Journals / Acta Medica Alanya / 2026 / Cilt: 10 Sayı: 3

Early Neurodevelopmental Assessment in Primary Care: Knowledge, Clinical Practices, And Barriers Among Family Physicians

Birinci Basamakta Erken Nörogelişimsel Değerlendirme: Aile Hekimlerinin Bilgi Düzeyi, Klinik Uygulamaları ve Karşılaştıkları Engeller

Özden Aksu Sayman(Social Pediatrics Doctorate Programme, Institute of Child Health Department, İstanbul University)0000-0003-2283-9117
Duygu Çalışkan(Alanya Alaaddin Keykubat University, School of Medicine, Department of Child Health and Disease)0000-0002-3579-0722
Günce Başarır(Unıversity of Health Science Haseki Education an Research Hospital Child Neurology)0000-0001-5887-6468
Cansu Turan(Alanya Alaaddin Keykubat University, School of Medicine, Department of Child Health and Disease)0000-0003-3146-6391
Semra Özal Özkan Alpaslan(Alanya Alaaddin Keykubat University, School of Medicine, Department of Child Health and Disease)0009-0004-1898-9811
Arife Uslu Gökceoğlu(Alanya Alaaddin Keykubat University, School of Medicine, Department of Child Health and Disease)0000-0002-5331-0315
Pages
231–238
Publication Date
2026-10-20
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Training models that strengthen physicians' practical skills and brief screening tools integrated into routine practice will enable more effective monitoring of neurodevelopmental processes at the primary care level.

📌 3 Key Takeaways

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Objective & Hypothesis:Aim: The objective of this study was to systematically evaluate the knowledge levels, clinical practices, and perceive barriers to early childhood neurodevelopmental assessment among family physicians working in primary care settings.
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Key Findings & Data:Methods: This cross-sectional study included 121 family physicians who had been actively working for at least six months in two districts and volunteered to participate in the research.
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Conclusion & Impact:Training models that strengthen physicians' practical skills and brief screening tools integrated into routine practice will enable more effective monitoring of neurodevelopmental processes at the primary care level.
🔬Design:Survey & Empirical Study
📍Scope:2025 Verileri
⚙️Variables:Nörogelişimsel değerlendirme · Birinci Basamak Sağlık Hizmeti · Gelişimsel Tarama

Abstract

Aim: The objective of this study was to systematically evaluate the knowledge levels, clinical practices, and perceive barriers to early childhood neurodevelopmental assessment among family physicians working in primary care settings. Methods: This cross-sectional study included 121 family physicians who had been actively working for at least six months in two districts and volunteered to participate in the research. A 23-item structured questionnaire, developed based on current literature, was utilized as the data collection tool. Data were collected between November 15 and December 31, 2025. Results: The majority of physicians conducting early neurodevelopmental assessments stated that they based their evaluations on clinical observation and physical examination. Only 2 (1.9%) reported using a standard screening tool. Forty participants (33.0%) stated that they had never heard of any developmental screening tests before. The most frequently reported barrier to implementation was insufficient examination time, followed by workload and difficulty accessing appropriate tools. Red flag knowledge levels were scored out of 10, with a median value of 6 (4-7). There was no statistically significant difference between red flag knowledge scores and having previously received training in developmental assessment (p=0.3), professional experience (p=0.87), or level of professional education (p=0.7). Conclusion: The absence of significant differences in neurodevelopmental knowledge scores based on previous training indicates that current training models have limited effectiveness in improving clinical competence. Furthermore, time constraints and insufficient use of standardized screening tools underscore the concrete need for structured support at the primary care level. Training models that strengthen physicians' practical skills and brief screening tools integrated into routine practice will enable more effective monitoring of neurodevelopmental processes at the primary care level.

