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Sturla Irizarry SM, Cathey AL, Zimmerman E, Rosario Pabón ZY, Huerta Montañez G, Vélez Vega CM, Alshawabkeh AN, Cordero JF, Meeker JD, Watkins DJ. Prenatal polycyclic aromatic hydrocarbon exposure and neurodevelopment among children in Puerto Rico. CHEMOSPHERE 2024; 366:143468. [PMID: 39369740 DOI: 10.1016/j.chemosphere.2024.143468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 09/04/2024] [Accepted: 10/03/2024] [Indexed: 10/08/2024]
Abstract
Polycyclic aromatic hydrocarbons (PAHs) are widespread environmental contaminants produced through the combustion of organic matter, with sources ranging from traffic pollution to diet. Although PAH exposure has been associated with adverse health effects, few studies have examined its impact on neurodevelopmental delay (NDD). Thus, our study aims to investigate the effect of prenatal PAH exposure on the odds of NDD. We measured 7 hydroxylated PAH metabolites in spot urine samples collected up to three times during pregnancy in the PROTECT birth cohort. NDD was identified using score cutoffs from the Ages and Stages Questionnaire, 3rd edition offered in Spanish, across five domains at 12, 24, 36, and 48 months. We utilized logistic regression and mixed effects logistic regression models to assess associations between prenatal PAH concentrations and NDD. Our results showed mostly lower odds of NDD with higher PAH exposure (p < 0.05). However, male children showed higher odds of NDD in relation to PAH exposure, particularly in the Fine Motor domain. For example, 1-hydroxypyrene was associated with 1.11 (1.01, 1.23) times odds of delay in fine motor function in male children versus 0.91 (0.82, 1.00) times odds in female children. Our preliminary sex-specific results suggest that PAH exposure may impact neurodevelopment in male children and prompt further investigation into the potential sex-specific mechanisms of PAHs on motor function.
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Affiliation(s)
| | - Amber L Cathey
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA.
| | - Emily Zimmerman
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA, USA.
| | - Zaira Y Rosario Pabón
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, USA.
| | - Gredia Huerta Montañez
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, USA.
| | - Carmen M Vélez Vega
- Department of Social Sciences, Doctoral Program in Social Determinants of Health, University of Puerto Rico, Medical Sciences Campus, San Juan, PR, USA.
| | - Akram N Alshawabkeh
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, USA.
| | - José F Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, USA.
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA.
| | - Deborah J Watkins
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA.
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Balasubramanian H, Ahmed J, Ananthan A, Srinivasan L, Mohan D. Comparison of parent or caregiver-completed development screening tools with Bayley Scales of Infant Development: a systematic review and meta-analysis. Arch Dis Child 2024; 109:759-766. [PMID: 38811056 DOI: 10.1136/archdischild-2023-326771] [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: 12/15/2023] [Accepted: 05/10/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Parent/caregiver-completed developmental testing (PCDT) is integral to developmental care in children; however, there is limited information on its accuracy. In this systematic review, we compared the diagnostic accuracy of PCDT with concurrently administered Bayley Scales of Infant Development for detection of developmental delay (DD) in children below 4 years of age. METHODS We searched databases PubMed, Embase, CINAHL, PsycINFO and Google Scholar until November 2023. Bivariate and multiple thresholds summary receiver operating characteristics were used to obtain the summary sensitivity and specificity with 95% CIs. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used for risk of bias assessment. RESULTS A total of 38 studies (31 in the meta-analysis) were included. Ages and Stages Questionnaire (ASQ) and Parent Report of Children's Abilities-Revised (PARCA-R) were the most commonly evaluated PCDTs. ASQ score >2 SD below the mean had an overall sensitivity of 0.72 (0.6, 0.82) and 0.63 (0.50, 0.75) at a median specificity of 0.89 (0.82, 0.94) and 0.81 (0.76, 0.86) for diagnosing moderate to severe DD and severe DD, respectively. PARCA- R had an overall sensitivity of 0.69 (0.51, 0.83) at median specificity of 0.75 (0.64, 0.83) for predicting severe DD. Participant selection bias and partial verification bias were found in over 50% of the studies. The certainty of evidence was low for the studied outcomes. CONCLUSIONS The most commonly studied parental tools, ASQ and PARCA-R, have moderate to low sensitivity and moderate specificity for detecting DD in young children. High risk of bias and heterogeneity in the available data can potentially impact the interpretation of our results. PROSPERO REGISTRATION NUMBER CRD42021268629.
