Episode 74 (Dr Sarah McIntyre)
GLOBAL PREVALENCE OF CEREBRAL PALSY: A SYSTEMATIC ANALYSIS
Reflections on this episode (Dr Pool)
This systematic review aimed to identify the trends in birth prevalence for cerebral palsy or CP of pre or perinatal origin, post neonatal CP and overall CP by region and was combined for two major networks that being the Surveillance of Cerebral Palsy in Europe and the Australian Cerebral Palsy Register since birth year 1995. This review also aimed to identify the most recent birth prevalence estimate and period prevalence estimate of CP by region and combined for those with data available from birth year 2010 for a current prevalence estimate.
The results include representation from 41 regions from 27 countries across 5 continents. It was found that pre-perinatal birth prevalence has declined significantly across Europe and Australia, with no changes in post neonatal CP. However, from the data that was available from regions of low and middle income countries, the birth prevalence for pre/perinatal CP is high.
It is exciting to see the prevalence rates decrease by 25% in high income countries. This reflects collaborative efforts in research and implementing these findings into real world practice. What I found interesting though is that prevalence rates are nearly double that in low to middle income countries. There is much work to be done here and I was so inspired to hear of the active collaborative efforts occurring to bring these rates down whilst also improving outcomes.
What was important to emphasise in our conversation was that translating what works in high income countries isn’t necessarily the right approach. This highlights the importance of context specific interventions where it isn’t just about the direct intervention but that it is also about the infrastructure and the policies that are in place that surround the child and the family.
On reflection, I can see how this concept is relevant to us as allied health professionals too. Whilst I work in Australia as a physiotherapist and researcher, I am also involved with disability and therapy organisations in low to middle income countries. Over my 15 years of being involved in these organisations, I can safely say that the process of working within local contexts, policies and cultures takes time and indeed what might work in my context in Australia doesn’t always necessarily work in low to middle income countries. This seems so obvious to say but as Professor Rosenbaum said last week, it’s obvious once you point it out!
So this conversation hit a lot of points for me and most of all, I was so encouraged and inspired to know that we have researchers already working together, thinking ahead and preparing for the future not just in the country I call home but in many countries around the world. It is all about health equity and we can all certainly play a part to contribute to this.
Episode 73 (Professor Peter Rosenbaum)
PARENTING A CHILD WITH A NEURODEVELOPMENTAL DISORDER
Reflections on this episode (Dr Pool)
Traditional thinking and focus in childhood disability have been on the child with the impairment - to make the right diagnosis and find the right treatments. The expectation here is that interventions should “fix” the problems which has led to the process of professionals conducting the investigation and management with parents expected to comply with professional’s recommendations. There is certainly much less attention being paid to parent’s perspectives or their well-being.
With the ICF and ‘F-words for Child Development’ we recognise the family as the unity of interest and the parent’s voices as essential elements to all aspects of management. There are important implications of these developments on structure, processes and content of services for children with neurodevelopmental disorders, their families and the services designed to support them.
This episode will make you think deeply. I love how Peter challenges us, as well as himself about our views of neurodevelopmental disorders. It’s the traditional biomedical model and its contrasts with a strengths based approach.
No matter what area of child health you are in, this episode is relevant - the opportunity to challenge your thoughts by drawing on the latest scientific evidence and decades of clinical experience from some of the most dedicated teams in the world.
As Peter said - it’s only obvious when it is pointed out. I couldn’t agree more.
Episode 72 (Professor Mark Bellgrove)
AUSTRALIAN EVIDENCE BASED CLINICAL PRACTICE GUIDELINE FOR ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD).
Reflections on this episode (Dr Pool)
The Australian evidence-based clinical practice guideline for attention deficit hyperactivity disorder aims to promote accurate and timely diagnosis and provide guidance on optimal and consistent assessment and treatment of ADHD.
This guideline integrates the best available evidence along with multidisciplinary clinical expertise and lived experience - essentially the definition of evidence based practice. The result is a guideline that outlines a roadmap for ADHD clinical practice, research and policy.
With 1 million Australians living with ADHD, costing $20.42 billion per year or $25,071 per individual per annum, this is an important conversation piece. From a practical standpoint, it was wonderful to get through some of the myths that are associated with ADHD. It is not something that can be diagnosed from TikTok videos and labeling someone with ADHD when in fact they do not is stigmatizing for an individual that lives with ADHD.
In addition to knowing what the guidelines say, I found it very interesting to learn about “masking” which is particularly prevalent in girls and women. I would also highly recommend taking a look at Table 13 - a wonderful guide and reference point about our language that was created by people with lived experience. I do hope that you enjoy this podcast as much as I did - it really does cut through all the noise about ADHD.