An effective community-based approach to the identification of neurodevelopmental delay in childhood.
The contribution of specially trained developmental nurses (DNs) to the accuracy of developmental screening in well-baby units was assessed. Of 13,580 children between two and 48 months of age, the well-baby clinic identified definitive developmental delay in 310, and 357 children were classified as 'questionable'. After DN assessment at 12 months follow-up, only 31 per cent of the questionable group required referral to the Child Development Centre (CDC). Comparison of the original queried recommendations to the CDC with the DN's recommendation indicated a false-positive and -negative rate of 60 and 20 per cent, respectively. This procedure resulted in false-positive and -negative screening accuracies of 1.2 and 6 per cent, respectively, for the total cohort of children screened. The economic and clinical advantages of this model are discussed.
Tirosh
E
E
Hanne Khoushi Child Development Center, Paediatric Department, Haifa, Israel.
Lechtman
M
M
Diamand
H
H
Jaffe
M
M
D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D003151:Community Health Centers; D002658:Developmental Disabilities / Q000175:diagnosis*; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012017:Referral and Consultation