Rethinking diagnosis-based service models for childhood neurodevelopmental disabilities in Canada: a question of equity

Angie Ip; Brenda T Poon; Tim F Oberlander

doi:10.1093/pch/pxac131

Rethinking diagnosis-based service models for childhood neurodevelopmental disabilities in Canada: a question of equity

Paediatr Child Health. 2023 Mar 29;28(8):480-482. doi: 10.1093/pch/pxac131. eCollection 2023 Dec.

Authors

Angie Ip^{1

2

3}, Brenda T Poon^{2

4}, Tim F Oberlander^{1

2

3

5}

Affiliations

¹ Division of Developmental Pediatrics, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
² School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
³ Sunny Hill Health Centre, BC Children's Hospital, Vancouver, British Columbia, Canada.
⁴ Human Early Learning Partnership, University of British Columbia, Vancouver, British Columbia, Canada.
⁵ BC Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada.

Abstract

Neurodevelopmental disability in children covers a vast array of congenital and acquired long-term conditions associated with brain or neuromuscular impairments that impact function. While some presentations of neurodevelopmental disability align with diagnostic labels, many do not, leaving children whose conditions don't fit neatly under diagnostic labels struggling to access services or families and professionals feeling pressured to assign a diagnostic label in order to access services. In this paper, we (1) discuss the evidence showing that there is often a mismatch between a child's neurodevelopmental diagnosis, or lack of diagnosis, and function, (2) comment on the inequities exacerbated by diagnosis-based approaches for services, and (3) highlight the potential benefits of using a function and participation-based approach for providing services to children with neurodevelopmental disabilities. We close with three calls to action for function and participation-based approaches that could better support equitable services for children with neurodevelopmental disabilities.

Keywords: Diagnosis; Equity; Function; Neurodevelopmental Disability; Participation.