19th December 2024
Researchers at the NIHR Children Policy Research Unit have published their latest paper “What do parents, professionals and policy colleagues want from a universal assessment of child development in the early years? A qualitative study in England” in the BMJ Open.
Launching the paper on social media, the researchers summarised the findings stating, “Parents and health visiting professionals in England want a measure of child development at 2-2½ years to be a springboard for a ‘warm conversation about what’s going on – covering child, sibling and parent wellbeing. Not just ‘tick, tick, tick’”.
Objective: Every child in England should be offered a health and development review at age 2-2½ years by the health visiting service, part of which includes an assessment of child development. To inform policy and practice, the study gathered the views and experiences of parents and health visiting professionals on key priorities for, and barriers to, a universal assessment of early child development at age 2-2½ years.
Design, setting, participants: Data were collected through 15 focus groups with 29 parents, 24 health visitors and nursery nurses, five service managers and five policy colleagues in England. Participants were asked to reflect on their experiences of, and priorities for, measuring child development at the 2-2½ year universal review.
Analysis: The research team analysed data using Reflexive Thematic Analysis.
Results: Two overarching themes were identified in the data:
- The first theme, ‘just a part of the puzzle’: a useful tool in a holistic review, reflected a consistent priority – across all focus groups – for a measure of child development that was well embedded in the wider review, that facilitated conversations about the child and family system and allowed negotiation of parent and professional judgement of the child’s development, and had a clear stated purpose.
- The second theme, ‘they need to know why they’re doing it: a need for clarification’, reflected the need for a clear purpose for, and less variable delivery of, the tool, including a need for clarification on its intended purpose to provide population-level data.
Conclusions: Parents and practitioners wanted a tool that facilitated a holistic conversation about development, wellbeing and health across the family system, with direct observation of the child by the professional. Used skilfully, the Ages and Stages developmental assessment tool can constitute an intervention in itself, as it helps scaffold a conversation about how parents can support their child’s optimal growth and development. Consideration should be given to the experience of and support available to the practitioner using the tool within the health and developmental review.
Responding to the publication, Alison Morton, iHV CEO said:
“The findings from this important research paper are no surprise – but it’s important to have them validated through research. When parents and health visiting practitioners were asked what they want from child development reviews, they both agreed – put the child in the centre, observe how they are developing and interacting with the world around them – listen to parents and work together to gain an understanding of the child as a unique person.
“And, above all, be focused on the purpose of the review and stop ‘ticking the box and missing the point’.
“The universal health visiting service in England only reviews all children at four mandated reviews between birth and school entry (the number of reviews, and programme of health visiting support, is much higher in the other UK nations) – at the very least, we owe it to our babies, children and families, to get this right.
“I hope that this research will act as a powerful catalyst for change and a shift back to more personalised care. Any tool that is used to support the assessment of child development and wellbeing must be used as part of a holistic assessment to support professional’s observation, parental report and clinical decision-making – not to replace it.”
iHV would like to extend thanks to the research team (Joanna L Lysons, Rocio Mendez Pineda, Maria Raisa Jessica Aquino, Hannah Cann, Pasco Fearon, Sally Kendall, Jennifer Kirman and Jenny Woodman) for this important research which brings out what parents and health visiting practitioners want from child development reviews.
