The 'Watch Me Grow’ App (WMG) for identification of developmental and mental health problems in 1-2 year old children: a validation study

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Data from the 2015 Australian Government Early Developmental Index Census (AEDI; 2015) suggests that around 22% of Australian children are “developmentally vulnerable” on one or more domains at the start of school, with rates as high as 33% in disadvantaged communities. Recent advances in early childhood and brain development science highlight the importance of early identification and intervention for children at developmental risk to maximize child and family function and participation outcomes. Such opportunities are unfortunately missed in a substantial majority due to poor uptake of current surveillance programs that are voluntary with no mechanism for follow up. There is also evidence for an ‘inverse care law’, with those at highest risk (e.g., mothers born overseas, lower educational and income levels) being least likely to access developmental surveillance programs (Eapen et al., 2014). While GPs are usually the first point of contact for families, time pressures and lack of knowledge and confidence about assessments and referral pathways/support systems limit opportunities for early identification/intervention during these most critical years. We believe that by utilizing an interactive web-based tool at general appointments for children and during 18-month vaccination visit contacts at GP practices/Child and Family Health Nurse (CFHN) clinics, the uptake and coverage of current developmental surveillance programs will be significantly enhanced. This project will test the diagnostic accuracy of a web application developmental surveillance tool comprising (1) the ‘Watch Me Grow’ app (WMG app), a web-based application for parents, and (2) a GP/Health professional component that includes an algorithm with recommendations for next steps regarding review/assessments/investigations and/or referral pathways to early intervention. The project will take place over 3 phases: Phase 1. Recruitment and 18-month screening: Children (n=240) aged 18 months attending GP practices and CFHN clinics will be recruited for this study. At the clinic-based 18-month immunisation/personal health record (PHR) appointment, the parent will complete the WMG app assessment and the GP/CFHN/Practice Nurse will receive a summary of the screening results, referral considerations and parenting options through a secure messaging system (using the child’s name and date of birth) to inform their management plan. Phase 2. Comprehensive developmental assessment: All children identified at 18-months through the WMG app as being at developmental risk together with 10% of those who screen negative (to cover for any false negative results), will complete a comprehensive gold-standard developmental assessment protocol at 2 years of age. Phase 3. Comparison of numbers of children referred for more detailed developmental assessment during the study period with current “usual practice” at the participating sites..

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