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Affiliation(s)
| | - Javed Ahmed
- Department of Neonatology, McMaster Childrens Hospital and McMaster University, Hamilton, Ontario, Canada
| | - Anitha Ananthan
- Department of Neonatology, Seth GS Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India
| | - Lakshmi Srinivasan
- Department of Pediatrics, The Childrens Hospital of Philadelphia and University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Diwakar Mohan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Bluett-Duncan M, Bullen P, Campbell E, Clayton-Smith J, Craig J, García-Fiñana M, Hughes DM, Ingham A, Irwin B, Jackson C, Kelly T, Morrow J, Rushton S, Winterbottom J, Wood AG, Yates LM, Bromley RL. The use of parent-completed questionnaires to investigate developmental outcomes in large populations of children exposed to antiseizure medications in pregnancy. Epilepsia 2024; 65:2017-2029. [PMID: 38776170 DOI: 10.1111/epi.18001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 04/16/2024] [Accepted: 04/22/2024] [Indexed: 05/24/2024]
Abstract
OBJECTIVE This study was undertaken to assess the utility of the Ages and Stages Questionnaire-3rd Edition (ASQ-3) and the Vineland Adaptive Behavior Scales-2nd Edition (VABS-II) as neurodevelopmental screening tools for infants exposed to antiseizure medications in utero, and to examine their suitability for use in large-population signal generation initiatives. METHODS Participants were women with epilepsy who were recruited from 21 hospitals in England and Northern Ireland during pregnancy between 2014 and 2016. Offspring were assessed at 24 months old using the Bayley Scales of Infant Development-3rd Edition (BSID-III), the VABS-II, and the ASQ-3 (n = 223). The sensitivity and specificity of the ASQ-3 and VABS-II to identify developmental delay at 24 months were examined, using the BSID-III to define cases. RESULTS The ASQ-3 identified 65 children (29.1%) as at risk of developmental delay at 24 months using standard referral criteria. Using a categorical approach and standard referral criteria to identify delay in the ASQ-3 and BSID-III at 24 months, the ASQ-3 showed excellent sensitivity (90.9%) and moderate specificity (74.1%). Utilizing different cut-points resulted in improved properties and may be preferred in certain contexts. The VABS-II exhibited the strongest psychometric properties when borderline impairment (>1 SD below the mean) was compared to BSID-III referral data (sensitivity = 100.0%, specificity = 96.6%). SIGNIFICANCE Both the ASQ-3 and VABS-II have good psychometric properties in a sample of children exposed to antiseizure medications when the purpose is the identification of at-risk groups. These findings identify the ASQ-3 as a measure that could be used effectively as part of a tiered surveillance system for teratogenic exposure by identifying a subset of individuals for more detailed investigations. Although the VABS-II has excellent psychometric properties, it is more labor-intensive for both the research team and participants and is available in fewer languages than the ASQ-3.
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Affiliation(s)
| | - Philip Bullen
- Department of Obstetric and Fetal Medicine, St. Mary's Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Ellen Campbell
- Department of Neurology, Belfast Health and Social Care Trust, Belfast, UK
| | - Jill Clayton-Smith
- Manchester Centre for Genomic Medicine, St. Mary's Hospital, University of Manchester, Manchester, UK
- Division of Evolution and Genomic Sciences, School of Biological Sciences, University of Manchester, Manchester, UK
| | - John Craig
- Department of Neurology, Belfast Health and Social Care Trust, Belfast, UK
| | - Marta García-Fiñana
- Department of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - David M Hughes
- Department of Health Data Science, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Amy Ingham
- Manchester Centre for Genomic Medicine, St. Mary's Hospital, University of Manchester, Manchester, UK
| | - Beth Irwin
- Department of Neurology, Belfast Health and Social Care Trust, Belfast, UK
| | - Cerian Jackson
- Department of Neuropsychology, Walton Centre for Neurology and Neurosurgery NHS Foundation Trust, Liverpool, UK
| | - Teresa Kelly
- Department of Obstetric and Fetal Medicine, St. Mary's Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - James Morrow
- Department of Neurology, Belfast Health and Social Care Trust, Belfast, UK
| | - Sarah Rushton
- Manchester Centre for Genomic Medicine, St. Mary's Hospital, University of Manchester, Manchester, UK
| | - Janine Winterbottom
- Department of Neurology, Walton Centre for Neurology and Neurosurgery NHS Foundation Trust, Liverpool, UK
| | - Amanda G Wood
- School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Laura M Yates
