[8315.6] Utilization of a Culturally Relevant Milestone Chart for Children in Underdeveloped Areas
Alfred L. Scherzer. Pediatrics and Preventive Medicine, State University of New York, Stony Brook, School of Medicine, Stony Brook, NY.
BACKGROUND: Parents in underdeveloped areas are often unaware of delayed milestones when seeking medical attention for their children. Health staff need to recognize possible delays in the course of medical management. These may indicate a progessive pathologic process, or a static developmental condition such as cerebral palsy. Charting development of young children is essential in order to provide a visible record to heighten professional awareness, and to direct early referral for diagnosis and care. The currently available instruments, such as the Denver II, have limitations in ease of administration, cultural relevance, and predictive validity. Alternative means of milestone recording for underdeveloped areas need to be considered.
OBJECTIVE: To utilize design of a developmental milestone chart as part of a teaching program for pediatricians, with the following characteristics:
1.expected milestones listed by age-grouped categories from birth to 8 years;
2. simple check-off of achieved milestones;
3. milestone chart a permanent visable record enabling up-dating on subsequent hospital/clinic contacts.
DESIGN/METHODS: 1.Pediatric trainees at the Angkor Hospital for Children in Siem Reap, Cambodia, were assigned to identify culturally acceptable developmental milestones in various age groups and to design an easily recordable form to be used with all patients
2. The form was tested and and revised with outpatients;
3. Predictability for delay/early disability was assessed.
RESULTS: A developmental milestone chart appropriate for children in Cambodia was prepared and translated into Khmer as part of pediatric student training and evaluated for predictability of delays/disability in an outpatient setting.
CONCLUSIONS: 1.A pediatric student training experience in Cambodia enabled construction of a culturally relevant developmental milestone chart that is simple to administer, and is a reliable instrument for identifying developmental delays and early signs of disability.
2. The instrument is part of the permanent record and enables up-dating of development through the age of 8 years;
3. The record provides a visual recognition of delay to enable early referral for appropriate developmental care and parent education.
4. A similar instrument should be devised and routinely utilized in pediatric training programs for other underdeveloped areas.