Deepa Jeyaseelan|Michael Sawyer
Developmental literacy: A universal intervention to help children with developmental disorders
Women's and Children's Health Network|Women's and Children's Hospital|University of Adelaide|Women's and Children's Health Network
journal paediatrics child healthvolume 53 issue 2 p 101104 viewpointfree access developmental literacy universal intervention help children developmental disorders deepa c jeyaseelan corresponding author deepa c jeyaseelan deepajeyaseelansagovau child family health service womens childrens health network adelaide south australia australia child development unit womens childrens hospital adelaide south australia australiacorrespondence dr deepa c jeyaseelan child development unit womens childrens hospital 72 king william road north adelaide sa 5006 australia fax 61 88161 6009 email deepajeyaseelansagovausearch papers authormichael g sawyer michael g sawyer school medicine university adelaide adelaide south australia australia research evaluation unit womens childrens health network adelaide south australia australiasearch papers author deepa c jeyaseelan corresponding author deepa c jeyaseelan deepajeyaseelansagovau child family health service womens childrens health network adelaide south australia australia child development unit womens childrens hospital adelaide south australia australiacorrespondence dr deepa c jeyaseelan child development unit womens childrens hospital 72 king william road north adelaide sa 5006 australia fax 61 88161 6009 email deepajeyaseelansagovausearch papers authormichael g sawyer michael g sawyer school medicine university adelaide adelaide south australia australia research evaluation unit womens childrens health network adelaide south australia australiasearch papers author first published 04 january 2017 httpsdoiorg101111jpc13456citations 3 conflict interest dc jeyaseelan employed clinician child family health service mg sawyer conflict interest aboutsectionspdf toolsrequest permissionexport citationadd favoritestrack citation shareshare give accessshare full text accessshare fulltext accessplease review terms conditions use check box share fulltext version articlei read accept wiley online library terms conditions useshareable linkuse link share fulltext version article friends colleagues learn morecopy url share linkshare onfacebooktwitterlinkedinredditwechat developmental disorders characterised onset infancy early childhood impairment delay development functions strongly related biological maturation central nervous system typically follow steady course without remissions relapses except autism spectrum disorders phase regression communication skills may evident1 areas impaired functioning include physical speech language social adaptive cognitive domains recently diagnostic statistical manual mental disorders 5th edition international classification diseases 11th edition icd11 neurodevelopmental category broadened include intellectual disability1 2 estimated prevalence developmental disorders ranges 14 1735 prevalence global developmental delay delays 2 developmental domains estimated 1 3 children aged less five years6 7 likely variations diagnostic criteria changes criteria time strong likelihood cooccurring developmental conditions contributed variations prevalence estimates disorders8 current estimates suggest approximately 42 000 estimated 300 000 children born year australia9 experience developmental disorders reducing impact developmental disorders populationlevel poses major challenge child health services australia three broad approaches used achieve goal10 firstly universal interventions provided children irrespective risk status presence health problems time universal intervention delivered eg children geographical region secondly targeted interventions comprised selective andor indicated interventions utilised selective interventions focus children increased risk developmental problems result exposure known risk factors indicated interventions focus children early symptoms developmental problems finally clinical interventions provided children assessed identified developmental problems require direct facetoface help health professionals currently health education services primarily use targeted clinical interventions help children developmental disorders based evidence systems coordinated care promote childrens ageappropriate development early years effective helping developmental progress infants toddlers5 11 programmes could widely successfully implemented prior school commencement potential provide important benefits reducing health financial social costs supporting individuals developmental disorders adult years12 advantage targeted clinical approaches solely rely parental judgement childrens developmental progress active helpseeking parents however challenged difficulty accurately identifying children developmental disorders given variability age children achieve functional skills relevant domains furthermore substantial resources required screen large numbers children identify existing problems high risk future problems13 result small percentage children severe developmental disability typically identified young age often outside normal screening programmes majority less severe problems identified school entry time impact disorders much greater5 14 15 developmental literacy alternative approach south australia child family health service cafhs focusing strengthening universal intervention strategy using concept developmental literacy guide work concept developmental literacy derived mental health literacy turn successfully adapted concept health literacy16 17 jorm et al 16 defined mental health literacy knowledge beliefs mental disorders aid recognition management prevention p 182 purpose south australian programme developmental literacy defined knowledge beliefs child development aid early recognition support children developmental disorders components developmental literacy include understanding typical developmental milestones range achievement key developmental concepts ability recognise different types developmental delay disorders knowledge risk factors developmental delay knowledge potential longterm consequences unaddressed developmental delay knowledge seek developmental health information attitudes facilitate recognition appropriate helpseeking knowledge beliefs selfhelp interventions knowledge beliefs professional help interventions approach two main goals first concept developmental literacy designed provide clear focus work cafhs staff responsible helping children developmental disorders south australia second approach designed emphasise importance parents active knowledgeable participants aiding early identification monitoring support children developmental disorders important early childhood developmental