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Marks KP, Madsen Sjö N, Wilson P. Comparative use of the Ages and Stages Questionnaires in the USA and Scandinavia: a systematic review. Dev Med Child Neurol 2019; 61:419-430. [PMID: 30246256 DOI: 10.1111/dmcn.14044] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2018] [Indexed: 11/30/2022]
Abstract
AIM The aim of this systematic review was to investigate screening practices with the Ages and Stages Questionnaires (ASQ) and the Ages and Stages Questionnaires: Social-Emotional (ASQ:SE) in the USA and Scandinavia and to identify practical lessons and research opportunities. METHOD The review was performed for ASQ- and ASQ:SE-related studies in children from birth to 5 years. From nine databases and 1689 references (published from 1988-2018), 127 articles were included and categorized using Covidence online software. The Critical Appraisal Skills Programme Checklists were used before data synthesis. RESULTS US studies primarily use the ASQ/ASQ:SE to detect delays in general and at-risk populations in medical settings, which increases early detection, clinician-referral, and intervention rates. Scandinavian studies commonly use the ASQ/ASQ:SE to monitor developmental-behavioural differences in intervention/exposure-based cohorts. Pre-visit screening yields completion/return rates of 83% to more than 90% and fosters same-day interpretation. When referrals are indicated, systemwide care coordination or colocation with a developmental-behavioural specialist is beneficial. INTERPRETATION Practical implementation lessons are reviewed. Research opportunities include investigating and measuring the ASQ/ASQ:SE's 'overall' sections. Danish, Norwegian, and Swedish translations are available but up-to-date norming and validation studies are needed throughout Scandinavia. Randomized controlled trials are needed to investigate outcomes in screened versus unscreened cohorts. WHAT THIS PAPER ADDS General and at-risk populations broadly benefited from periodic Ages and Stages Questionnaires (ASQ) and/or Ages and Stages Questionnaires: Social-Emotional (ASQ:SE) screening. Pre-visit ASQ and/or ASQ:SE screenining implementation systems work best. The ASQ and ASQ:SE 'overall' sections are not quantifiable and under-researched.
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Affiliation(s)
- Kevin P Marks
- Department of Pediatrics, PeaceHealth Medical Group, Eugene, OR, USA
| | - Nina Madsen Sjö
- National Research Centre for Disadvantaged Children and Youth, University College Copenhagen, Copenhagen, Denmark
| | - Philip Wilson
- Centre for Research and Education in General Practice, University of Copenhagen, Copenhagen, Denmark.,Centre for Rural Health, University of Aberdeen, Aberdeen, UK
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Madigan S, Browne D, Racine N, Mori C, Tough S. Association Between Screen Time and Children's Performance on a Developmental Screening Test. JAMA Pediatr 2019; 173:244-250. [PMID: 30688984 PMCID: PMC6439882 DOI: 10.1001/jamapediatrics.2018.5056] [Citation(s) in RCA: 216] [Impact Index Per Article: 43.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
IMPORTANCE Excessive screen time is associated with delays in development; however, it is unclear if greater screen time predicts lower performance scores on developmental screening tests or if children with poor developmental performance receive added screen time as a way to modulate challenging behavior. OBJECTIVE To assess the directional association between screen time and child development in a population of mothers and children. DESIGN, SETTING, AND PARTICIPANTS This longitudinal cohort study used a 3-wave, cross-lagged panel model in 2441 mothers and children in Calgary, Alberta, Canada, drawn from the All Our Families study. Data were available when children were aged 24, 36, and 60 months. Data were collected between October 20, 2011, and October 6, 2016. Statistical analyses were conducted from July 31 to November 15, 2018. EXPOSURES Media. MAIN OUTCOMES AND MEASURES At age 24, 36, and 60 months, children's screen-time behavior (total hours per week) and developmental outcomes (Ages and Stages Questionnaire, Third Edition) were assessed via maternal report. RESULTS Of the 2441 children included in the analysis, 1227 (50.2%) were boys. A random-intercepts, cross-lagged panel model revealed that higher levels of screen time at 24 and 36 months were significantly associated with poorer performance on developmental screening tests at 36 months (β, -0.06; 95% CI, -0.10 to -0.01) and 60 months (β, -0.08; 95% CI, -0.13 to -0.02), respectively. These within-person (time-varying) associations statistically controlled for between-person (stable) differences. CONCLUSIONS AND RELEVANCE The results of this study support the directional association between screen time and child development. Recommendations include encouraging family media plans, as well as managing screen time, to offset the potential consequences of excess use.
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Affiliation(s)
- Sheri Madigan
- Department of Psychology, University of Calgary,
Calgary, Alberta, Canada,Department of Paediatrics, Alberta Children’s
Hospital Research Institute, Calgary, Alberta, Canada
| | - Dillon Browne
- Department of Psychology, University of Waterloo,
Waterloo, Ontario, Canada
| | - Nicole Racine
- Department of Psychology, University of Calgary,
Calgary, Alberta, Canada,Department of Paediatrics, Alberta Children’s
Hospital Research Institute, Calgary, Alberta, Canada
| | - Camille Mori
- Department of Psychology, University of Calgary,
Calgary, Alberta, Canada,Department of Paediatrics, Alberta Children’s
Hospital Research Institute, Calgary, Alberta, Canada
| | - Suzanne Tough
- Department of Paediatrics, Alberta Children’s
Hospital Research Institute, Calgary, Alberta, Canada
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Plomgaard AM, Alderliesten T, van Bel F, Benders M, Claris O, Cordeiro M, Dempsey E, Fumagalli M, Gluud C, Hyttel-Sorensen S, Lemmers P, Pellicer A, Pichler G, Greisen G. No neurodevelopmental benefit of cerebral oximetry in the first randomised trial (SafeBoosC II) in preterm infants during the first days of life. Acta Paediatr 2019; 108:275-281. [PMID: 29908039 PMCID: PMC6585779 DOI: 10.1111/apa.14463] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/20/2018] [Accepted: 06/13/2018] [Indexed: 11/30/2022]
Abstract
AIM Cerebral hypoxia has been associated with neurodevelopmental impairment. We studied whether reducing cerebral hypoxia in extremely preterm infants during the first 72 hours of life affected neurological outcomes at two years of corrected age. METHODS In 2012-2013, the phase II randomised Safeguarding the Brains of our smallest Children trial compared visible cerebral near-infrared spectroscopy (NIRS) monitoring in an intervention group and blinded NIRS monitoring in a control group. Cerebral hypoxia was significantly reduced in the intervention group. We followed up 115 survivors from eight European centres at two years of corrected age, by conducting a medical examination and assessing their neurodevelopment with the Bayley Scales of Infant and Toddler Development, Second or Third Edition, and the parental Ages and Stages Questionnaire (ASQ). RESULTS There were no differences between the intervention (n = 65) and control (n = 50) groups with regard to the mean mental developmental index (89.6 ± 19.5 versus 88.4 ± 14.7, p = 0.77), ASQ score (215 ± 58 versus 213 ± 58, p = 0.88) and the number of children with moderate-to-severe neurodevelopmental impairment (10 versus six, p = 0.58). CONCLUSION Cerebral NIRS monitoring was not associated with long-term benefits or harm with regard to neurodevelopmental outcome at two years of corrected age.
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Affiliation(s)
- Anne M. Plomgaard
- Department of Neonatology; Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
| | - Thomas Alderliesten
- Wilhelmina Children's Hospital; University Medical Center Utrecht; Utrecht The Netherlands
| | - Frank van Bel
- Wilhelmina Children's Hospital; University Medical Center Utrecht; Utrecht The Netherlands
| | - Manon Benders
- Wilhelmina Children's Hospital; University Medical Center Utrecht; Utrecht The Netherlands
| | - Olivier Claris
- Department of Neonatology; Hospices Civils de Lyon; Claude Bernard University; Lyon France
| | - Malaika Cordeiro
- Department of Neonatology; La Paz University Hospital; Madrid Spain
| | | | - Monica Fumagalli
- NICU; Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico; Università degli Studi di Milano; Milan Italy
| | - Christian Gluud
- Copenhagen Trial Unit; Centre for Clinical Intervention Research; Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
| | - Simon Hyttel-Sorensen
- Department of Neonatology; Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
| | - Petra Lemmers
- Wilhelmina Children's Hospital; University Medical Center Utrecht; Utrecht The Netherlands
| | - Adelina Pellicer
- Department of Neonatology; La Paz University Hospital; Madrid Spain
| | - Gerhard Pichler
- Department of Pediatrics; Research Unit for Neonatal Micro- and Macrocirculation; Medical University of Graz; Graz Austria
| | - Gorm Greisen
- Department of Neonatology; Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
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Ramdin T, Ballot D, Rakotsoane D, Madzudzo L, Brown N, Chirwa T, Cooper P, Davies V. Neurodevelopmental outcome of late preterm infants in Johannesburg, South Africa. BMC Pediatr 2018; 18:326. [PMID: 30322374 PMCID: PMC6190537 DOI: 10.1186/s12887-018-1296-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 10/01/2018] [Indexed: 11/29/2022] Open
Abstract
Background Late preterm infants, previously considered low risk, have been identified to be at risk of developmental problems in infancy and early childhood. There is limited information on the outcome of these infants in low and middle income countries. Methods Bayley scales of infant and toddler development, version III, were done on a group of late preterm infants in Johannesburg, South Africa. The mean composite cognitive, language and motor sub-scales were compared to those obtained from a group of typically developed control infants. Infants were considered to be “at risk” if the composite subscale score was below 85 and “disabled” if the composite subscale score was below 70. Infants identified with cerebral palsy were also reported. Results 56 of 73 (76.7%) late preterm infants enrolled in the study had at least one Bayley assessment at a mean age of 16.5 months (95% CI 15.2–17.6). The mean birth weight was 1.9 kg (95%CI 1.8–2.0) and mean gestational age 33.0 weeks (95% CI 32.56–33.51). There was no difference in the mean cognitive subscales between late preterm infants and controls (95.4 9, 95% CI 91.2–99.5 vs 91.9.95% CI 87.7–96.0). There was similarly no difference in mean language subscales (94.5, 95% CI 91.3–97.7 vs 95.9, 95% CI 92.9–99.0) or motor subscales (96.2, 95% CI 91.8–100.7 vs 97.6, 95% CI 94.7–100.5). There were four late preterm infants who were classified as disabled, two of whom had cerebral palsy. None of the control group was disabled. Conclusions This study demonstrates that overall developmental outcome, as assessed by the Bayley scales of infant and toddler development, was not different between late preterm infants and a group of normal controls. However, 7.1% of the late preterm infants, had evidence of developmental disability. Thus late preterm infants in low and middle income countries require long term follow up to monitor developmental outcome. In a resource limited setting, this may best be achieved by including a parental screening questionnaire, such as the Ages and Stages Questionnaire, in the routine well baby clinic visits.
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Affiliation(s)
- Tanusha Ramdin
- Neonatal Unit, Department of Paediatrics and Child Health, Charlotte Maxeke Johannesburg Academic Hospital, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Daynia Ballot
- Neonatal Unit, Department of Paediatrics and Child Health, Charlotte Maxeke Johannesburg Academic Hospital, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.
| | - David Rakotsoane
- Neonatal Unit, Department of Paediatrics and Child Health, Charlotte Maxeke Johannesburg Academic Hospital, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Lethile Madzudzo
- Neonatal Unit, Department of Paediatrics and Child Health, Charlotte Maxeke Johannesburg Academic Hospital, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicolette Brown
- Neonatal Unit, Department of Paediatrics and Child Health, Charlotte Maxeke Johannesburg Academic Hospital, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Tobias Chirwa
- Department of Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Peter Cooper
- Neonatal Unit, Department of Paediatrics and Child Health, Charlotte Maxeke Johannesburg Academic Hospital, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Victor Davies
- Neonatal Unit, Department of Paediatrics and Child Health, Charlotte Maxeke Johannesburg Academic Hospital, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
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Zhang Z, Tran NT, Nguyen TS, Nguyen LT, Berde Y, Tey SL, Low YL, Huynh DTT. Impact of maternal nutritional supplementation in conjunction with a breastfeeding support program during the last trimester to 12 weeks postpartum on breastfeeding practices and child development at 30 months old. PLoS One 2018; 13:e0200519. [PMID: 30011318 PMCID: PMC6047798 DOI: 10.1371/journal.pone.0200519] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 06/25/2018] [Indexed: 01/09/2023] Open
Abstract
Background Maternal nutrition during pregnancy and breastfeeding is important for the healthy growth and development of the fetus and infant. Purpose This study aimed to evaluate the long-term effects of a maternal milk supplementation (MMS) in conjunction with a breastfeeding support program on breastfeeding practices including duration of any breastfeeding and exclusive breastfeeding and child neurodevelopment outcomes at 30 months old. Methods We followed up the offspring of 204 Vietnamese women who completed a randomized controlled trial where the intervention group received MMS with a breastfeeding support program from the last trimester to 12 weeks postpartum while the control group received standard care. At 30 months postpartum, information on child feeding practices was collected and child neurodevelopment was assessed by the Bayley Scales of Infant and Toddler Development (Bayley-III). Results There was no significant difference in the duration of any breastfeeding (ABF) from birth between the groups. However, the intervention group had longer exclusive breastfeeding (EBF) duration (p = 0.0172), higher EBF rate at 6 months (p = 0.0093) and lower risk of discontinuing EBF (p = 0.0071) than the control. Children in the intervention group had significantly higher Bayley-III composite scores in the domains of cognitive (p = 0.0498) and motor (p = 0.0422) functions, as well as a tendency toward better social-emotional behavior (p = 0.0513) than children in the control group. The association between maternal intervention and child development was attenuated after further adjustment for birth weight but not EBF duration, suggesting that improvements in child development may be partially attributed to the benefits of prenatal nutrition supplementation on birth outcomes. Conclusions MMS with breastfeeding support during late pregnancy and early postpartum significantly improved EBF practices. The intervention was also associated with improvements in neurodevelopment in children at 30 months old.
