L’implantation des PCO dans le dispositif français de repérage des troubles du neurodéveloppement : comparaison de l’activité de deux plateformes (Finistère/Vendée)

Objective

The aim of the study presented here is to compare the activity of two neurodevelopmental disorders coordination and orientation platforms (PCO–TND) set up at different times in the history of this system (implemented in 2019). Two studies were conducted: A comparative cross-sectional study of the first 101 screening booklets recorded on both platforms, and a longitudinal study based on data from the Finistère PCO comparing the contents of the booklets of the first 101 children addressed to the PCO with those of the 101 booklets recorded exactly one year later. The questions we aimed to answer are as follows: did the activity of the Vendée PCOs implanted one year later benefit from feedback from the first implanted PCOs? What points of similarity were revealed from a cross-sectional comparison of the activity of these two platforms? What points of dissimilarity? A longitudinal comparison of the activity of the Finistère PCO revealed what changes had taken place over time in terms of the characteristics of the children addressed and the types of referring doctors?

Method

The same data collection tool was used at the Finistère and Vendée PCOs. It consisted of a Google form file which recorded the characteristics of the addressed child (age, sex), his/her other high-risk TND factors, particular instinctual, sensory and emotional behaviors, TND warning signs, the suspected disorder(s) justifying referral to the platform, and the assessments prescribed.

Results

The age of addressed children tended to fall within the length of time the platform had been in operation. The type of referring doctor varied according to the territory in which the PCO was located. A quarter of the children referred to the two platforms were thought to have an overall developmental delay (motor skills, language and cognition). Sleep disorders and “exaggerated intolerance to change” were identified in around 25 % of children referred to the two PCOs. The longitudinal study carried out on the Finistère PCO revealed an evolution in the quantitative and qualitative characteristics of the activity in the direction of greater compliance with the original objectives of the system.

Discussion–Conclusion

Once this screening system has found its place in the host region, at-risk children can be identified earlier and their care provided more promptly which would improve their prognosis. Over time, first-line doctors will become more familiar with the booklet and with TND symptoms and will therefore be better able to identify them, which in turn increases the rate of referral of at-risk children to the platform.