Using iPad and mobile phones, Valsa Eapen is engaging parents when they visit their local GP to monitor and identify development issues, including autism, in their child, enabling parents and GPs to intervene earlier to enhance the child’s development and quality of life.
The Challenge: Kids with developmental problems aren't being identified early enough
Children with developmental problems (such as delay in speaking, walking, social responsiveness, and autism) are usually not detected early enough for interventions to make a difference to their quality of life. For example, the mean age for diagnosis of autism in Australia is four years. This needs to be earlier as the brain develops significantly in the first three years.
To achieve this, a research team led by Valsa is working to improve the access and uptake of the NSW Government’s child health and developmental Blue Book program. This book recommends parents get their children checked at various ages and record it in the book but, since it is not mandatory, there is low uptake, particularly among minority and refugee populations. Valsa has observed these parents prefer to attend their local GP rather than a state sponsored GP, for language reasons and because their local GPs are nearby, saving them transport costs and time.
UNSW's solution: Use a web app to engage parents at the GP
A background study conducted by Valsa’s team (together with NHMRC and NSW Health) found that with the Blue Book program there was an ‘inverse care law’ where children who were most disadvantaged and with highest developmental risks were the ones not accessing help. The team’s current project aims to address this gap by bringing the Blue Book program to preschool children and their parents at the local GP level, in multicultural playgroups, and in other early childhood education centres in the community. Parents are provided the webapp and asked around 17 key questions about their child’s development. Parents then receive guidance on the development of their child, and if issues are raised, they are recommended to consult a relevant professional. The GP also receives this information, enabling him or her to conduct further assessment on the spot, if needed. Parents also receive an email reminder to repeat the developmental check at six monthly intervals until the child is six years of age (as per the Blue Book).
In a related project, Valsa is consulting to the Trivandrum Medical College (Kerala) and the Kerala Government on the implementation of a universal developmental surveillance program for children with a focus on autism. Kerala has high vaccination rates. The team expects that by carrying out developmental checks in conjunction with vaccinations, they can achieve coverage of more than 90% of preschool children. Two faculty members from Trivandrum Medical College visited Valsa in 2016 to gain exposure to the program. A pilot is underway in 2018 in a community in Kerala. Early results indicate strong parental and professional engagement, with plans to scale up the program in 2019. Valsa is engaged in similar projects and discussions with colleagues from Vietnam, Lebanon and the United Arab Emirates.
The Impact: Earlier detection and intervention, better developmental outcomes and quality of life
The use of a technology to go to parents to extract developmental information and provide guidance empowers parents to actively monitor their child’s development. A family’s GP also receives this information, enabling them to better identify and respond to developmental risks. That means developmental risks are being identified and addressed sooner, paving the way for earlier intervention to improve the child’s development and quality of life. The program also saves parents the anxiety of not knowing what could be wrong with their child, and time and money they would have otherwise spent searching for answers. Early diagnosis and intervention also saves parents and public health systems the additional costs associated with missed or delayed diagnosis.
Professor Valsamma Eapen is Professor and Chair of Infant Child and Adolescent Psychiatry at UNSW; Head of the academic unit of Child Psychiatry in South West Sydney (AUCS); Program 1 Director for the Autism Co-operative Research Centre; Stream leader for the Clinical Academic Group “Early Life Determinants of Health (ELDoH)” within the Sydney Partnership for Health Education Research and Enterprise (SPHERE); and lead for the BestSTRAT academic unit at the South West Sydney Local Health District. Valsa’s research interests include Tourette Syndrome and autism as well as the neurobiological underpinnings of attachment and the intergenerational transmission of anxiety.