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Affiliation(s)
- Zhiying Zhang
- Abbott Nutrition Research and Development Asia-Pacific Center, Singapore
| | - Nga T. Tran
- National Institute of Nutrition, Ha Noi, Vietnam
| | - Tu S. Nguyen
- National Institute of Nutrition, Ha Noi, Vietnam
| | | | - Yatin Berde
- Statistical Services, Cognizant Technologies Solution Pvt. Ltd., Airoli, Navi Mumbai, India
| | - Siew Ling Tey
- Abbott Nutrition Research and Development Asia-Pacific Center, Singapore
| | - Yen Ling Low
- Abbott Nutrition Research and Development Asia-Pacific Center, Singapore
| | - Dieu T. T. Huynh
- Abbott Nutrition Research and Development Asia-Pacific Center, Singapore
- * E-mail:
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Bell GA, Sundaram R, Mumford SL, Park H, Mills J, Bell EM, Broadney M, Yeung EH. Maternal polycystic ovarian syndrome and early offspring development. Hum Reprod 2018; 33:1307-1315. [PMID: 29668891 PMCID: PMC6251548 DOI: 10.1093/humrep/dey087] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 03/12/2018] [Accepted: 03/26/2018] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Is maternal polycystic ovarian syndrome (PCOS) associated with developmental delays in offspring? SUMMARY ANSWER Offspring of mothers with PCOS were at higher risk of failure on the Ages and Stages Questionnaire (ASQ). WHAT IS KNOWN ALREADY There is growing evidence that offspring of mothers with PCOS may be at higher risk for developmental disorders due to potential exposure to hyperandrogenism and insulin resistance. Few studies exist regarding maternal PCOS and early childhood development in the USA. STUDY DESIGN, SIZE, DURATION The Upstate KIDS Study is a population-based prospective cohort study of infants born between 2008 and 2010 in New York State (excluding New York City), originally designed to study-and finding no impact of-infertility treatment exposure on child development. Children were followed up to 36 months of age. In all, 4453 mothers completed one or more developmental screening instruments for 5388 children (35.5% twins) up to 36 months of age. PARTICIPANTS/MATERIALS, SETTING, METHODS In our study, 458 mothers (10.3%) reported a healthcare provider's diagnosis of PCOS, as well as the related treatment received, on the baseline study questionnaire. Parents completed the ASQ on their child's development at 4, 8, 12, 18, 24, 30 and 36 months of age to assess fine motor, gross motor, communication, personal-social functioning and problem-solving cognitive domains. We used generalized linear mixed models to estimate odds ratios (OR) between PCOS diagnosis and failures in the ASQ adjusted for maternal age, race, BMI, education, marital status, smoking, alcohol consumption, diabetes, insurance and plurality. MAIN RESULTS AND THE ROLE OF CHANCE Diagnosis of PCOS was associated with increased risk of the offspring failing the fine motor domain (adjusted odds ratio (aOR) = 1.77; 95% CI: 1.09, 2.89), largely driven by higher risk in female singletons (aOR = 2.23; 1.16, 4.29). Twins of mothers with PCOS had higher risk of failing the communication (aOR = 1.94; 1.19, 3.18) and personal-social functioning (aOR = 1.76; 1.12, 2.77) domains compared to twins born to mothers without PCOS. Compared to offspring of women without PCOS, offspring of women who reported receiving no treatment for their PCOS had a stronger association with failing the ASQ (aOR = 1.68; 0.95, 2.75) than the association among offspring of women who reported PCOS treatment (aOR = 1.16; 0.79, 1.73). LIMITATIONS, REASONS FOR CAUTION Further study is needed to confirm the role of maternal PCOS in early offspring development with provider-validated diagnosis of PCOS. WIDER IMPLICATIONS OF THE FINDINGS If confirmed, these findings suggest that offspring of women with PCOS may be at increased risk for developmental delay. STUDY FUNDING/COMPETING INTEREST(S) Supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD; contracts HHSN275201200005C, #HHSN267200700019C). Authors have no competing interests to declare. TRIAL REGISTRATION NUMBER Not applicable.
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Affiliation(s)
- Griffith A Bell
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Drive, Bethesda, MD, USA
| | - Rajeshwari Sundaram
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Drive, Bethesda, MD, USA
| | - Sunni L Mumford
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Drive, Bethesda, MD, USA
| | - Hyojun Park
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Drive, Bethesda, MD, USA
| | - James Mills
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Drive, Bethesda, MD, USA
| | - Erin M Bell
- Department of Environmental Health Services, University at Albany, State University of New York, 1 University Place, Rensselaer, NY, USA
| | - Miranda Broadney
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Drive, Bethesda, MD, USA
| | - Edwina H Yeung
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6710B Rockledge Drive, Bethesda, MD, USA
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Sajedi F, Habibi E, Hatamizadeh N, Shahshahanipour S, Malek Afzali H. Early storybook reading and childhood development: A cross-sectional study in Iran. F1000Res 2018; 7:411. [PMID: 30135726 PMCID: PMC6092897 DOI: 10.12688/f1000research.14078.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/20/2018] [Indexed: 11/20/2022] Open
Abstract
Background: Development is a process that continues from childhood to death, and most developmental changes occur during childhood. UNICEF introduced early storybook-reading (ESR) and storytelling as part of child care indicators. The aim of this study was to investigate the status of book-reading to children and its relationship with early childhood development in Iran. Methods: This is a descriptive-analytic study conducted in Tehran April-May 2017. In total, 272 mothers of children aged 3-30 months, who were referred to health centers, were selected using a convenience sampling method. Exclusion criteria was scoring below the cutoff point of any developmental domains of the Ages and Stages Questionnaire (ASQ). ESR was assessed by checklist and child development was assessed by the ASQ. Data were analyzed using SPSS. Results: The mean number of children's books owned was 10.23±8.642, and 84.75% had at least 3 books. The average book reading, storytelling and singing duration for children was 10±9.65, 11.48±11.756, and 23.88 ±17.880 min per day, respectively. Average book reading, storytelling, and singing duration was significantly greater in children 18-30 months than <17 months. There was a significant relationship between the number of books and a child's age, mother's age, family income, income satisfaction, father's employment, and parents' education. The score of communication domain in the ASQ questionnaire was significantly related to the number of books, duration of reading and storytelling, while problem-solving had a significant relationship only with the number of books (p˂0.05). Based on linear regression, child's age, income, and mother's and father's educational level were models for predicting the number of children's books (p=0.0001 for all). Conclusions: ESR was associated with some developmental domains of communication and problem-solving in the present study. Therefore, creation of ESR culture in Iranian families as an integral part of the life of children is necessary from birth.
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Affiliation(s)
- Firoozeh Sajedi
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- International Child Neurology Association, Cape Town, South Africa
| | - Elham Habibi
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Nikta Hatamizadeh
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Soheila Shahshahanipour
- Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hosein Malek Afzali
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Murray E, Fernandes M, Newton CRJ, Abubakar A, Kennedy SH, Villar J, Stein A. Evaluation of the INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA) in 2 year-old children. PLoS One 2018; 13:e0193406. [PMID: 29489865 PMCID: PMC5831101 DOI: 10.1371/journal.pone.0193406] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Accepted: 02/09/2018] [Indexed: 01/18/2023] Open
Abstract
Background The INTER-NDA is a novel assessment of early child development measuring cognition, language, motor skills, behaviour, attention, and socio-emotional reactivity in 2 year olds in 15 minutes. Here, we present the results of an evaluation of the INTER-NDA against the Bayley Scales of Infant Development III edition (BSID-III), its sensitivity and specificity and its psychometric properties. Methods Eighty-one infants from Oxford, UK, aged 23.1–28.3 months, were evaluated using the INTER-NDA and the BSID-III. The agreement between the INTER-NDA and the BSID-III was assessed using interclass correlations (for absolute agreement), Bland-Altman analyses (for bias and limits of agreement), and sensitivity and specificity analyses (for accuracy). The internal consistency of the INTER-NDA and uni-dimensionality of its subscales were also determined. Results The interclass correlation coefficients between the BSID-III and the INTER-NDA cognitive, motor and behaviour scores ranged between 0.745 and 0.883 (p<0.001). The Bland-Altman analysis showed little to no bias in the aforementioned subscales. The sensitivity and specificity of INTER-NDA cognitive scores ≤1 SD below the mean are 66.7% and 98.6% respectively, with moderate agreement between INTER-NDA and BSID-III classifications (κ = 0.72, p<0.001). The sensitivity and specificity of INTER-NDA scores <2 SD below the mean, in predicting low BSID-III scores (<70), are 100% each for cognition, and 25% and 100% respectively for language. More than 97% of children who scored in the normal range of the INTER-NDA (<1SD below mean) also scored in the normal range in the BSID-III (≥85). The INTER-NDA demonstrates satisfactory internal consistency and its subscales demonstrate good unidimensionality. Conclusion The INTER-NDA shows good agreement with the BSID-III, and demonstrates satisfactory psychometric properties, for the assessment of ECD at 22–28 months.
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Affiliation(s)
- Elizabeth Murray
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
| | - Michelle Fernandes
- Nuffield Department of Obstetrics & Gynaecology, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
- Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom
- Department of Paediatrics, Southampton General Hospital, University of Southampton, Southampton, United Kingdom
- * E-mail:
| | - Charles R. J. Newton
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
| | - Amina Abubakar
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
- Department of Psychology, Lancaster University, Lancaster, United Kingdom
| | - Stephen H. Kennedy
- Nuffield Department of Obstetrics & Gynaecology, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
- Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom
| | - Jose Villar
- Nuffield Department of Obstetrics & Gynaecology, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
- Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom
| | - Alan Stein
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, United Kingdom
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Shapiro EG, Escolar ML, Delaney KA, Mitchell JJ. Assessments of neurocognitive and behavioral function in the mucopolysaccharidoses. Mol Genet Metab 2017; 122S:8-16. [PMID: 29128371 DOI: 10.1016/j.ymgme.2017.09.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/12/2017] [Accepted: 09/13/2017] [Indexed: 12/25/2022]
Abstract
The mucopolysaccharidoses (MPS) are a group of rare, inherited lysosomal storage disorders in which accumulation of glycosaminoglycans (GAGs) leads to progressive tissue and organ dysfunction. In addition to a variety of somatic signs and symptoms, patients with rapidly progressing MPS I (Hurler), II, III, and VII can present with significant neurological manifestations, including impaired cognitive abilities, difficulties in language and speech, behavioral abnormalities, sleep problems, and/or seizures. Neurological symptoms have a substantial impact on the quality of life of MPS patients and their families. Due to the progressive nature of cognitive impairment in these MPS patients, neurocognitive function is a sensitive indicator of disease progression, and a relevant outcome when testing efficacy of therapies for these disorders. In order to effectively manage and develop therapies that address neurological manifestations of MPS, it is important to use appropriate neurocognitive assessment tools that are sensitive to changes in neurocognitive function in MPS patients. This review discusses expert opinions on key issues and considerations for effective neurocognitive testing in MPS patients. In addition, it describes the neurocognitive assessment tools that have been used in clinical practice for these patients. The content of this review is based on existing literature and information from a meeting of international experts with extensive experience in managing and treating MPS disorders.
