Williams A N, Mold B, Kilbey L, Naganna P
Virtual Academic Unit, CDC, Northampton General Hospital, Northampton, UK.
Child Care Health Dev. 2018 May;44(3):364-369. doi: 10.1111/cch.12552. Epub 2018 Feb 20.
To explore 40 years of Child Development Centre (CDC) activity and outcomes at Northampton General Hospital 1974-2014.
The study comprises 3 data sets: a published report from 1974 to 1999, an internal audit from 2001 to 2004, and more recent data collected from 2005 to 2014. The medical notes of all children who were assessed by the CDC in 2014 were reviewed, along with referral data collected by the CDC manager from this year and the preceding 10 years.
From January 1, 1974 to December 31, 2014, 3,786 children were assessed. The male to female ratio is 2.8:1 from 2005 to 2014. Referrals for behavioural difficulties increased from 10% (10/100 referrals) in 1999-2004 to 17.8% (18/101 referrals) in 2014. Similarly, referrals for social and communication problems, "interaction" increased two and a half fold from 10% (10/100 referrals) in 1999-2004 to 26.7% (27/101 referrals) in 2014. Between 2004 and 2014, numbers of referrals for "developmental delay" halved (22.2% to 12%).
We are aware of no other comparable extant UK CDC database. Services should plan for a referral rate of 6.5 per 1,000 preschool children. Between 1974 and 2014, there has clearly been a change in recorded assessment outcomes. From the mid-1980s, this reflects the change to a preschool assessment role and a shift away from purely educational outcome to include medical conditions. Covering 1974-2014, we demonstrate a clear increase in the number of referrals together with an increasing demand for assessments for social interaction and behavioural difficulties. This reflects the increased awareness of these neurodevelopmental difficulties and the changing diagnostic criteria which will now more likely result in an Autistic Spectrum Disorder diagnosis than previously. Together, these two features are most likely to have considerable implications for service development within Child Development Centres (CDCs) and Child Development Teams (CDTs).
探究1974年至2014年北安普敦综合医院儿童发展中心（CDC）40年的活动及成果。
该研究包含3组数据集：1974年至1999年的一份已发表报告、2001年至2004年的一次内部审计，以及2005年至2014年收集的最新数据。回顾了2014年由儿童发展中心评估的所有儿童的病历，以及该中心管理人员从当年及此前10年收集的转诊数据。
从1974年1月1日至2014年12月31日，共评估了3786名儿童。2005年至2014年的男女比例为2.8:1。行为困难的转诊比例从1999年至2004年的10%（10/100次转诊）增至2014年的17.8%（18/101次转诊）。同样，社交和沟通问题（“互动”）的转诊比例从1999年至2004年 的10%（10/100次转诊）增至2014年的26.7%（27/101次转诊），增长了两倍半。2004年至2014年期间，“发育迟缓”的转诊数量减半（从22.2%降至12%）。
我们知晓英国目前没有其他类似的儿童发展中心数据库。服务机构应为每1000名学龄前儿童设定6.5的转诊率。1974年至2014年期间，记录的评估结果显然发生了变化。从20世纪80年代中期起，这反映了向学龄前评估角色的转变，以及从单纯的教育成果转向纳入医疗状况。涵盖1974年至2014年，我们表明转诊数量明显增加，对社交互动和行为困难评估的需求也在增加。这反映了对这些神经发育困难的认识提高，以及诊断标准的变化，现在比以前更有可能导致自闭症谱系障碍的诊断。这两个特征加在一起，很可能对儿童发展中心（CDC）和儿童发展团队（CDT）的服务发展产生重大影响。
