Early detection of developmental delays in vulnerable children by community care workers using an mHealth tool

ABSTRACT

Developmental delays are increasing worldwide, as a result of exposure to environmental risk factors. Early detection services are often inaccessible in low- and middle-income countries (LMIC). An mHealth developmental screening programme with community care workers (CCWs) was investigated. CCWs administered a smartphone application to vulnerable families during home-based services. One-hundred and thirty-eight children were screened and those who failed were rescreened. CCWs completed a questionnaire regarding their perceptions of community-based mHealth-assisted screening. The overall referral rate was 69%. Older children (19–38 months old) had a significantly higher (p < .05; Chi-Square) referral rate (84%; n = 62) compared to those aged 0–18 months (52%; n = 33). CCWs perceived mHealth screening as valuable in terms of utility, outcomes and contribution to developmental knowledge for community members and CCWs. Community-based services are a promising platform to implement mHealth-assisted early developmental screening programmes. CCWs and mHealth-assisted developmental screening can facilitate better access to early detection and developmental surveillance for vulnerable populations.

KEYWORDS:

• Development
• screening
• community health workers
• mHealth

Acknowledgements

The authors acknowledge the CCWs and staff from Future Families for their availability and highly appreciated contribution to the research project.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Maria Neethling van der Merwe obtained her degree in Speech-Language Pathology in 2015 at the University of Pretoria. In 2016, she completed her community service year in Barberton, Mpumalanga. In 2017, she obtained her master’s degree in Speech-Language Pathology, focusing on training and empowering community health workers to conduct developmental screening, using mHealth, in their community. While completing her masters, she also provided school-based speech therapy services in Pretoria. In 2018, she started with her Ph.D., continuing and building on the research done for her master study. She is currently appointed as a clinical lecturer at the University of Pretoria.

Renata Mosca forms part of the early intervention team at the Department of Speech-Language Pathology and Audiology, University of Pretoria. The early intervention team trains students in the assessment and treatment of early communication disorders in the Clinic for High-Risk Babies (CHRIB) using a family-based approach. Mosca is a Hanen certified speech-language therapist and is involved in encouraging Early Intervention in a variety of South African contexts and communities. She is currently conducting her Ph.D. studies relating to the relationships between music instruction, phonological awareness and early literacy skills in young learners.

Prof. De Wet Swanepoel is professor in the Department of Speech-Language Pathology and Audiology, University of Pretoria with adjunct positions at the University of Western Australia, and is a senior research fellow at the Ear Science Institute Australia. Prof. Swanepoel’s research capitalizes on the growth in information and communication technologies to explore, develop and evaluate innovative service delivery models and applied solutions to improve access to early development and health services, particularly in ear and hearing care. He has published more than 140 peer-reviewed articles, books and book chapters and has received numerous national and international awards in recognition of his work. Prof. Swanepoel serves as president of the International Society of Audiology and as deputy editor-in-chief of the International Journal of Audiology.

Dr. Frances Page Glascoe is the author of PEDS, co-author of the PEDS: DM, and has conducted abundant research on these measures as well as other screening tools. For 12 years, she directed the rotation in developmental and behavioural peadiatrics at Vanderbilt University and is the recipient of the American Academy of Pediatrics Dale Richmond Award for contributions in child development. Dr. Glascoe is a Professor of Peadiatrics at Vanderbilt University and serves on the editorial board of the Journal of Developmental and Behavioral Pediatrics. She has one child (well, a young adult actually) who is a costumer at the Metropolitan Opera in New York City.

Dr. Jeannie van der Linde is senior lecturer in the Department of Speech-Language Pathology and Audiology, University of Pretoria. Her research explores early childhood development and service delivery in underserved communities. Innovative solutions are explored to improve service delivery in these communities. Her research focus originated from her masters and Ph.D. studies. Her recent publications include: ‘Evaluation of a Zulu translation of the Parents’Evaluation of Developmental Status’ (van der Merwe, Cilliers, Mare, van der Linde, & le Roux, 2017 and ‘Early detection of communication delays with the PEDS tools in at-risk South African infants’ (van der Linde, Swanepoel, Hanekom, Lemmer, Schoeman, Glascoe, & Vinck, 2016).

ORCID

Maria N. van der Merwe http://orcid.org/0000-0003-3432-2588

De Wet Swanepoel http://orcid.org/0000-0001-8313-1636

Jeannie van der Linde http://orcid.org/0000-0002-8706-6605