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Affiliation(s)
- Elsa G Shapiro
- Shapiro Neuropsychology Consultants, LLC, Portland, OR, USA; Department of Pediatrics and Neurology, University of Minnesota, Minneapolis, MN, USA.
| | - Maria L Escolar
- Department of Pediatric Neurodevelopment, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - John J Mitchell
- Departments of Endocrinology and Metabolism & Medical Genetics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada
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Ghassabian A, Sundaram R, Chahal N, McLain AC, Bell E, Lawrence DA, Yeung EH. Determinants of neonatal brain-derived neurotrophic factor and association with child development. Dev Psychopathol 2017; 29:1499-1511. [PMID: 28462726 PMCID: PMC6201316 DOI: 10.1017/s0954579417000414] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Using a population-based birth cohort in upstate New York (2008-2010), we examined the determinants of brain-derived neurotrophic factor (BDNF) measured in newborn dried blood spots (n = 2,637). We also examined the association between neonatal BDNF and children's development. The cohort was initially designed to examine the influence of infertility treatment on child development but found no impact. Mothers rated children's development in five domains repeatedly through age 3 years. Socioeconomic and maternal lifestyle determinants of BDNF were examined using multivariable linear regression models. Generalized linear mixed models estimated odds ratios for neonatal BDNF in relation to failing a developmental domain. Smoking and drinking in pregnancy, nulliparity, non-White ethnicity/race, and prepregnancy obesity were associated with lower neonatal BDNF. Neonatal BDNF was not associated with failure for developmental domains; however, there was an interaction between BDNF and preterm birth. In preterm infants, a higher BDNF was associated with lower odds of failing any developmental domains, after adjusting for confounders and infertility treatment. This result was particularly significant for failure in communication. Our findings suggest that BDNF levels in neonates may be impacted by maternal lifestyle characteristics. More specifically, lower neonatal BDNF might be an early marker of aberrant neurodevelopment in preterm infants.
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Abstract
OBJECTIVE Standardised developmental screening tools are important for the evaluation and management of developmental disorders in children with CHD; however, psychometric properties and clinical utility of screening tools, such as the Ages & Stages Questionnaires, Third Edition (ASQ-3), have not been examined in the CHD population. We hypothesised that the ASQ-3 would be clinically useful for this population. Study design ASQ-3 developmental classifications for 163 children with CHD at 6, 12, 24, and/or 36 months of age were compared with those obtained from concurrent developmental testing with the Bayley Scales of Infant and Toddler Development, Third Edition. RESULTS When ASQ-3 screening failure was defined as ⩾1 SD below the normative mean, specificity (⩾81.9%) and negative predictive value (⩾81.0%) were high across ASQ-3 areas. Sensitivity was high for gross motor skills (79.6%), increased with age for communication (35.7-100%), and generally decreased with age for problem solving (73.1-50.0%). When ASQ-3 screening failure was defined as ⩾2 SD below the normative mean, specificity (⩾93.6%) and positive predictive value (⩾74.5%) were generally high across ASQ-3 areas, but sensitivity was low (31.1%) to fair (62.8%). The ASQ-3 showed improved accuracy in predicting delays over clinical risk factors alone. CONCLUSIONS The ASQ-3 appears to be a clinically useful tool for screening development in children with CHD, although its utility varied on the basis of developmental area and time point. Clinicians are encouraged to refer children scoring ⩾1 SD below the normative mean on any ASQ-3 area for formal developmental evaluation.
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Developmental Assessments during Injury Research: Is Enrollment of Very Young Children in Crèches Associated with Better Scores? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101130. [PMID: 28954441 PMCID: PMC5664631 DOI: 10.3390/ijerph14101130] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 09/18/2017] [Accepted: 09/18/2017] [Indexed: 12/02/2022]
Abstract
The Developmental Study is part of a larger intervention on “saving of lives from drowning (SoLiD)” where children were enrolled either into crèches (daycare centers) or playpens to prevent drowning in rural Bangladesh. Sampling ~1000 children between the ages of 9–17 months, we compared problem-solving, communication, motor and personal-social outcomes assessed by the Ages and Stages Questionnaire in the two interventions. After controlling for variables such as home stimulation in multivariate regressions, children in crèches performed about a quarter of a standard deviation better in total scores (p < 0.10) and 0.45 standard deviations higher in fine motor skills (p < 0.05). Moreover, once the sample was stratified by length of exposure to the intervention, then children in crèches performed significantly better in a number of domains: those enrolled the longest (about 5 months) have higher fine motor (1.47, p < 0.01), gross motor (0.40, p < 0.05) and personal-social skills (0.95, p < 0.01) than children in playpens. In addition, children in crèches with the longer exposure (about 5 months) have significantly higher personal-social and problem-solving scores than those in crèches with minimum exposure. Enrollment in crèches of very young children may be positively associated with psychosocial scores after accounting for important confounding variables.
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Chong KC, Zhou VL, Tarazona D, Tuesta H, Velásquez-Hurtado JE, Sadeghi R, Llanos F. ASQ-3 scores are sensitive to small differences in age in a Peruvian infant population. Child Care Health Dev 2017; 43:556-565. [PMID: 28480511 DOI: 10.1111/cch.12469] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 04/01/2017] [Accepted: 04/03/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The Ages and Stages Questionnaires Edition 3 (ASQ-3) are a well-validated international screen for developmental delays in young children. However, previous studies demonstrate variable scores between children eligible to take the same ASQ-3 interval. This study aimed to determine a relationship between age and ASQ-3 score for each screening interval. METHODS This was a baseline exploratory cross-sectional study of infants under 2 years old evaluated for the Peruvian social programme Cuna Más. Participants were included in Cuna Más if they lived in districts with fewer than 2000 inhabitants or 400 homes, indicating a predominantly rural population. The appropriate ASQ-3 screening interval was administered to each subject. Subjects were divided into four 2-week chronological subgroups based on age within each 2-month screening window and aggregated across all 12 screening intervals. Fisher's exact test, analysis of variance and Bonferonni post hoc test were used to compare differences between age subgroups. Linear regression was performed to assess the relationship between ASQ-3 score and both aggregated and disaggregated age subgroup. RESULTS A total of 5850 Peruvian infants were evaluated in 2013. Mean age was 13 ± 6.6 months, 50.7% were male and mean maternal education was 6.6 ± 4.0 years; 34.8% infants were stunted, 7.8% were underweight, 0.9% were wasted and 2% had age adjusted greater than 35 days for prematurity for ASQ-3 interval assignment. Mean total ASQ-3 was 42.2 ± 8.2. The ASQ-3 allocated 49.6% with suspected delay in one or more developmental areas. Before and after adjusting for wealth quintile, maternal education level, infant nutritional status and prematurity adjustment, age subgroup remained significantly associated with total ASQ-3 score (β = 1.8, CI: 1.7-2.0, P < 0.001), sectional ASQ-3 score (all P < 0.001) and inversely associated with one or more scores indicating suspected developmental delay (P < 0.001). CONCLUSIONS The ASQ-3 may underestimate the sensitivity of child development to small differences in age in this population.
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Affiliation(s)
- K C Chong
- School of Medicine, University of Rochester, Rochester, NY, USA
| | - V L Zhou
- School of Medicine, University of Rochester, Rochester, NY, USA
| | - D Tarazona
- Ministry of Development and Social Inclusion, Lima, Peru
| | - H Tuesta
- Ministry of Development and Social Inclusion, Lima, Peru
| | - J E Velásquez-Hurtado
- Ministry of Development and Social Inclusion, Lima, Peru.,School of Medicine, School of Public Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - R Sadeghi
- Department of Emergency Medicine, University of Rochester, Rochester, NY, USA
| | - F Llanos
- Ministry of Development and Social Inclusion, Lima, Peru.,School of Medicine, School of Public Health, Universidad Peruana Cayetano Heredia, Lima, Peru
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Comparison of Development Indicators, According to Ages and Stages Questionnaires in Children with Pollakiuria Compared to Healthy Children. Nephrourol Mon 2017. [DOI: 10.5812/numonthly.45898] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Prenatal fish oil supplementation and early childhood development in the Upstate KIDS Study. J Dev Orig Health Dis 2017; 8:465-473. [PMID: 28434427 DOI: 10.1017/s2040174417000253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Fish oil contains omega-3 fatty acids, which play a vital role in fetal growth and development. In utero exposure to omega-3 fatty acids is exclusively dependent on maternal nutrition. Previous studies have suggested that prenatal fish oil supplementation has positive impacts on child neurodevelopment later in life. This study examines the associations between fish oil supplementation both before pregnancy and throughout pregnancy and subsequent child development. Mother-child pairs from the Upstate KIDS Study, a birth cohort consisting of children born between 2008 and 2010, were included. Self-reported prenatal fish oil supplementation data were available for 5845 children (3807 singletons and 2038 twins). At multiple time points, from 4 months to 3 years of age, child development was reported by the parents on the Ages and Stages Questionnaire (ASQ). Five developmental domains were assessed: fine motor, gross motor, communication, personal-social functioning and problem solving. Generalized linear mixed models were used to estimate odds ratios (OR) while adjusting for covariates. Primary analyses showed that the risk of failing the ASQ problem-solving domain was significantly lower among children of women who took fish oil before pregnancy (OR 0.40, 95% confidence intervals (CI) 0.18-0.89) and during pregnancy (OR 0.43, 95% CI 0.22-0.83). Gender interaction was not statistically significant, although stratified results indicated stronger associations among girls. Similarly, associations were primarily among singletons. Prenatal fish oil supplementation may be beneficial in regards to neurodevelopment. Specifically, it is associated with a lower risk of failing the problem-solving domain up to 3 years of age.
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Charkaluk ML, Rousseau J, Calderon J, Bernard JY, Forhan A, Heude B, Kaminski M. Ages and Stages Questionnaire at 3 Years for Predicting IQ at 5-6 Years. Pediatrics 2017; 139:peds.2016-2798. [PMID: 28360034 DOI: 10.1542/peds.2016-2798] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To assess the predictive value of the 36-month Ages & Stages Questionnaire (ASQ) score for IQ score at age 5 to 6 years in the general population and to identify factors associated with IQ <85 once the ASQ score is taken into account. METHODS Data were collected from 939 children enrolled in a population-based prospective cohort study. Developmental outcomes at 36 months were assessed via the ASQ and at 5 to 6 years via the Wechsler Preschool and Primary Scale of Intelligence. The ASQ threshold was identified via the receiver operating characteristic curve. Additional predictive factors to obtain an IQ <85 were investigated, and their interaction with ASQ score was studied. RESULTS Sixty-nine children (7.3%) had an IQ <85. A 36-month ASQ score threshold of 270 was optimal to identify children with an IQ <85 at 5 to 6 years, with a 0.77 ± 0.11 sensitivity and 0.68 ± 0.03 specificity. Maternal educational level and occupational activity at the time of ASQ completion were associated with the risk of an IQ <85 at a given ASQ level. In the multivariate model, no interaction between the studied factors and ASQ score reached significance. CONCLUSIONS In the general pediatric population, 36-month ASQ parental reports could be used to identify children at later risk of cognitive delay. Low maternal education level should also be considered as a major risk factor for lower IQ in preschool children regardless of ASQ score.
