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Parental Compliance After Screening Social Development in Toddlers
Claudine Dietz, MSc;
Sophie H. N. Swinkels, PhD;
Emma van Daalen, MD;
Herman van Engeland, MD, PhD;
Jan K. Buitelaar, MD, PhD
Arch Pediatr Adolesc Med. 2007;161(4):363-368.
Objectives To examine the prevalence of parents' compliance with follow-up measurements after their child tested positive at a screening to assess problems in social development, as well as to find demographic, screening-related, and child-specific factors associated with parental compliance.
Design Two-stage screening design.
Setting Utrecht, the Netherlands.
Participants A random population of 31 724 children were screened at well-baby clinics at age 14 to 15 months (screen 1). Three hundred sixty-four children underwent screen 2 (255 children who scored positive at screen 1 [population screening] and 109 children younger than 36 months who were identified by surveillance because of suspected problems in their social development).
Main Exposure A 2-stage screening was applied.
Main Outcome Measures Compliance with recommendations of having either a second screening (after screen 1) or clinical evaluation (after screen 2).
Results Of 370 children who tested positive at screen 1, parents of 255 children (69%) complied with screen 2. Three groups were distinguished after screen 2 (n = 173): early compliance (clinical evaluation within 6 months) (68%), late compliance (clinical evaluation after 6 months) (14%), and noncompliance (no clinical evaluation) (18%). Late compliance and noncompliance were more common in parents of younger children and children who were identified via population screening. Parents of children with either relatively high cognitive skills and/or low scores on screening measures were less inclined to comply.
Conclusions Study results suggest higher effectiveness of surveillance over population screening. Screening may well be applied as a second step after surveillance to identify children who need further clinical evaluation.
Author Affiliations: Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands (Ms Dietz and Drs van Daalen and van Engeland); and Department of Psychiatry, Radboud University Nijmegen Medical Center, and Karakter Child and Adolescent Psychiatry University Center Nijmegen, Nijmegen, the Netherlands (Drs Swinkels and Buitelaar).
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