An analysis of the referral system to the neurodevelopmental clinic at a tertiary hospital in the Eastern Cape

Early diagnosis and initiation of management of neurodevelopmental disorders improve outcomes. Time from caregiver initial concern to the point when a diagnosis is made has not been described in patients attending a tertiary-level hospital in the Eastern Cape. A descriptive cross-sectional study was conducted to assess waiting times before the neurodevelopmental clinic (NDC) appointment and to describe the range of neurodevelopmental disorders seen at the NDC Frere Hospital, Eastern Cape, South Africa. A total of 50 children were enrolled in the study. The mean time from initial parental concern until the NDC appointment was 19.3 months, with half of this time being before accessing the healthcare system. Time spent on the waiting list of the NDC contributed 20.2% to the total waiting period. The top two neurodevelopmental diagnoses seen at the NDC were attention deficit hyperactivity disorder (n=21; 42.0%) and autism spectrum disorder (n=12; 24.0%). Several components within the referral pathway which resulted in prolonged referral timelines have been identified. Recommendations are made for further avenues of research and service improvements.
A research report submitted to the Faculty of Health Sciences, the University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Science in Medicine in Child Health Neurodevelopment