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Affiliation(s)
- Marie-Laure Charkaluk
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Hôpital Tenon, Paris, France; .,Université Catholique de Lille, Lille, France.,Service de Néonatologie, Hôpital Saint Vincent de Paul, Groupement des Hôpitaux de l'Institut Catholique Lillois/Faculté de Médecine et Maïeutique, Lille, France
| | - Jessica Rousseau
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Hôpital Tenon, Paris, France
| | - Johanna Calderon
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Jonathan Y Bernard
- Inserm UMR 1153, Developmental Origins of Health and Disease (ORCHaD) Team, Epidemiology and Biostatistics Sorbonne Paris Cité Centre,Villejuif, France.,Paris Descartes University, Paris, France; and.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Anne Forhan
- Inserm UMR 1153, Developmental Origins of Health and Disease (ORCHaD) Team, Epidemiology and Biostatistics Sorbonne Paris Cité Centre,Villejuif, France.,Paris Descartes University, Paris, France; and
| | - Barbara Heude
- Inserm UMR 1153, Developmental Origins of Health and Disease (ORCHaD) Team, Epidemiology and Biostatistics Sorbonne Paris Cité Centre,Villejuif, France.,Paris Descartes University, Paris, France; and
| | - Monique Kaminski
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Hôpital Tenon, Paris, France
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Wilson J, Tay RY, McCormack C, Allsop S, Najman J, Burns L, Olsson CA, Elliott E, Jacobs S, Mattick RP, Hutchinson D. Alcohol consumption by breastfeeding mothers: Frequency, correlates and infant outcomes. Drug Alcohol Rev 2017; 36:667-676. [DOI: 10.1111/dar.12473] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 06/27/2016] [Accepted: 07/01/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Judy Wilson
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney Australia
| | - Rui Yang Tay
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney Australia
| | - Clare McCormack
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney Australia
- Department of Psychiatry; Columbia University; New York USA
| | - Steve Allsop
- National Drug Research Institute; Curtin University; Perth Australia
| | - Jake Najman
- Queensland Alcohol and Drug Research and Education Centre and Schools of Population Health and Social Science; University of Queensland; Brisbane Australia
| | - Lucy Burns
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney Australia
| | - Craig A. Olsson
- School of Psychology, Centre for Social and Early Emotional Development; Deakin University; Geelong Australia
- Centre for Adolescent Health, Murdoch Childrens Research Institute; The Royal Children's Hospital; Melbourne Australia
- Department of Paediatrics; The University of Melbourne; Melbourne Australia
| | - Elizabeth Elliott
- Discipline of Paediatrics and Child Health; The University of Sydney, The Children's Hospital at Westmead; Sydney Australia
| | - Sue Jacobs
- Department of Obstetrics; Royal Prince Alfred Hospital; Sydney Australia
| | - Richard P. Mattick
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney Australia
| | - Delyse Hutchinson
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney Australia
- School of Psychology, Centre for Social and Early Emotional Development; Deakin University; Geelong Australia
- Centre for Adolescent Health, Murdoch Childrens Research Institute; The Royal Children's Hospital; Melbourne Australia
- Department of Paediatrics; The University of Melbourne; Melbourne Australia
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Yeung EH, Sundaram R, Ghassabian A, Xie Y, Buck Louis G. Parental Obesity and Early Childhood Development. Pediatrics 2017; 139:peds.2016-1459. [PMID: 28044047 PMCID: PMC5260147 DOI: 10.1542/peds.2016-1459] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/03/2016] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Previous studies identified associations between maternal obesity and childhood neurodevelopment, but few examined paternal obesity despite potentially distinct genetic/epigenetic effects related to developmental programming. METHODS Upstate KIDS (2008-2010) recruited mothers from New York State (excluding New York City) at ∼4 months postpartum. Parents completed the Ages and Stages Questionnaire (ASQ) when their children were 4, 8, 12, 18, 24, 30, and 36 months of age corrected for gestation. The ASQ is validated to screen for delays in 5 developmental domains (ie, fine motor, gross motor, communication, personal-social functioning, and problem-solving ability). Analyses included 3759 singletons and 1062 nonrelated twins with ≥1 ASQs returned. Adjusted odds ratios (aORs) and 95% confidence intervals were estimated by using generalized linear mixed models accounting for maternal covariates (ie, age, race, education, insurance, marital status, parity, and pregnancy smoking). RESULTS Compared with normal/underweight mothers (BMI <25), children of obese mothers (26% with BMI ≥30) had increased odds of failing the fine motor domain (aOR 1.67; confidence interval 1.12-2.47). The association remained after additional adjustment for paternal BMI (1.67; 1.11-2.52). Paternal obesity (29%) was associated with increased risk of failing the personal-social domain (1.75; 1.13-2.71), albeit attenuated after adjustment for maternal obesity (aOR 1.71; 1.08-2.70). Children whose parents both had BMI ≥35 were likely to additionally fail the problem-solving domain (2.93; 1.09-7.85). CONCLUSIONS Findings suggest that maternal and paternal obesity are each associated with specific delays in early childhood development, emphasizing the importance of family information when screening child development.
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Affiliation(s)
| | | | | | | | - Germaine Buck Louis
- Office of the Director, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, Maryland
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Singh A, Yeh CJ, Boone Blanchard S. Ages and Stages Questionnaire: a global screening scale. BOLETIN MEDICO DEL HOSPITAL INFANTIL DE MEXICO 2017; 74:5-12. [PMID: 29364814 DOI: 10.1016/j.bmhimx.2016.07.008] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 05/21/2016] [Accepted: 07/07/2016] [Indexed: 11/28/2022] Open
Abstract
With standardized screening tools, research studies have shown that developmental disabilities can be detected reliably and with validity in children as young as 4 months of age by using the instruments such as the Ages and Stages Questionnaire. In this review, we will focus on one tool, the Ages and Stages Questionnaire, to illustrate the usefulness of developmental screening across the globe.
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Affiliation(s)
- Ajay Singh
- College of Education and Technology, Eastern New Mexico University, Portales, New Mexico, USA.
| | - Chia Jung Yeh
- Department of Human Development and Family Science, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, USA
| | - Sheresa Boone Blanchard
- Department of Human Development and Family Science, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, USA
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Singh A, Yeh CJ, Boone Blanchard S. Ages and Stages Questionnaire: a global screening scale. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.bmhime.2016.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Simpson S, D'Aprano A, Tayler C, Toon Khoo S, Highfold R. Validation of a culturally adapted developmental screening tool for Australian Aboriginal children: Early findings and next steps. Early Hum Dev 2016; 103:91-95. [PMID: 27544061 DOI: 10.1016/j.earlhumdev.2016.08.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 08/09/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Early detection of developmental problems is important for facilitating access to targeted intervention and maximising its positive effects. The later problems are identified, the more likely that they will become increasingly difficult to ameliorate. Standardised developmental screening tools are known to improve detection rates of developmental problems compared to clinical judgement alone and are widely recommended for use with all children. The Ages and Stages Questionnaire (ASQ-3) is a tool that is widely used in Australia. However, mainstream screening tools may not be appropriate for remote-dwelling Australian Aboriginal children. While Australian Aboriginal children face multiple developmental risk factors, there are no developmental screening tools that have been validated for use in this population. AIMS To determine the concurrent validity of the culturally adapted ASQ-3 - the ASQ-TRAK - for Australian Aboriginal children compared to the Bayley Scales of Infant and Toddler Development (Bayley-III), a standardised, professionally administered developmental assessment. SUBJECTS The ASQ-TRAK and Bayley-III were administered cross-sectionally to 67 Central Australian Aboriginal children between 2 and 36months of age. RESULTS The ASQ-TRAK communication, gross motor, fine motor and problem-solving domains and the corresponding domains on the Bayley-III were moderately correlated. Overall sensitivity for the ASQ-TRAK was 71% (95% CI 29-96) and specificity was 92% (95% CI 88-99). Percentage agreement between the ASQ-TRAK and the Bayley-III was 90%. CONCLUSIONS The ASQ-TRAK shows promise as a tool that can be used to improve developmental monitoring for remote dwelling Australian Aboriginal children. Further research is necessary to build on the current findings.
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Affiliation(s)
- Samantha Simpson
- Melbourne Graduate School of Education, The University of Melbourne, 100 Leicester Street, Carlton, VIC 3053, Australia.
| | - Anita D'Aprano
- Melbourne Graduate School of Education, The University of Melbourne, 100 Leicester Street, Carlton, VIC 3053, Australia
| | - Collette Tayler
- Melbourne Graduate School of Education, The University of Melbourne, 100 Leicester Street, Carlton, VIC 3053, Australia
| | - Siek Toon Khoo
- Australian Council for Educational Research, 19 Prospect Hill Road, Camberwell, VIC 3124, Australia
| | - Roxanne Highfold
- Central Australian Aboriginal Congress, PO Box 1604, Alice Springs, NT 0871, Australia
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Sananès N, Gabriele V, Weingertner AS, Ruano R, Sanz-Cortes M, Gaudineau A, Langer B, Nisand I, Akladios CY, Favre R. Evaluation of long-term neurodevelopment in twin-twin transfusion syndrome after laser therapy. Prenat Diagn 2016; 36:1139-1145. [DOI: 10.1002/pd.4950] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 10/10/2016] [Accepted: 10/18/2016] [Indexed: 12/13/2022]
Affiliation(s)
- Nicolas Sananès
- Department of Obstetrics and Gynecology; Strasbourg University Hospital; Strasbourg France
- INSERM, UMR-S 1121, ‘Biomatériaux et Bioingénierie’; Strasbourg France
| | - Victor Gabriele
- Department of Obstetrics and Gynecology; Strasbourg University Hospital; Strasbourg France
| | | | - Rodrigo Ruano
- Texas Children's Fetal Center and Baylor College of Medicine; Houston TX USA
| | | | - Adrien Gaudineau
- Department of Obstetrics and Gynecology; Strasbourg University Hospital; Strasbourg France
| | - Bruno Langer
- Department of Obstetrics and Gynecology; Strasbourg University Hospital; Strasbourg France
| | - Israël Nisand
- Department of Obstetrics and Gynecology; Strasbourg University Hospital; Strasbourg France
| | | | - Romain Favre
- Department of Obstetrics and Gynecology; Strasbourg University Hospital; Strasbourg France
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Visser M, Nel M, Bronkhorst C, Brown L, Ezendam Z, Mackenzie K, van der Merwe D, Venter M. Childhood disability population-based surveillance: Assessment of the Ages and Stages Questionnaire Third Edition and Washington Group on Disability Statistics/UNICEF module on child functioning in a rural setting in South Africa. Afr J Disabil 2016; 5:265. [PMID: 28730058 PMCID: PMC5433463 DOI: 10.4102/ajod.v5i1.265] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 06/21/2016] [Indexed: 11/17/2022] Open
Abstract
Background Epidemiological information on childhood disability provides the basis for a country to plan, implement and manage the provision of health, educational and social services for these vulnerable children. There is, however, currently no population-based surveillance instrument that is compatible with the International Classification of Functioning, Disability and Health (ICF), internationally comparable, methodologically sound and comprehensively researched, to identify children under 5 years of age who are living with disability in South Africa and internationally. We conducted a descriptive pilot study to investigate the sensitivity and specificity of translated versions of the Ages and Stages Questionnaire Third Edition (ASQ-III) and the Washington Group on Disability Statistics/UNICEF module on child functioning (WG/UNICEF module) as parent-reported measures. The aim of our study was to identify early childhood disabilities in children aged 24–48 months in a rural area of South Africa, to determine the appropriateness of these instruments for population-based surveillance in similar contexts internationally. Methods This study was conducted in the Xhariep District of the Free State Province in central South Africa, with 50 carers whose children were registered on the South African Social Security Agency (SASSA) database as recipients of a grant for one of the following: Care Dependency, Child Support or Foster Care. The researchers, assisted by community healthcare workers and SASSA staff members, conducted structured interviews using forward–backward translated versions of the ASQ-III and the WG/UNICEF module. Results Both measurement instruments had a clinically meaningful sensitivity of 60.0%, high specificity of 95.6% for the ASQ-III and 84.4% for the WG/UNICEF module, and the two instruments agreed moderately (Kappa = 0.6). Conclusion Since the WG/UNICEF module is quicker to administer, easier to understand and based on the ICF, it can be considered as an appropriate parent-reported measure for large-scale, population-based as well as smaller, community-specific contexts. It is, however, recommended that future research and development continues with the WG/UNICEF module to enhance its conceptual equivalence for larger-scale, population-based studies in South Africa and internationally.
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Affiliation(s)
- Marieta Visser
- Department of Occupational Therapy, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Mariette Nel
- Department of Biostatistics, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Caretha Bronkhorst
- Department of Occupational Therapy, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Lara Brown
- Department of Occupational Therapy, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Zaskia Ezendam
- Department of Occupational Therapy, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Kira Mackenzie
- Department of Occupational Therapy, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Deidré van der Merwe
- Department of Occupational Therapy, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Marné Venter
- Department of Occupational Therapy, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
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The effectiveness of the peer delivered Thinking Healthy Plus (THPP+) Programme for maternal depression and child socio-emotional development in Pakistan: study protocol for a three-year cluster randomized controlled trial. Trials 2016; 17:442. [PMID: 27608926 PMCID: PMC5017048 DOI: 10.1186/s13063-016-1530-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 07/21/2016] [Indexed: 11/13/2022] Open
Abstract
Background The negative effects of perinatal depression on the mother and child start early and persist throughout the lifecourse (Lancet 369(9556):145–57, 2007; Am J Psychiatry 159(1):43-7, 2002; Arch Dis Child 77(2):99–101, 1997; J Pak Med Assoc 60(4):329; J Psychosoma Res 49(3):207–16, 2000; Clin Child Fam Psychol Rev 14(1):1–27, 2011). Given that 10–35 % of children worldwide are exposed to perinatal depression in their first year of life (Int Rev Psychiatry 8(1):37–54, 1996), mitigating this intergenerational risk is a global public health priority (Perspect Public Health 129(5):221–7, 2009; Trop Med Int Health 13(4):579–83, 2008; Br Med Bull 101(1):57–79, 2012). However, it is not clear whether intervention with depressed women can have long-term benefits for the mother and/or her child. We describe a study of the effectiveness of a peer-delivered depression intervention delivered through 36 postnatal months, the Thinking Healthy Program Peer-delivered PLUS (THPP+) for women and their children in rural Pakistan. Methods/design The THPP+ study aims are: (1) to evaluate the effects of an extended 36-month perinatal depression intervention on maternal and index child outcomes using a cluster randomized controlled trial (c-RCT) and (2) to determine whether outcomes among index children of perinatally depressed women in the intervention arm converge with those of index children born to perinatally nondepressed women. The trial is designed to recruit 560 pregnant women who screened positive for perinatal depression (PHQ-9 score ≥10) from 40 village clusters, of which 20 receive the THPP+ intervention. An additional reference group consists of 560 perinatally nondepressed women from the same 40 clusters as the THPP+ trial. The women in the nondepressed group are not targeted to receive the THPP+ intervention; but, by recruiting pregnant women from both intervention and control clusters, we are able to evaluate any carryover effects of the THPP+ intervention on the women and their children. Perinatally depressed women in the THPP+ intervention arm receive bimonthly group-based sessions. Primary outcomes are 3-year maternal depression and 3-year child development indicators. Analyses are intention-to-treat and account for the clustered design. Discussion This trial, together with the reference group, has the potential to further our understanding of the early developmental lifecourse of children of both perinatally depressed and perinatally nondepressed women in rural Pakistan and to determine whether intervening with women’s depression in the perinatal period can mitigate the negative effects of maternal depression on 36-month child development. Trial registration THPP-P ClinicalTrials.gov Identifier: NCT02111915 (registered on 9 April 2014). THPP+ ClinicalTrials.gov Identifier: NCT02658994 (registered on 21 January 2016). Sponsor: Human Development Research Foundation (HDRF). Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1530-y) contains supplementary material, which is available to authorized users.