- Department for Clinical Genetics, Northern Genetics Service, Newcastle, UK
| | - Rebecca L Bromley
- Division of Neuroscience, University of Manchester, Manchester, UK
- Royal Manchester Children's Hospital, Manchester University Hospitals NHS Foundation Trust and Manchester Academic Health Sciences Centre, Manchester, UK
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Cao Q, Wang R, Zhou R, Huang X, Li Y, Zhu H, Qiao X, Huang W. The early development of offspring born to women with polycystic ovary syndrome: Insights from a prospective birth cohort study in Southwestern China. Psychoneuroendocrinology 2024; 163:106984. [PMID: 38340540 DOI: 10.1016/j.psyneuen.2024.106984] [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: 10/28/2023] [Revised: 01/28/2024] [Accepted: 02/03/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE This prospective cohort study aimed to investigate the effect of maternal polycystic ovary syndrome (PCOS) on the offspring early development. METHODS A total of 91 mother-child pairs, consisting of 33 PCOS and 58 non-PCOS, were recruited. Peripheral blood tests were performed during 12-16, 24-28, and 32-36 weeks of gestation. Ages & Stages Questionnaires (ASQ) were utilized to assess the motor development of offspring at 27 months of age. Logistic regression models were employed to compare groups and control confounding variables. RESULTS Women with PCOS had a higher level of testosterone and free androgen index than the non-PCOS group in all three detection windows. There were no intergroup differences in any of the five domains of specific ASQ domain scores or the body measurements of the offspring at 27 months old. Stratification by sex of offspring suggested that no significant differences were detected in the male offspring. However, in the female offspring, the PCOS group exhibited lower gross motor scores in female offspring than the non-PCOS group (48.1 ± 11.8 vs. 55.2 ± 8.1, P = 0.027), as well as lower fine motor scores (48.5 ± 8.5 vs. 53.6 ± 11.0, P = 0.028). The gross motor score of female offspring in the PCOS group remained lower even after adjustments. Each 1 ng/mL increase in testosterone at 12-16 weeks of gestation was associated with a decrease in gross motor score of female offspring by 12.2 (95% CI = -23.3 to -1.0, P = 0.038). The highest tertile of testosterone at 12-16 weeks of gestation was associated with a 7.75-point decrease in gross motor score of female offspring compared to the lowest tertile of testosterone (95% CI = -14.9 to -0.6, P = 0.040), with a significant linear trend observed (P for trend = 0.031). CONCLUSIONS The findings of this study suggest that maternal PCOS could exert a negative influence on the gross motor development of female offspring, potentially associated with intrauterine androgen exposure during the early stages of pregnancy.
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Affiliation(s)
- Qi Cao
- Department of Reproductive Medical Center, West China Second University Hospital, Chengdu, Sichuan 610041, PR China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, PR China; Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Ruiying Wang
- Department of Reproductive Medical Center, West China Second University Hospital, Chengdu, Sichuan 610041, PR China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, PR China; Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Rong Zhou
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, PR China; Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Xin Huang
- Department of Reproductive Medical Center, West China Second University Hospital, Chengdu, Sichuan 610041, PR China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, PR China; Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Yujing Li
- Department of Reproductive Medical Center, West China Second University Hospital, Chengdu, Sichuan 610041, PR China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, PR China; Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Huili Zhu
- Department of Reproductive Medical Center, West China Second University Hospital, Chengdu, Sichuan 610041, PR China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, PR China; Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Xinyu Qiao
- Department of Reproductive Medical Center, West China Second University Hospital, Chengdu, Sichuan 610041, PR China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, PR China; Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Wei Huang
- Department of Reproductive Medical Center, West China Second University Hospital, Chengdu, Sichuan 610041, PR China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, PR China; Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China; Key Laboratory of Chronobiology of National Health Commission (Sichuan University), Chengdu, Sichuan 610041, PR China.
