Background The American Academy of Pediatrics recommends that developmental screening includes a valid, standardized assessment tool. Barriers to regular use of such tools may include poor knowledge and attitudes of medical providers about child development and interventions. Our survey assessed the knowledge and attitudes of pediatric resident physicians about children's development prior to and following the introduction of newer developmental assessment tools.
Methods Residents in the UAMS Pediatric Program were asked at 2 separate housestaff meetings to complete an assessment survey entitled "Survey of Primary Care Providers-Developmental Screening and Referral for Early Intervention Services. " Portions of the survey, developed as part of the Commonwealth Fund's Assuring Better Child Development project in North Carolina, focused on knowledge and attitudes regarding developmental assessment and early intervention strategies. A third section added to the survey assessed residents' education and comfort level in using the Ages and Stages Questionnaire (ASQ). Protocols for referral for developmental services were also reviewed with the residents between surveys. Twenty-one residents completed the survey pre- and post-interventions and their answers comprise the data analysis. The knowledge and attitude questions used a 5-point Likert scale while the comfort level questions used a 4-point Likert scale. Statistics were calculated for the knowledge, attitudes, education and comfort items, and for overall scores. Pre-intervention to post-intervention change was determined using the Wilcoxon signed rank test or McNemar test, as appropriate.
Results Post-intervention, residents showed a collective increase in knowledge and comfort level for scoring and interpreting the ASQ. Pre-intervention, 52% were comfortable scoring and interpreting the ASQ. Post-intervention, 77% felt comfortable scoring and interpreting the ASQ. However, the time involved to administer screening proved a larger concern and was the only attitude variable that did not improve post-intervention.
Conclusions Residents' knowledge and attitudes regarding child development improved after intervention. Residents acknowledged that training to use the ASQ and about the developmental referral process subsequently raised their comfort levels in scoring and interpreting the ASQ, in assessing child development, and in discussing development with parents. The improved knowledge and attitude scores and residents' concern about time challenges to systematic use of a developmental screening tool in practice suggest implications for pediatric resident training.
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