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Parental Concerns, Developmental Temperature Taking, and the Necessary Conditions for Developmental Surveillance and Screening. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2016. [DOI: 10.1007/s40474-016-0095-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Vanvuchelen M, Van Schuerbeeck L, Braeken MAKA. Screening accuracy of the parent-completed Ages and Stages Questionnaires – second edition as a broadband screener for motor problems in preschoolers with autism spectrum disorders. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016; 21:29-36. [DOI: 10.1177/1362361315621703] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Children with autism spectrum disorders are at risk for motor problems. However, this area is often overlooked in the developmental evaluation in autism diagnostic clinics. An alternative can be to identify children who should receive intensive motor assessment by using a parent-based screener. The aim of this study was to examine whether the Ages and Stages Questionnaires – second edition may be used to identify gross and fine motor problems in children. High-functioning children with autism spectrum disorder (n = 43, 22–54 m) participated in this study. Sensitivity, specificity, predictive values and areas under the receiver operating characteristic curve were calculated by comparing the Ages and Stages Questionnaires – second edition scores to the developmental evaluation of the Peabody Developmental Motor Scale – second edition. The results revealed that both the Ages and Stages Questionnaires – second edition gross and fine motor domain may be used to identify children without motor problems. In contrast, sensitivity analyses revealed the likelihood of under screening motor problems in this population. The Ages and Stages Questionnaires – second edition met only the criteria of a fair to good accuracy to identify poor gross motor (sensitivity = 100%) and below-average fine motor development (sensitivity = 71%) in this sample. Hence, the capacity of the Ages and Stages Questionnaires – second edition to identify motor problems in preschoolers with autism spectrum disorder appears to be limited. It is recommended to include a formal standardized motor test in the diagnostic procedure for all children with autism spectrum disorder.
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Muhoozi GKM, Atukunda P, Mwadime R, Iversen PO, Westerberg AC. Nutritional and developmental status among 6- to 8-month-old children in southwestern Uganda: a cross-sectional study. Food Nutr Res 2016; 60:30270. [PMID: 27238555 PMCID: PMC4884678 DOI: 10.3402/fnr.v60.30270] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 04/26/2016] [Accepted: 04/27/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Undernutrition continues to pose challenges to Uganda's children, but there is limited knowledge on its association with physical and intellectual development. OBJECTIVE In this cross-sectional study, we assessed the nutritional status and milestone development of 6- to 8-month-old children and associated factors in two districts of southwestern Uganda. DESIGN Five hundred and twelve households with mother-infant (6-8 months) pairs were randomly sampled. Data about background variables (e.g. household characteristics, poverty likelihood, and child dietary diversity scores (CDDS)) were collected using questionnaires. Bayley Scales of Infant and Toddler Development (BSID III) and Ages and Stages questionnaires (ASQ) were used to collect data on child development. Anthropometric measures were used to determine z-scores for weight-for-age (WAZ), length-for-age (LAZ), weight-for-length (WLZ), head circumference (HCZ), and mid-upper arm circumference. Chi-square tests, correlation coefficients, and linear regression analyses were used to relate background variables, nutritional status indicators, and infant development. RESULTS The prevalence of underweight, stunting, and wasting was 12.1, 24.6, and 4.7%, respectively. Household head education, gender, sanitation, household size, maternal age and education, birth order, poverty likelihood, and CDDS were associated (p<0.05) with WAZ, LAZ, and WLZ. Regression analysis showed that gender, sanitation, CDDS, and likelihood to be below the poverty line were predictors (p<0.05) of undernutrition. BSID III indicated development delay of 1.3% in cognitive and language, and 1.6% in motor development. The ASQ indicated delayed development of 24, 9.1, 25.2, 12.2, and 15.1% in communication, fine motor, gross motor, problem solving, and personal social ability, respectively. All nutritional status indicators except HCZ were positively and significantly associated with development domains. WAZ was the main predictor for all development domains. CONCLUSION Undernutrition among infants living in impoverished rural Uganda was associated with household sanitation, poverty, and low dietary diversity. Development domains were positively and significantly associated with nutritional status. Nutritional interventions might add value to improvement of child growth and development.
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Affiliation(s)
- Grace K M Muhoozi
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Human Nutrition and Home Economics, Kyambogo University, Kampala, Uganda;
| | - Prudence Atukunda
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Robert Mwadime
- School of Food Technology, Nutrition and Bioengineering, Makerere University, Kampala, Uganda
| | - Per Ole Iversen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Hematology, Oslo University Hospital, Oslo, Norway
| | - Ane C Westerberg
- Institute of Health Sciences, Kristiania University College, Oslo, Norway
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King-Dowling S, Rodriguez MC, Missiuna C, Cairney J. Validity of the Ages and Stages Questionnaire to detect risk of Developmental Coordination Disorder in preschoolers. Child Care Health Dev 2016; 42:188-94. [PMID: 26686096 DOI: 10.1111/cch.12314] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 11/04/2015] [Accepted: 11/22/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND A reliable and valid screening tool for detecting children at risk for Developmental Coordination Disorder (DCD) is needed. The purpose of this study was to evaluate the ability of the Ages and Stages Questionnaire-Third Edition (ASQ-3) motor scales to detect children at risk for DCD in a community-based sample of children aged 3.5-5.5 years. METHODS One hundred and sixty parent-child pairs were recruited from community-based organizations. Children were eligible if they spoke English and had no known physical impairments. Eligible parents were asked to fill out the ASQ-3, following which their child's fine motor and gross motor proficiency was assessed using the Movement Assessment Battery for Children-Second Edition (MABC-2). DCD risk was defined as those children scoring at or below the 16th percentile on the MABC-2. Sensitivity and specificity of the fine and gross motor areas of the ASQ-3 were examined and referenced against the DCD risk classification. RESULTS The ASQ-3 total motor score correlated moderately with overall standard score on the MABC-2 (r = 0.41; p < 0.001). Regardless of the ASQ-3 cut-off used, sensitivities of the ASQ-3 fine motor or gross motor scale to detect DCD risk were low at 21-47%, whereas specificities were high at 89-96%. CONCLUSION Early identification of motor skill delays is important in order to intervene and hopefully prevent the associated negative health consequences. However, because of the low sensitivity of the ASQ-3 motor scales, these results suggest that the ASQ-3 is not an appropriate screening tool to identify children at risk for DCD in the preschool population.
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Affiliation(s)
- S King-Dowling
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada.,Infant and Child Health Lab, McMaster University, Hamilton, ON, Canada
| | - M C Rodriguez
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada.,Infant and Child Health Lab, McMaster University, Hamilton, ON, Canada
| | - C Missiuna
- School of Rehabilitation Science and CanChild, McMaster University, Hamilton, ON, Canada.,Infant and Child Health Lab, McMaster University, Hamilton, ON, Canada
| | - J Cairney
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada.,Department of Family Medicine, McMaster University, Hamilton, ON, Canada.,School of Rehabilitation Science and CanChild, McMaster University, Hamilton, ON, Canada.,Infant and Child Health Lab, McMaster University, Hamilton, ON, Canada
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Yeung EH, Sundaram R, Bell EM, Druschel C, Kus C, Ghassabian A, Bello S, Xie Y, Buck Louis GM. Examining Infertility Treatment and Early Childhood Development in the Upstate KIDS Study. JAMA Pediatr 2016; 170:251-8. [PMID: 26746435 PMCID: PMC5000851 DOI: 10.1001/jamapediatrics.2015.4164] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
IMPORTANCE An increasing percentage of births are conceived with assisted reproductive technology (ART) and other infertility treatment. Despite findings that such treatments may be associated with diminished gestation and birth size, scarce data exist regarding infertility treatments and children's development in the United States. OBJECTIVE To assess the use and type of infertility treatment in relation to children's development through age 36 months. DESIGN, SETTING, AND PARTICIPANTS Prospective cohort study (conducted 2008-2014) that sampled based on infertility treatment and plurality. Included in the study were infants born between 2008 and 2010 in New York state (excluding New York City) whose parents completed developmental screening instruments through 36 months of age. A total of 4824 mothers (97% of 4989) completed 1 or more developmental screening instruments for 5841 children, including 1830 conceived with infertility treatment and 2074 twins. EXPOSURES Maternal self-report of any infertility treatment was further categorized into ART and ovulation induction/intrauterine insemination. Assisted reproductive technology use was previously validated by linkage with the Society for Assisted Reproductive Technology-Clinical Outcome Reporting System. MAIN OUTCOMES AND MEASURES Five developmental domains (fine motor, gross motor, communication, personal-social functioning, and problem-solving ability), as measured by the parental completion of the Ages and Stages Questionnaires at 4, 8, 12, 18, 24, 30, and 36 months of age. Generalized linear mixed modeling techniques estimated adjusted odds ratios (aORs) and 95% CIs for use and type of infertility treatment in relation to failing a developmental domain. Data were stratified by plurality and weighted for the sampling scheme. RESULTS There were 1422 mothers (29.5%; mean [SD], age, 34.1 [5.2] years) who underwent infertility treatment. Infertility treatment was not associated with risk of their children failing any developmental domain (aOR, 1.33; 95% CI, 0.94-1.89). Assisted reproductive technology was associated with increased risk for failing any developmental domain but only when singletons and twins were evaluated together (aOR, 1.81; 95% CI, 1.21-2.72). Adjustment for birth weight further attenuated this estimate (aOR, 1.26; 95% CI, 0.82-1.93). After stratifying by plurality, type of treatment also was not significantly associated with failing any developmental domain for ovulation induction/intrauterine insemination (aOR, 1.00; 95% CI, 0.57-1.77 for singletons and aOR, 1.30; 95% CI, 0.76-2.21 for twins) or ART (aOR, 1.38; 95% CI, 0.78-2.43 for singletons and aOR, 1.58; 95% CI, 0.94-2.65 for twins). CONCLUSIONS AND RELEVANCE After considering plurality, children's development through age 3 years was similar irrespective of infertility treatment or specific type. To our knowledge, these findings are among the first to focus on non-ART treatments in the United States.
