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DEVELOPMENTAL PAEDIATRICS
The regular developmental assessment of infants and young children by paediatricians,
family doctors and local authority medical officers is now accepted as a
necessary and valuable service to children and parents. The main benefits accrue
from the early detection of physical or mental handicap which may be responsive
to treatment or require special facilities to enable a child to achieve his potential.
A secondary benefit is the re-assurance or advice available to parents at the time of
the examinations, and subsequently if required. Both clinic medical officers and
family doctors who carry out developmental assessments in their own premises,
work closely with health visitors who follow up any advice that has been given, and
ensure that necessary services are made available by visits to the home.
The keeping of an observation register of children who have physical or mental
disabilities enables the Medical Officer of Health to correlate information from
different sources—clinics, family doctors, hospitals. Social Services Departments,
etc., and thus to ensure that a child who may be under the care of several agencies
is in fact receiving all necessary services and that these are co-ordinated.
Developmental assessments of children are carried out in all infant health clinics
in the borough, and clinic doctors are specially trained in this branch of paediatrics.
The examinations are done regularly—at three to four weeks, six months, one year,
eighteen months, two years and then annually to school age: should there be need,
a child will be seen more frequently. If, on examination, any significant deviation
from the expected rate of development is noted, further investigations are arranged
in consultation with the family doctor. Children who are not brought for an assessment
are checked in their own home by the health visitor who notifies any defects
which she may find.
The developmental assessment of a child at any age includes appropriate tests
for hearing and speech, vision, and those fine movements requiring accurate hand/
eye co-ordination, posture and large movements, a study of relationships, attitudes
and intelligence (often demonstrated in play situations) and also a full physical
examination of the child. Regular observation is necessary as very often defects
do not become apparent until a certain level of development has been reached.
Doctors and health visitors must therefore maintain a high standard of vigilance.
The early detection of a handicap, distressing though it may be at the time to the
parents, does lead to the best possible course of action being taken, involving
appropriate investigations and providing all available services for the maximum
benefit of a handicapped child.