When and by Whom is Concern First Expressed for Children with Neuromotor Problems?

When and by Whom is Concern First Expressed for Children with Neuromotor Problems?

When and by Whom is Concern First Expressed for Children with Neuromotor Problems?

When and by Whom is Concern First Expressed for Children with Neuromotor Problems?s

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Référence bibliographique [3772]

Archives of Pediatrics & Adolescent Medicine, vol. 159, no 9, p. 882-886.

Fiche synthèse

1. Objectifs


Intentions :
« The objective of our study was to determine the child’s age at the time of initial recognition of the problem (’Age at initial concern’) by either the parent or the physician in a cohort of children with neuromotor disabilities (aged 0-6 years) who were referred to rehabilitation. » (p. 882)

2. Méthode


Échantillon/Matériau :
« We conducted a survey of parents of 92 children (aged 0-6 years) who were on the waiting list for physical or occupational therapy services at rehabilitation centers in Montreal, Quebec. » (p. 882)

Instruments :
« Parents were interviewed regarding their child’s medical history and utilization of health care services. » (p. 882)
« The interview included questions regarding the medical history of the child, the child’s diagnosis (according to the parent), who first noticed that there was a problem and when this was noticed, current use of services, burden of care (as a proxy for severity), family empowerment, date of referral to rehabilitation services, and demographic data. Burden of care (severity) was measured by the WeeFIM (Functional Independence Measure for Children) [Msall & al., 1994], a reliable and valid tool that is scored on 3 subscales (self-care, mobility, and cognition) in addition to a total score. Family empowerment was measured by the service system subscale of the Family Empowerment Scale, a reliable and valid scale that measures empowerment on a scale of 0 (least empowered) to 60 (most empowered) [Koren & al., 1992]. » (p. 883)

Type de traitement des données :
Analyse statistique

3. Résumé


« Parents were concerned later than physicians were regarding their child’s development (mean difference, 8.2 months; 95% confidence interval [CI], 3.7-12.6 months). There was no significant difference in time of recognition of problems between the premature (10.2 months) and full-term (11.9 months) groups. Even after controlling for risk group, parental concern occurred later than physician concern (beta coefficient, 7.3; 95% CI, 2.5-12.2). The child’s age at the time of initial concern was associated with the child’s age at referral to rehabilitation (beta coefficient, 0.04; 95% CI, 0.01-0.06). Early recognition is important if a child is to benefit from early rehabilitation. It may be important to improve primary care screening of children for neuromotor problems and to increase parental awareness regarding normal motor development of their children. Prompt, simultaneous referral to medical evaluation and rehabilitation resources may decrease delays in rehabilitation. » (p. 882)