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Affiliation(s)
- Edwina H. Yeung
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Rajeshwari Sundaram
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Erin M. Bell
- Department of Environmental Health Sciences, University at Albany School of Public Health, Albany, New York3Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Albany, New York
| | - Charlotte Druschel
- Department of Environmental Health Sciences, University at Albany School of Public Health, Albany, New York4Bureau of Environmental and Occupational Epidemiology, Center for Environmental Health, New York State Department of Health, Albany
| | - Christopher Kus
- Division of Family Health, New York State Department of Health, Albany
| | - Akhgar Ghassabian
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Scott Bello
- Developmental Pediatrics, CapitalCare Pediatrics–Troy, Troy, New York
| | - Yunlong Xie
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Germaine M. Buck Louis
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
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Lockwood Estrin G, Kyriakopoulou V, Makropoulos A, Ball G, Kuhendran L, Chew A, Hagberg B, Martinez-Biarge M, Allsop J, Fox M, Counsell SJ, Rutherford MA. Altered white matter and cortical structure in neonates with antenatally diagnosed isolated ventriculomegaly. NEUROIMAGE-CLINICAL 2016; 11:139-148. [PMID: 26937382 PMCID: PMC4753810 DOI: 10.1016/j.nicl.2016.01.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 01/05/2016] [Accepted: 01/12/2016] [Indexed: 12/31/2022]
Abstract
Ventriculomegaly (VM) is the most common central nervous system abnormality diagnosed antenatally, and is associated with developmental delay in childhood. We tested the hypothesis that antenatally diagnosed isolated VM represents a biological marker for altered white matter (WM) and cortical grey matter (GM) development in neonates. 25 controls and 21 neonates with antenatally diagnosed isolated VM had magnetic resonance imaging at 41.97(± 2.94) and 45.34(± 2.14) weeks respectively. T2-weighted scans were segmented for volumetric analyses of the lateral ventricles, WM and cortical GM. Diffusion tensor imaging (DTI) measures were assessed using voxel-wise methods in WM and cortical GM; comparisons were made between cohorts. Ventricular and cortical GM volumes were increased, and WM relative volume was reduced in the VM group. Regional decreases in fractional anisotropy (FA) and increases in mean diffusivity (MD) were demonstrated in WM of the VM group compared to controls. No differences in cortical DTI metrics were observed. At 2 years, neurodevelopmental delays, especially in language, were observed in 6/12 cases in the VM cohort. WM alterations in isolated VM cases may be consistent with abnormal development of WM tracts involved in language and cognition. Alterations in WM FA and MD may represent neural correlates for later neurodevelopmental deficits. This study compared brain development in neonates with isolated VM to controls. Neonates with isolated VM have enlarged cortical volumes compared to controls. FA was reduced and MD was increased in the WM of the VM cohort. Children with antenatal isolated VM are at increased risk for language delay.
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Affiliation(s)
- G Lockwood Estrin
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, United Kingdom; Robert Steiner Unit, Imaging Sciences Department, MRC Clinical Sciences Centre, Hammersmith Hospital, Imperial College London, London W12 0HS, United Kingdom
| | - V Kyriakopoulou
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, United Kingdom
| | - A Makropoulos
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, United Kingdom
| | - G Ball
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, United Kingdom
| | - L Kuhendran
- Robert Steiner Unit, Imaging Sciences Department, MRC Clinical Sciences Centre, Hammersmith Hospital, Imperial College London, London W12 0HS, United Kingdom
| | - A Chew
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, United Kingdom; Robert Steiner Unit, Imaging Sciences Department, MRC Clinical Sciences Centre, Hammersmith Hospital, Imperial College London, London W12 0HS, United Kingdom
| | - B Hagberg
- Robert Steiner Unit, Imaging Sciences Department, MRC Clinical Sciences Centre, Hammersmith Hospital, Imperial College London, London W12 0HS, United Kingdom; Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Kungsgatan 12, 411 18 Gothenburg, Sweden
| | - M Martinez-Biarge
- Robert Steiner Unit, Imaging Sciences Department, MRC Clinical Sciences Centre, Hammersmith Hospital, Imperial College London, London W12 0HS, United Kingdom
| | - J Allsop
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, United Kingdom
| | - M Fox
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, United Kingdom
| | - S J Counsell
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, United Kingdom
| | - M A Rutherford
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London SE1 7EH, United Kingdom
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Dempsey AG, Abrahamson CW, Keller-Margulis MA. Developmental Screening Among Children Born Preterm in a High-Risk Follow-Up Clinic. J Pediatr Psychol 2015; 41:573-81. [PMID: 26542281 DOI: 10.1093/jpepsy/jsv101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 10/02/2015] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The psychometric properties of two formats of developmental screening tools that may be used in follow-up clinics providing primary care to children born preterm are presented. METHODS 28 children born extremely preterm (<27 weeks) attending a high-risk clinic at the time of their 18-24 month visit were administered the Child Development Review, Brigance Early Head Start Screen II, and Bayley Scales of Infant and Toddler Development-Third Edition. RESULTS Both screeners identified the majority of the sample as at-risk. The Brigance Screen II more accurately identified children at-risk compared with the Child Developmental Review (sensitivity: 1.00 and 0.44; specificity: 0.60 and 0.80; positive predictive value: 79% and 80%; negative predictive value: 100% and 44%, respectively). CONCLUSIONS Screening assessments using direct skills assessment may be an efficient and effective method of identifying children with developmental delays, particularly high-frequency but lower severity difficulties, in high-risk follow-up care settings.
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Infant formula and neurocognitive outcomes: impact of study end-point selection. J Perinatol 2015; 35:867-74. [PMID: 26248129 DOI: 10.1038/jp.2015.87] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 06/02/2015] [Accepted: 06/04/2015] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Assessing validity and reliability of end points used in docosahexanoic and arachidonic acids (DHA and ARA) infant formula supplementation trials as an example for addressing the impact of end-point selection and critical need for well-defined, reliable and validated clinical outcome assessments for neurocognitive assessment in neonates and infants. STUDY DESIGN We searched eight electronic databases and reviewed all randomized, controlled human trials using DHA/ARA supplements with neurodevelopment clinical outcomes. We systematically evaluated the validity and reliability of end-point measures based on the criteria for studying nutritional additives recommended by the Institute of Medicine, criteria described in the Food and Drug Administration guidance for clinical outcome assessment, development and literature review. RESULTS We identified 29 articles that met the selection criteria. The end points that were used for neurodevelopment measures in 23 out of 29 original short-term studies included the Bayley Scale of Infant Development (BSID)-I and -II (n=12), Brunet-Lezine test (n=2), videotape infant's movements (n=1), record time to milestones including sitting, crawling, standing and walking (n=1), problem-solving test (n=2), brainstem auditory-evoked potential (n=1), Touwen examination (n=1), Fagan test of infant intelligence (n=2) and visual habituation protocol (n=1). None of these end points have a long-term predictive property for neurocognitive assessment. Compared with standard infant formula, the beneficial effects of DHA/ARA supplementation on neurodevelopment were reported in 2 out of 12 studies using BSID vs 8 out of 11 studies using other end-point measures. In addition, 6 out of 29 long-term follow-up studies used the end points including Stanford-Binet IQ test (n=1), Wechsler Preschool and Primary Scale of Intelligence (n=4) and Bracken Basic Concept Scale (n=1), which are generally scales of intellectual ability and typically do not change substantively in the short term. None of these long-term follow-up studies demonstrated beneficial effects of DHA/ARA supplementation on neurodevelopment. CONCLUSION The choice of end-point measures affects the outcomes of DHA/ARA-supplemented infant formula trials. Available data are currently inadequate to conclude that DHA/ARA supplementation has a clinically meaningful beneficial effect upon neurological development. Although BSID is validated to assess early developmental delays, it is not designed to predict long-term neurocognitive outcome. A well-defined, valid and reliable clinical outcome assessment that measures neurocognitive function in neonates and infants is essential to provide the scientific evidence required for future clinical trials.
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Kerstjens JM, Nijhuis A, Hulzebos CV, van Imhoff DE, van Wassenaer-Leemhuis AG, van Haastert IC, Lopriore E, Katgert T, Swarte RM, van Lingen RA, Mulder TL, Laarman CR, Steiner K, Dijk PH. The Ages and Stages Questionnaire and Neurodevelopmental Impairment in Two-Year-Old Preterm-Born Children. PLoS One 2015; 10:e0133087. [PMID: 26193474 PMCID: PMC4508030 DOI: 10.1371/journal.pone.0133087] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 06/22/2015] [Indexed: 11/18/2022] Open
Abstract
Objective To test the ability of the Ages and Stages Questionnaire, Third Edition (ASQ3) to help identify or exclude neurodevelopmental impairment (NDI) in very preterm-born children at the corrected age of two. Methods We studied the test results of 224 children, born at <32 postmenstrual weeks, who had scores on ASQ3 and Bayley Scales of Infant and Toddler Development, Third Edition (BSIDIII) and neurological examination at 22–26 months’ corrected age. We defined NDI as a score of <70 on the cognitive—or motor composite scale of BSIDIII, or impairment on neurological examination or audiovisual screening. We compared NDI with abnormal ASQ3 scores, i.e., < -2SDs on any domain, and with ASQ3 total scores. To correct for possible overestimation of BSIDIII, we also analyzed the adjusted BSIDIII thresholds for NDI, i.e., scores <80 and <85. Results We found 61 (27%) children with abnormal ASQ3 scores, and 10 (4.5%) children who had NDI with original BSIDIII thresholds (<70). Twelve children had NDI at BSIDIII thresholds at <80, and 15 had <85. None of the 163 (73%) children who passed ASQ3 had NDI. The sensitivity of ASQ3 to detect NDI was excellent (100%), its specificity was acceptable (76%), and its negative predictive value (NPV) was 100%. Sensitivity and NPV remained high with the adjusted BSIDIII thresholds. Conclusion The Ages and Stages Questionnaire is a simple, valid and cost-effective screening tool to help identify and exclude NDI in very preterm-born children at the corrected age of two years.
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Affiliation(s)
- Jorien M. Kerstjens
- Division of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, Groningen, The Netherlands
| | - Ard Nijhuis
- Division of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, Groningen, The Netherlands
| | - Christian V. Hulzebos
- Division of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, Groningen, The Netherlands
| | - Deirdre E. van Imhoff
- Division of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Ingrid C. van Haastert
- Department of Neonatology, Wilhelmina Children's Hospital/University Medical Center Utrecht, Utrecht, The Netherlands
| | - Enrico Lopriore
- Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Titia Katgert
- Department of Medical Psychology, Máxima Medical Center, Veldhoven, The Netherlands
| | - Renate M. Swarte
- Department of Neonatology, Erasmus MC-Sophia, Rotterdam, The Netherlands
| | - Richard A. van Lingen
- Princess Amalia Department of Pediatrics, Department of Neonatology, Isala, Zwolle, The Netherlands
| | - Twan L. Mulder
- Department of Pediatrics, Maastricht University Medical Center, GROW–School for Oncology and Developmental Biology, Maastricht, The Netherlands
| | - Céleste R. Laarman
- Division of Neonatology, Department of Pediatrics, VU University Medical Center, Amsterdam, The Netherlands
| | - Katerina Steiner
- Division of Neonatology, Department of Pediatrics, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands
| | - Peter H. Dijk
- Division of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, Groningen, The Netherlands
- * E-mail:
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Cheung AK, Harden KP, Tucker-Drob EM. From specialist to generalist: Developmental transformations in the genetic structure of early child abilities. Dev Psychobiol 2015; 57:566-83. [PMID: 25975938 DOI: 10.1002/dev.21309] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 03/11/2015] [Indexed: 11/06/2022]
Abstract
The heritability of abilities increases substantially over development, and much of heritable variation in abilities is shared with other abilities. No study, however, has formally tested the extent to which developmental increases in heritability occur on shared versus unique variation in child abilities. A transactional perspective predicts that the relative proportion of shared to total genetic variance will increase with age, whereas an endogenous perspective predicts that such proportion will be invariant with age. We tested these competing predictions using data from a sample of 292 twins providing a total of 578 cross-sectional and longitudinal observations between ages 0 and 6 years on measures of Communication, Gross Motor, Fine Motor, Problem-Solving, and Personal-Social abilities. Consistent with predictions of the transactional perspective, developmental increases in heritability were localized to variance shared across abilities.
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Affiliation(s)
- Amanda K Cheung
- Department of Psychology, University of Texas at Austin, 108 E. Dean Keeton Street A8000, Austin, TX, 78712-0187
| | - K Paige Harden
- Department of Psychology, University of Texas at Austin, 108 E. Dean Keeton Street A8000, Austin, TX, 78712-0187.,Population Research Center, University of Texas at Austin, Austin, TX
| | - Elliot M Tucker-Drob
- Department of Psychology, University of Texas at Austin, 108 E. Dean Keeton Street A8000, Austin, TX, 78712-0187.,Population Research Center, University of Texas at Austin, Austin, TX
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86
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Coley RL, Lynch AD, Kull M. Early Exposure to Environmental Chaos and Children's Physical and Mental Health. EARLY CHILDHOOD RESEARCH QUARTERLY 2015; 32:94-104. [PMID: 25844016 PMCID: PMC4379485 DOI: 10.1016/j.ecresq.2015.03.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Environmental chaos has been proposed as a central influence impeding children's health and development, with the potential for particularly pernicious effects during the earliest years when children are most susceptible to environmental insults. This study evaluated a high-risk sample, following 495 low-income children living in poor urban neighborhoods from infancy to age 6. Longitudinal multilevel models tested the main tenets of the ecobiodevelopmental theory, finding that: (1) numerous distinct domains of environmental chaos were associated with children's physical and mental health outcomes, including housing disorder, neighborhood disorder, and relationship instability, with no significant results for residential instability; (2) different patterns emerged in relation to the timing of exposure to chaos, with more proximal exposure most strongly associated with children's functioning; and (3) the intensity of chaos also was a robust predictor of child functioning. Contrary to expectations, neither biological vulnerability (proxied through low birth weight status), maternal sensitivity, nor maternal distress moderated the role of chaos. Rather, maternal psychological distress functioned as a pathway through which environmental chaos was associated with children's functioning.