Özet

Amaç: Bu çalışmanın amacı, birinci basamak sağlık hizmetlerinde çalışan aile hekimlerinin erken çocukluk dönemi nörogelişimsel değerlendirmesine ilişkin bilgi düzeylerini, klinik uygulamalarını ve algılanan engelleri sistematik olarak değerlendirmektir. Yöntem: Kesitsel tasarıma sahip bu çalışmada, iki ilçede en az altı aydır aktif olarak çalışan ve araştırmaya katılmayı kabul eden 121 aile hekimi örnekleme dahil edilmiştir. Veri toplama aracı olarak literatüre dayalı geliştirilen 23 maddelik yapılandırılmış bir anket formu kullanılmıştır. Veriler 15 Kasım -31 Aralık 2025 tarihleri arasında toplanmıştır. Bulgular: Erken nörogelişimsel değerlendirme yapan hekimlerin büyük çoğunluğu klinik gözlem ve fizik muayeneye dayalı olarak değerlendirme yaptığını ifade etmiştir. Sadece 2’si (%1,9) standart bir tarama aracı kullandığını belirtmiştir. Katılımcıların 40’ı (%33,0) gelişimsel tarama testlerinden herhangi birini daha önce duymadığını dile getirmiştir. En sık bildirilen uygulama engeli, yetersiz muayene süresi olup, bunu iş yükü ve uygun araçlara erişim güçlüğü izlemiştir. Kırmızı bayrak bilgi düzeyleri, 10 üzerinden puanlandırılmış olup, medyan değeri 6 (4-7) olarak saptanmıştır. Gelişimsel değerlendirme konusunda daha önce eğitim almış olmak (p=0.3), mesleki deneyim (p=0.87) ve mesleki eğitim düzeyi (p=0.7) ile kırmızı bayrak bilgi puanı arasında istatistiksel olarak anlamlı bir fark bulunmamıştır. Sonuç: Erken gelişimsel değerlendirme hakkında eğitim almış olmanın, nörogelişimsel bilgi skorları ile anlamlı bir fark göstermemesi, mevcut eğitim modellerinin klinik yetkinlik kazandırmadaki sınırlılıklarına işaret etmektedir. Zaman kısıtılığı ve standardize tarama aracı kullanımının çok düşük düzeyde kalması, birinci basamakta yapılandırılmış destek ihtiyacını somutlaştırmaktadır. Hekimlerin pratik becerilerini güçlendiren eğitim modelleri ve rutin işleyişe entegre edilmiş kısa tarama araçları, erken nörogelişimsel süreçlerin birinci basamakta daha etkin izlenmesine imkan tanıyacaktır.

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Cite This Article

Sayman, Ö. A., Çalışkan, D., Başarır, G., Turan, C., Alpaslan, S. Ö. Ö., Gökceoğlu, A. U. (2026). Early Neurodevelopmental Assessment in Primary Care: Knowledge, Clinical Practices, And Barriers Among Family Physicians. Acta Medica Alanya, Cilt: 10 Sayı: 3, 231–238. https://doi.org/10.30565/medalanya.1873067

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References (23)