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5
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Guo X, Xu J, Tian Y, Ouyang F, Yu X, Liu J, Yan C, Zhang J. Interaction of prenatal maternal selenium and manganese levels on child neurodevelopmental trajectories-the Shanghai birth cohort study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 915:170095. [PMID: 38224892 DOI: 10.1016/j.scitotenv.2024.170095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 01/09/2024] [Accepted: 01/09/2024] [Indexed: 01/17/2024]
Abstract
OBJECTIVE The fetal brain is particularly plastic, and may be concurrently affected by chemical exposure and malnutritional factors. Selenium is essential for the developing brain, and excess manganese exposure may exert neurotoxic effects. However, few epidemiological studies have evaluated the interaction of manganese and selenium assessed in different prenatal stages on postnatal neurodevelopmental trajectories. METHODS This study contained 1024 mother-child pairs in the Shanghai-birth-cohort study from 2013 to 2016 recruited since early/before pregnancy with complete data on manganese and selenium levels in different prenatal stages and infant neurodevelopmental trajectories. Whole blood manganese and selenium in early pregnancy and around birth were measured by inductively-coupled-plasma-mass-spectrometry (ICP-MS), children's cognitive development was evaluated at 6, 12, and 24 months of age using Age & Stage-Questionnaire (ASQ)-3 and Bayley-III. Multiple linear regression was used to investigate the interaction of prenatal selenium and manganese on neurodevelopmental trajectories. RESULTS The prenatal manganese and selenium levels were 1.82 ± 0.98 μg/dL and 13.53 ± 2.70 μg/dL for maternal blood in early pregnancy, and 5.06 ± 1.67 μg/dL and 11.81 ± 3.35 μg/dL for umbilical cord blood, respectively. Higher prenatal Se levels were associated with better neurocognitive performances or the consistently-high-level trajectory (P < 0.05), with more significant associations observed in early pregnancy than around birth. However, such positive relationships became non-significant or even adverse in high (vs. low) manganese status, and the effect differences between low and high manganese were more significant in early pregnancy. CONCLUSIONS Prenatal Selenium was positively associated with child neurodevelopment, but prenatal high manganese may mitigate such favorable effects. The effects were mainly observed in earlier prenatal stage.
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Affiliation(s)
- Xiangrong Guo
- The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai 200030, China
| | - Jian Xu
- The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Embryo Original Diseases, Shanghai 200030, China.
| | - Ying Tian
- MOE-Shanghai Key Lab of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China; Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Fengxiu Ouyang
- MOE-Shanghai Key Lab of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Xiaodan Yu
- MOE-Shanghai Key Lab of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China; Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
| | - Junxia Liu
- MOE-Shanghai Key Lab of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Chonghuai Yan
- MOE-Shanghai Key Lab of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Jun Zhang
- MOE-Shanghai Key Lab of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
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Kapp-Simon KA, Albert M, Edwards TC, Jones SM, Crilly Bellucci C, Rosenberg J, Patrick DL, Heike CL. Developmental Risk for Infants with Cleft Lip with or Without Cleft Palate Based on Caregiver-Proxy Reports. Cleft Palate Craniofac J 2024:10556656231225304. [PMID: 38196373 PMCID: PMC11231059 DOI: 10.1177/10556656231225304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024] Open
Abstract
OBJECTIVES (1) Assess caregiver-reported development in infants born with cleft lip ± alveolus (CL ± A) and cleft lip and palate (CLP); (2) determine factors associated with increased developmental risk; and (3) determine consistency of developmental risk before and after surgery for cleft lip. DESIGN Prospective, longitudinal assessment of development. Time (T) 1, prior to lip closure; T2, 2 months post lip closure. SETTING Three US craniofacial teams and online parent support groups. PARTICIPANTS 123 total caregivers (96% mothers); 100 at T1, 92 at T2, and 69 at both T1 and T2. MEASURE Ages and Stages Questionnaire-3 (ASQ-3): Communication, Gross Motor, Fine Motor, Problem Solving, Personal Social Domains. RESULTS At T1 47%; at T2 42% passed all 5 Domains; 36% of infants pass all 5 Domains at both T1 and T2. Infants with CLP were at greatest risk on Communication [B = 1.449 (CI = .149-20.079), p = .038; Odds Ratio (OR) = 4.3 (CI = .923-19.650)] and Gross Motor Domains [B = 1.753 (CI = .316-20.605), p = .034; OR = 5.8 (CI = 1.162-28.671)]. Male infants were at greatest risk on Fine Motor [B = 1.542 (CI = .495-20.005), p = .009; OR = 4.7 (CI = 1.278-17.101)] and Problem Solving Domains [B = 1.200 (CI = .118-19.708), p = .044; OR = 3.3 (CI = .896-12.285)]. CONCLUSIONS Based on caregiver report, infants with CL ± A and CLP meet referral criteria at a high rate. Infants with CLP and male infants were at greatest risk. Regular developmental screening is recommended.
