It is beneficial to systematise the exchange of information between parents, preschool and child care centres (CHCs) to increase the focus on young children with mental health problems. This is shown in a recently conducted study from Uppsala University, published in the journal PLOS One.
“ All three groups in our study – nurses, preschool teachers and parents – thought that the systematic approach works well and that the routine with questionnaires provides more knowledge about the children for both preschool and child healthcare services. However, the use of standardised questionnaires is a controversial issue among preschool teachers,” says Elizabeth Fält, PhD student and district nurse, who carried out the study.
Although it is the child healthcare system’s task to monitor children’s health, behaviour and development, it is preschool teachers that possess much of the information needed to make a comprehensive assessment of the child. Their knowledge is not systematically utilised within child healthcare since there is no established channel for information sharing between the healthcare and preschool systems.
The ongoing study "Children and Parents in Focus" was launched in Uppsala, Sweden, in 2013. The study evaluated a method to enhance communication between parents, preschool and child healthcare, regarding children's mental health.
When the parents of all 3-, 4-, and 5-year-olds in Uppsala receive the invitation letter for the child's annual visit to the child health centre, they also receive an additional form with 25 questions. This form, the Strengths and Difficulties Questionnaire (SDQ), is widely used internationally and contains questions about the child's behaviour, emotions, and social relationships.
The parents receive three SDQ forms. If the family agrees to participate in the study, the parents each complete a separate form and take the third questionnaire to their child’s preschool for the teachers to complete. The completed forms are then returned to the CHC nurse and reviewed during the child's regular visits to the CHC.
All stakeholders were in favour of the new procedure, though all stakeholders also noted some problems.
“They argue that the use of structured (normative) forms is regarded as outdated in preschool and that such tools are contradictory to preschool’s policy documents. They fear the children might be labelled and thus affected negatively in the future if they are assessed with standardised forms. Nevertheless, preschools have a responsibility to offer all children adequate support in their development and to collaborate with parents, so there is a conflict there,” says Elizabeth Fält.
The preschool teachers also feel worried about parents' reactions to the preschool assessment. At the same time, they acknowledge that the information transfer benefits the preschool, as the new routine can contribute by giving the preschool a more detailed picture of each child and can result in good collegial discussions.
Elisabet Fält et al., Exploring Nurses’, Preschool Teachers’ and Parents’ Perspectives on Information Sharing Using SDQ in a Swedish Setting – A Qualitative Study Using Grounded Theory, PLOS ONE, 11th January 2016, http://dx.plos.org/10.1371/journal.pone.0168388
Elisabet Fält, PhD and district nurse at Department of Women's and Children's Health, Uppsala University, firstname.lastname@example.org, +46-706-106614, +46-18-6115963
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