Assessing wellness in the well-child check: What about social and emotional development?
Bibliographic record
Abstract
OBJECTIVE: To determine whether Canadian children aged 4 to 6 received well-child checks; to explore the nature of these checkups in a large family practice; and to examine the merit of using parent questionnaires about child resilience as a means of introducing a discussion about social and emotional development into this checkup. DESIGN: Three-part mixed-methods study, using data derived from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), chart reviews of a family practice, and semistructured interviews with parents. SETTING: Primary care practices associated with CPCSSN, and a large primary care practice in Kingston, Ont. PARTICIPANTS: Patients who were born between 2008 and 2011, and a sample of parents whose children were between the ages of 6 and 9. METHODS: International Classification of Diseases, version 9, codes from CPCSSN records were used to identify the prevalence of well-child checks in the 4-to-6 age group. Then 110 randomly selected charts from a large family practice were audited for inclusion of behavioural and social assessments of those aged 4 to 6. Finally, randomly selected parents from the same practice were invited to pilot-test the PERIK (Positive development and resilience in kindergarten) resilience questionnaire, interviewed about its merit, and asked to recall whether the identified areas of child development had been included in previous well-child checkups. MAIN FINDINGS: Data from CPCSSN indicated that 11% of Canadian children aged 4 to 6 had had an explicit well-child check by their family physician. Among the reviewed charts from the one practice, social context was documented for 45% of them, but social and behavioural development was usually not recorded. The 42 parents interviewed found the PERIK questionnaire useful, but not perfect, for opening discussions about aspects of child development that they had not realized were central to the child's future health. CONCLUSION: This study offers an initial approach to exploring resilience in children and therefore addressing recognized and alterable predictors of adult well-being. Early social and emotional development predicts resilience that, in turn, foreshadows future health. The PERIK questionnaire facilitated discussions that could add tremendous value to the well-child checks of children aged 4 to 6.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".