Equipping parents of at-risk kids to catch child development issues early

Many children with developmental difficulties are not being detected until they attend preschool or school. By then, the children’s needs are greater and intervention is considerably more expensive, difficult and less effective. In addition, health and family care costs may spiral because the family needs extra support, and parents may leave paid employment to care for their children.

Traditionally, one of the opportunities for early detection of child developmental issues was a visit to the Child and Family Health Nurse Clinic but, in 2020, in the midst of the COVID-19 pandemic, many of these clinics were impacted by COVID-19 restrictions.

This gave the Sydney South West Local Health District the chance to further test and enhance an existing electronic program, called Watch Me Grow, designed to help parents monitor and self-report on their own child’s development at key ages. The program has been translated into multiple languages, including Mandarin, Arabic and Vietnamese, and if parents raise any concerns while completing the program, it flags the issue and suggests further assessment by a health professional.

Watch Me Grow was initially trialled on iPads in GP waiting rooms, taking advantage of the opportunistic contact of children and parents with GPs, but in the latest research funded by NSW Health it is being rolled out through Child and Family Health Nurse Services to more families.

More support for those who need it most

The research has a focus on people from disadvantaged, and culturally and linguistically diverse backgrounds. “The kids most at risk for unrecognised developmental disorders are those whose mum is born overseas, whose parents don’t have English as a first language, or those from lower socioeconomic groups,” said the program’s leader, Professor Valsamma Eapen.

“For those families, it is a double whammy because the children are at risk, but failure to identify the risk early means that they miss out on early intervention. When COVID-19 struck, we were quite concerned that even the little contact that was being made was declining because most of the clinics were impacted by COVID-19 restrictions. These children could get to the start of school, and the teacher might ask, ‘Why is this child not talking?’, or you find the child has autism, and you’ve missed out on all the opportunities for early intervention when the brain’s plasticity is greatest.”

In the latest incarnation of Watch Me Grow, Eapen and her team added questions to check on the mental and social health of the parents. “We know that COVID-19 has increased the number of families in financial hardship and employment stress and we have enough evidence to show that kids in psychosocially adverse situations are at increased risk for poor development outcomes.”

So, along with a question such as ‘Does your child respond by turning to you when his/her name is called?’, the parents are now also asked questions such as, ‘During the past 30 days, about how often did you feel hopeless?’ and ‘Do you have trouble paying your electricity bill?’

Eapen said previous research had shown Watch Me Grow was effective in picking up child developmental disorders earlier. “It’s all about engagement,” she said.

According to a recent national survey on the impact of COVID-19, three suburbs in the Sydney South West Local Health District – Fairfield, Bankstown and Campbelltown – were in the 10 areas most adversely affected by employment stress during COVID-19. Fairfield and the rural community of Murrumbidgee were chosen for this latest study, which will run until mid-2023.

By Ken Eastwood