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Affiliation(s)
- Kathleen A Kapp-Simon
- Cleft/Craniofacial Center, Shriners Children's, Chicago, Chicago, IL, USA
- Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA
| | - Meredith Albert
- Cleft/Craniofacial Center, Shriners Children's, Chicago, Chicago, IL, USA
- Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA
| | - Todd C Edwards
- School of Public Health, University of Washington, Seattle, WA, USA
| | - Salene M Jones
- Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | | | - Janine Rosenberg
- Craniofacial Center, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA
| | - Donald L Patrick
- School of Public Health, University of Washington, Seattle, WA, USA
| | - Carrie L Heike
- Craniofacial Center, Seattle Children's Hospital, Seattle, WA, USA
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Agarwal PK, Xie H, Sathyapalan Rema AS, Meaney MJ, Godfrey KM, Rajadurai VS, Daniel LM. Concurrent validity of the ages and stages questionnaires with Bayley Scales of Infant Development-III at 2 years - Singapore cohort study. Pediatr Neonatol 2024; 65:48-54. [PMID: 37544806 DOI: 10.1016/j.pedneo.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 02/09/2023] [Accepted: 03/02/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND With increasing acceptance of universal developmental screening in primary care, it is essential to evaluate the local validity and psychometric properties of commonly used questionnaires like the parent-completed Ages and Stages Questionnaires, 3rd Edition (ASQ-3) in identifying developmental delays. The aim of this study is to assess the convergent validity of the ASQ-3 with the Bayley Scales of Infant Development-3rd edition (Bayley-III) in identifying developmental delay in a low-risk term cohort in Singapore. METHODS ASQ-3 and Bayley-III data was collected prospectively with generation of ASQ-3 cut-off scores using three different criteria: 1-standard deviation (SD) (Criterion-I) or 2-SD (Criterion-II) below the mean, and using a Receiver Operator Curve (ROC) (Criterion-III). Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were calculated. Correlations between the ASQ-3 and Bayley-III domains were evaluated using Pearson coefficients. RESULTS With all three criteria across different domains ASQ-3 showed high specificity (72-99%) and NPV (69-98%), but lower sensitivity (19-74%) and PPV (11-59%). Criterion-I identified 11-21% of children as "at-risk of developmental delay," and was the most promising criterion measure, with high specificity (82-91%), NPV (69-74%) and overall agreement of 64-71%. Moderate-strong correlations were seen between ASQ-3 Communication and Bayley-III Language scales (r = 0.44-0.59, p < 0.01). The lowest sensitivities were seen in the motor domains. CONCLUSIONS ASQ-3 is reliable in low-risk settings in identifying typically developing children not at risk of developmental delay, but it has modest sensitivity. Moderate-strong correlations seen in the communication domain are clinically important for early identification of language delay, which is one of the most prevalent areas of early childhood developmental delay.
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Affiliation(s)
| | - Huichao Xie
- Psychology and Child & Human Development, Nanyang Technological University National Institute of Education, Singapore
| | | | | | - Keith M Godfrey
- MRC Life Course Epidemiology Centre and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, UK
| | | | - Lourdes Mary Daniel
- Dept of Child Development; KK Women's and Children's Hospital Singapore, Singapore
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Rah SS, Jung M, Lee K, Kang H, Jang S, Park J, Yoon JY, Hong SB. Systematic Review and Meta-analysis: Real-World Accuracy of Children's Developmental Screening Tests. J Am Acad Child Adolesc Psychiatry 2023; 62:1095-1109. [PMID: 36592715 DOI: 10.1016/j.jaac.2022.12.014] [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: 12/20/2021] [Revised: 11/10/2022] [Accepted: 12/23/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVE This review presents a list of developmental screening tests used in clinical settings worldwide and provides a broad estimate of their accuracy (PROSPERO: CRD42021236474). METHOD Following the PRISMA Diagnostic Test Accuracy (DTA) guidelines, this review involved searching PubMed, PsycINFO, Cochrane, EMBASE, CINAHL, and Google Scholar (for manual searching). Inclusion criteria included studies published in English through 2020 that compared the accuracy of developmental screening tests against developmental diagnostic tests among children under 13 years of age. Six researchers, in pairs, independently selected the studies and extracted the data. A hierarchical model was applied to meta-analyze the diagnostic accuracy of the tests, and meta-regression was used to identify the moderators using R 4.1.3 software. RESULTS The meta-analysis included 56 studies (17 screening tests and 61 outcomes). The most frequently used screening tests were the Ages and Stages Questionnaire (ASQ), Denver Developmental Screening Test (DDST), and Parent's Evaluation of Developmental Status (PEDS). The pooled sensitivity and specificity were 0.75 (95% CI = 0.69-0.80) and 0.76 (95% CI = 0.71-0.80), and the overall diagnostic accuracy of the total outcomes (area under the curve) was 0.80. High heterogeneity was observed between the included studies with various thresholds of the tests. Participants' developmental concerns at the baseline significantly moderated the accuracy of the screening tests, resulting in double the positive predictive value and prevalence compared to those without the concerns. CONCLUSION We recommend a standardized process of validation studies for diagnostic accuracy, to ensure the effectiveness of developmental screening tests in clinical settings. STUDY PREREGISTRATION INFORMATION Accuracy of Developmental Screening Tools among Children in Real World: a Systematic Review and Meta Analysis; https://www.crd.york.ac.uk/; CRD42021236474.
