International variation in programmes for assessment of children’s neurodevelopment in the community: understanding disparate approaches to evaluation of motor, social, emotional, behavioural and cognitive function

Philip Wilson (Corresponding Author), Rachael Wood, Kirsten Lykke, Anette Hauskov Graungaard, Ruth Kirk Ertmann, Merethe Kirstine Andersen, Ole Rikard Haavet, Per Lagerløv, Eirik Abildsnes, Mina P. Dahli, Marjukka Mäkelä, Aleksi Varinen, Merja Hietanen, Nordic Research Network for Children and Adolescents in General Practice

Research output: Contribution to journalArticle

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Abstract

Background: Few areas of medicine demonstrate such international divergence as child development screening and surveillance. Many countries have nationally mandated surveillance policies, but the content of programmes and mechanisms for delivery vary enormously. The cost of programmes is substantial but no economic evaluations have been carried out. We have critically examined the history, underlying philosophy, content and delivery of programmes for child development assessment in five countries with comprehensive publicly funded health services (Denmark, Finland, Norway, Scotland and Sweden). The specific focus of this article is on motor, social, emotional, behavioural and global cognitive functioning including language. Findings: Variations in developmental surveillance programmes are substantially explained by historical factors and gradual evolution although Scotland has undergone radical changes in approach. No elements of universal developmental assessment programmes meet World Health Organization screening criteria, although some assessments are configured as screening activities. The roles of doctors and nurses vary greatly by country as do the timing, content and likely costs of programmes. Inter-professional communication presents challenges to all the studied health services. No programme has evidence for improved health outcomes or cost effectiveness. Conclusions: Developmental surveillance programmes vary greatly and their structure appears to be driven by historical factors as much as by evidence. Consensus should be reached about which surveillance activities constitute screening, and the predictive validity of these components needs to be established and judged against World Health Organization screening criteria. Costs and consequences of specific programmes should be assessed, and the issue of inter-professional communication about children at remediable developmental risk should be prioritised.
Original languageEnglish
Pages (from-to)805-816
Number of pages12
JournalScandinavian Journal of Public Health
Volume46
Issue number8
Early online date4 May 2018
DOIs
Publication statusPublished - 1 Dec 2018

Fingerprint

Cognition
Scotland
Child Development
Costs and Cost Analysis
Health Services
Cost-Benefit Analysis
Communication
Nurse's Role
Denmark
Finland
Norway
Sweden
Consensus
Language
History
Medicine
Health

Keywords

  • paediatrics
  • screening
  • child developments
  • parents
  • organisation of care
  • health surveillance
  • general practice
  • primary (health) care
  • community nurse
  • well-child checks

Cite this

International variation in programmes for assessment of children’s neurodevelopment in the community : understanding disparate approaches to evaluation of motor, social, emotional, behavioural and cognitive function. / Wilson, Philip (Corresponding Author); Wood, Rachael; Lykke, Kirsten ; Graungaard, Anette Hauskov ; Ertmann, Ruth Kirk ; Andersen, Merethe Kirstine ; Haavet, Ole Rikard ; Lagerløv, Per ; Abildsnes, Eirik ; Dahli, Mina P. ; Mäkelä, Marjukka ; Varinen, Aleksi ; Hietanen, Merja ; Nordic Research Network for Children and Adolescents in General Practice.

In: Scandinavian Journal of Public Health, Vol. 46, No. 8, 01.12.2018, p. 805-816.

