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Ramu R, Govindan R, Marimuthu P. Effectiveness of training on primary care nurses' knowledge and screening practice in identification of children at risk for developmental delay: An Indian perspective. J Family Med Prim Care 2024; 13:3067-3073. [PMID: 39228618 PMCID: PMC11368284 DOI: 10.4103/jfmpc.jfmpc_1953_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/18/2024] [Accepted: 02/19/2024] [Indexed: 09/05/2024] Open
Abstract
Background In India, overall, 1.5-19.8% of the children were found to be developmentally delayed. The evaluation of development in young children and health professionals' early referrals for diagnostic assessment will accelerate appropriate early intervention as early as possible. Nurses can screen the children and help the parents by providing the necessary information and support. Aim To train the primary care nurses on developmental screening and early identification of developmental delay (DD) in children and find the effectiveness of the same. Objectives of the study To evaluate the effectiveness of the training program on the knowledge and screening practice of the nurses towards the identification of children at risk for DD and to find out the relationship between nurses' knowledge and screening practice. Methods and Materials A quasi-experimental, one-group pretest, post-test design was adopted among 69 nurses, who were providing child care services and working in the selected government hospitals in Bengaluru, South India. Nurses' knowledge and screening practice in identifying children at risk for DD were assessed before and after the training. SPSS package 21.00 version was used to analyse the descriptive and inferential statistics. Results The training program was effective in the enhancement of primary care nurses' knowledge and screening practice in the identification of DDs in under-five children. Conclusion The findings of this study concluded that developmental screening can be performed by nurses with suitable training programs. The training program played a significant role in the enhancement of nurses' knowledge and screening practice in the identification of DDs in under-five children.
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Suresh S, Janakiraman A, Narasimhan U, Rajanandh MG, Liyakath Ali AN, Murugan S. Diagnostic Accuracy of Bayley III Screening Tool to Detect Developmental Delay in Moderate to High-Risk Indian Preterm Children. Indian J Pediatr 2024; 91:730-732. [PMID: 37796402 DOI: 10.1007/s12098-023-04855-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/22/2023] [Indexed: 10/06/2023]
Abstract
The present study aimed to evaluate the ability of the Bayley III screening tool to detect developmental delay in moderate to high-risk preterm children in India. In this cross-sectional study, 94 preterm babies were enrolled. The Bayley III screener (index test) and the gold-standard, Developmental assessment scale for Indian Infants (DASII) test were administered to all the enrolled children. Researchers were blinded while performing the tests. Diagnostic accuracy parameters were compared. The Bayley III screener's sensitivity and specificity for predicting the delay (with a DASII cut-off of <70) were 84.62% and 85.18% in the mental domain and 61.11% and 96.05% in the motor domain, respectively. When the DASII cut-off was raised to 85, the sensitivity and specificity in the mental domain were 60.61% and 95.08%, respectively, whereas they were 36.11% and 98.27%, respectively, in the motor domain. The Bayley III screener is found to have good specificity rather than sensitivity with good predictive values.
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Affiliation(s)
- Sanmathi Suresh
- Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Chennai, Tamil Nadu, India
| | - Abhinayaa Janakiraman
- Department of Developmental Pediatrics, Cloudnine Hospital, Chennai, Tamil Nadu, India
| | - Udayakumar Narasimhan
- Karthikeyan Child Developmental Unit, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Chennai, Tamil Nadu, India
| | - Muhasaparur Ganesan Rajanandh
- Department of Pharmacy Practice, SRM College of Pharmacy, SRM Institute of Science and Technology, Deemed to be University, Chennai, Tamil Nadu, India.
| | - Ayesha Nabeela Liyakath Ali
- Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Chennai, Tamil Nadu, India
| | - Sreelekha Murugan
- Karthikeyan Child Developmental Unit, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Chennai, Tamil Nadu, India
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Handargule A, Meshram RJ, Taksande A, Malik A, K SSNSP, Desai K. A Review of Developmental Scales in Pediatric Practice: Recent Guidelines. Cureus 2024; 16:e62941. [PMID: 39044889 PMCID: PMC11263965 DOI: 10.7759/cureus.62941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 06/22/2024] [Indexed: 07/25/2024] Open
Abstract
Imitation, fine motor abilities, eye-to-hand coordination, perception, gross motor abilities, mental abilities, and verbal cognitive abilities are assessed on the developmental scale. The behavioral scale also assesses social interaction, emotional expression, activity, curiosity, sensory reactivity, and language. The current developmental scales in pediatrics are discussed in this paper. These scales have evolved. International scales for Indian children are difficult to administer due to cultural differences in self-care and gender roles. If parental awareness and demand are raised, postnatal growth interventions for psychosocial development will benefit infants in developing nations. Routine screening involves identifying an appropriate opportunity, acquisition, tool selection, administration, interpreting data, scoring, counseling, and training.
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Affiliation(s)
- Anuja Handargule
- Pediatrics, Datta Meghe Institute of Higher Education and Research Centre, Wardha, IND
| | - Revat J Meshram
- Pediatrics, Datta Meghe Institute of Higher Education and Research Centre, Wardha, IND
| | - Amar Taksande
- Pediatrics, Datta Meghe Institute of Higher Education and Research Centre, Wardha, IND
| | - Aashita Malik
- Pediatrics, Datta Meghe Institute of Higher Education and Research Centre, Wardha, IND
| | | | - Kushal Desai
- Pediatrics, Datta Meghe Institute of Higher Education and Research Centre, Wardha, IND
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Mukherjee D, Bhavnani S, Lockwood Estrin G, Rao V, Dasgupta J, Irfan H, Chakrabarti B, Patel V, Belmonte MK. Digital tools for direct assessment of autism risk during early childhood: A systematic review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:6-31. [PMID: 36336996 PMCID: PMC10771029 DOI: 10.1177/13623613221133176] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
LAY ABSTRACT The challenge of finding autistic children, and finding them early enough to make a difference for them and their families, becomes all the greater in parts of the world where human and material resources are in short supply. Poverty of resources delays interventions, translating into a poverty of outcomes. Digital tools carry potential to lessen this delay because they can be administered by non-specialists in children's homes, schools or other everyday environments, they can measure a wide range of autistic behaviours objectively and they can automate analysis without requiring an expert in computers or statistics. This literature review aimed to identify and describe digital tools for screening children who may be at risk for autism. These tools are predominantly at the 'proof-of-concept' stage. Both portable (laptops, mobile phones, smart toys) and fixed (desktop computers, virtual-reality platforms) technologies are used to present computerised games, or to record children's behaviours or speech. Computerised analysis of children's interactions with these technologies differentiates children with and without autism, with promising results. Tasks assessing social responses and hand and body movements are the most reliable in distinguishing autistic from typically developing children. Such digital tools hold immense potential for early identification of autism spectrum disorder risk at a large scale. Next steps should be to further validate these tools and to evaluate their applicability in a variety of settings. Crucially, stakeholders from underserved communities globally must be involved in this research, lest it fail to capture the issues that these stakeholders are facing.
