Applicability of a Tool for Comprehensive Pediatric Assessments: The Expanded Guide for Monitoring Child Development

Background: Tools that provide comprehensive information about children and families without increasing face-to-face time during healthcare encounters are critically needed in clinical practice. We aimed to examine the applicability of such a tool, an expanded version of the international Guide for Monitoring ChildDevelopment (Expanded GMCD), a largely open-ended written questionnaire that incorporates the World Health Organization International Classification of Functioning, Disability and Health and Nurturing Care frameworks.
Methods: Parents of children attending Ankara University Developmental Pediatrics Division, Turkey, were asked to complete the Expanded GMCD and bring it back for their first developmental assessment. Child and family related factors associated with completion rates were ascertained using multivariate analyses.
Results: Of 494 eligible children, 480 (97%) comprised the study sample. Most were boys (57%); median age was 17.0 (IQR: 9.0-27.0) months. All four domains of the Expanded GMCD were completed by 78% of the families; 87% completed at least three and 92% at least two domains. The domain “child functioning” was completed by 94%; “activities and participation,” “health” and “nurturing care environment” domains were completed by > 80% of families. Families provided comprehensive information on the Expanded GMCD: developmental difficulties (87%), chronic health conditions (60%) in their children; as well as environmental
risk factors including stigmatization (27%), maternal depression (20%), financial difficulties (17%) and inadequate social support (14%). Families of children aged ≤ 6 months were more likely not to fully complete the Expanded GMCD (OR: 2.24; 95% CI: 1.25-3.72); other child or family related factors were not associated with completion.
Conclusion: The applicability of the Expanded GMCD in this study implies its potential for applicability in other clinical settings. The use of the free-of-charge, readily available Expanded GMCD may address the urgent need of child healthcare providers in obtaining comprehensive information about children and families without lengthening face-to-face time.

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Author: Ezgi Ozalp Akin

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