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Affiliation(s)
- Rebekah Levine Coley
- Boston College, Applied Developmental and Educational Psychology, 140 Commonwealth Ave, Chestnut Hill MA 02467
| | - Alicia Doyle Lynch
- Boston College, Applied Developmental and Educational Psychology, 140 Commonwealth Ave, Chestnut Hill MA 02467
| | - Melissa Kull
- Boston College, Applied Developmental and Educational Psychology, 140 Commonwealth Ave, Chestnut Hill MA 02467
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87
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Dagvadorj A, Takehara K, Bavuusuren B, Morisaki N, Gochoo S, Mori R. The quick and easy Mongolian Rapid Baby Scale shows good concurrent validity and sensitivity. Acta Paediatr 2015; 104:e94-9. [PMID: 25443770 DOI: 10.1111/apa.12884] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 09/23/2014] [Accepted: 11/27/2014] [Indexed: 11/27/2022]
Abstract
AIM In developing countries, around 200 million children with poor development cannot excel academically. Detecting children with developmental delay is fundamental in targeting early interventions. As the lack of a convenient screening tool in Mongolia remains a significant barrier, we aimed to produce an easy-to-administer developmental screening tool in Mongolia and to validate it against an internationally recognised instrument, the Bayley Scales of Infant and Toddler Development Third Edition (Bayley-III). METHODS We developed the Mongolian Rapid Baby Scale consisting of 161 items arranged under seven developmental domains for children aged from zero months 16 days to 42 months 15 days. We recruited 150 children in Ulaanbaatar, Mongolia. After conducting face and content validity of the tool, we evaluated concurrent validity. RESULTS Concurrent validity ranged from high correlation (r = 0.86) to very high (r = 0.97) for each of the corresponding domains between the two tests. Summary statistics showed good sensitivity (81.8%) and moderate specificity (52.3%). CONCLUSION Our newly developed tool takes only 15 min to complete and is easy to administer. It demonstrated good concurrent validity and sensitivity for the screening of developmental status in young children. This innovative tool will be useful to identify children who may benefit from early interventions in Mongolia.
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Affiliation(s)
- Amarjargal Dagvadorj
- Department of Health Policy; National Center for Child Health and Development; Tokyo Japan
| | - Kenji Takehara
- Department of Health Policy; National Center for Child Health and Development; Tokyo Japan
| | | | - Naho Morisaki
- Department of Health Policy; National Center for Child Health and Development; Tokyo Japan
- Department of Pediatrics; Graduate School of Medicine; University of Tokyo; Tokyo Japan
| | - Soyolgerel Gochoo
- Medical Care Policy Implementation and Coordination; Ministry of Health; Ulaanbaatar Mongolia
| | - Rintaro Mori
- Department of Health Policy; National Center for Child Health and Development; Tokyo Japan
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88
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Steenis LJP, Verhoeven M, Hessen DJ, van Baar AL. Parental and professional assessment of early child development: the ASQ-3 and the Bayley-III-NL. Early Hum Dev 2015; 91:217-25. [PMID: 25703316 DOI: 10.1016/j.earlhumdev.2015.01.008] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 12/17/2014] [Accepted: 01/17/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND The Ages and Stages Questionnaire (ASQ-3) is frequently used for screening developmental delay in problem solving, communication, fine- and gross motor skills and personal-social behavior of infants, toddlers and preschool aged children. The adequacy of the ASQ-3 is evaluated for Dutch children by comparing results of the ASQ-3, completed by parents, to results of a standardized, professionally administered developmental assessment of cognition, fine- and gross motor skills and receptive and expressive communication for infants and toddlers: the Bayley-III-NL. METHODS The ASQ-3 and Bayley-III-NL were administered to 1244 children aged 1 to 43months old. Two age cohorts were used: 1) the 2-16month age-versions; and 2) the 18-42month age-versions. Cutoff points for all ASQ-3 age-versions were calculated in three ways. Sensitivity and specificity of the ASQ-3 were evaluated with four methods, using different cutoff point combinations of 1 SD or 2 SD below the mean. RESULTS Overall, sensitivity was between 7% and 77% and specificity between 53% and 99%. Sensitivity and specificity values were higher for the older age-cohort than for the younger age-cohort. For the older age-cohort, the best sensitivity (69%) and specificity (92%) was found, using 1 SD for the total ASQ-3 score and 2 SD for the Bayley-III-NL subtests as cutoff points. CONCLUSIONS For the oldest age-cohort, the ASQ-3 for now has the best potential as a screener for Dutch children. The ASQ-3 identifies most children without a developmental delay according to the Bayley-III-NL, but sensitivity needs improvement.
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Affiliation(s)
- Leonie J P Steenis
- Child and Adolescent Studies, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, The Netherlands.
| | - Marjolein Verhoeven
- Child and Adolescent Studies, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, The Netherlands.
| | - Dave J Hessen
- Methods and statistics, Utrecht University, Padualaan 14, 3584 CH Utrecht, The Netherlands.
| | - Anneloes L van Baar
- Child and Adolescent Studies, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, The Netherlands.
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Veldhuizen S, Clinton J, Rodriguez C, Wade TJ, Cairney J. Concurrent validity of the Ages And Stages Questionnaires and Bayley Developmental Scales in a general population sample. Acad Pediatr 2015; 15:231-7. [PMID: 25224137 DOI: 10.1016/j.acap.2014.08.002] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 07/30/2014] [Accepted: 08/04/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Developmental delay is relatively common and produces serious impairment. Efforts to screen for delay often include parent-completed instruments. We evaluated the agreement between the most popular such instrument, the Ages and Stages Questionnaires (ASQ) and the third edition of the Bayley Scales of Infant Development (BSID-III). METHODS We analyzed a community sample of 587 children aged 1 month to 36 months who received both the ASQ and the BSID-III. We calculate sensitivity, specificity, and positive and negative predictive values. Because published BSID-III norms produced unexpectedly low prevalences, we also derived a set of distribution-based thresholds using quantile regression, and we repeated the validation analysis using these results. RESULTS BSID-III prevalence was 2.9% (95% confidence interval [CI] 1.7-4.6) with published norms and 7.7% (95% CI 5.6-10.1) with distribution-based thresholds, while 18.2% (95% CI 15.2-21.6) of children were positive on the ASQ. For published BSID-III norms, sensitivity was 41% (95% CI 18-67) and specificity 82% (95% CI 79-85). Results with distribution-based thresholds were essentially identical. Performance was somewhat better among children over 1 year (sensitivity 50%, specificity 87%). For subscales, sensitivities were generally lower (range 0-50%) and specificities higher (range 92-96%). CONCLUSIONS Agreement between the ASQ and BSID-III was relatively poor. Previous studies have reported somewhat better agreement. There are numerous possible explanations for differences, including the age ranges used, the risk profile of children, and differences in the ASQ administration. Results raise concerns about the performance of this instrument in primary care and community settings.
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Affiliation(s)
- Scott Veldhuizen
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada; Health Services and Health Equity Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
| | - Jean Clinton
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada; Departments of Psychiatry and Behavioral Neurosciences and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Christine Rodriguez
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Terrance J Wade
- Department of Community Health Sciences, Brock University, St Catharines, Ontario, Canada
| | - John Cairney
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada; Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada; Departments of Psychiatry and Behavioral Neurosciences and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
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90
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More K, Rao S, McMichael J, Minutillo C. Growth and developmental outcomes of infants with hirschsprung disease presenting in the neonatal period: a retrospective study. J Pediatr 2014; 165:73-77.e2. [PMID: 24721468 DOI: 10.1016/j.jpeds.2014.02.062] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 01/13/2014] [Accepted: 02/27/2014] [Indexed: 01/16/2023]
Abstract
OBJECTIVES To describe the presentation and progress over the first year of life of neonates with Hirschsprung disease, to describe their physical and developmental outcomes at 12 months of age, and to compare the outcomes of infants with short- vs long-segment Hirschsprung disease. STUDY DESIGN A retrospective study of neonates born with Hirschsprung disease in Western Australia between January 1, 2001, and December 31, 2010, to review their presentation, progress, growth, and development at 12 months of age. RESULTS Fifty-four infants were identified (40 with short and 11 with long segment and 3 with total colonic aganglionosis); 9 infants had a recognized syndrome and 1 infant died, unrelated to Hirschsprung disease. A primary pull-through procedure was performed in 97% and 21% of neonates with short- and non-short-segment Hirschsprung disease, respectively; 17 (31%) infants developed anal stenosis requiring dilatations. Enterocolitis occurred in 14 (26%) infants. Griffiths Mental Development Scale scores (1 year) were available in 31 of 45 nonsyndromic survivors: mean general quotient (94.2, SD 8.89) was significantly less than the population mean (P = .007), but the number of infants with developmental delay was within the expected range. Physical growth, except length, appeared adequate in nonsyndromic infants. There were no significant differences in the outcomes of infants with short- vs non-short-segment Hirschsprung disease. CONCLUSIONS At 1 year of age, many infants with Hirschsprung disease have ongoing gastrointestinal problems. Their overall growth appears satisfactory, and most infants are developing normally; however, their mean general quotient appears shifted to the left. Longer-term studies will better define developmental outcomes.
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Affiliation(s)
- Kiran More
- Princess Margaret Hospital for Children, Perth, Australia; King Edward Memorial Hospital for Women, Perth, Australia
| | - Shripada Rao
- Princess Margaret Hospital for Children, Perth, Australia; King Edward Memorial Hospital for Women, Perth, Australia; Centre for Neonatal Research and Education, University of Western Australia, Perth, Australia.
| | - Judy McMichael
- Princess Margaret Hospital for Children, Perth, Australia; King Edward Memorial Hospital for Women, Perth, Australia
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Buck Louis GM, Hediger ML, Bell EM, Kus CA, Sundaram R, McLain AC, Yeung E, Hills EA, Thoma ME, Druschel CM. Methodology for establishing a population-based birth cohort focusing on couple fertility and children's development, the Upstate KIDS Study. Paediatr Perinat Epidemiol 2014; 28:191-202. [PMID: 24665916 PMCID: PMC4563277 DOI: 10.1111/ppe.12121] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Critical data gaps remain regarding infertility treatment and child development. We assessed the utility of a birth certificate registry for developing a population cohort aimed at answering such questions. METHODS We utilised the Upstate New York livebirth registry (n = 201,063) to select births conceived with (n = 4024) infertility treatment or exposed infants, who were then frequency-matched by residence to a random sample of infants conceived without (n = 14,455) treatment or unexposed infants, 2008-10. Mothers were recruited at 2-4 months postpartum and queried about their reproductive histories, including infertility treatment for comparison with birth certificate data. Overall, 1297 (32%) mothers of exposed and 3692 of unexposed (26%) infants enrolled. RESULTS Twins represented 22% of each infant group. The percentage of infants conceived with/without infertility treatment was similar whether derived from the birth registry or maternal report: 71% none, 16% drugs or intrauterine insemination, and 14% assisted reproductive technologies (ART). Concordant reporting between the two data sources was 93% for no treatment, 88% for ART, and 83% for fertility drugs, but differed by plurality. Exposed infants had slightly (P < 0.01) earlier gestations than unexposed infants (38.3 ± 2.8 and 38.7 ± 2.7 weeks, respectively) based upon birth certificates but not maternal report (38.7 ± 2.7 and 38.7 ± 2.9, respectively). Conversely, mean birthweight was comparable using birth certificates (3157 ± 704 and 3194 ± 679 g, respectively), but differed using maternal report (3167 ± 692 and 3224 ± 661, respectively P < 0.05). CONCLUSIONS The birth certificate registry is a suitable sampling framework as measured by concordance with maternally reported infertility treatment. Future efforts should address the impact of factors associated with discordant reporting on research findings.
