Field testing of the ACCESS materials: a portfolio of materials to assist health workers to identify children with disabilities and offer simple advice to mothers.

Children in less-developed countries with mild to moderate disabilities often remain unidentified until school age. Delayed identification leads to less successful interventions for most children and risks secondary disabilities. The disability group at the Centre for International Child Health was funded to address this issue by developing a screening portfolio. The field testing of this portfolio is reported here. The results collected through quantitative analysis of the children brought for screening, and the fact that the field workers identified disabilities in children over the age of 2 years with over 82% accuracy when compared with professionals, suggests that health workers can be taught to use the portfolio effectively. Among younger children the accuracy is poorer. Field workers can additionally be trained to give advice to mothers and/or refer where appropriate. Equally important, results from focus group discussions with both health workers and parents, and questionnaires to health workers, demonstrate that both groups found the process clear and useful. Parents liked the process and found the advice materials helpful. Several health workers made comments about how the portfolio's use helped to develop positive attitudes towards disability and improved their own self-confidence.