News at Medicine - June 2010 - Getting it right at 18 months

Getting it right at 18 months
June 9, 2010
A new initiative in Ontario will provide funding for family physicians to conduct an enhanced 18-month well-baby visit. One of the tools doctors will use for this visit is the Rourke Baby Record (Ontario version), developed by Drs. Leslie and James Rourke, both now at Memorial’s Faculty of Medicine.
We developed this baby record in 1979 when we first started our medical practice in Goderich, Ontario,” explained Dr. Leslie Rourke, an associate professor in the Disciple of Family Medicine. Her husband, Dr. James Rourke, is dean of medicine. The Rourke Baby Record was first published in 1985 and the most recent edition was completed in 2009 by Drs. L and J Rourke and co-author Dr. Denis Leduc, an associate professor of pediatrics at McGill University and a past president of the Canadian Pediatric Society.

Dr. Leslie Rourke said the Rourke Baby Record is a practical health supervision tool for health care practitioners of children from birth to five years of age. “It is evidence-based and includes structured forms for well baby and child visits, growth charts, an immunization chart and selected guidelines and resources.”

In Ontario, the enhanced 18-month well-baby visit builds on the current 18-month check-up. The Ministry of Children and Youth Services describes this initiative as introducing a process which uses standardized tools to allow physicians to have a discussion with parents on child development and parenting, to identify those children who will require referral to specialized services and to inform parents about the local community programs that promote healthy child development and early learning.

Dr. Rourke said 18 months is an important time to assess a child’s development. “It is an optimal time to assess development in speech and language as well as for consideration of autism spectrum disorder. It’s late enough to detect problems in the child’s development but early enough to do something about it.”

Eighteen months is also an important time because it is the age of the last scheduled immunization before the pre-school vaccines, and thus some children are not seen again until almost five years of age.

Would an initiative like Ontario’s be valuable to the people of Newfoundland and Labrador? "Absolutely,” said Dr. Rourke. “It is time to look into this and to involve several groups locally such as pediatricians, public health professionals and the provincial government.”

Since coming to Memorial in 2004, Dr. Leslie Rourke has continued work on the Rourke Baby Record.  Related projects have included validation research on the tool with support from the province of Ontario, Ontario College of Family Physicians, and MUN's Primary Healthcare Research Unit (PHRU).  She has also developed a website with the help of staff in the Faculty of Medicine's Professional Development and Conferencing Services, assisted by a Dr. Wallace Ingram Award for new faculty from the MUN Medical Graduates’ Society. The website address is