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Affiliation(s)
- Sung Sil Rah
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Minho Jung
- Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyungmin Lee
- Seoul National University College of Nursing, Seoul, Republic of Korea
| | - Hannah Kang
- Seoul National University College of Nursing, Seoul, Republic of Korea
| | - Soyoung Jang
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, Seoul National University College of Nursing, Seoul, Republic of Korea
| | - Junghyun Park
- Seoul National University College of Nursing, Seoul, Republic of Korea
| | - Ju Young Yoon
- Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea
| | - Soon-Beom Hong
- Seoul National University College of Medicine, Seoul, Republic of Korea; Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.
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Duggan C, Irvine AD, O'B Hourihane J, Kiely ME, Murray DM. ASQ-3 and BSID-III's concurrent validity and predictive ability of cognitive outcome at 5 years. Pediatr Res 2023; 94:1465-1471. [PMID: 36841883 PMCID: PMC10589087 DOI: 10.1038/s41390-023-02528-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 01/20/2023] [Accepted: 01/28/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND Early detection of cognitive disability is challenging. We assessed the domain-specific, concurrent validity of the ages and stages questionnaire (ASQ-3) and the Bayley Scales of Infant and Toddler Development (BSID-III), and their ability to predict cognitive delay at school age. METHODS Within a longitudinal birth cohort study, a nested cohort of children was assessed using ASQ-3 and BSID-III at 24 months, and at 5 years using the Kaufmann brief IQ test (KBIT). RESULTS 278 children were assessed using BSID-III and ASQ-3 at 24-months; mean(SD) BW = 3445(506) grams, M:F ratio=52:48. ASQ-3 had reasonable predictive ability (AUROC, p value, sensitivity:specificity) of same domain delay for motor (0.630, p = 0.008, 50%:76.1%) and language (0.623, p = 0.010, 25%:99.5%) at 2 years, but poor ability to detect cognitive delay compared to BSID-III (0.587, p = 0.124, 20.7%/96.8%;). 204/278 children were assessed at 5 years. BSID-III language and cognition domains showed better correlation with verbal and nonverbal IQ (R = 0.435, p < 0.001 and 0.388, p < 0.001 respectively). Both assessments showed high specificity and low sensitivity for predicting delay at 5 years. CONCLUSIONS The ASQ-3 cognitive domain showed poor concurrent validity with BSID-III cognitive score. Both ASQ-3 and BSID-III at 2 years poorly predict cognitive delay at 5 years. IMPACT The ASQ-3 does not adequately detect cognitive delay or predict cognitive delay at 5 years, particularly for children with mild to moderate delay. The ASQ-3 shows reasonable concurrent validity with the motor and language subscales of the BSID-III. Neither early screening nor formal developmental testing demonstrated significant predictive validity to screen for cognitive delay at school age. This article highlights the need to analyse our existing model of using the ASQ-3 to screen for cognitive delay in children aged 2 years.
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Affiliation(s)
- Cian Duggan
- Department of Paediatrics and Child Health, Cork University Hospital, Cork, Ireland.
