Magai Dorcas N, Berman Brad D, Mutua Agnes M, Smythe Tracey, Olusanya Bolajoko O, Gulati Sheffali, Mwesige Angelina Kakooza, Blaikie Andrew, Lusobya Rebecca Claire, Coghill David, Gladstone Melissa
Department of Public Health, Policy & Systems, Institute of Population Health, University of Liverpool, Liverpool, UK.
Department of Pediatrics, University of San Francisco, San Francisco, California, USA.
BMJ Paediatr Open. 2025 Aug 18;9(1):e003571. doi: 10.1136/bmjpo-2025-003571.
Childhood disability is increasingly prevalent, particularly in low-income and middle-income countries, as more children survive worldwide. Global practice guidelines are essential to address the need for timely identification, evaluation and management of children with developmental disabilities, particularly in resource-limited settings. This scoping review aims to summarise recent evidence-based practice guidelines for the assessment and care of children aged 0-5 years at risk or with developmental disabilities and identify those practice guidelines that are suitable for use across both global and resource-limited settings.
We searched PubMed, Scopus, CINAHL as well as websites for professional associations using Google to identify evidence-based practice guidelines for specific developmental disabilities with established global prevalence estimates. We identified additional literature through snowballing. Practice guidelines were included if they were published between September 2012 and June 2024, were in English, and demonstrated a systematic process of reviewing available evidence, which then provided information on the detection, diagnosis, treatment and management of children under five with developmental disabilities. Three reviewers independently screened results by title, abstract and full text. Study characteristics and outcome data were extracted, and results were narratively synthesised.
43 practice guidelines met the eligibility search criteria. Few evidence-based practice guidelines were generated from resource-limited settings (n=3, 7.0%). Of these, two were published in Malaysia and one from Cameroon. Most of the practice guidelines focused on both assessment and management (n=20, 46.5%), with some addressing only assessment (n=9, 20.9%) or management of the conditions (n=14, 32.6%).
Practice guidelines focusing on the identification and support of children with developmental disabilities, chiefly published within high-income settings, are available to be selectively adapted and utilised across similar localities globally. All young children with developmental disabilities worldwide have the right to access equitable, timely and quality health and developmental care services.
随着全球范围内更多儿童存活下来，儿童残疾现象日益普遍，尤其是在低收入和中等收入国家。全球实践指南对于满足及时识别、评估和管理发育障碍儿童的需求至关重要，特别是在资源有限的环境中。本范围综述旨在总结近期针对0至5岁有发育障碍风险或患有发育障碍儿童的评估和护理的循证实践指南，并确定那些适用于全球和资源有限环境的实践指南。
我们检索了PubMed、Scopus、CINAHL以及使用谷歌搜索的专业协会网站，以识别针对具有既定全球患病率估计的特定发育障碍的循证实践指南。我们通过滚雪球的方式识别了其他文献。如果实践指南在2012年9月至2024年6月之间发表、为英文且展示了系统的现有证据审查过程，该过程随后提供了关于5岁以下发育障碍儿童的检测、诊断、治疗和管理的信息，则将其纳入。三名评审员独立通过标题、摘要和全文筛选结果。提取研究特征和结果数据，并对结果进行叙述性综合。
43项实践指南符合纳入标准。资源有限环境中产生的循证实践指南很少（n = 3，7.0%）。其中，两项在马来西亚发表，一项来自喀麦隆。大多数实践指南侧重于评估和管理（n = 20，46.5%），一些仅涉及评估（n = 9，20.9%）或病症管理（n = 14，32.6%）。
主要在高收入环境中发表的侧重于识别和支持发育障碍儿童的实践指南可供全球类似地区有选择地改编和利用。全世界所有发育障碍幼儿都有权获得公平、及时和优质的健康与发育护理服务。
