Caregiver Perspectives on the Outcomes of a Multidisciplinary Developmental Assessment Service for Rural and Remote Children With Complex Needs and Adverse Childhood Experiences: A Mixed-Methods Study.

INTRODUCTION

This study describes the psychosocial complexity of rural and remote children and families who accessed a multidisciplinary developmental assessment service in New South Wales, Australia, as well as caregiver perspectives regarding service impact and outcome.

METHODS

This parallel convergent mixed-methods study involved thematic analysis of semi-structured interviews (n = 8) and descriptive analysis of cross-sectional survey responses (n = 154) with caregivers of children involved in a multidisciplinary pediatric developmental assessment service for rural and remote Australian children.

RESULTS

Survey respondents reported high rates of Adverse Childhood Experiences (ACEs) and related life events, including caregiver mental health issues (61%) and children's experiences of community violence (35%) and discrimination (31%). Interviewees highlighted the importance of diagnosis for understanding their child's behavior.

DISCUSSION: Rural and remote children in Australia experience alarming rates of ACEs, financial and other psychosocial stresses. Responsive, family-centered, multidisciplinary diagnostic services are perceived by caregivers as impactful.