A 'chronic disorder' health-care model for children with complex developmental disorders.
OBJECTIVE
To conceptualize, develop and evaluate a 'chronic disorder' clinical model of health services for children with 'low-severity' developmental disorders assessed and treated within a public Child Development Unit.


METHODS
Concepts of family empowerment, child resiliency and the management of clinical complexity were explicitly incorporated into the service model and the clinical strategies in order to address long-term goals of prevention and health promotion. To explore the efficacy of this model, a telephone audit survey was conducted of parents of 42 children seen sequentially through this modified service.


RESULTS
Parent data indicate a high level of satisfaction with the integrated, individualized assessment processes and effective transmission of information through both written reports and dedicated discussion visits. A treatment methodology based on parent chosen treatment goals for short and long time-frames was experienced as achievable and successful.


CONCLUSIONS
These data suggest that the service goals of an integrated team process, parent empowerment and effective clinical collaborations may be achievable from a health care setting. A change in emphasis from remedial treatment to adaptation, health promotion and tertiary prevention is integral to these strategies. The concepts, clinical model and evaluation are presented to stimulate discussion around the question of what child health services are attempting to achieve for children with complex developmental disorders.
McDowell
M
M
Community Child Health, Royal Children's Hospital, Brisbane, Queensland, Australia. michael@childdreams.com.au
Klepper
K
K
D001315:Australia; D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D002658:Developmental Disabilities / Q000628:therapy; D006801:Humans; D017146:Models, Organizational; D010043:Outcome and Process Assessment, Health Care; D015397:Program Evaluation