| | - Alan D Irvine
- Department of Clinical Medicine, Trinity College, Dublin, Ireland
- Department of Paediatric Dermatology, Our Lady's Children's Hospital, Dublin, Ireland
| | - Jonathan O'B Hourihane
- Department of Paediatrics and Child Health, Cork University Hospital, Cork, Ireland
- The INFANT Research Centre, University College Cork, Cork, Ireland
| | - Mairead E Kiely
- The INFANT Research Centre, University College Cork, Cork, Ireland
- University College Cork, Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, Cork, Ireland
| | - Deirdre M Murray
- Department of Paediatrics and Child Health, Cork University Hospital, Cork, Ireland
- The INFANT Research Centre, University College Cork, Cork, Ireland
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Rocha HAL, Machado MMT, Santana OMMLD, Rocha SGMO, Aquino CMD, Gomes LGA, Albuquerque LDS, Soares MDDA, Leite ÁJM, Correia LL, Sudfeld CR. Association of Sociodemographic Factors and Maternal Educational Attainment with Child Development among Families Living below the Poverty Line in the State of Ceará, Northeastern Brazil. CHILDREN 2023; 10:children10040677. [PMID: 37189926 DOI: 10.3390/children10040677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/16/2023] [Accepted: 03/29/2023] [Indexed: 04/05/2023]
Abstract
Maternal educational attainment has been identified as relevant to several child health and development outcomes. This study aimed to evaluate the association of sociodemographic and maternal education factors with child development in families living below the poverty line. A cross-sectional study was conducted through telephone contact from May to July 2021 in Ceará, a state in Northeastern Brazil. The study population comprised families with children up to six years of age participating in the cash transfer program “Mais infância”. The families selected to participate in this program must have a monthly per capita income of less than US$16.50. The Ages and Stages Questionnaire version 3 was applied to assess the children’s development status. The mothers reported maternal educational attainment as the highest grade and or degree obtained. The final weighted and adjusted model showed that maternal schooling was associated with the risk of delay in all domains except for the fine motor domain. The risk of delay in at least one domain was 2.5-fold higher in mothers with a lower level of schooling (95% CI: 1.6–3.9). The findings of this study suggest that mothers with higher educational attainment have children with better child development outcomes.
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Affiliation(s)
- Hermano A. L. Rocha
- Department of Community Health, Federal University of Ceará, Fortaleza 60430-270, CE, Brazil
| | - Márcia M. T. Machado
- Department of Community Health, Federal University of Ceará, Fortaleza 60430-270, CE, Brazil
| | - Onélia M. M. L. de Santana
- Laboratory of Epidemiology and Data Analysis, University Health Center ABC, Faculdade de Medicina do ABC, Santo André 09060-870, SP, Brazil
- Social Protection Secretariat, Ceará State Government, Fortaleza 60130-160, CE, Brazil
| | - Sabrina G. M. O. Rocha
- Integração Serviço, Escola e Comunidade, Unichristus University Center, Fortaleza 60430-275, CE, Brazil
| | - Camila M. de Aquino
- Department of Maternal and Child Health, Federal University of Ceará, Fortaleza 60430-270, CE, Brazil
| | - Laécia G. A. Gomes
- Social Protection Secretariat, Ceará State Government, Fortaleza 60130-160, CE, Brazil
| | - Lucas de S. Albuquerque
- Department of Community Health, Federal University of Ceará, Fortaleza 60430-270, CE, Brazil
| | - Maria D. de A. Soares
- Social Protection Secretariat, Ceará State Government, Fortaleza 60130-160, CE, Brazil
| | - Álvaro J. M. Leite
- Laboratory of Epidemiology and Data Analysis, University Health Center ABC, Faculdade de Medicina do ABC, Santo André 09060-870, SP, Brazil
| | - Luciano L. Correia
- Department of Community Health, Federal University of Ceará, Fortaleza 60430-270, CE, Brazil
| | - Christopher R. Sudfeld
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
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Muthusamy S, Wagh D, Tan J, Bulsara M, Rao S. Utility of the Ages and Stages Questionnaire to Identify Developmental Delay in Children Aged 12 to 60 Months: A Systematic Review and Meta-analysis. JAMA Pediatr 2022; 176:980-989. [PMID: 36036913 PMCID: PMC9425289 DOI: 10.1001/jamapediatrics.2022.3079] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 06/30/2022] [Indexed: 01/23/2023]
Abstract
