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Refugees' perspectives on child development support screenings
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Perspectives from refugees on child development suggested that standardized screening for children was supported and may influence parents’ response and recognition to child development concerns, a study in Pediatrics reported.
“Developmental screening and surveillance is recommended by the AAP for all children in the context of well-child care,” Abigail L.H. Kroening, MD, assistant professor in the department of pediatrics at Golisano Children’s Hospital, University of Rochester Medical Center, and colleagues wrote. “However, standardized assessment instruments validated for use in non-Western cultures and languages are limited, and little is known about the cultural beliefs, perceptions and practices around identification of developmental delays in refugee communities.”
Kroening and colleagues used the Health Belief Model (HBM) as a guide to conduct 19 interviews and two focus groups that included refugees primarily from Bhutan, Burma, Iraq and Somalia (n = 16), community collaborators (n = 7) and providers from the Center for Refugee Health in Rochester, New York, (n = 6) to extract elements necessary for child developmental screening among refugees. Interviews took place in Rochester, a refugee resettlement location, from March 2014 to February 2015.
The interviews were categorized into 21 themes of four domains: values and beliefs about disability and development, practices on development and disability, the refugee experience, and opinions specific to the Parents’ Evaluation of Developmental Status screen. On average, delays in speech and language and behavioral challenges were paramount to refugee families. Physical impairments or delays were considered common and more acceptable. Limited education, a lack of knowledge about health care, language and traditional healing practices were deemed barriers to identification and care. All of the refugee communities expressed a high parental concern about childhood developmental delays, although parents did not believe children exhibit delays until aged 2 or 3 years.
“Integration of this rich, community-based data within the HBM offers pediatric providers a conceptual framework through which to engage with refugee parents to support standardized developmental screening and early identification of developmental delays,” the researchers wrote. “Results from this study point to the value of the medical home. Our data suggest that parents of refugee status need a primary care setting that is accessible, continuous, comprehensive, family-centered, coordinated, compassionate and culturally effective.” – by Kate Sherrer
Disclosure: The researchers report no relevant financial disclosures.
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