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Affiliation(s)
- Debarati Mukherjee
- Indian Institute of Public Health - Bengaluru, Public Health Foundation of India, India
| | | | | | - Vaisnavi Rao
- Institute for Democracy and Economic Affairs (IDEAS), Malaysia
| | | | | | | | - Vikram Patel
- Child Development Group, Sangath, India
- Harvard Medical School, USA
- Harvard T.H. Chan School of Public Health, USA
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Sheel H, Suárez L, Marsh NV. Screening Children in India: Translation and Psychometric Evaluation of the Parents' Evaluation of Developmental Status and the Strength and Difficulties Questionnaire. Pediatr Rep 2023; 15:750-765. [PMID: 38133435 PMCID: PMC10745979 DOI: 10.3390/pediatric15040067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/06/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023] Open
Abstract
Timely screening and surveillance of children for developmental delay and social-emotional learning difficulties are essential in Low- and Middle-Income Countries like India. Screening measures like the Parents' Evaluation of Developmental Status (PEDS) and Strength and Difficulties Questionnaire (SDQ) are considered suitable for India due to their low cost, easy accessibility, and no training requirement for administration. However, India lacks validated screening measures, and the PEDS and SDQ have yet to be validated for children in India. The study aimed to translate the PEDS and SDQ from English to Hindi and psychometrically evaluate the same measures on children aged 4-8 years in India. The original PEDS and SDQ forms and their translations were pilot tested on 55 participants and evaluated using data from 407 children with typical development (TD) and 59 children with developmental disability (DD). Parents and teachers reported no meaningful discrepancy between the original and translated (Hindi) questionnaires. Internal consistency for the PEDS was acceptable, but unacceptable for most subscales on the SDQ, for both TD and DD samples. Test-retest reliability was poor for the PEDS but adequate for the SDQ. Results from known-group validity testing showed that the PEDS scores could be used to distinguish between the TD and DD samples. The results from this study provide further support for the use of the PEDS and SDQ in developing countries like India.
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Affiliation(s)
- Hina Sheel
- School of Social and Health Sciences, James Cook University, Singapore 387380, Singapore (L.S.)
- School of Health and Life Sciences, De Montfort University, Academic City, Dubai 294345, United Arab Emirates
| | - Lidia Suárez
- School of Social and Health Sciences, James Cook University, Singapore 387380, Singapore (L.S.)
| | - Nigel V. Marsh
- School of Social and Health Sciences, James Cook University, Singapore 387380, Singapore (L.S.)
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Mujoo H, Bowden N, Thabrew H, Kokaua J, Audas R, Taylor B. Identifying neurodevelopmental disabilities from nationalised preschool health check. Aust N Z J Psychiatry 2023; 57:1140-1149. [PMID: 36748102 PMCID: PMC10363952 DOI: 10.1177/00048674231151606] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Models of psychometric screening to identify individuals with neurodevelopmental disabilities (NDDs) have had limited success. In Aotearoa/New Zealand, routine developmental surveillance of preschool children is undertaken using the Before School Check (B4SC), which includes psychometric and physical health screening instruments. This study aimed to determine whether combining multiple screening measures could improve the prediction of NDDs. METHODS Linked administrative health data were used to identify NDDs, including attention deficit hyperactivity disorder, autism spectrum disorder and intellectual disability, within a multi-year national cohort of children who undertook the B4SC. Cox proportional hazards models, with different combinations of potential predictors, were used to predict onset of a NDD. Harrell's c-statistic for composite models were compared with a model representing recommended cutoff psychometric scores for referral in New Zealand. RESULTS Data were examined for 287,754 children, and NDDs were identified in 10,953 (3.8%). The best-performing composite model combining the Strengths and Difficulties Questionnaire, the Parental Evaluation of Developmental Status, vision screening and biological sex had 'excellent' predictive power (C-statistic: 0.83) compared with existing referral pathways which had 'poor' predictive power (C-statistic: 0.68). In addition, the composite model was able to improve the sensitivity of NDD diagnosis detection by 13% without any reduction in specificity. CONCLUSIONS Combination of B4SC screening measures using composite modelling could lead to significantly improved identification of preschool children with NDDs when compared with surveillance that rely on individual psychometric test results alone. This may optimise access to academic, personal and family support for children with NDDs.
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Affiliation(s)
- Himang Mujoo
- A Better Start National Science Challenge, Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
| | - Nicholas Bowden
- A Better Start National Science Challenge, Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
| | - Hiran Thabrew
- A Better Start National Science Challenge, Liggins Institute, University of Auckland, Auckland, New Zealand
- The Werry Centre, Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Jesse Kokaua
- A Better Start National Science Challenge, Liggins Institute, University of Auckland, Auckland, New Zealand
- Va’a O Tautai – Centre for Pacific Health, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Richard Audas
- Faculty of Medicine, Memorial University of Newfoundland and Labrador, St. John’s, NL, Canada
| | - Barry Taylor
- A Better Start National Science Challenge, Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
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Mukherjee SB, Meghana S, Singh AK, Sharma S, Kapoor D. Diagnostic Accuracy of the Government of India Mother and Child Protection Card for Developmental Screening of Indian Children Aged 2–36 Months: A Hospital-based Mixed Method Study. Indian Pediatr 2023. [DOI: 10.1007/s13312-023-2832-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
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Sheel H, Suárez L, Marsh NV. Parents' Evaluation of Developmental Status and Strength and Difficulties Questionnaire as Screening Measures for Children in India: A Scoping Review. Pediatr Rep 2023; 15:175-196. [PMID: 36976721 PMCID: PMC10055800 DOI: 10.3390/pediatric15010014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 03/29/2023] Open
Abstract
Due to the limited availability of suitable measures, screening children for developmental delays and social-emotional learning has long been a challenge in India. This scoping review examined the use of the Parents' Evaluation of Developmental Status (PEDS), PEDS: Developmental Milestones (PEDS:DM), and the Strength and Difficulties Questionnaire (SDQ) with children (<13 years old) in India. The scoping review was conducted following the Joanna Briggs Institute Protocol to identify primary research studies that examined the use of the PEDS, PEDS:DM, and SDQ in India between 1990 and 2020. A total of seven studies for the PEDS and eight studies for the SDQ were identified for inclusion in the review. There were no studies using the PEDS:DM. Two empirical studies used the PEDS, while seven empirical studies used the SDQ. This review represents the first step in understanding the use of screening tools with children in India.
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Affiliation(s)
- Hina Sheel
- School of Social and Health Sciences, James Cook University, 149 Sims Drive, Singapore 387380, Singapore
| | - Lidia Suárez
- School of Social and Health Sciences, James Cook University, 149 Sims Drive, Singapore 387380, Singapore
| | - Nigel V Marsh
- School of Social and Health Sciences, James Cook University, 149 Sims Drive, Singapore 387380, Singapore
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Sobieski M, Sobieska A, Sekułowicz M, Bujnowska-Fedak MM. Tools for early screening of autism spectrum disorders in primary health care – a scoping review. BMC PRIMARY CARE 2022; 23:46. [PMID: 35291950 PMCID: PMC8925080 DOI: 10.1186/s12875-022-01645-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 02/21/2022] [Indexed: 12/30/2022]
Abstract
Abstract
Background
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that manifests itself in early childhood. Early diagnosis of these disorders allows for the initiation of early therapy, which is crucial for the child's further functioning in society.
Objectives
This review aims to gather and present the existing ASD screening tools that can be used in primary care and adapted to different countries conditions linguistically and culturally.
