Abstract
Objectives: The Hall report (1989, 1991) specified the early detection of mild to moderate Learning Difficulties (LD) as one aim of the Child Health Surveillance System (CHS). This study examines the efficacy of the preschool CHS in the early recognition and management of children with these disorders.
Subjects: All children (n=408) with mild to moderate LD born between 01/07/83 and 30/06/84 and resident in N&W Belfast.
Controls: 2750 birth records and 183 full CHR's controlled for age and area.
Results: - The prevalence of mild to moderate LD in N&W Belfast was 17%. Coverage of the CHS was ranging from 90% at the 2 year examination to 98% at the 4 year examination. LD were documented in only 6% of the preschool CHR. Speech delay (OR= 3.3), poor parenting skills (OR=1.21), enuresis (OR=2.4), vision (OR=1.8) and behaviour (OR=2.8) were the only preschool indicators significantly predictive of later LD. Perinatal factors such as lower social class (OR=4.6), prematurity (OR=2.1), male sex (OR=1.6), and marital status (OR = 65) were also significant. The CHS had very poor positive predictive value (<20%) in detecting LD in the preschool period. Only half the children were referred for assessment.
Conclusions: The CHS as it existed bom 1933 to 1989 in N&W Belfast was pooily sensitive to the detection of mild to moderate LD. The significance of certain risk factors such as speech delay would appear to have been missed.
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Corrigan, N., Stewart, M., Scott, M. et al. The predictive value of preschool Child Health Surveillance in the detection of mild to moderate Learning Difficulties. Pediatr Res 35, 265 (1994). https://doi.org/10.1203/00006450-199402000-00065
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DOI: https://doi.org/10.1203/00006450-199402000-00065