Opinions and practices of public health nurses concerning assessment of preschool child development

In many instances developmental delays are undetected until a child is school age. Earlier identification of these delays be the professional nurse concerned with child health supervision would provide for earlier diagnosis and treatment by a physician. The public health nurse is committed to child health supervision. She works closely with a child and his family during home visits and would have the opportunity to detect delayed development. The purpose of the present study was (s) to ascertain the opinions and practices of public health nurses concerning their assessment of preschool child development, (b) to obtain the opinions of public health nurse concerning a simple device which could be used by nurses as an aid to detect delays in preschool child development. Public health staff nurses from five public health agencies within the State of Utah participated in the study. Their opinions and practices in assessing developmental levels of preschool children were elicited by means of a questionnaire developed for this purpose. Responses to the questionnaire indicated that public health nurses were confused as to the existence of a formal policy requiring evaluation of child development. However, the majority of public health nurses identified developmental assessment as one of their functions in child health supervision. The accuracy of present methods to assess preschool child development was questionable. Most public health nurses were dependent upon growth and development concepts, past experiences, observation of unusual child behavior or questions directed to mothers for appraisal of developmental levels. Some utilized a screening device made available to public heath agencies by the Utah State Division of Health. The time required to evaluate child development concerned most of the public health nurses. They were of the opinion that an average of 26 minutes was all that was available for this purpose. Their discouragement in using the available screening device seemed to be due to the length of time required for its administration (an average of 45 minutes). Public health nurses responded favorably to a simplified developmental assessment device (Denver Developmental Screening Test). This aid was presented to public health nurse because it was relatively simple to administer and did not require psychological skill. In most instances, public health nurses were of the opinion the (a) they could learn to administer the DDST, (b) instructions for its use were easily understood (c) it was not too time consuming, (d) it would be useful for counseling parents, and (f) it was better in comparison to any method they now used. Most public health nurses were of the opinion that assessment of preschool child development is important. Neither age nor level of educational preparation affected this belief to any great degree. Recommendation for further research were (a) to repeat the study with a larger sample of public health nurses to validate the present findings, (b) to survey opinions of public health nursing services directors and supervisors concerning assessment of preschool child development as compared to opinions of public health staff nurses.