Eligibility criteria
We searched for English-language publications on ASD screening tools for children aged 0–3 years suitable for use in primary care (i.e. free, requiring no additional training or qualifications).
Sources of evidence
Four databases were explored to find English studies on ASD screening tools intended for the rapid assessment of children aged 0–3.
Charting methods
The information sought (specific features of the questionnaires relevant to primary health care workers, psychometric and diagnostic values of a given cultural adaptation of screening tools, and the linguistic and cultural changes made) were extracted and collected to create profiles of these tools.
Results
We found 81 studies which met inclusion criteria and underwent full data extraction. Three additional data sources were included. These allowed to create 75 profiles of adaptations for 26 different screening tools and collect data on their psychometric values and characteristic features.
Conclusions
The results of our study indicate the availability of several diagnostic tools for early ASD screening in primary care setting concordant culturally and linguistically with a given population. They could be an effective method of accelerating the diagnostic process and starting personalized therapy faster. However, most tools have significant limitations – some are only available for research purposes, while others do not have scientific evidence to prove their effectiveness.
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Mengi M, Malhotra D. A systematic literature review on traditional to artificial intelligence based socio-behavioral disorders diagnosis in India: Challenges and future perspectives. Appl Soft Comput 2022. [DOI: 10.1016/j.asoc.2022.109633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Uchitel J, Alden E, Bhutta ZA, Cavallera V, Lucas J, Oberklaid F, Patterson J, Raghavan C, Richter L, Rikard B, Russell RR, Mikati MA. Role of Pediatricians, Pediatric Associations, and Academic Departments in Ensuring Optimal Early Childhood Development Globally: Position Paper of the International Pediatric Association. J Dev Behav Pediatr 2022; 43:e546-e558. [PMID: 35980036 DOI: 10.1097/dbp.0000000000001112] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 04/15/2022] [Indexed: 02/04/2023]
Abstract
ABSTRACT Early childhood (birth-8 years), particularly the first 3 years, is the most critical time in development because of the highly sensitive developing brain. Providing appropriate developmental care (i.e., nurturing care, as defined by the World Health Organization [WHO]) during early childhood is key to ensuring a child's holistic development. Pediatricians are expected to play a critical role in supporting early childhood development (ECD) through providing developmental services such as developmental monitoring, anticipatory guidance, screening, and referral to medical and/or community-based services when delay is identified. Pediatricians are also expected to serve as advocates within their clinics and communities for improved delivery of ECD services, such as advocating for increasing funding for ECD initiatives, increasing insurance coverage of ECD services, and working to increase other pediatricians' awareness of the principles of ECD and how to deliver developmental services. However, this does not always occur. Typically, pediatricians' training and practice emphasizes treating disease rather than enhancing ECD. Pediatricians are further hindered by a lack of uniformity across nations in guidelines for developmental monitoring and screening. In this article, we present the vision of the International Pediatric Association (IPA) of the roles that pediatricians, academic departments, medical training programs, and pediatric associations should fulfill to help support ECD, including raising ECD to higher levels of priority in routine pediatric care. First, we present the challenges that face these goals in supporting ECD. We then propose, with supportive literature, strategies and resources to overcome these challenges in collaboration with local and international stakeholders, including the IPA, the WHO, UNICEF, and the World Bank.
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Affiliation(s)
- Julie Uchitel
- Department of Paediatrics, University of Cambridge, The Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- Division of Pediatric Neurology and Developmental Medicine, Duke University Health System, Durham, NC
| | - Errol Alden
- International Pediatric Association, Uniformed Services of Health Sciences, Bethesda, MD
| | - Zulfiqar A Bhutta
- International Pediatric Association; Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
| | | | - Jane Lucas
- Consultant in International Health and Child Development to UNICEF and the World Health Organization, New York, NY
| | - Frank Oberklaid
- Centre for Community Child Health, The Royal Children's Hospital, Melbourne, Australia
| | - Janna Patterson
- Global Child Health and Life Support, American Academy of Pediatrics, Chicago, IL
| | - Chemba Raghavan
- Early Childhood Development Specialist/Acting Chief, UNICEF, New York, NY
| | - Linda Richter
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Blaire Rikard
- Division of Pediatric Neurology and Developmental Medicine, Duke University Health System, Durham, NC
| | - Robert Ross Russell
- European Board of Paediatrics, European Academy of Paediatrics; Paediatric Respiratory Paediatrics, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Mohamad A Mikati
- Early Childhood Development Standing Advisory Group, International Pediatrics Association; Department of Pediatrics, Division of Pediatric Neurology and Developmental Medicine Duke University Medical Center, Durham, NC
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Suman P, Mushtaq I, Tandon R. Validation of Hindi Translation of Survey of Well-Being of Young Children Tool in Indian Children. Indian Pediatr 2022. [DOI: 10.1007/s13312-022-2556-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mukherjee SB, Verma S, Sharma S, Aneja S. Diagnostic Accuracy of Parents' Evaluation of Developmental Status (PEDS), PEDS Developmental Milestones, and PEDS Combined in Indian Children Aged Less than 2 Years. Indian J Pediatr 2022; 89:459-465. [PMID: 33620632 DOI: 10.1007/s12098-020-03651-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 12/29/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the diagnostic accuracy of Parent's Evaluation of Developmental Status (PEDS), PEDS Developmental Milestones (PEDS:DM) and PEDS Combined for developmental screening of Indian children aged less than 2 y. METHOD A hospital-based study of diagnostic accuracy was conducted over 17 mo. Children under 24 mo (n = 180) were enrolled after exclusion of severe illnesses or known neurodevelopment disorders. The index tools included standardized Hindi translations of PEDS and PEDS:DM. The reference tool was Developmental Assessment Scale for Indian Infants (DASII). Both were administered by blinded researchers. Parameters of diagnostic accuracy were computed. RESULTS There were 13 (7.2%) failures in PEDS, 119 (66.1%) in PEDS:DM and 119 (66.1%) in PEDS Combined. DASII identified 3 children with developmental delay. Sensitivity (Sn) [95% CI] of PEDS was 33.3 [0.8-90.6] and Specificity (Sp) 93.2 [88.5-96.5]. The Sn and Sp of both PEDS:DM and PEDS Combined were 100 [29.2-100] and 34.5 [27.5-42.0], respectively. CONCLUSIONS Hindi translations of PEDS, PEDS:DM and PEDS Combined are not suitable for developmental screening of children less than 2 y due to suboptimal diagnostic accuracy.