Research output: Contribution to journalArticle

Wilson, P, Wood, R, Lykke, K, Graungaard, AH, Ertmann, RK, Andersen, MK, Haavet, OR, Lagerløv, P, Abildsnes, E, Dahli, MP, Mäkelä, M, Varinen, A, Hietanen, M & Nordic Research Network for Children and Adolescents in General Practice 2018, 'International variation in programmes for assessment of children’s neurodevelopment in the community: understanding disparate approaches to evaluation of motor, social, emotional, behavioural and cognitive function', Scandinavian Journal of Public Health, vol. 46, no. 8, pp. 805-816. https://doi.org/10.1177/1403494818772211
Wilson, Philip ; Wood, Rachael ; Lykke, Kirsten ; Graungaard, Anette Hauskov ; Ertmann, Ruth Kirk ; Andersen, Merethe Kirstine ; Haavet, Ole Rikard ; Lagerløv, Per ; Abildsnes, Eirik ; Dahli, Mina P. ; Mäkelä, Marjukka ; Varinen, Aleksi ; Hietanen, Merja ; Nordic Research Network for Children and Adolescents in General Practice. / International variation in programmes for assessment of children’s neurodevelopment in the community : understanding disparate approaches to evaluation of motor, social, emotional, behavioural and cognitive function. In: Scandinavian Journal of Public Health. 2018 ; Vol. 46, No. 8. pp. 805-816.
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abstract = "Background: Few areas of medicine demonstrate such international divergence as child development screening and surveillance. Many countries have nationally mandated surveillance policies, but the content of programmes and mechanisms for delivery vary enormously. The cost of programmes is substantial but no economic evaluations have been carried out. We have critically examined the history, underlying philosophy, content and delivery of programmes for child development assessment in five countries with comprehensive publicly funded health services (Denmark, Finland, Norway, Scotland and Sweden). The specific focus of this article is on motor, social, emotional, behavioural and global cognitive functioning including language. Findings: Variations in developmental surveillance programmes are substantially explained by historical factors and gradual evolution although Scotland has undergone radical changes in approach. No elements of universal developmental assessment programmes meet World Health Organization screening criteria, although some assessments are configured as screening activities. The roles of doctors and nurses vary greatly by country as do the timing, content and likely costs of programmes. Inter-professional communication presents challenges to all the studied health services. No programme has evidence for improved health outcomes or cost effectiveness. Conclusions: Developmental surveillance programmes vary greatly and their structure appears to be driven by historical factors as much as by evidence. Consensus should be reached about which surveillance activities constitute screening, and the predictive validity of these components needs to be established and judged against World Health Organization screening criteria. Costs and consequences of specific programmes should be assessed, and the issue of inter-professional communication about children at remediable developmental risk should be prioritised.",
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AU - Wilson, Philip

AU - Wood, Rachael

AU - Lykke, Kirsten

AU - Graungaard, Anette Hauskov

AU - Ertmann, Ruth Kirk

AU - Andersen, Merethe Kirstine

AU - Haavet, Ole Rikard

AU - Lagerløv, Per

AU - Abildsnes, Eirik

AU - Dahli, Mina P.

AU - Mäkelä, Marjukka

AU - Varinen, Aleksi

AU - Hietanen, Merja

AU - Nordic Research Network for Children and Adolescents in General Practice

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PY - 2018/12/1

Y1 - 2018/12/1

N2 - Background: Few areas of medicine demonstrate such international divergence as child development screening and surveillance. Many countries have nationally mandated surveillance policies, but the content of programmes and mechanisms for delivery vary enormously. The cost of programmes is substantial but no economic evaluations have been carried out. We have critically examined the history, underlying philosophy, content and delivery of programmes for child development assessment in five countries with comprehensive publicly funded health services (Denmark, Finland, Norway, Scotland and Sweden). The specific focus of this article is on motor, social, emotional, behavioural and global cognitive functioning including language. Findings: Variations in developmental surveillance programmes are substantially explained by historical factors and gradual evolution although Scotland has undergone radical changes in approach. No elements of universal developmental assessment programmes meet World Health Organization screening criteria, although some assessments are configured as screening activities. The roles of doctors and nurses vary greatly by country as do the timing, content and likely costs of programmes. Inter-professional communication presents challenges to all the studied health services. No programme has evidence for improved health outcomes or cost effectiveness. Conclusions: Developmental surveillance programmes vary greatly and their structure appears to be driven by historical factors as much as by evidence. Consensus should be reached about which surveillance activities constitute screening, and the predictive validity of these components needs to be established and judged against World Health Organization screening criteria. Costs and consequences of specific programmes should be assessed, and the issue of inter-professional communication about children at remediable developmental risk should be prioritised.

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KW - organisation of care

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KW - well-child checks

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