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Patterns of attendance at developmental assessment clinics
Insights
Child developmental assessments at clinics may not reach children most in need. Clinic attendees had higher social class and IQs than those assessed at school, suggesting a potential bias in service provision.
Area of Science:
- Pediatric Health
- Developmental Pediatrics
- Public Health
Background:
- Child health surveillance aims to identify developmental needs early.
- Local Authority (LA) developmental assessment clinics are a key service.
- Understanding clinic attendance patterns and demographic representativeness is crucial.
Purpose of the Study:
- To compare the characteristics of children attending a developmental assessment clinic with those assessed only at school.
- To investigate potential social and cognitive biases in clinic attendance.
Main Methods:
- A cohort of 489 children was initially sampled at birth.
- Follow-up at ages four and five years involved clinic attendance records and school tracing.
- Children seen at clinic were compared to those identified via school records.
Main Results:
- Only 47% of invited children attended the four-year clinic assessment.
- Children attending the clinic were from higher social classes and had higher IQs compared to those assessed at school.
- Children without initial clinic records were more likely to be traced via schools.
Conclusions:
- Developmental assessment clinics may disproportionately serve children from higher socioeconomic backgrounds and with higher cognitive abilities.
- This suggests that children with the greatest need may be less likely to access or attend clinic-based services.
- Public health strategies may need to address barriers to clinic access for underserved populations.
Abstract:
A random sample of 489 children was collected at birth. There were clinic records for only 356 (73 per cent) of these children, and from this number 30 left the district or died. The parents of those with record cards were invited to bring their children to clinic when they reached the age of four years. Only 152 children (47 per cent) attended. Of the non-attenders, 129 were traced to schools in the borough when they reached the age of five years, as were 67 (51 per cent) of the 133 children without record cards. The children seen only at school were compared with the children seen at a Local Authority developmental assessment clinic. The clinic group were judged to come from the higher social classes and to have higher IQs than the school group, which suggests that clinics may be catering for those whose need is least.
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