screening programmes rely facetoface contact children community become increasingly unsustainable given large size population needing screened limited resources available address issues believe interventions need move model parents largely passive participants targeted screening programmes professionalled programmes programmes parents provided knowledge capacity actively monitor support problems severe seek professional help child parentled programmes statewide universal intervention based concept developmental literacy four potential benefits first potential encourage active involvement parents recognising monitoring early childhood developmental problems important given current evidence child health development need replace fixed agebased reviews continuous approach sensitive developmental variability combining increased awareness developmental issues population level18 second parents helped accurately identify assess early developmental problems increase likelihood children attending scarce facetoface clinical services assessment treatment actually need professional intervention third interventions designed increase parent knowledge typical child development effective parenting strategies eg teaching parents observe understand childrens behaviour development associated reduced parental stress lowered child maltreatment overall better child outcomes19 20 fourth improved developmental literacy may result greater parentcare giver engagement assessment intervention programmes designed improve longterm outcomes children developmental disorders may also encourage parents children developmental issues seek utilise home community based activities eg reading together joining playgroups kindergyms could provide parents readily accessible developmentally focussed interventions enabling help child manner encourages empowers parents light long waiting times potential costs parents encounter attempting access assessment treatment developmental specialists developmental literacy programme encourage parents take appropriate steps help childs development earliest time concerns rather waiting specialist services parents knowledgeable child development demonstrate higher parenting efficacy competence likely create environment appropriate childs emerging abilities2022 turn associated better child outcomes19 context universal programme developmental literacy offers potential benefits children developmental problems also children community developmental literacy implementation strategies internet access among women childbearing age australia ubiquitous new mothers making extensive use internet obtain childraising information social support2325 example proportion australian households access internet home increased 67 households 2007200826 86 households 20142015 97 households children aged less 15 years25 time proportion adult australians smartphones increased 49 2012 79 201527 changes offer opportunity child health services use new internetbased methods service delivery greater population reach traditional facetoface telephonebased support developmental literacy implementation strategy place particular emphasis use internet means engage support parents using local national international resources well local level programme closely connected communitybased health services local cafhs clinics cafhs also provides postnatal health checks mothers south australia used engage mothers developmental literacy programme provided via local cafhs clinics internet mothers access programme via internet reminded availability local health services directed additional local sources help needed similarly staff cafhs clinics alert mothers developemental literacy internet programme encourage engage promote health wellbeing child internetbased component developmental literacy programme use hyperlinks driect parents existing welldeveloped internetbased resources parenting childhood mental health websites supported australian federal government well internationally developed online resources parent child focus28 29 avoid duplication resources also ensure costs developmental literacy programme kept manageable proportions given concerns variable quality information provided online sources linked external websites appropriately reviewed cafhs regular basis developmental literacy programme also incorporate new emums programme trialled cafhs30 emums nursemoderated internet groupbased programme developed provide new mothers easy access nurse peer support secure website includes parenting information developmental timeline showing typical developmental milestones reminders key dates vaccinations health checks online parenting group moderated cafhs nurse mothers access programme via mobile phones computers 24 h day without leave home nurses regularly access online groups able provide support mothers longer period time possible facetoface parenting groups advantage programme potential spread nurse knowledge clinical expertise wider audience finally potential facilitate continuous active monitoring developmental progress rather less sensitive traditional approach periodic agebased monitoring approaches used implement programme include use traditional print reading materials effective increasing maternal knowledge19 south australia parent easy guides31 produced cafhs provide written parenting advice range child health development wellbeing topics advice evidencebased information health professionals remains valuable part developmental literacy programme child health development record commonly called blue book south australia provided mothers south australia32 record enables parents care givers professionals document childs growth immunisations development longitudinal manner parents often less aware many child health record books also provide care givers readily accessible source information range health promotion practices including agebased developmental checklists monitor childs progress strategies support stimulate development tips seek support developmental concerns strategies promote awareness source information vital increasing developmental literacy learning together programme33 operates across disadvantaged areas south australia programme provided families children aged birth 4 years age aims improve early learning play opportunities children assist parents support childs learning development support parents learning shared understandings childrens learning strategy could delivered broader population use videos modules child health websites platforms advertising campaigns highlight example scenarios model behaviours second author mg sawyer manuscript chief investigator successful application national health medical research council centre excellence funding key focus centre excellence evaluation new innovative interventions delivered part regular community child