Conclusions and Recommendations

Conclusions and Recommendations Arising from the Symposium and Workshop:

 

  1. Survivors of certain neonatal and childhood diseases are at high risk of developmental disability.
  2. Such children should be followed regularly to determine whether there is evidence of developmental delay. Ideally this follow-up could be incorporated into existing community child monitoring programs.
  3. When at all feasible, research programs in which community health workers diagnose and treat neonatal or childhood infections should include developmental follow up programs.
  4. Developmental follow up should be associated with services to families to support normal development: This should include caregiver training in child rearing and stimulation as well as nutritional support.
  5. Developmental follow up and caregiver training should be part of health systems available to all families and not just to “high risk” groups.
  6. There is an urgent need to determine the prevalence of handicapping disorders in developing countries; this is necessary in order to alert governments and health systems of the importance of this problem. It is important also to determine the causes of these developmental disabilities.
  7. It is likely that over 200 million children in the world are failing to reach their developmental potential. Causes include nutritional deficiency, poverty, disease and inadequate stimulation in the home.
  8. Children displaying developmental delay can improve through adequate nutrition and improved home-based stimulation. Early diagnosis is important to improvement. .
  9. It is likely that a major cause of developmental disability in some developing countries is untreated (and often unrecognized) hyperbilirubinemia. Childhood infections, such as malaria, are also a major cause of developmental disability. There is an urgent need to study the impact of these disorders on child development.
  10. Developmental handicaps are costly to society; their treatment and especially their prevention would provide positive health benefits to society.
  11. A sensitive and uniform screening test for childhood development, applicable especially to the first two years of life, should be developed and validated. A committee has been formed to study this problem with the goal of determining a suitable screening test applicable in developing countries.
  12. The application of community-based screening tests for development should be supported by adequate back up services for further diagnosis, interventions and appropriate referrals.
  13. Professionals and community health workers should be trained in developmental assessment and in educating families about optimal child rearing and stimulation.
  14. The training of community health workers in development assessment and child   rearing should be organized carefully and critically analyzed for effectiveness.
  15. Existing studies of neonatal care in which the babies and mothers have been critically assessed should include developmental studies. Similarly prospective studies of pregnant women and their babies (now planned or in progress) could be expanded to include developmental studies. A committee has been established to determine all such studies and suggest which can include developmental studies.