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Affiliation(s)
- Sharmila Banerjee Mukherjee
- Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, Bangla Sahib Road, New Delhi, 110001, India.
| | - Sangeeta Verma
- Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, Bangla Sahib Road, New Delhi, 110001, India
| | - Suvasini Sharma
- Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, Bangla Sahib Road, New Delhi, 110001, India
| | - Satinder Aneja
- Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, Bangla Sahib Road, New Delhi, 110001, India
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Mukherjee SB, Jain A, Annadurai A, Sharma S. Application of the "Monitoring Child Development in Integrated Management of Childhood Illnesses Context" in Indian Infants and Toddlers. J Dev Behav Pediatr 2022; 43:e246-e254. [PMID: 34740216 DOI: 10.1097/dbp.0000000000001022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 09/02/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this study was to determine the diagnostic accuracy of "Monitoring Child Development in the Integrated Management of Childhood Illnesses Context" (MCDIC) for developmental screening of Indian children younger than 3 years. METHOD A hospital-based study of diagnostic accuracy was conducted over 17 months after obtaining institutional ethics committee approval. Children younger than 3 years were included in this study. Children with acute illnesses and who presented without their primary caregiver were excluded from this study. The calculated sample size was 272. Eligible children were enrolled after informed consent and stratified by age. MCDIC (index tool) was administrated to primary caregivers by trained interviewers to identify "suspected/probable developmental delay (SDD/PDD)." The reference tools included Developmental Profile, Third Edition, which assessed developmental status based on General Developmental Score (GDS), and Vineland Adaptive Behavior Scale, Second Edition, which evaluated adaptive function based on Adaptive Behavior Composite (ABC). Parameters of diagnostic accuracy were computed according to the number of children with "SDD/PDD" and "developmental delay" (GDS and ABC < -2 SDs). RESULTS The number of eligible children was 312. The sensitivity of MCDIC was 88.0% (95% confidence interval [CI] 68.8-97.5), specificity 85.7 (95% CI 81.1-89.6), positive predictive value 34.9 (95% CI 28.0-42.5), and negative predictive value 98.8 (95% CI 96.6-99.6). CONCLUSION MCDIC had a high sensitivity and specificity that were above 70% and 80%, respectively, and a high negative predictive value, making it a suitable tool for screening and surveillance of Indian children younger than 3 years.
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Affiliation(s)
- Sharmila Banerjee Mukherjee
- Department of Pediatrics, Lady Hardinge Medical College & Associated Kalawati Saran Children's Hospital, New Delhi, India
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15
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Dora S, Bhatia V, Behera BK, Satapathy AK. Capacity Building of Frontline Workers for Detection of Children (0-6 Years) with Developmental Delays in a Rural Setting: A Cluster-Randomized Trial. Indian J Pediatr 2022; 89:351-357. [PMID: 34757573 DOI: 10.1007/s12098-021-03912-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 06/10/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Development during the early stage of life i.e. in the first 1000 d is crucial in determining the psychosocial productivity of a child in the future. Frontline workers (FLWs) are not trained to detect of developmental delays (DDs) in children under the national programme of Rashtriya Bal Swasthya Karyakram (RBSK) in India. OBJECTIVE To train the FLWs and assess the effectiveness of a training strategy in detection of DDs in children less than 6 y of age using a cluster-randomized trial approach. METHODS A community-based interventional study was conducted in Khurdha district of Odisha. Training was imparted to FLWs in intervention arm using a training module developed in regional language. Knowledge level of FLWs was assessed before and after the training in both study arms using a structured questionnaire, and data were analyzed in IBM SPSS 22. Outcomes were compared using chi square, Student t (both paired and unpaired) and Man-Whitney U test. After 3 mo of intervention, the investigator examined a sample of children (intervention arm: 870, control arm: 847) for DDs using the Denver Developmental Screening Test II. RESULTS The mean difference in knowledge scores of FLWs was found to be 7.26 (8.8 to 5.7) and 1.11 (1.38 to 0.84) in intervention and control arm, respectively. Case detection rate by FLWs in intervention and control arm was 61.5% and 9.09%, respectively. CONCLUSION Capacity building of the FLWs should be considered by the government for integrating them in the Rashtriya Bal Swasthya Karyakram (RBSK) programme for screening children.
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Affiliation(s)
- Susmita Dora
- Department of Community Medicine & Family Medicine, AIIMS, Bhubaneswar, Odisha, 751019, India.
| | - Vikas Bhatia
- Department of Community Medicine & Family Medicine, AIIMS, Bhubaneswar, Odisha, 751019, India
- Executive Director, AIIMS, Bibinagar, Telengana, India
| | - Binod Kumar Behera
- Department of Community Medicine & Family Medicine, AIIMS, Bhubaneswar, Odisha, 751019, India
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Shekhawat DS, Gupta T, Singh P, Sharma P, Singh K. Monitoring tools for early identification of children with developmental delay in India: an update. Child Neuropsychol 2022; 28:814-830. [DOI: 10.1080/09297049.2021.2022113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Tanu Gupta
- Clinical Psychologist Department of Psychiatry, All India Institute of Medical Sciences Jodhpur, India
| | - Pratibha Singh
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences Jodhpur, India
| | - Praveen Sharma
- Department of Biochemistry, All India Institute of Medical Sciences Jodhpur, India
| | - Kuldeep Singh
- Department of Pediatrics, All India Institute of Medical Sciences Jodhpur, India
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Garibaldi A, Venkatesh L, Bhat JS, Boominathan P. Relationship between parental report of language skills and children's performance among 3-year-olds: Implications for screening language among preschoolers. Int J Pediatr Otorhinolaryngol 2021; 151:110943. [PMID: 34700297 DOI: 10.1016/j.ijporl.2021.110943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/28/2021] [Accepted: 10/12/2021] [Indexed: 10/20/2022]
Abstract
AIM The study compared parental ratings of children's language abilities at 3-years of age with observations of children's language performance by Speech Language Pathologists (SLPs). METHOD Children (n=85) around 3-years of age were recruited from a child development clinic. Detailed speech and language assessments were completed during a one-hour semi-structured clinician-child interactive session. Language assessment was carried out using a criterion-referenced checklist and the language sections of the Bayley Scale for Infant Development- 3rd Edition (BSID-III). All parents rated their children's language skills using seven statements related to reception and expression domains of language on a 7-point rating scale. The language status of the child (typical language vs delay) determined by the parental report was matched with the language status as per the child's performance during the SLP assessment. RESULTS AND DISCUSSION Mean parental ratings of children assessed as having language delay by an SLP were significantly lower than children with typical language. Total parental rating score correlated highly with overall language scores on BSID-III; the highest correlation was observed for ratings of statements related to expressive language skills focusing on formation of sentences. Parental report of below normal performance on any one of the seven statements demonstrated acceptable sensitivity (0.95) and a high negative predictive value (0.98) with the child's performance as the gold standard. CONCLUSION Parental ratings of language skills correlated with child's performance at 3-years of age with a higher agreement for identifying children with delays. Parental reports can be useful to red-flag children for further assessment and continued monitoring of language development in busy developmental clinics and preschools, especially in the context of low-resource settings.
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Affiliation(s)
- Adhirai Garibaldi
- Department of Speech, Language and Hearing Sciences, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Porur, Chennai, Tamil Nadu, 600116, India.
| | - Lakshmi Venkatesh
- Department of Speech, Language and Hearing Sciences, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Porur, Chennai, Tamil Nadu, 600116, India.
| | - Jayashree S Bhat
- Department of Audiology and Speech Language Pathology, Kasturba Medical College, Manipal Academy of Higher Education and Research (Deemed to be University), Manipal, Karnataka, 576104, India.
| | - Prakash Boominathan
- Department of Speech, Language and Hearing Sciences, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Porur, Chennai, Tamil Nadu, 600116, India.
