The impact of early referral on milestone development of babies with Down Syndrome at the Bloemfontein Child Information Centre, South Africa

Abstract

Background: The Bloemfontein Child Information Centre (BCIC) was established in 1985 with a focus on community service in the Free State, South Africa. At the BCIC infants with Down Syndrome (DS) are enrolled in an integrated developmental programme called the Developmental Resource Stimulation Programme (DRSP) as part of their intervention protocol.

Aim: This retrospective, descriptive design study aimed to obtain information on the impact of early referral on the milestone development of infants with DS at BCIC.

Methods and Procedures: The data were collected at the BCIC from January 2010 until July 2023 and included 87 infants with DS. The Bayley Scales of Infant and Toddler Development (3^rd Edition) (Bayley-III) was used to determine the scaled scores for five developmental domains at the following milestone development ages (in months): 3-, 6-, 9-, 12-, 16-, 18- and over 24-months. The data is presented using descriptive statistics and visualisations. To establish the effect of various factors on the scores, linear mixed-effects models were utilised.

Outcomes and Results: This study demonstrated that early referral does have an impact on future development. Specifically, significant differences (-values ) in scaled scores were observed for four of the five developmental domains for the following three factors: milestone development ages, frequency of follow-up visits and time of referral. Furthermore, the combination of early referral and frequent follow-up intervention sessions resulted in significantly improved scaled scores (-values ) for the receptive language domain.

Conclusions and Implications: Infants with DS should be referred before eight (8) weeks for optimal changes to positively impact milestone development.

Implications for practice

• Early intervention assists in the analyses of challenges and needs of infants with DS.
• The positive impact on early development is evident when infants with DS are referred early for early intervention.
• Sustainable development outcomes are proven.
• The importance of early referrals highlights occupational therapy intervention for infants with DS.