Screening in child health: studies of the efficacy and relevance of preventive care practices

The role of well-child visits in detecting developmental delay in preschool children

BACKGROUND

Early detection of developmental delay (DD) in preschool children is crucial for counselling parents, initiating diagnostic work-up, and starting early intervention (EI).

METHODS

We conducted a register study of all preschool children referred for EI in the Canton of Zurich, Switzerland, in 2017 (N = 1,785) and used an online survey among primary care physicians (PCPs, N = 271) to evaluate the care service of DD children.

RESULTS

PCPs accounted for 79.5% of all referrals by physicians and had correctly referred over 90% of the children in need of EI at an average age of 39.3 months (SD 8.9). In the survey, which represents 59.2% of all pediatricians and 11.3% of all general practitioners in the Canton, PCPs reported performing a mean of 13.5 (range 0-50, SD 10.7) well-child visits per week to preschool children and estimated well-child visits to be the most frequent type of consultation (66.7%) for the identification of DD. Parents' hesitancy in accepting further evaluation or support were reported by 88.7%.

CONCLUSIONS

Most preschool children with DD are identified in well-child visits. These visits represent an ideal opportunity for early detection of developmental impairment and initiation of EI. Carefully addressing parents' reservations could reduce the rate of refusal, thus improving early support for children with DD.

The Association between Types of COVID-19 Information Source and the Avoidance of Child Health Checkups in Japan: Findings from the JACSIS 2021 Study

The coronavirus disease 2019 (COVID-19) pandemic can affect children's well-being through mothers' avoidance of health checkups for children due to media portrayal of the disease. This study investigated the association between the type of information source for COVID-19 received by mothers and the avoidance of their children's health checkups. The study was an online-based survey, and the participants comprised 5667 postpartum women with children aged under 2 years during the study period. We analyzed the analytic sample and three groups of women with children aged 0-3 months, 4-6 months, and 6 months or older according to the timing of children's health checkups in Japan. Among the participants, 382 women (6.7%) avoided their children's health checkups. Multivariate logistic regression analysis revealed that mothers with children over 6 months who used magazines as an information source about COVID-19 tended to avoid their children's health checkups (adjusted odds ratio (aOR): 3.19; 95% confidence interval (CI): 1.68-6.05) compared with those who did not. In contrast, those using public websites were less likely to avoid their children's health checkups (aOR 0.58, 95% CI 0.43-0.77). This study showed that specific types of information source on COVID-19 could have varying effects on mothers' decisions about their children's health checkups.