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Tesfay H, Sebsibe G, Tesfaye T. Practice of Early Childhood Developmental Milestone Assessment and Its Determinants Among Health Professionals Working at Public Hospitals in Addis Ababa, Ethiopia: A Cross-Sectional Study. Pediatric Health Med Ther 2021; 12:521-532. [PMID: 34866960 PMCID: PMC8638751 DOI: 10.2147/phmt.s300397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 08/03/2021] [Indexed: 11/23/2022] Open
Abstract
Background Early childhood developmental assessment refers to the continual process of observing, gathering, recording, and interpreting information to make developmental and instructional decisions and measure young children’s performance over time. Significant changes in the physical and neuropsychomotor developmental milestones take place in the first 2 years of life. Children younger than 3 years of age (36 months) who are at risk of having developmental delays may be eligible for early intervention treatment services. The study aimed to assess practice in early childhood developmental assessment and its determinants among health professionals working in public hospitals in Addis Ababa, Ethiopia. Methods This facility-based descriptive cross-sectional study was conducted from September to April 2018, with a total sample size of 268 health professionals from six public hospitals in Addis Ababa, Ethiopia. The data were entered into EpiData software version 4.2, and analyzed by SPSS version 23 software for bivariate and multivariable logistic regression analysis. Significant associations were taken as p<0.05 and the strength of associations was expressed using odds ratios. Results The practice of early childhood developmental milestone assessment was found to be 27.8%. Being a general practitioner (AOR=23.826, 95% CI: 6.77–83.9, p=0.000) or health officer (AOR=11.02, 95% CI: 2.1–58.812, p=0.005), and work experience greater than 11 years (AOR=20.897, 95% CI: 1.5–291.49, p=0.024) were significantly associated with good practice of early childhood developmental milestone assessment. Conclusion Practice of early childhood developmental milestone assessment remains poor. Training and sharing experiences among different professions, and assigning professionals with the highest levels of work experience in the service could improve the practice levels.
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Affiliation(s)
- Haileslassie Tesfay
- College of Medicine and Health Sciences, Debre Birhan University, Debre Birhan, Ethiopia
| | - Girum Sebsibe
- Department of Nursing, School of Nursing and Midwifery, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tewodros Tesfaye
- Department of Nursing, School of Nursing and Midwifery, Addis Ababa University, Addis Ababa, Ethiopia
- Correspondence: Tewodros Tesfaye Department of Nursing, School of Nursing and Midwifery, Addis Ababa University, PO Box 4412, Addis Ababa, EthiopiaTel +251 913 69 80 81 Email
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Madaan P, Saini L, Sondhi V. Development Assessment Scale for Indian Infants: A Systematic Review and Perspective on Dwindling Cutoffs. Indian J Pediatr 2021; 88:918-920. [PMID: 33555568 DOI: 10.1007/s12098-021-03671-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/15/2021] [Indexed: 11/30/2022]
Abstract
The Developmental Assessment Scale for Indian Infants (DASII) remains the mainstay in India for diagnostic confirmation and validation of upcoming screening tools for development in infants and toddlers. This is an Indian adaptation of Bayley Scales of Infant Development which is the globally accepted gold standard. However, the DASII cutoff points used for categorizing development and distinguishing normal from abnormal development are not in agreement across different studies conducted over the last two decades in India. This is probably due to a lack of mention of cutoff points in the DASII manual and existing literature. The current systematic review summarizes the heterogeneity in literature for interpretation of DASII and its cutoff points. Also, a perspective on the ideal cutoff points is presented.
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Affiliation(s)
- Priyanka Madaan
- Pediatric Neurology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Lokesh Saini
- Pediatric Neurology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
| | - Vishal Sondhi
- Department of Pediatrics, Armed Forces Medical College, Pune, Maharashtra, India
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Nimkar S, Joshi S, Kinikar A, Valvi C, Devaleenal DB, Thakur K, Bendre M, Khwaja S, Ithape M, Kattagoni K, Paradkar M, Gupte N, Gupta A, Suryavanshi N, Mave V, Dooley KE, Arenivas A. Mullen Scales of Early Learning Adaptation for Assessment of Indian Children and Application to Tuberculous Meningitis. J Trop Pediatr 2021; 67:fmaa034. [PMID: 32620972 PMCID: PMC8496186 DOI: 10.1093/tropej/fmaa034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Tuberculous meningitis (TBM) results in significant morbidity and mortality among children worldwide. Associated neurocognitive complications are common but not well characterized. The Mullen Scales of Early Learning (MSEL), a well-established measure for assessment of neurodevelopment, has not yet been adapted for use in India. This study's goal was to adapt the MSEL for local language and culture to assess neurocognition among children in India, and apply the adapted measure for assessment of children with TBM. METHODS Administration of MSEL domains was culturally adapted. Robust translation procedures for instructions took place for three local languages: Marathi, Hindi and Tamil. Multilingual staff compared instructions against the original version for accuracy. The MSEL stimuli and instructions were reviewed by psychologists and pediatricians in India to identify items concerning for cultural bias. RESULTS MSEL stimuli unfamiliar to children in this setting were identified and modified within Visual Reception, Fine-Motor, Receptive Language and Expressive Language Scales. Item category was maintained for adaptations of items visually or linguistically different from those observed in daily life. Adjusted items were administered to six typically developing children to determine modification utility. Two children diagnosed with confirmed TBM (ages 11 and 29 months) were evaluated with the adapted MSEL before receiving study medications. Skills were below age-expectation across visual reception, fine motor and expressive language domains. CONCLUSIONS This is the first study to assess children with TBM using the MSEL adapted for use in India. Future studies in larger groups of Indian children are warranted to validate the adapted measure.
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Affiliation(s)
- Smita Nimkar
- Clinical Trial Unit, Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research Site, Pune, India
- Department of Health and Biomedical Sciences, Symbiosis International (Deemed) University, Lavale, Pune, India
| | - Suvarna Joshi
- Department of Health and Biomedical Sciences, Symbiosis International (Deemed) University, Lavale, Pune, India
- Department of Pediatrics, Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - Aarti Kinikar
- Department of Pediatrics, Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - Chhaya Valvi
- Department of Pediatrics, Byramjee Jeejeebhoy Government Medical College, Pune, India
| | - D Bella Devaleenal
- Department of Clinical Research, ICMR - National Institute for Research in Tuberculosis, Chennai, India
| | - Kiran Thakur
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Manjushree Bendre
- Clinical Trial Unit, Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research Site, Pune, India
| | - Saltanat Khwaja
- Clinical Trial Unit, Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research Site, Pune, India
| | - Mahesh Ithape
- Clinical Trial Unit, Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research Site, Pune, India
| | - Krishna Kattagoni
- Department of Clinical Research, ICMR - National Institute for Research in Tuberculosis, Chennai, India
| | - Mandar Paradkar
- Clinical Trial Unit, Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research Site, Pune, India
| | - Nikhil Gupte
- Divisions of Clinical Pharmacology and Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Amita Gupta
- Divisions of Clinical Pharmacology and Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nishi Suryavanshi
- Clinical Trial Unit, Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research Site, Pune, India
| | - Vidya Mave
- Clinical Trial Unit, Byramjee Jeejeebhoy Government Medical College, Johns Hopkins University Clinical Research Site, Pune, India
- Divisions of Clinical Pharmacology and Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kelly E Dooley
- Divisions of Clinical Pharmacology and Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ana Arenivas
- Department of Rehabilitation Psychology and Neuropsychology, The Institute for Rehabilitation and Research (TIRR) Memorial Hermann, Houston, TX, USA
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA
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Indian Academy of Pediatrics Position Paper on Nurturing Care for Early Childhood Development. Indian Pediatr 2021. [DOI: 10.1007/s13312-021-2332-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Jacob P, Ts J, G SK, L M, Gr G, K T, Srinath S. Behavioural, emotional and rhythm-related disturbances in toddlers: Preliminary findings from a community-based study in Kerala, India. Infant Ment Health J 2021; 42:292-298. [PMID: 33394552 DOI: 10.1002/imhj.21905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE The need to enhance mental health in primary care settings for infants and toddlers is increasingly becoming apparent. However, the lack of trained healthcare personnel and culturally appropriate measures makes it a challenge in low- and middle-income countries. A needs-based assessment of the extent of the problems in toddlers will help address the lacunae in providing mental health services. METHODS A needs-based assessment was carried out of a community sample of 9,287 mothers with toddlers aged between 13 and 25 months in Kerala, India. This assessment was conducted by junior public health nurses using an indigenously developed checklist titled 'Screening checklist for Behavioural, Emotional and Rhythm-related disturbances in Toddlers' (S-BERT). RESULTS According to the mothers surveyed, 30.4% of toddlers had concerning or distress causing behaviours. Three factors, namely behavioural, rhythm-related and emotional disturbances, were deemed significant when the item response theory was used to examine the factor structure of S-BERT. CONCLUSION This study suggests that behaviours that cause distress to mothers of toddlers are common, if queried specifically. Given the constraints in health resources as the cultural factors in operation, use of indigenous tools and principles of collaborative stepped care may be the way forward.
