Neurodevelopmental assessments
Parents look forward to the birth of a child with excitement. Most parents dream of their child growing up to become a responsible adult in society.
For some parents, this may mean the child becoming a doctor, lawyer, actor, musician, pastor, artist, engineer, designer, hairstylist etc. In our Ghanaian society, a child may be given titles to show this desire, such as ‘Lawyer Kwame’, ‘Dr. Kofi’.
When this dream child is born and has difficulties in their development, this dream may seem to have been shattered.
These difficulties can include neck control, walking, seeing, hearing, understanding and using language, learning etc. Sometimes when parents see a health professional, neurodevelopmental assessments may be recommended.
Neurodevelopmental assessments are a detailed and comprehensive evaluation of a child’s abilities, difficulties and needs, often done by a neuro paediatrician to find out how a child’s brain is working. Neurodevelopmental assessments often help in understanding the underlying cause of the difficulties and possibly making a diagnosis.
The process
The process of the assessments may vary from child to child as every child is different. In Ghana, children are often referred to a neuro paediatrician for these assessments. The neuro paediatrician usually begins with an interaction with the parents to get a full picture of the child’s development. This may include information about pregnancy to birth.
Delving deep into the history of the child offers the assessor the opportunity to get more information about the child’s development until that stage when they are assessed. They get information about the child’s strengths, areas of needs and possibly some strategies that are helpful. Sometimes, families can be reluctant to see the neuro paediatrician for fear of the child being ‘labelled’.
A diagnosis is often seen as a ‘label’ for the child that often leads to stigma, discrimination and a stumbling block for inclusion. In as much as this can be true, a diagnosis is helpful in getting the child the appropriate support and giving clarity to the source of their difficulties, which can be a relief.
During assessment, the neuro paediatrician may engage the child in play or interaction to make some observations about the child. This may vary for a child depending on what the child is motivated by. During the interaction, they will observe the child’s physical features (face, eyes, ears, dentition, tongue etc.) attention, eye contact, understanding, expressive language or talking, behaviour and others. The neuro paediatrician may measure the child’s head to check whether their head size is what is expected of their age, as a smaller head size can sometimes be due to the presence of a condition. These are all important in understanding why the child has these difficulties.
In addition to the observations, depending on the child’s age, they may be required to do some tests tools/assessments.
There are several test tools that a neuro paediatrician can use with a child. The test tool will often depend on the reason for the referral or depending on the concerns of the parents. These tests are often scored and provide more information about the child’s development.
Depending on the concerns raised by the child’s parents, specific tests may be conducted further (such as hearing, vision, speech and language assessment etc.). These assessments may not just be within a day’s visit to the neuro paediatrician. It may take a few appointments depending on the concerns and the investigations required as well as the child’s attention span and engagement with the assessment. A detailed assessment will help the neuro paediatrician to make the right diagnosis or diagnoses.
With the right diagnosis (diagnoses), a child can get the appropriate intervention to help with their areas of need to get the best outcome in their lives.
The author is a Speech and Language Therapist/Clinical Tutor at the University of Ghana