Caregiver Perspectives on the Outcomes of a Multidisciplinary Developmental Assessment Service for Rural and Remote Children With Complex Needs and Adverse Childhood Experiences: A Mixed-Methods Study.

INTRODUCTION: This study describes the psychosocial complexity of rural and remote children and families who accessed a multidisciplinary developmental assessment service in New South Wales, Australia, as well as caregiver perspectives regarding service impact and outcome. METHODS: This parallel convergent mixed-methods study involved thematic analysis of semi-structured interviews (n = 8) and descriptive analysis of cross-sectional survey responses (n = 154) with caregivers of children involved in a multidisciplinary pediatric developmental assessment service for rural and remote Australian children. RESULTS: Survey respondents reported high rates of Adverse Childhood Experiences (ACEs) and related life events, including caregiver mental health issues (61%) and children's experiences of community violence (35%) and discrimination (31%). Interviewees highlighted the importance of diagnosis for understanding their child's behavior. DISCUSSION: Rural and remote children in Australia experience alarming rates of ACEs, financial and other psychosocial stresses. Responsive, family-centered, multidisciplinary diagnostic services are perceived by caregivers as impactful.