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Affiliation(s)
- Preeti Jacob
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Jaisoorya Ts
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | | | - Manoj L
- National Health Mission, Kerala, India
| | - Gokul Gr
- National Health Mission, Kerala, India
| | - Thennarasu K
- Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Shoba Srinath
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
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Jain K, Solomon J, Ramachandran S. Knowledge, attitude and practices on developmental surveillance and screening among health professionals in Indian health care settings: An exploratory sequential mixed methods study. J Pediatr Rehabil Med 2021; 14:55-63. [PMID: 33492251 DOI: 10.3233/prm-190649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The purpose of this study was to assess the knowledge, attitude and practices of health care professionals in pediatric settings on developmental surveillance and screening programs and also to identify the barriers and facilitators during its implementation. METHODS The data were collected from health professionals involved in pediatric developmental care, practicing in various hospitals, clinics and nursing homes in a suburban city on west coast of Southern India. The study involved cross-sectional exploratory sequential mixed method design which included a quantitative questionnaire survey on health professionals (n= 52) followed by qualitative face-to-face interviews with chosen respondents who participated in the survey (n= 8). The survey data are reported with descriptive statistics, and interview data are subjected to inductive content analysis for deriving codes, categories and themes. RESULTS The study results indicate that health professionals involved in pediatric developmental care in Indian health care settings have fair knowledge and a favorable attitude towards the use of developmental surveillance and screening. Furthermore, the facilitators and barriers of implementation have been reported. The strategies outlined by interview respondents to improve adherence to implementation have been discussed. CONCLUSIONS The practice of developmental surveillance and screening is limited despite favorable knowledge and attitude among health professionals in pediatric developmental care and is dependent on health care organizational setup.
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Philip M, Ramu R, Prasannan RV, Thomas M, James N, V. KB. Mothers' Knowledge of Childhood Neurodevelopmental Disorders: Indian Perspective. J Neurosci Rural Pract 2021; 12:165-170. [PMID: 33531777 PMCID: PMC7846324 DOI: 10.1055/s-0040-1722094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Objectives This study aims to assess the knowledge of childhood neurodevelopmental disorders (CNDDs) among mothers of children younger than 5 years and to promote awareness through health education to promote early identification. Methods Quantitative approach, a descriptive survey in nature research design, was used. A total of 173 mothers who contented the inclusion conditions were chosen as sample on the basis of purposive sampling. The research study was done at the selected Primary Health Centre, Bengaluru, Karnataka. The tabulations were measured and construed based on the objectives of the study by using descriptive and inferential statistics. Results The findings showed that most of the mothers have insufficient knowledge (mean and standard deviation: 3.02 ± 2.75) and there is no substantial relationship found between mothers' knowledge on CNDD and their demographic variables except their occupation and majority of the mothers communicated that they needed further facts toward CNDD. Conclusion The government and nongovernmental organizations can take initiations to conduct health education programs toward childhood developmental delays and disorders for the general public including mothers and community health workers.
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Affiliation(s)
- Maria Philip
- College of Nursing, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Rajalakshmi Ramu
- College of Nursing, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Rakhi V. Prasannan
- College of Nursing, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Merin Thomas
- College of Nursing, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Ninitha James
- College of Nursing, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Kathyayani B. V.
- College of Nursing, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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Govindan R, Ramu R. Nurses' Knowledge and Understanding about Autism. Indian J Community Med 2020; 45:382-383. [PMID: 33354026 PMCID: PMC7745801 DOI: 10.4103/ijcm.ijcm_290_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 01/16/2020] [Indexed: 11/04/2022] Open
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Faruk T, King C, Muhit M, Islam MK, Jahan I, Baset KU, Badawi N, Khandaker G. Screening tools for early identification of children with developmental delay in low- and middle-income countries: a systematic review. BMJ Open 2020; 10:e038182. [PMID: 33234622 PMCID: PMC7684835 DOI: 10.1136/bmjopen-2020-038182] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 10/19/2020] [Accepted: 10/30/2020] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To systematically review, identify and report the screening tools used for early identification of developmental delay in low- and middle-income countries. DESIGN Systematic review. DATA SOURCES Four bibliographic databases: Medline (1946 to 13 July 2020), Embase (1974 to 13 July 2020), Scopus (1823 to 11 July 2020) and PsycINFO (1987 to July week 1 2020). ELIGIBILITY CRITERIA Peer-reviewed original articles published in English addressing validated culturally sensitive developmental screening tools among children aged <5 years were included in this review. DATA EXTRACTION AND SYNTHESIS One author (CK, medical librarian) developed the search strategy. Three authors conducted the database search (phase I: CK; phase II: IJ and MKI). Three authors (TF, IJ and MKI) independently screened the title and abstracts. TF, MKI and GK independently performed the full-text review of the screened articles. During each step of the study selection process, disagreements were resolved through discussion. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was used to guide the systematic review. Data extraction and analysis were performed using MS Excel. Meta-analysis was not possible due to heterogeneity of the study findings. RESULTS We identified 3349 articles, of which 18 studies from 10 countries, reporting 16 screening tools, were selected for qualitative synthesis. Six cultural contexts were explored. Twelve general, two motor and two speech-language tools were identified. Seven of them found to be parent-completed ones. Five screening tools (American Speech-Language and Hearing Association, Guide for Monitoring Child Development, Infant Neurological International Battery, New Delhi-Development Screening Questionnaire and Woodside Screening Technique) reported relatively higher sensitivity (82.5%-100%) and specificity (83%-98.93%). CONCLUSIONS Limited number of culturally sensitive developmental screening tools were validated for children aged <5 years in low- and middle-income countries. Revising existing screening tools in different ethnic and cultural settings and subsequent validation with normative value should be a research priority.
