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Developmental-behavioural problems in general paediatrics
1Community Child Health Service, Royal Children's Hospital and District Health Service, Brisbane, Queensland, Australia.
Insights
Private general paediatricians manage a significant number of children with developmental-behavioural (DB) problems. Findings highlight a need for improved training and public/private collaboration in child health services.
Area of Science:
- Child Health
- Developmental Paediatrics
- Behavioural Science
Background:
- Private general paediatricians play a crucial role in managing children's developmental and behavioural issues.
- Understanding their current involvement is essential for service planning.
Purpose of the Study:
- To determine the current role of private general paediatricians in managing developmental-behavioural (DB) problems.
- To assess their referral rates, ongoing management practices, and training needs.
Main Methods:
- A survey was distributed to general paediatricians registered with the Australian College of Paediatrics.
- Data analysis focused on 172 private practitioners spending over 25% of their time on developmental-behavioural issues.
Main Results:
- An average of 32% of new referrals were for DB problems.
- Paediatricians opted to co-manage with allied health services in 65% of presented clinical vignettes.
- Respondents recommended increased training durations in DB paediatrics, developmental disabilities, and child psychiatry.
Conclusions:
- Private general paediatricians are actively involved in developmental-behavioural care.
- The study indicates a need for enhanced training programs and better collaboration between public and private child health sectors.
Objective:
To determine the current role of private general paediatrics in the care of children with problems of development and behaviour.
Methods:
We surveyed all general paediatricians registered with the Australian College of Paediatrics to assess their current role in developmental-behavioural (DB) problems--their rate of referrals, their role in the continuing management, and opinions regarding duration of training in this area.
Results:
Of 394 questionnaires sent, 284 replies were received (72%). From these 284 we analysed results for all 172 who spent more than 25% of their time in private general paediatric practice. On average, 32% of new referrals were for DB problems. With 10 DB clinical vignettes presented, paediatricians chose to continue to manage in conjunction with allied health services in 65% of cases. Other management choices included referral to a multidisciplinary team (16%), referral elsewhere (10%) and manage alone (7%). For training to be a general paediatrician, they indicated 3 months should be spent during basic training in each of the three areas of; DB paediatrics, developmental disabilities and child psychiatry (separately or concurrently); and 6 months of each during advanced training. Free comments highlighted lack of public allied health and psychosocial services.
Conclusion:
Private community-based general paediatricians are deeply involved in this area of work. The results raise questions about services for training and for clinical collaboration between public and private child health providers.
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