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Affiliation(s)
- Germaine M. Buck Louis
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health & Human Development, 6100 Executive Blvd., Room 7B03, Rockville, MD 20852
| | - Mary L. Hediger
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health & Human Development, 6100 Executive Blvd., Room 7B03, Rockville, MD 20852
| | - Erin M. Bell
- Department of Environmental Health Sciences, University at Albany School of Public Health, Albany, NY
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Albany, NY
| | - Christopher A. Kus
- Division of Family Health, New York State Department of Health, Albany, NY
| | - Rajeshwari Sundaram
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health & Human Development, 6100 Executive Blvd., Room 7B03, Rockville, MD 20852
| | - Alexander C. McLain
- Department of Epidemiology & Biostatistics, Arnold School of Public Health, University of South Carolina at Columbia
| | - Edwina Yeung
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health & Human Development, 6100 Executive Blvd., Room 7B03, Rockville, MD 20852
| | - Elaine A. Hills
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Albany, NY
- Congenital Malformations Registry, New York State Department of Health, Albany, NY
| | - Marie E. Thoma
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health & Human Development, 6100 Executive Blvd., Room 7B03, Rockville, MD 20852
| | - Charlotte M. Druschel
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Albany, NY
- Congenital Malformations Registry, New York State Department of Health, Albany, NY
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McNally S, Quigley J. An Irish Cohort Study of Risk and Protective Factors for Infant Language Development at 9 Months. INFANT AND CHILD DEVELOPMENT 2014. [DOI: 10.1002/icd.1861] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Jean Quigley
- School of Psychology; Trinity College Dublin; Ireland
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93
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Engel S, Tronhjem KMH, Hellgren LI, Michaelsen KF, Lauritzen L. Docosahexaenoic acid status at 9 months is inversely associated with communicative skills in 3-year-old girls. MATERNAL & CHILD NUTRITION 2013; 9:499-510. [PMID: 22642227 PMCID: PMC6860840 DOI: 10.1111/j.1740-8709.2012.00411.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The objective of the present observational study was to investigate if the docosahexaenoic acid (DHA) status assessed in infant erythrocytes (RBC) at 9 months was associated with the age when the infants reach developmental milestones and their psychomotor function at 3 years of age. Three hundred eleven healthy Danish children were followed from 9 months to 3 years of age (the SKOT cohort). RBC fatty acid composition was analysed by gas chromatography in 272 of the children. Milestone age was collected by questionnaires at 9 and 18 months and psychomotor development at 3 years of age was assessed by the parents using third edition of the Ages and Stages Questionnaire (ASQ-3). RBC DHA levels ranged from 2.2% to 12.6% of the RBC fatty acids. The age of reaching milestones correlated with psychomotor development, particularly with gross motor function at 3 years. An association between milestones and later personal and social skills was also observed, but only for girls. In girls, RBC-DHA was found to be inversely correlated with communication at 3 years of age (odds ratio = 0.69, 95% confidence interval: 0.56-0.86, P = 0.001), but no other associations with psychomotor development or milestones were found. The results from study indicate that DHA status at 9 months may not have a pronounced beneficial effect on psychomotor development in early childhood and that communicative skills at 3 years of age may even be inversely associated with early RBC-DHA levels in girls.
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Affiliation(s)
- Sara Engel
- Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Frederiksberg, Denmark
| | | | - Lars I. Hellgren
- Department of System Biology, Technical University of Denmark, Lyngby, Denmark (BLH)
| | - Kim F. Michaelsen
- Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - Lotte Lauritzen
- Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Frederiksberg, Denmark
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94
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Minutillo C, Rao SC, Pirie S, McMichael J, Dickinson JE. Growth and developmental outcomes of infants with gastroschisis at one year of age: a retrospective study. J Pediatr Surg 2013; 48:1688-96. [PMID: 23932608 DOI: 10.1016/j.jpedsurg.2012.11.046] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2012] [Revised: 11/28/2012] [Accepted: 11/29/2012] [Indexed: 10/26/2022]
Abstract
BACKGROUND The aim of the study was to describe the physical growth and developmental outcomes of babies born with gastroschisis. METHODS We retrospectively reviewed all cases of gastroschisis in Western Australia born between 1997 and 2010. RESULTS In the 128 pregnancies with fetal gastroschisis, 117 babies were live born. 112 (95.7%) survived to one year. 19% had z scores of<-1.28 for weight at birth (<10th centiles) compared with 30% at one year. Neurodevelopmental data were available in 88/112 (79%) of survivors (Griffiths scores in 67; reports of ages and stages questionnaire (ASQ) in 21). The mean GQ at 12 months was 99 (SD 9.8). Suboptimal neurodevelopmental outcomes were noted in eight. Complex gastroschisis (present at birth) and acquired gut related complications were associated with adverse long term outcomes. The incidence of acquired gut complications was least (5%) in those who underwent silo reduction as the primary management. However, on univariate and multivariate analysis, the type of primary reduction did not significantly influence the outcome. CONCLUSIONS A large proportion of infants with gastroschisis exhibit suboptimal weight gain during the first year. The incidence of adverse developmental outcomes appears to be low.
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Affiliation(s)
- Corrado Minutillo
- Department of Neonatology, Princess Margaret Hospital for Children, Perth, Western Australia
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95
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Veiby G, Daltveit AK, Schjølberg S, Stoltenberg C, Øyen AS, Vollset SE, Engelsen BA, Gilhus NE. Exposure to antiepileptic drugs in utero and child development: a prospective population-based study. Epilepsia 2013; 54:1462-72. [PMID: 23865818 DOI: 10.1111/epi.12226] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2013] [Indexed: 11/30/2022]
Abstract
PURPOSE Antiepileptic drugs may cause congenital malformations. Less is known about the effect on development in infancy and childhood. The aim of this study was to examine whether exposure to antiepileptic drugs during pregnancy has an effect on early child development. METHODS From mid-1999 through December 2008, children of mothers recruited at 13-17 weeks of pregnancy were studied in the ongoing prospective Norwegian Mother and Child Cohort Study. Information on birth outcomes were obtained from the Medical Birth Registry (108,264 children), and mothers reported on their child's motor development, language, social skills, and autistic traits using items from standardized screening tools at 18 months (61,351 children) and 36 months (44,147 children) of age. The relative risk of adverse outcomes in children according to maternal or paternal epilepsy with and without prenatal exposure to antiepileptic drugs was estimated as odds ratios (ORs), using logistic regression with adjustment for maternal age, parity, education, smoking, depression/anxiety, folate supplementation, and child congenital malformation or low birth weight. KEY FINDINGS A total of 333 children were exposed to antiepileptic drugs in utero. At 18 months, the exposed children had increased risk of abnormal scores for gross motor skills (7.1% vs. 2.9%; OR 2.0, 95% confidence interval [CI] 1.1-3.7) and autistic traits (3.5% vs. 0.9%; OR 2.7, CI 1.1-6.7) compared to children of parents without epilepsy. At 36 months, the exposed children had increased risk of abnormal score for gross motor skills (7.5% vs. 3.3%; OR 2.2, CI 1.1-4.2), sentence skills (11.2% vs. 4.8%; OR 2.1, CI 1.2-3.6), and autistic traits (6.0% vs. 1.5%; OR 3.4, CI 1.6-7.0). The drug-exposed children also had increased risk of congenital malformations (6.1% vs. 2.9%; OR 2.1, CI 1.4-3.4), but exclusion of congenital malformations did not affect the risk of adverse development. Children born to women with epilepsy who did not use antiepileptic drugs had no increased risks. Children of fathers with epilepsy generally scored within the normal range. SIGNIFICANCE Exposure to antiepileptic drugs during pregnancy is associated with adverse development at 18 and 36 months of age, measured as low scores within key developmental domains rated by mothers. Exposures to valproate, lamotrigine, carbamazepine, or multiple antiepileptic drugs were associated with adverse outcome within different developmental domains.
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Affiliation(s)
- Gyri Veiby
- Department of Clinical Medicine, Section for Neurology, University of Bergen, Bergen, Norway.
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96
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Schonhaut L, Armijo I, Schönstedt M, Alvarez J, Cordero M. Validity of the ages and stages questionnaires in term and preterm infants. Pediatrics 2013; 131:e1468-74. [PMID: 23629619 DOI: 10.1542/peds.2012-3313] [Citation(s) in RCA: 188] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND This study assessed the concurrent validity of the parent-completed developmental screening measure Ages and Stages Questionnaires, Third Edition (ASQ-3) compared with the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) in children born term, late preterm, or extremely preterm at 8, 18, or 30 months of corrected gestational ages (CGA). METHODS Data were collected from 306 term and preterm children ages 8, 18, and 30 months' CGA recruited from an ambulatory well-child clinic in Santiago, Chile. Parents completed the ASQ-3 in their homes, and afterward a trained professional administered the Bayley-III in a clinic setting. On the ASQ-3, the presence of any domain screened <2 SDs below the mean area score was considered a positive screen (indicating failure or delay). A Bayley-III score less than ≤1 SD indicated mild or severe delay. RESULTS ASQ-3 showed adequate psychometric properties (75% sensitivity and 81% specificity) and modest agreement with the Bayley-III (r = 0.56). Sensitivity, specificity, and correlations between measures improved with testing age and in children who were born extremely preterm. CONCLUSIONS Considering its psychometric properties, the ASQ-3 can be recommended for routine use in screening low-risk children at 8, 18, and 30 months' CGA and is advisable to be included in follow-up programs for children with biological risk factors such as those born preterm.
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Affiliation(s)
- Luisa Schonhaut
- Department of Pediatrics, Clínica Alemana, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile.
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Williams ME, Hutchings J, Bywater T, Daley D, Whitaker CJ. Schedule of Growing Skills II: Pilot Study of an Alternative Scoring Method. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/psych.2013.43021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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98
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A Family Psychosocial Risk Questionnaire for Use in Pediatric Practice. Matern Child Health J 2012; 17:1990-2006. [DOI: 10.1007/s10995-012-1208-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Teune MJ, van Wassenaer AG, Malin GL, Asztalos E, Alfirevic Z, Mol BWJ, Opmeer BC. Long-term child follow-up after large obstetric randomised controlled trials for the evaluation of perinatal interventions: a systematic review of the literature. BJOG 2012; 120:15-22. [PMID: 23078194 DOI: 10.1111/j.1471-0528.2012.03465.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Although the hope is that many perinatal interventions are performed with an ultimate aim to improve the long-term health and development of the child, long-term outcome is rarely used as a primary end-point in perinatal randomised controlled trials (RCTs). OBJECTIVE To evaluate how often and with which tools long-term follow-up is performed after large obstetric RCTs. SEARCH STRATEGY We searched the Cochrane Library for Cochrane reviews published by the Cochrane Pregnancy and Childbirth Group for reviews on interventions that aimed to improve neonatal outcome. Selection criteria Reviews on perinatal interventions that were not performed to improve the condition of the neonate were excluded. We limited our review to RCTs with more than 350 participating women. For each included study, we checked in Web of Science as to whether the researchers had reported on follow-up in subsequent publications. DATA COLLECTION AND ANALYSIS Relevant information was extracted from these RCTs by two reviewers using a predefined data collection sheet. All information was analysed using SPSS 17.0 (SPSS Inc., Chicago, IL, USA). MAIN RESULTS We studied 212 reviews including 1837 RCTs on perinatal interventions, 249 (14%) of which included 350 participants. Only 40 of 249 RCTs (16%) followed the children after discharge from the hospital to evaluate the effect of a specific perinatal intervention. The number of RCTs with long-term follow-up remained stable, with 10 of 67 RCTs (15%) reporting follow-up before 1990, 17 of 115 (15%) between 1990 and 2000, and 13 of 67 (19%) after 2000 (P = 0.68). CONCLUSIONS Only a small minority of large perinatal RCTs report the long-term follow-up of the child. Future obstetric RCTs should consider performing long-term follow-up at the start of the trial.
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Affiliation(s)
- M J Teune
- Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, the Netherlands.
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Developmental and functional outcomes in children with a positive newborn screen for Krabbe disease: a pilot study of a phone-based interview surveillance technique. J Pediatr 2012; 161:258-63.e1. [PMID: 22381022 DOI: 10.1016/j.jpeds.2012.01.044] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Revised: 12/01/2011] [Accepted: 01/20/2012] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the utility of a telephone-based interview system in providing ongoing monitoring of the developmental and functional status of children with both positive newborn screens for Krabbe disease and low galactocerebrosidase activity on confirmatory testing, and to determine whether this approach provides improved compliance with follow-up compared with formal neuropsychological testing. STUDY DESIGN Infants with low galactocerebrosidase activity (as detected by the New York State newborn screening program) were eligible for this longitudinal prospective cohort study. Consenting families were interviewed by telephone at infant ages of 4, 8, 12, 18, and 24 months. Designated instruments were the Ages and Stages Questionnaires, the Clinical Linguistic and Auditory Milestone Scale, the Gross Motor Quotient, the Warner Initial Developmental Evaluation of Adaptive and Functional Skills 50, and the WeeFIM II 0-3 instrument. Assessments with the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley III) were scheduled at age 12 and 24 months. RESULTS Seventeen patients were enrolled; 16 were assessed at age 12 and 18 months, and 15 were assessed at age 24 months. Scores were within the normal range on all tests of developmental and functional status, with the exception of expressive language. Only 7 patients completed the Bayley Scales of Infant and Toddler Development, Third Edition assessments; all their scores were in the normal range. CONCLUSION This telephone-based technique allows close monitoring of the developmental and functional status of children with a positive newborn screen for this neurometabolic disease, with special attention to detecting plateauing or regression of developmental milestones. Compliance is improved compared with formal neuropsychological testing.
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