Rethinking diagnosis-based service models for childhood neurodevelopmental disabilities in Canada: a question of...

Area of Science:

• Pediatrics
• Developmental Neuroscience
• Health Services Research

Background:

• Neurodevelopmental disability encompasses diverse congenital and acquired conditions affecting children's brain and neuromuscular function.
• Current service provision often relies on diagnostic labels, which may not accurately reflect a child's functional abilities.
• This can lead to inequities and difficulties in accessing appropriate support for children with complex needs.

Purpose of the Study:

• To examine the mismatch between neurodevelopmental diagnoses and functional capacity in children.
• To analyze how diagnosis-based service models exacerbate inequities.
• To advocate for a function and participation-based approach to improve service delivery.

Main Methods:

• Literature review and synthesis of evidence on diagnosis versus function in neurodevelopmental disability.
• Analysis of service access inequities stemming from diagnostic criteria.
• Conceptual framework development for a function and participation-based service model.

Main Results:

• Evidence indicates a frequent discrepancy between a child's neurodevelopmental diagnosis and their actual functional level.
• Diagnosis-centric service models create barriers and inequities for children whose conditions do not fit standard diagnostic categories.
• A function and participation-based approach offers a more equitable and effective pathway for service provision.

Conclusions:

• Shifting from diagnosis-based to function and participation-based approaches is crucial for equitable neurodevelopmental disability services.
• Implementing function-based assessments can better identify children's needs and facilitate access to tailored support.
• Calls to action are proposed to guide the transition towards more inclusive and equitable service models.