Are Ethnicity and Migration Associated with Developmental Referrals in Prescbool Children in East Bristol

Global Health BSc Student Dissertation - Alissa Ambrose

Background: Early intervention during childhood is one of the most powerful tools to combating developmental disabilities.
Although globalisation, migration and ethnic diversity are increasing, little is known about the e↵ect of either on child development.
This study aims to assess the association between ethnicity, birth origin and a referral to a community paediatricians for a
developmental concern.
Methods: This retrospective analysis of case files analysed the ethnicity and birth origin of all under five referrals (n=1246) to a
community paediatric trust. This population-based study was conducted between 2012-2016 in East Bristol, which has an underfive
population of 9,500. All available files (n=514) were analysed for the primary outcome measure which was a developmental
referral.
Results: Children of Somali ethnicity or 2 Migrant Parents had the highest proportions of developmental referrals (84.75% (50/59)
and 81.25% (91/112) respectively). Both birth origin and ethnicity were significantly associated with developmental referrals (Chisquared
p-values both <0.001). Children from a Black or Ethnic Minority background were nearly twice (IRR1.89 (95% Confidence
Intervals (CI), 1.49-2.43, p-value=0.009)) as likely to be referred for a developmental referral than White UK children. Having a
migrant parent was also significantly associated with a developmental referral (1.29 (CI, 1.01-1.65, p-value=0.03))
Conclusions: This study identifies di↵erential referral patterns for early developmental assessment in children from a UK urban
population according to ethnicity and parental migration status. This study wishes to initiate an investigation into aetiological mechanisms
of e↵ect and calls for the development of culturally-appropriate developmental testing, to enable targeted and meaningful
support for families in need.