Browsing by Author "Springer, P. E."
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- ItemComparison of the demographic and diagnostic profile of new patients attending a neurodevelopmental clinic in 2008/2009 and 2016(Health & Medical Publishing Group, 2019-04) Rasdien, U.; Springer, P. E.Background. Literature suggests an increasing prevalence of developmental disabilities, and specifically of conditions such as autism and attention deficit/hyperactivity disorder. The resulting burden on paediatric neurodevelopmental services has not been described in the South African setting. Objective. To compare the demographic and diagnostic profile of new patients attending a neurodevelopmental service across two 12-month periods, after a change in referral pathway and the introduction of a secondary clinic. Methods. We conducted a retrospective, descriptive cross-sectional folder review of new patients seen in the neurodevelopmental service at Tygerberg Hospital in 2008/2009 and 2016. Results. The number of new patients increased from 84 in 2008/2009 to 240 in 2016. In both periods the majority of patients were male. The median (IQR) age decreased from 62 (31 - 92) months in 2008/2009 to 53 (37 - 67) months in 2016 (p=0.17). In 2008/2009 only one patient was from the Khayelitsha health subdistrict compared with 49 (20.4%) in 2016, following the subdistrict’s addition to the hospital’s drainage area in 2011. The number of patients referred by allied health professionals increased between the two periods (30.4% in 2016 v. 16.4% in 2008/2009). Cases of autism spectrum disorder (ASD) increased notably: from 10 (8.4%) in 2008/2009 to 84 (35%) in 2016. Conclusion. The notable increase in neurodevelopmental referrals over the past 8 years cannot be fully explained by a regional population increase or a change in referral pathway. The number of ASD cases has increased disproportionately, with important implications for health and educational service planning.
- ItemLongitudinal developmental profile of children from low socio-economic circumstances in Cape Town, using the 1996 Griffiths Mental Development Scales(Health & Medical Publishing Group, 2010) Laughton, Barbara; Springer, P. E.; Grove, D.; Seedat, S.; Cornell, M.; Kidd, M.; Madhi, S. A.; Cotton, M. F.Background. The Griffiths Mental Development Scales (GMDS) have not been standardised in South African children. Neurodevelopmental scores of infants from deprived environments decline with age, but there is no evidence on how young South African children from such backgrounds perform on serial assessments. Aim. To describe the longitudinal developmental profile of infants from low socio-economic backgrounds at Tygerberg Children's Hospital by comparing the GMDS scores performed at 10 - 12 months and 20 - 22 months. Methods. Infants born to HIV-uninfected women attending the public service programme were recruited from a vaccine study in Cape Town, South Africa. The GMDS 0 - 2 years and a neurological examination were performed between 10 and 12 months and between 20 and 22 months. Results. Thirty-one infants (14 girls, 17 boys) were assessed. Their mean (standard deviation (SD)) age was 11.6 (0.8) months and 21.0 (0.5) months at the first and second assessments, respectively. The mean (SD) general quotient decreased significantly from 107.3 (11.7) to 95.0 (11.0) (p<0.001). All sub-quotients decreased significantly except for locomotor. The hearing and language sub-quotient was most affected, with a decrease in mean quotients from 113.0 to 93.2 (p<0.001). There was no evidence of intercurrent events to explain the decline. Interpretation. Scores on the GMDS of this group of children from low socio-economic backgrounds were normal at 11 months and, other than locomotor, decreased significantly at 21 months, with language the most affected. Further research is needed to determine the specific reasons for the decline.