Caregiver experiences of accessing a child developmental assessment service in a culturally diverse population in Australia: a mixed methods study.

Background: While there is a high level of concern among parents about waiting for child developmental services, there is limited research on caregiver perspectives on accessing public developmental diagnostic services, especially for families from culturally diverse backgrounds. We aimed to explore caregiver perspectives and satisfaction after attending a Child Developmental Assessment Service (CDAS) appointment for their child in South Western Sydney, as part of a large quality improvement project.

Methods: Over a 6-month period between June and December 2022, we surveyed caregivers after their child's first CDAS appointment, using an adapted caregiver questionnaire that contained Likert scale and free-text responses. We analysed the data using simple descriptive and thematic data analysis.

Results: Of 107 caregiver satisfaction questionnaires completed, almost two-thirds (63%) were from culturally and linguistically diverse backgrounds. Over 90% caregivers reported a satisfaction response of 'Agree' to 'Strongly Agree', 88% felt that the assessment was suitable to their child's needs and 85% considered waiting times reasonable. The mean overall caregiver satisfaction score was 4.5 (SD 1.1). About 30% of families had doubts about their child's neurodevelopmental diagnosis. The themes identified from free-text responses were (1) positive caregiver experience; (2) clinician attributes; (3) quality of the service delivery; (4) information received. Caregivers expressed very high levels of satisfaction with the quality of service and clinicians' skills, appreciated enhanced understanding of their child's development and found the assessment helpful.

Conclusions: Our study showed surprisingly high levels of caregiver satisfaction in attending a neurodevelopmental assessment service, in a culturally diverse metropolitan setting. Our findings support the importance of providing interpersonal sensitivity and family-centred practice for children with neurodevelopmental difficulties. We need to respond to the families who disagreed with the diagnostic formulation or were dissatisfied with the service, to improve the service quality, using longitudinal evaluation and more in-depth qualitative analysis.