The PLUSS model for preschool children with neurodevelopmental difficulties: a study protocol for quasi-experimental evaluation of a multi-professional and intersectoral working model (Preprint)

Abstract

Neurodevelopmental difficulties with various emotional and behavioural symptoms increase the risk of mental health problems later in life. Although we know that early detection and interventions are effective, there is a lack of intersectoral, integrative and evidence-based working models to provide these services for preschool children and their parents. PLUSS (Mental health, learning, development, collaboration around preschool children) is a collaborative "One way in"-model involving parents, health care, preschools, social services and researchers. PLUSS provides coordinated services to screen, evaluate and support toddlers with neurodevelopmental problems. It also provides parental interventions and education for preschool teachers.

The model is studied in a research project that aims to investigate a) using a quasi-experimental study on longitudinal trajectories of neurodevelopmental difficulties and ability to function among participating preschoolers, b) user satisfaction and c) implementation of the model and its effectiveness. The long-term goal is to provide evidence-based coordinated services to reduce problems related to neurodevelopmental difficulties among preschool children as well as to promote well-being and functioning in everyday life.

The population of interest is children aged 1.5-5 years who are referred from the Child Healthcare nurse for further assessment due to suspected neurodevelopmental problems. Data is collected using questionnaires and semi-structured interviews. Measures include sociodemographic data, longitudinal data on neurodevelopmental problems, parental wellbeing and satisfaction, the effectiveness of parental and preschool teacher training and implementation of the model and fostered multisectoral collaborations. Data is analysed with qualitative and quantitative methods.

The PLUSS model has been approved by the National Ethics Review Board, #2019–04839. This study was supported by FUTURUM grant number 910161 and 910441. The data collection started during the period of April 2019 with the data collection period planned to be completed in May 2024.

This study provides an integrative working model that has via multi-professional competence and intersectoral collaborations capacity to early help for preschool children with neurodevelopmental problems and their parents. PLUSS provides parental and preschool teacher training and support. Via educational and collaborative activities increases capacity among professionals to detect, assess and support children with neurodevelopmental difficulties. The study is run in one Swedish county and generalizability needs to be studied separately. Loss to follow-up could impact the longitudinal analysis.

PLUSS, Trial registration: Clinical Trials 2021, PLUSS identifier, NCT04815889.