Comparison of the demographic and diagnostic profile of new patients attending a neurodevelopmental clinic in 2008/2009 and 2016

Abstract

Background. Literature suggests an increasing prevalence of developmental disabilities, and specifically of conditions such as autism and attention deficit/hyperactivity disorder. The resulting burden on paediatric neurodevelopmental services has not been described in the South African setting. 

Objective. To compare the demographic and diagnostic profile of new patients attending a neurodevelopmental service across two 12-month periods, after a change in referral pathway and the introduction of a secondary clinic. 

Methods. We conducted a retrospective, descriptive cross-sectional folder review of new patients seen in the neurodevelopmental service at Tygerberg Hospital in 2008/2009 and 2016. 

Results. The number of new patients increased from 84 in 2008/2009 to 240 in 2016. In both periods the majority of patients were male. The median (IQR) age decreased from 62 (31 - 92) months in 2008/2009 to 53 (37 - 67) months in 2016 (p=0.17). In 2008/2009 only one patient was from the Khayelitsha health subdistrict compared with 49 (20.4%) in 2016, following the subdistrict’s addition to the hospital’s drainage area in 2011. The number of patients referred by allied health professionals increased between the two periods (30.4% in 2016 v. 16.4% in 2008/2009). Cases of autism spectrum disorder (ASD) increased notably: from 10 (8.4%) in 2008/2009 to 84 (35%) in 2016. 

Conclusion. The notable increase in neurodevelopmental referrals over the past 8 years cannot be fully explained by a regional population increase or a change in referral pathway. The number of ASD cases has increased disproportionately, with important implications for health and educational service planning.