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Affiliation(s)
- Tasnuva Faruk
- Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh
- Department of Public Health, Independent University Bangladesh, Dhaka, Bangladesh
| | - Catherine King
- The Children's Hospital at Westmead Clinical School, The Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Mohammad Muhit
- Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh
- CSF Global, Dhaka, Bangladesh
| | - Md Kafiul Islam
- Department of Electrical and Electronic Engineering, Independent University Bangladesh, Dhaka, Bangladesh
| | - Israt Jahan
- Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh
- CSF Global, Dhaka, Bangladesh
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Kamran Ul Baset
- Department of Public Health, Independent University Bangladesh, Dhaka, Bangladesh
- Road Safety and Driving School, BRAC, Dhaka, Bangladesh
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, New South Wales, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Gulam Khandaker
- Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh
- CSF Global, Dhaka, Bangladesh
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia
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Bhavnani S, Mukherjee D, Dasgupta J, Verma D, Parameshwaran D, Divan G, Sharma KK, Thiagarajan T, Patel V. Development, feasibility and acceptability of a gamified cognitive DEvelopmental assessment on an E-Platform (DEEP) in rural Indian pre-schoolers - a pilot study. Glob Health Action 2019; 12:1548005. [PMID: 31154989 PMCID: PMC6338262 DOI: 10.1080/16549716.2018.1548005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background: Assessment of cognitive development is essential to identify children with faltering developmental attainment and monitor the impact of interventions. A key barrier to achieving these goals is the lack of standardized, scalable tools to assess cognitive abilities. Objective: This study aimed to develop a tablet-based gamified assessment of cognitive abilities of 3-year-old children which can be administered by non-specialist field workers. Methods: Workshops among domain experts, literature search for established and gamified paradigms of cognitive assessments and rapid review of mobile games for 3-year-old children was done to conceptualize games for this study. Formative household visits (N = 20) informed the design and content of the games. A cross-sectional pilot study (N = 100) was done to assess feasibility of the tool and check if increasing levels of difficulty and the expected variability between children were evident in game metrics. In-depth interviews (N = 9) were conducted with mothers of participating children to assess its acceptability. Results: Six cognitive domains were identified as being integral to learning – divided attention, response inhibition, reasoning, visual form perception and integration and memory. A narrative, musical soundtrack and positive reinforcement were incorporated into the tool to enhance participant engagement. Child performance determined level timers and difficulty levels in each game. Pilot data indicate that children differ in their performance profile on the tool as measured by the number of game levels played and their accuracy and completion time indicating that it might be possible to differentiate children based on these metrics. Qualitative data suggest high levels of acceptability of the tool amongst participants. Conclusions: A DEvelopmental assessment on an E-Platform (DEEP) has been created comprising distinct games woven into a narrative, which assess six cognitive domains, and shows high levels of acceptability and generates metrics which may be used for validation against gold standard cognitive assessments.
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Affiliation(s)
- Supriya Bhavnani
- a Centre for Chronic Conditions and Injuries , Public Health Foundation of India , Gurugram , India
| | - Debarati Mukherjee
- a Centre for Chronic Conditions and Injuries , Public Health Foundation of India , Gurugram , India
| | - Jayashree Dasgupta
- a Centre for Chronic Conditions and Injuries , Public Health Foundation of India , Gurugram , India.,b Sangath , New Delhi , India
| | | | | | | | | | | | - Vikram Patel
- d Department of Global Health and Social Medicine , Harvard Medical School and the Harvard Chan School of Public Health , Boston , MA , USA
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Ramaswamy S, Seshadri S. Methodologies and skills in child and adolescent mental health, psychosocial care, and protection: A repository of training and intervention materials. Indian J Psychiatry 2019; 61:226-227. [PMID: 31142897 PMCID: PMC6532474 DOI: 10.4103/psychiatry.indianjpsychiatry_155_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Sheila Ramaswamy
- Department of Child and Adolescent Psychiatry, NIMHANS, Bengaluru, Karnataka, India.,Department of Women and Child Development, Government of Karnataka, Karnataka, India
| | - Shekhar Seshadri
- Department of Child and Adolescent Psychiatry, NIMHANS, Bengaluru, Karnataka, India
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Boggs D, Milner KM, Chandna J, Black M, Cavallera V, Dua T, Fink G, Kc A, Grantham-McGregor S, Hamadani J, Hughes R, Manji K, McCoy DC, Tann C, Lawn JE. Rating early child development outcome measurement tools for routine health programme use. Arch Dis Child 2019; 104:S22-S33. [PMID: 30885963 PMCID: PMC6557219 DOI: 10.1136/archdischild-2018-315431] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 01/23/2019] [Accepted: 01/28/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Identification of children at risk of developmental delay and/or impairment requires valid measurement of early child development (ECD). We systematically assess ECD measurement tools for accuracy and feasibility for use in routine services in low-income and middle-income countries (LMIC). METHODS Building on World Bank and peer-reviewed literature reviews, we identified available ECD measurement tools for children aged 0-3 years used in ≥1 LMIC and matrixed these according to when (child age) and what (ECD domains) they measure at population or individual level. Tools measuring <2 years and covering ≥3 developmental domains, including cognition, were rated for accuracy and feasibility criteria using a rating approach derived from Grading of Recommendations, Assessment, Development and Evaluations. RESULTS 61 tools were initially identified, 8% (n=5) population-level and 92% (n=56) individual-level screening or ability tests. Of these, 27 tools covering ≥3 domains beginning <2 years of age were selected for rating accuracy and feasibility. Recently developed population-level tools (n=2) rated highly overall, particularly in reliability, cultural adaptability, administration time and geographical uptake. Individual-level tool (n=25) ratings were variable, generally highest for reliability and lowest for accessibility, training, clinical relevance and geographical uptake. CONCLUSIONS AND IMPLICATIONS Although multiple measurement tools exist, few are designed for multidomain ECD measurement in young children, especially in LMIC. No available tools rated strongly across all accuracy and feasibility criteria with accessibility, training requirements, clinical relevance and geographical uptake being poor for most tools. Further research is recommended to explore this gap in fit-for-purpose tools to monitor ECD in routine LMIC health services.