health services cafhs key partner work provide funding expertise evaluate several elements developmental literacy programme conclusion proportion children developmental disorders identified supported using targeted clinical interventions remains low14 15 34 moreover vast majority children attend health clinics developmental assessments problems requiring clinical assessment making greater use universal interventions including employment internetbased technology educate support parents population level potential help address problems universal interventions aim improve parents knowledge skills areas normal child development ii key developmental indicators suggesting assessment community nurse medical practitioner assessment warranted iii approaches parents use foster childs early development well potential directly improve developmental outcomes children improvements areas potential increase likelihood scarce screening clinical services utilised children likely benefit types intervention references 1 world health organization icd10 classification mental behavioural disorders clinical descriptions diagnostic guidelines geneva organization 1992 2 american psychiatric association diagnostic statistical manual mental disorders 5th edn arlington va american psychiatric publishing 2013 3 yearginallsopp oakley gp murphy cc sikes rk multiplesource method studying prevalence developmental disabilities children metropolitan atlanta developmental disabilities study pediatrics 1992 89 624 30 4 boyle ca boulet schieve la et al trends prevalence developmental disabilities us children 19972008 pediatrics 2011 127 1034 42 5 national health medical research council child health screening surveillance critical review evidence canberra council 2002 rescinded 2014 6 shevell ashwal donley et al practice parameter evaluation child global developmental delay neurology 2003 60 367 80 7 silgrove n collins f ellaway c update investigation children delayed development j paediatr child health 2013 49 519 25 8 zablotsky b black li maenner mj schieve l blumberg estimated prevalence autism developmental disabilities following questionnaire changes 2014 national health interview survey hyattsville md national centre health statistics 2015 national health statistics reports 87 9 australian bureau statistics 2014 year book australia births australia canberra bureau 2014 cat 33010 available httpwwwabsgovauausstatsabsnsfmf33010 accessed 29 october 2015 10 mrazek p haggerty j reducing risks mental disorders frontiers preventive intervention research washington dc national academy press 1994 11 schonkoff jp hausercram p early intervention disabled infants families quantitative analysis pediatrics 1987 80 650 8 12 barnett ws escobar cm economic costs benefits early intervention sj meisels jp shonkoff eds handbook early childhood intervention cambridge cambridge university press 1990 560 82 13 glascoe fp dworkin ph role parents detection developmental behavioural problems pediatrics 1995 95 829 36 14 scherzer al chhagan kauchali susser e global perspective early diagnosis intervention children developmental delays disabilities dev med child neurol 2012 54 1079 84 15 glascoe fp evidencebased approach developmental behavioural surveillance using parents concerns child care health dev 2000 26 137 49 16 jorm af korten ae jacomb pa christensen h rodgers b pollitt p mental health literacy survey publics ability recognise mental disorders beliefs effectiveness treatment med j aust 1997 166 182 6 17 nutbeam wise bauman harris e leeder goals targets australias health year 2000 beyond report prepared commonwealth department health housing community services canberra australian govt pub 1993 18 bright futures steering committee medical home initiatives children special needs project advisory committee identifying infants young children developmental disorders medical home algorithm developmental surveillance screening pediatrics 2006 118 405 20 19 reich mothers know maternal knowledge child development infant ment health j 2005 26 143 56 20 tamislemonda cs shannon j spellmann low income adolescent mothers knowledge domains child development infant ment health j 2002 23 88 103 21 rikhy sr tough trute b benzies k kehler h johnston dw gauging knowledge developmental milestones among albertan adults crosssectional survey bmc public health 2010 10 183 22 huang ky obrien caughy genevro jl miller tl maternal knowledge child development quality parenting among white africanamerican hispanic mothers j appl dev psychol 2005 26 149 70 23 plantin l daneback k parenthood information support internet literature review research parents professionals online bmc fam pract 2009 10 1 12 24 doty jl dworkin j online social support parents critical review marriage fam rev 2014 50 174 98 25 australian bureau statistics household use information technology canberra bureau 2015 cat 81460 available httpwwwabsgovauausstatsabsnsflookup81460mainfeatures1201415opendocument accessed 13 june 2016 26 australian bureau statistics household use information technology canberra bureau 2008 cat 81460 available httpwwwabsgovauausstatsabsnsfallprimarymainfeaturesa6cca61410c0b988ca25768d0021d429opendocument accessed 13 june 2016 27 australian communications media authority acma communications report 201415 available httpapoorgaunode61152 accessed 14 june 2016 28 raising children network department social services australian government available httpraisingchildrennetau accessed 2 feburay 2016 29 kids matter australian early childhood mental health initiative available httpwwwkidsmattereduauearlychildhood accessed 17 june 2016 30 department education child development government south australia available httpswwwdecdsagovauworkingdecdworkingteacherteacherinitiativesdecdtvwebisodesemumsengagingclientsvirtualspacechildandfamilyhealthservicecafhs accessed 13 june 2016 31 government south australia parent easy guides available httpwwwparentingsagovaupegshtm accessed 12 july 2016 32 parenting child health child youth health womens childrens health network sa health available httpwwwcyhcomsubcontentaspxp469 accessed 12 july 2016 33 department education child development government south australia learning together program government south australia available httpwwwsagovautopicseducationskillsandlearningearlychildhoodeducationandcareplaycentresplaygroupsandparentinglearningtogetherprogram accessed 12 july 2016 34 council children disabilities section developmental behavioural pediatrics bright futures steering committee medical home initiatives children special needs project advisory committee identifying infants young children developmental disorders medical home algorithm developmental surveillance screening pediatrics 2006 118 405 20 citing literature volume53 issue2february 2017pages 101104 referencesrelatedinformation