What percentage of Canadian Children score as vulnerable on the early development index in kindergarten?
27% score as vulnerable
vulnerable rates of >10% are considered excessive
this statement talks about the 18 month visit as the potential last routine visit for healthy kids and it’s impotence in helping ensure that kids are healthy and prepared for school
rates vary across Canadian neighbourhoods —depending on socioeconomic, cultural, family and local governance factors
True or false - most developmental vulnerabilities that kids present with in school are preventablet
true - two-thirds of the developmental vulnerabilities (language/cognitive, physical or social-emotional) that children present with in school are preventable .
being a vulnerable child on the EDI - negative effect on school, reduces well being, decreases chance of a job
reduce Canada’s GDP by 1% over the working lifetime, economic growth reduced by 15-20% over 60 years
Name the 5 essential components of the 18 month visit based on the recommendations of the CPS
- A physician prompted heath supervision guide (ie Rourke record)
- developmental screening tool to discuss development with parent (i.e. asq, nipissing,)
- screen for parental co-morbiditis (i.e. mental health, abuse, substance misuse, physical illness)
- promotion of early literacy (reading, singing, and speaking to babies)
- information about early childhood development resources for every family
kids who aren’t meeting milestones, including socio emotional development, should be referred to early years centres
True or false - all Canadian provinces have a fee code for an enhanced 18 month visit
false - in 2009, Ontario introduced this
barriers included time, inadequate places to refer kids
working on getting it better
need to advocate for other provinces to get this too
all provinces do have some contact for immunization at this age, but the person and setting of the immunization is varied a lot (i.e. in some provinces, PH nurses give the immunization - Alberta, PEI, Newfoundland) as well as connect to resources Ontario is mixed) different provinces are starting to introduce screening clinics etc.
True or false - most countries recommend the use of standardized tools for assessment of development
false - most don’t recommend this unless there is cause for concern
also lots of variety in the number of well child visits between countries
many countries use milestone checklists instead of validated developmental screening tools
ASQ is a validated tool, however it is very long
At which age does Canada currently have a country wide population based evaluation of early childhood development?
population based approach - best way to assess early childhood development in Canada
kindergarten - EDI (early development instrument) done by kindergarten teachers over the course of one wring day, looks at all different aspects (language/cognitive, communication, social, physical and emotional skills), currently in the process of having a similar tool for 18 months and grade 4 (middle childhood)
What are advantages of having a longitudinal based evaluation of childhood development?
(although best way is population based as stated above)
direct follow-up, in this case, of a representative sample of a given population of children and their families, through questionnaires and biological testing.
1. better to study individual children’s trajectories, and personal, familial and environmental determinants
2. better to assess the timing and impact of key developmental events and to evaluate causal claims
currently (quebec, going strong, national, not so much
a new approach - linking data - being done in Manitoba, and BC, link birth records to school records, look at people’s trajectories
What are important components in developing a useful index of child health?
- In the context of early child development, an index should include data on determinants of child development , for example
- the percentage of families with children living below the poverty line
- the number of hours per year parents are in the labour force)
- investments in the early years
also, outcome information from a variety of sources. When it was in operation, the Canadian Council on Learning initiated the Composite Learning Index, which shared some of these properties. A Canadian Index of Well-being is being developed, with a child learning and development component. This tool deserves consideration as a social indicator for ECD.
(a similar tool is the consumer price index, which is dependable enough that pension amounts are based on them)