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Physician Awareness of Developmental Screening and Referral in the State of Kuwait

Hix-Small, Hollie PhD*; Alkherainej, Khaled PhD

Journal of Developmental & Behavioral Pediatrics: November/December 2017 - Volume 38 - Issue 9 - p 743–752
doi: 10.1097/DBP.0000000000000493
Original Articles

Objective: In the State of Kuwait, family physicians and pediatricians are responsible for identifying and referring children at risk of disability. The aims of this study were to better understand physician (1) use of developmental screening instruments, (2) referral practices for children at risk of developmental disability, (3) interpretation of screening results, and (4) anticipatory guidance topics prioritized over child screening.

Methods: A nonprobability volunteer, self-selection sample of family physicians, general practitioners, and pediatricians (n = 398) completed a 60-item paper questionnaire. Items assessed included: (1) practitioner familiarity with, belief in, and use of screening instruments; (2) familiarity with early childhood intervention services; (3) perceived barriers to screening implementation; and (4) anticipatory topics prioritized over screening. Logistic regression was used to test a priori hypotheses.

Results: In general, family doctors and pediatricians practicing in public hospitals and primary health care centers in the State of Kuwait do not use or know how to use a developmental screening instrument, while over half prioritized immunization counseling over child screening. Screening confidence and training on using screening instruments increased the likelihood of tool use. Staff shortages, time constraints, and a perceived lack of Arabic screening instruments were barriers to tool use.

Conclusion: Raising health care providers' awareness of standardized developmental screening instruments and establishment of an early identification system in the State of Kuwait are needed. Standardization and adaptation of technically sound Arabic-language screening tools for use in the State of Kuwait and physician training programs on screening are recommended.

*Department of Special Education, Graduate School of Education, Portland State University, Portland, OR;

Department of Educational Psychology, College of Education, Kuwait University, Kuwait City, Kuwait.

Address for reprints: Hollie Hix-Small, PhD, Department of Special Education, Graduate School of Education, Portland State University, 1900 SW 4th Avenue #200, Portland, OR 97201; e-mail:

All authors were involved in the conceptualization, design, acquisition, processing, analysis, and interpretation of the data. Both authors wrote and approved the version of the article submitted for review. The authors followed ethical standards in the research process and have no conflict of interest which may be interpreted as influencing the research process.

This is an original manuscript and has not been previously published and is not under consideration elsewhere.

Received February , 2017

Accepted June , 2017

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.