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Affiliation(s)
- Dorothy Boggs
- Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene and Tropical Medicine, London, UK
- International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, UK
| | - Kate M Milner
- Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene and Tropical Medicine, London, UK
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Jaya Chandna
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Maureen Black
- University of Maryland School of Medicine, Baltimore, Maryland, USA
- Research Triangle Park, RIT International, Durham, USA
| | - Vanessa Cavallera
- Department of Mental Health and Substance Abuse, World Health Organisation, Geneva, Switzerland
| | - Tarun Dua
- Department of Mental Health and Substance Abuse, World Health Organisation, Geneva, Switzerland
| | - Guenther Fink
- Swiss Tropical and Public Health Institute and University of Basel, Basel, Switzerland
| | - Ashish Kc
- International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Sally Grantham-McGregor
- Institute of Child Health, Faculty of Population Health Sciences, University College London, London, UK
| | - Jena Hamadani
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Rob Hughes
- Children's Investment Fund Foundation, London, UK
- Maternal & Child Health Intervention Research Group, Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Karim Manji
- Department of Paediatrics and Child Health, Muhimbili University of Allied Health Sciences, Dar es Salaam, Tanzania
| | - Dana Charles McCoy
- Harvard Graduate School of Education, Harvard University, Massachusetts, USA
| | - Cally Tann
- Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene and Tropical Medicine, London, UK
- Neonatal Medicine, University College Hospitals NHS Trust, London, UK
| | - Joy E Lawn
- Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene and Tropical Medicine, London, UK
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Marlow M, Servili C, Tomlinson M. A review of screening tools for the identification of autism spectrum disorders and developmental delay in infants and young children: recommendations for use in low- and middle-income countries. Autism Res 2019; 12:176-199. [DOI: 10.1002/aur.2033] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 06/08/2018] [Accepted: 06/27/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Marguerite Marlow
- Department of Psychology; Stellenbosch University; Stellenbosch South Africa
| | - Chiara Servili
- Department of Mental Health and Substance Abuse; World Health Organization; Geneva Switzerland
| | - Mark Tomlinson
- Department of Psychology; Stellenbosch University; Stellenbosch South Africa
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Ts J, Jacob P, Srinath S, G SK, L M, Gr G, Robins DL, K T. Toddlers at risk for Autism Spectrum Disorders from Kerala, India - A community based screening. Asian J Psychiatr 2018; 31:10-12. [PMID: 29306218 DOI: 10.1016/j.ajp.2017.12.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Revised: 12/06/2017] [Accepted: 12/26/2017] [Indexed: 12/01/2022]
Abstract
AIMS To study the at-risk rate for Autism Spectrum Disorders (ASD) on a parent-report questionnaire in toddlers between the ages of 16-24 months. MATERIALS AND METHODS 6237 toddlers from Kerala, India selected by cluster random sampling were surveyed by community nurses using the Modified Checklist for Autism in Toddlers - Revised (M-CHAT-R) translated to Malayalam and culturally adapted. RESULTS 5.5% toddlers were at risk on M-CHAT-R and 2.7% on "Best Seven". CONCLUSIONS M-CHAT-R and its "Best Seven" could be viable community level screening instruments, albeit with further cultural adaptation for a primarily non-English speaking population in India.
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Affiliation(s)
- Jaisoorya Ts
- National Institute of Mental Health and Neurosciences, Bangalore, 560 029, India.
| | - Preeti Jacob
- National Institute of Mental Health and Neurosciences, Bangalore, 560 029, India.
| | - Shoba Srinath
- National Institute of Mental Health and Neurosciences, Bangalore, 560 029, India.
| | | | - Manoj L
- National Health Mission, Kerala, India.
| | - Gokul Gr
- National Health Mission, Kerala, India.
| | - Diana L Robins
- AJ Drexel Autism Institute, Drexel University, Philadelphia PA, USA.
| | - Thennarasu K
- National Institute of Mental Health and Neurosciences, Bangalore, 560 029, India.
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Designing and Validation of a Hindi-language Parent Self-report Developmental Screening Tool. Indian Pediatr 2017; 54:550-555. [PMID: 28737141 DOI: 10.1007/s13312-017-1066-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIM To design and validate Hindi-language parent self-report developmental screening questionnaires for 9-month and 18-month-old Indian children. DESIGN Cross-sectional study. SETTING Tertiary-care pediatric hospital from April 2014 to March 2016. PARTICIPANTS In each age group (9-month and 18-month), 45 children were enrolled for designing of questionnaires (30 for obtaining parental observations of current development and 15 for pre-testing). For validation of tool, 100 children (60 low risk and 40 high risk) were enrolled in each age group. METHODS For designing, observations regarding current developmental milestones were obtained from parents and a list of all enumerated milestones was prepared. After detailed discussion by a team of developmental pediatricians, pediatric resident, clinical psychologist and language specialist, milestones were chosen for drafting of questionnaires. In each age group, drafts were pre-tested and required modifications were done. The final questionnaires contained 20 items each to be scored on a Likert scale (total score ranging from 20 to 60, a lower score indicating a higher risk of developmental delay). These questionnaires were validated against Developmental Assessment Scale for Indian Infants (DASII), a gold standard instrument. RESULTS On ROC analysis, the 9-month and 18-month screening tool had area under curve of 0.988 and 0.953, respectively, for detecting developmental delay. Score ≤50 on the 9-months questionnaire had sensitivity of 100% and specificity of 87.2%. Score ≤49 on the 18-months questionnaire had sensitivity of 91.4% and specificity of 88.7%. CONCLUSION The new questionnaires have a promising role in developmental screening of children at the time of routine immunizations in our country.
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Wiznitzer M. Gene therapy for children with AADC deficiency. THE LANCET CHILD & ADOLESCENT HEALTH 2017; 1:250-251. [DOI: 10.1016/s2352-4642(17)30124-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 10/16/2017] [Indexed: 12/30/2022]
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Nickel RE, Huang-Storms L. Early Identification of Young Children with Autism Spectrum Disorder. Indian J Pediatr 2017; 84:53-60. [PMID: 26411730 DOI: 10.1007/s12098-015-1894-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 08/19/2015] [Indexed: 12/16/2022]
Abstract
Early identification and treatment of children with autism and other developmental disorders is an international priority. Currently there is great interest in lowering the age of identification. Attention has been focused on public awareness campaigns and the regular use of developmental screening tests by health care providers, health workers and others. In this article the authors discuss the rationale for the use of autism specific screening tests, review the characteristics of selected tools, and make recommendations for the diagnostic evaluation of young children for autism spectrum disorder in an international context.
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Affiliation(s)
- Robert E Nickel
- Institute on Development and Disability, Department of Pediatrics, Oregon Health & Science University, 707 SW Gaines, Portland, OR, 97349, USA
| | - Lark Huang-Storms
- Institute on Development and Disability, Department of Pediatrics, Oregon Health & Science University, 707 SW Gaines, Portland, OR, 97349, USA.
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Dabar D, Das R, Nagesh S, Yadav V, Mangal A. A Community-based Study on Growth and Development of Under-Five Children in an Urbanized Village of South Delhi. J Trop Pediatr 2016; 62:446-456. [PMID: 27143343 DOI: 10.1093/tropej/fmw026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Optimal development of children in their early months and years has a bearing on their achievement levels later in life. OBJECTIVES To assess the socio-emotional and cognitive development in children 0-5 years and to find out the proportion of children having developmental delay and its associated factors. METHODS A community-based cross-sectional study was carried out in 520 children in Delhi. Development was assessed using the Indian Council for Medical Research Development Screening Test. RESULTS In all, 10.6% of children <5 years old were found to be developmentally delayed. Maximum number of children (10.1%) were found to have a delay in the do main of 'hearing language, concept development'. Of all the factors, the strongest association was found with stunting, paternal education, alcohol abuse, attendance in anganwadi/playschool. CONCLUSIONS The study concludes that developmental delay is present in a sizable proportion of children <5 years of age and may be a significant factor in the overall achievement of life's potential in them.
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Affiliation(s)
- Deepti Dabar
- Department of Community Medicine, Vardhman Mahavir Medical College, New Delhi 110029, India
| | - Ranjan Das
- Department of Community Medicine, Lady Hardinge Medical College, New Delhi 110001, India
| | - Seetharamaiya Nagesh
- Department of Community Medicine, Lady Hardinge Medical College, New Delhi 110001, India
| | - Vikas Yadav
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Abha Mangal
- Department of Community Medicine, Vardhman Mahavir Medical College, New Delhi 110029, India
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