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The Utility of Developmental Checklists in Parent-held Health Records in Singapore

Koh, Hwan Cui PhD; Ang, Sandy Kai Ting BA; Kwok, Janell BA; Tang, Hui Nee MA; Wong, Chui Mae BMBS, MRCP, MRCPCH, PhD, FAMS; Daniel, Lourdes Mary MBBS, MMed, FAMS, EdM; Goh, Winnie MBBS, MMed, MRCP, FRCP, FAMS

Journal of Developmental & Behavioral Pediatrics: October 2016 - Volume 37 - Issue 8 - p 647–656
doi: 10.1097/DBP.0000000000000305
Original Articles

Objective: The aim of this study was to investigate parents' perceptions of developmental checklists and the child development monitoring schedule in the Singapore health booklet.

Method: Parents of children aged 2 years 6 months to 3 years 11 months with or without developmental concerns (n = 450) completed a structured interview, and their child's health booklets were reviewed.

Results: Most parents reported reading and using the developmental checklists. However, only about half of them attempted the checklists with minimal help from professionals. Approximately 7 in 10 parents of children with developmental concerns found the checklists useful for identifying concerns about their child. Despite positive feedback from parents about the checklists, only about 1 in 4 parents brought their child for a 2 to 3 years developmental monitoring visit at the time of the survey, and the completion rates of the checklists were less than desirable.

Conclusions: Further revisions to the checklists can include simplifying the words and sentences and providing relevant pictures to aid understanding. If the checklists are to be used for screening, standardization of how the checklists are to be completed and how children at risk of developmental delays can be identified on the checklists need to be provided. Parents' awareness of the importance of evaluating their child's development at 9 months, 18 months, and particularly at 2.5 years, needs to be raised. Developmental screening for children at these critical ages can be made mandatory. An electronic version of the health booklet is likely to facilitate implementation of developmental screening in the health care system.

Department of Child Development, KK Women's and Children's Hospital, Singapore, Singapore.

Address for reprints: Hwan Cui Koh, PhD, Department of Child Development, KK Women's and Children's Hospital, Women's Tower, Level 5, 100 Bukit Timah Rd, Singapore 229899, Singapore; e-mail:

Supported by the Ministry of Health, Singapore.

Disclosure: It is acknowledged that author W. Goh was an author of a government report titled Enabling Masterplan 2012 to 2016, a key reference in the manuscript. L. M. Daniel contributed to the development of the developmental checklists in the parent-held child health record of interest to the study. The other authors declare no conflict of interest.

Received December 16, 2015

Accepted March 17, 2016

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.