  1. Black MM, Walker SP, Fernald LCH, Andersen CT, DiGirolamo AM, Lu C, et al. Early childhood development coming of age: science through the life course. Lancet. 2017;389(10064):77–90. doi: 10.1016/S0140-6736(16)31389-7
  2. Hadders-Algra M. Early diagnostics and early intervention in neurodevelopmental disorders—age-dependent challenges and opportunities. J Clin Med. 2021;10(4):861. doi: 10.3390/jcm10040861.
  3. Sampaio F, Feldman I, Lavelle TA, Skokauskas N. The cost-effectiveness of treatments for attention deficit-hyperactivity disorder and autism spectrum disorder in children and adolescents: a systematic review. Eur Child Adolesc Psychiatry. 2022;31(11):1655−70. doi: 10.1007/s00787-021-01748-z.
  4. Çelik M, Limnili G, Güldal AD. Evaluation of Primary Health Care. Jour Turk Fam Phy. 2019;10(4):163−172. doi: 10.15511/tjtfp.19.00463.
  5. Tezel B, Aydın Ş, editors. Bebek, Çocuk, Ergen İzlem Protokolleri [Internet]. Ankara (TR): T.C. Sağlık Bakanlığı, Halk Sağlığı Genel Müdürlüğü, Çocuk ve Ergen Sağlığı Dairesi Başkanlığı; 2018 Sağlık Bakanlığı Yayın No: 1112. Available from: https://ekutuphane.saglik.gov.tr/Yayin/562 Accessed:02.01.2026
  6. World Health Organization, United Nations Children’s Fund, World Bank Group. Nurturing care for early childhood development: a framework for helping children survive and thrive to transform health and human potential. Geneva: World Health Organization; 2018. ISBN: 9789241514064. Available from: https://apps.who.int/iris/bitstream/handle/10665/272603/9789241514064-eng.pdf Accessed: 3.01.2026.
  7. Barbaro J, Winata T, Gilbert M, Nair R, Abdullahi I, Descallar J, et al. General practitioners’ perspectives regarding early developmental surveillance for autism within the Australian primary healthcare setting: a qualitative study. BMC Prim Care. 2023;24(1):159. doi: 10.1186/s12875-023-02121-6.
  8. Hirai AH, Kogan MD, Kandasamy V, Reuland C, Bethell C. Prevalence and variation of developmental screening and surveillance in early childhood. JAMA Pediatr. 2018;172(9):857−66. doi: 10.1001/jamapediatrics.2018.1524.
  9. Akdeniz M, Ungan M, Yaman H. The Development of Family Medicine as a Discipline in Turkey. GeroFam. 2010;1(1):29–40. doi: 10.5490/gerofam.2010.1.1.4.
  10. Lipkin PH, Macias MM. Council on Children with Disabilities; Section on Developmental Behavioral Pediatrics. Promoting optimal development: identifying infants and young children with developmental disorders through developmental surveillance and screening. Pediatrics. 2020;145(1):e20193449. doi: 10.1542/peds.2019-3449.
  11. Ayranci Sucakli I, Yalcin SS, Ilgaz S, Gorpelioglu S. Early childhood development awareness and practices of family physicians according to healthcare service affiliation: primary versus secondary and tertiary. Euras J Fam Med. 2024;13(3):107−19. doi: 10.33880/ejfm.2024130304.
  12. Carman KB, Kayhan M, Bilge U, Dinleyici M, Balcioglu H, Yarar C, et al. The evaluation of knowledge and practices of family physicians about developmental screening tests. Osmangazi Journal of Medicine. 2017;39(3):44-8. doi: 10.20515/otd.320953.
  13. Boulton KA, Hodge MA, Jewell A, Ong N, Silove N, Guastella AJ. Diagnostic delay in children with neurodevelopmental conditions attending a publicly funded developmental assessment service: findings from the Sydney Child Neurodevelopment Research Registry. BMJ Open. 2023;13(2):e069500. doi: 10.1136/bmjopen-2022-069500
  14. King TM, Tandon SD, Macias MM, Healy JA, Duncan PM, Swigonski NL, et al. Implementing developmental screening and referrals: lessons learned from a national project. Pediatrics. 2010;125(2):350–360. doi: 10.1542/peds.2009-0388.
  15. Scharf RJ, Scharf GJ, Stroustrup A. Developmental milestones. Pediatr Rev. 2016;37(1):25-37. doi: 10.1542/pir.2014-0103.
  16. Morelli DL, Pati S, Butler A, Blum NJ, Gerdes M, Pinto-Martin J, et al. Challenges to implementation of developmental screening in urban primary care: a mixed methods study. BMC Pediatr. 2014;14:16. doi: 10.1186/1471-2431-14-16.
  17. Mackrides PS, Ryherd SJ. Screening for developmental delay. Am Fam Physician. 2011;84(5):544-9. PMID: 21888305
  18. T.C. Sağlık Bakanlığı. Health Statistics Yearbook 2024 Press Release”. 2025. Available from: https://erisilebilir.saglik.gov.tr/TR-111038/saglik-istatistikleri-yilligi-2024-haber-bulteni.html. Accessed: 4.01.2026
  19. Vitrikas K, Savard D, Bucaj M. Developmental delay: when and how to screen. Am Fam Physician. 2017;96(1):36-43. PMID: 28671370
  20. Furley K, Mehra C, Goin-Kochel RP, Fahey MC, Hunter MF, Williams K, et al. Developmental regression in children: Current and future directions. Cortex. 2023;169:5-17. doi: 10.1016/j.cortex.2023.09.001.
  21. Yaylaci F, Guller B. Diagnostic evaluation of patients referred by family physicians with the suspicion of autism spectrum disorder. Int J Dev Disabil. 2022;69(6):936-945. doi: 10.1080/20473869.2022.2070419.
  22. Schickedanz A, Halfon N. Evolving roles for health care in supporting healthy child development. Future Child. 2020;30(2):143–64. doi: 10.1353/foc.2020.a807755
  23. Van Cleave J, Kuhlthau KA, Bloom S, Newacheck PW, Knapp AA, Homer CJ, et al. Interventions to improve screening and follow-up in primary care: a systematic review of the evidence. Acad Pediatr. 2012;12(4):269–82. doi: 10.1016/j.acap.2012.02.004