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Updated: Feb 7, 2026
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Involving Individuals with Developmental Language Disorder and Their Parents/Carers in Research Priority Setting
Published on: June 6, 2020
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Transitioning to a Flexible, Tiered, Developmentally Informed Same-Day Screening Model for Preschoolers in
Robyn Smith1, Elizabeth M Jordaan2, Dorothy C Russell3
1School of Health and Rehabilitation Sciences, University of the Free State, Bloemfontein, South Africa.
Child: Care, Health and Development
|February 6, 2026
Summary
A new flexible screening model improves early detection of developmental delays and health risks in preschool children in low-resource settings. This adaptable approach enhances early identification and referral within early childhood care and education platforms.
Area of Science:
- Child Development
- Public Health
- Global Health
Background:
- Preschool years (ages 3-5) are crucial for development and health, yet many low-resource settings miss early detection opportunities.
- Early childhood care and education (ECCE) platforms in low- and middle-income countries (LMICs) are underutilized for preventive services due to resource limitations and coordination challenges.
- Barriers include logistical constraints and low caregiver engagement, hindering effective early intervention.
Purpose of the Study:
- To iteratively refine an initial screening protocol into a flexible, tiered model for LMIC ECCE settings.
- To address implementation barriers identified through stakeholder feedback.
- To create a context-sensitive and scalable screening solution.
Main Methods:
- An observational, descriptive study in South Africa collected baseline data on preschoolers' development, sensory function, nutrition, and health.
- A Participatory Action Learning and Action Research (PALAR) approach was used to refine the initial multi-indicator protocol.
- Feedback from caregivers, facilitators, interpreters, fieldworkers, and healthcare professionals guided protocol adaptations.
Main Results:
- Key barriers identified: fragmented scheduling, long sessions, limited interpreters, caregiver disengagement, and challenges with children's behavior.
- A proposed flexible, tiered model was developed to consolidate visits, shorten sessions, improve interpreter support, and streamline tools.
- The model enhances feasibility, accuracy, and cultural responsiveness, supporting scalable application in low-resource ECCE contexts.
Conclusions:
- The proposed screening model offers a context-sensitive, scalable approach for early identification and referral in LMIC ECCE settings.
- Its adaptable structure facilitates broader implementation and better aligns with children's developmental needs.
- This model can inform future policy and integrated service planning for early childhood development.
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