Early identification of developmental impairments in infants from birth to nine months of age / |c by M. Grace Doherty

Early recognition of real or potential developmental impairments in infants is an important public health role. Community health nurses have initial access to the infant population by the mandated newborn visit and the necessary skills and tools to assess infants for developmental impairments. This experimental study was undertaken to determine the effectiveness of scheduled nursing assessments of growth, development, vision, hearing and nutrition from birth to nine months of age. A secondary purpose was to determine the predictive validity of currently used pregnancy and infant profiles for subsequent developmental impairment. The null hypotheses tested were: I. That the scheduled, community health nursing assessments between birth and nine months of age will not detect any developmental impairments which have not already been detected by existing health services. II. That there is no significant difference in the number of developmental impairments detected at nine months of age, between a group of infants screened by the proposed schedule of assessments and a group not so screened. III. That there is no significant difference in the number of children exhibiting developmental impairments by nine months of age, between a group of "at risk" and a group of not "at risk" infants, using the criteria from the Vancouver Health Department's Pregnancy Profile and Infant Profile At Risk Criteria. One hundred infants from one health unit area were studied, alternately assigned to an experimental and a control group. The experimental group received three visits in addition to the newborn visit, at 1 month, 3 months, and 6 months, for various combinations of five types of assessments. The control group received only the usual newborn visit, but no control was used to prevent access to any other health services during the study period. Pregnancy and infant profiles were completed for the subjects in both groups at the initial visit. 9 month assessments of growth, development, vision, hearing and nutrition were completed for both groups. The data were subjected to descriptive analysis and statistical analysis by Fisher's exact test of probability, using 2x2 contingency tables. The findings supported scheduled community health nursing assessments of infants from birth to nine months of age. The pregnancy and infant profiles were found to be sensitive but not specific tools for prediction of subsequent developmental impairment. The three null hypotheses were rejected.Applied Science, Faculty ofNursing, School ofGraduat