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Establishing a protocol for building a pan-Canadian population-based monitoring system for early childhood development for children with health disorders: Canadian Children’s Health in Context Study (CCHICS)
  1. Magdalena Janus1,
  2. Marni Brownell2,
  3. Caroline Reid-Westoby1,
  4. Teresa Bennett1,
  5. Catherine Birken3,4,
  6. Robert Coplan5,
  7. Eric Duku1,
  8. Mark A Ferro6,
  9. Barry Forer7,
  10. Stelios Georgiades1,
  11. Jan Willem Gorter8,9,
  12. Martin Guhn7,
  13. Jonathon L Maguire3,10,
  14. Heather Manson11,
  15. Jacqueline Pei12,
  16. Rob Santos13
  1. 1 Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
  2. 2 Manitoba Centre for Health Policy, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
  3. 3 Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
  4. 4 The Hospital for Sick Children, Toronto, Ontario, Canada
  5. 5 Department of Psychology, Carleton University, Ottawa, Ontario, Canada
  6. 6 School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
  7. 7 Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
  8. 8 Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
  9. 9 CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada
  10. 10 Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
  11. 11 Public Health Ontario, Toronto, Ontario, Canada
  12. 12 Department of Educational Psychology, University of Alberta, Edmonton, Alberta, Canada
  13. 13 Manitoba Education and Training, Healthy Child Manitoba, Government of Manitoba, Winnipeg, Manitoba, Canada
  1. Correspondence to Dr Magdalena Janus; janusm{at}


Introduction Health disorders early in life have tremendous impact on children’s developmental trajectories. Almost 80% of children with health disorders lack the developmental skills to take full advantage of school-based education relative to 27% of children without a health disorder. In Canada, there is currently a dearth of nationally representative data on the social determinants of early childhood development for children with health disorders. Evidence from Canada and other countries indicate that poorer developmental outcomes in typically developing children are associated with lower socioeconomic status (SES). However, to date, it is not known whether this relationship is stronger among children with health disorders. The study’s objectives are to estimate the prevalence and to investigate social determinants of developmental outcomes for young children with health disorders, using the Early Development Instrument (EDI).

Methods and analysis Study objectives will be achieved through three steps. First, using existing EDI data for 10 provinces and 2 territories collected from 2004 to 2015, we will investigate differences in developmental health outcomes among children with identified health disorders. Second, population-level EDI data will be linked with neighbourhood sociodemographic census data to explore associations between socioeconomic characteristics and rates of specific diagnoses among children aged 5–6 years, including trends over time. Third, for 3 of these 12 regions, additional health and/or education databases will be linked at an individual level. These data will be used to establish differences in EDI outcomes in relation to the age-of-onset of diagnosis, and presence of intervention or treatment.

Ethics and dissemination Study methodologies have been approved by the Hamilton Integrated Research Ethics Board. The results of the analyses of developmental health outcomes for children with health disorders combined with SES will have implications for both health service delivery and school-based intervention strategies. Results will contribute to a framework for public policy.

  • epidemiology
  • community child health
  • mental health
  • paediatrics
  • developmental neurology & neurodisability

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  • Contributors MJ and MB conceived the study. MJ, MB, TB, CB, RC, ED, MAF, BF, SG, JWG, MG, JLM, HM, JP and RS contributed to the study design and planning. CR-W prepared the first draft of the manuscript with MJ reviewing and amending early draft versions; MJ and CR-W finalised the manuscript. BF, MG and ED provided statistical expertise guiding the analytic plan. MJ, MB, BF, ED and MG developed the neighbourhood SES index. All authors edited and contributed to the final version of the manuscript and gave final approval to the submitted version. All authors will participate in the interpretation of findings and the drafting of manuscripts.

  • Funding This work was supported by an operating grant from the Canadian Institutes of Health Research, grant number 142416. Dr MJ is supported by the Ontario Chair in Early Childhood Development. Dr TB is supported by a Hamilton Health Sciences Early Career Award. Dr MAF is supported by the Canada Research Chair in Youth Mental Health.

  • Competing interests None declared.

  • Patient consent Not requried.

  • Ethics approval CCHICS has been approved by the Hamilton Integrated Research Ethics Board and the University of Manitoba Health Research Ethics Board.

  • Provenance and peer review Not commissioned; peer reviewed.

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