study of preschool children referred for EI in Zurich (N=1,785).
- Online survey among primary care physicians (PCPs, N=271) to evaluate DD care.
- Analysis of referral patterns and reported practices in well-child visits.
Main Results:
- PCPs made 79.5% of physician referrals for EI.
- Over 90% of children needing EI were correctly referred by PCPs at an average age of 39.3 months.
- Well-child visits were identified as the most frequent consultation for DD identification (66.7%), with 88.7% of parents showing hesitancy towards further evaluation or support.
Conclusions:
- Well-child visits are optimal opportunities for early detection of DD and initiation of EI.
- Addressing parental reservations is crucial to reduce refusal rates and improve access to early support.
- Strengthening the role of PCPs in DD screening can enhance EI services for preschool children.
Background:
Early detection of developmental delay (DD) in preschool children is crucial for counselling parents, initiating diagnostic work-up, and starting early intervention (EI).
Methods:
We conducted a register study of all preschool children referred for EI in the Canton of Zurich, Switzerland, in 2017 (N = 1,785) and used an online survey among primary care physicians (PCPs, N = 271) to evaluate the care service of DD children.
Results:
PCPs accounted for 79.5% of all referrals by physicians and had correctly referred over 90% of the children in need of EI at an average age of 39.3 months (SD 8.9). In the survey, which represents 59.2% of all pediatricians and 11.3% of all general practitioners in the Canton, PCPs reported performing a mean of 13.5 (range 0-50, SD 10.7) well-child visits per week to preschool children and estimated well-child visits to be the most frequent type of consultation (66.7%) for the identification of DD. Parents' hesitancy in accepting further evaluation or support were reported by 88.7%.
Conclusions:
Most preschool children with DD are identified in well-child visits. These visits represent an ideal opportunity for early detection of developmental impairment and initiation of EI. Carefully addressing parents' reservations could reduce the rate of refusal, thus improving early support for children with DD.
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