Importance The Ages and Stages Questionnaire (ASQ) is a commonly used developmental screening tool, but its utility is debated. Objectives To conduct a a systematic review and meta-analysis to evaluate ASQ's utility as a screening or diagnostic tool to identify developmental delay in children aged 12-60 months. Data Sources Medline, EMBASE, CINAHL, PsycINFO, and Mednar were searched from inception until December 2021. Study Selection Studies meeting both criteria were included. ASQ was performed at age 12 to 60 months or where the median age at ASQ was at least 12 months and formal developmental assessments were done within 2 months of ASQ. Data Extraction and Synthesis True positive, false positive, false negative, and true negatives from individual studies were extracted. Meta-analysis was conducted with Stata version 16.1. Risk of bias was assessed using the QUADAS-2 tool. Certainty of evidence (COE) was assessed using GRADE guidelines. Main Outcomes and Measures Ability of ASQ scores more than 2 SDs below the mean in more than 1 domain (ASQ-2SD) to identify any developmental delay or severe delay. Based on generally accepted interpretation of likelihood ratio (LR) values, a positive LR (PLR) more than 5 and a negative LR (NLR) of 0.2 or less were considered necessary to rule in or rule out developmental delay, respectively, with at least moderate probability. Results Initial search yielded 5777 citations of which 43 were included in the review. Of them, 36 were included in the meta-analysis. The pooled sensitivity, specificity, PLR, and NLR are as follows: ASQ-2SD to predict any delay in 1 or more domain (n = 16), 0.77 (95% CI, 0.64-0.86), 0.81 (95% CI, 0.75-0.86), 4.10 (95% CI, 3.17-5.30), and 0.28 (95% CI, 0.18-0.44); ASQ-2SD to predict severe delay in 1 or more domain (n = 15), 0.84 (95% CI, 0.75-0.90), 0.77 (95% CI, 0.71-0.82), 3.72 (95% CI, 2.98-4.64), and 0.20 (95% CI, 0.13-0.32); ASQ-2SD motor domain to predict motor delay (n = 7), 0.41 (95% CI, 0.26-0.57), 0.94 (95% CI, 0.87-0.97), 6.5 (95% CI, 3.8-11.1), and 0.63 (95% CI, 0.50-0.81); and ASQ-2SD cognitive domain to predict cognitive delay (n = 2), 0.44 (95% CI, 0.24-0.65), 0.93 (95% CI, 0.81-0.95), 6.4 (95% CI, 2.4-16.8), and 0.61 (95% CI, 0.43-0.86). The COE was low/very low. Conclusions and Relevance If a child aged 12 to 60 months passes all ASQ domains, there is a moderate probability that they do not have severe developmental delay (low COE). If a child aged 12-60 months fails the motor or cognitive domain of ASQ, there is a moderate probability that they have some motor or cognitive delay, respectively (very low COE). Trial Registration PROSPERO (CRD42021268543).
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Affiliation(s)
- Saravanan Muthusamy
- Neonatal Intensive Care Unit, Perth Children’s Hospital, Nedlands, Western Australia, Australia
- Neonatal Intensive Care Unit, King Edward Memorial Hospital for Women Perth, Subiaco, Western Australia, Australia
| | - Deepika Wagh
- Neonatal Intensive Care Unit, Perth Children’s Hospital, Nedlands, Western Australia, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Jason Tan
- Neonatal Intensive Care Unit, Perth Children’s Hospital, Nedlands, Western Australia, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Max Bulsara
- Institute for Health Research, University of Notre Dame, Fremantle, Western Australia, Australia
| | - Shripada Rao
- Neonatal Intensive Care Unit, Perth Children’s Hospital, Nedlands, Western Australia, Australia
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
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12
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Griffiths PD, Jarvis D, Connolly DJ, Mooney C, Embleton N, Hart AR. Predicting neurodevelopmental outcomes in fetuses with isolated mild ventriculomegaly. Arch Dis Child Fetal Neonatal Ed 2022; 107:431-436. [PMID: 34844985 DOI: 10.1136/archdischild-2021-321984] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 10/16/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Fetal ventriculomegaly is the the most common intracranial abnormality detected antenatally. When ventriculomegaly is mild and the only, isolated, abnormality detected (isolated mild ventriculomegaly (IMVM)) the prognosis is generally considered to be good. We aim to determine if there are features on in utero MRI (iuMRI) that can identify fetuses with IMVM who have lower risks of abnormal neurodevelopment outcome. METHODS We studied cases recruited into the MRI to enhance the diagnosis of fetal developmental brain abnormalities in utero (MERIDIAN) study, specifically those with: confirmed IMVM, 3D volume imaging of the fetal brain and neurodevelopmental outcomes at 3 years. We explored the influence of sex of the fetus, laterality of the ventriculomegaly and intracranial compartmental volumes in relation to neurodevelopmental outcome. FINDINGS Forty-two fetuses met the criteria (33 male and 9 female). There was no obvious correlation between fetal sex and the risk of poor neurodevelopmental outcome. Unilateral IMVM was present in 23 fetuses and bilateral IMVM in 19 fetuses. All fetuses with unilateral IMVM had normal neurodevelopmental outcomes, while only 12/19 with bilateral IMVM had normal neurodevelopmental outcomes. There was no obvious correlation between measure of intracranial volumes and risk of abnormal developmental outcomes. INTERPRETATION The most important finding is the very high chance of a good neurodevelopmental outcome observed in fetuses with unilateral IMVM, which is a potentially important finding for antenatal counselling. There does not appear to be a link between the volume of the ventricular system or brain volume and the risk of poor neurodevelopmental outcome.
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Affiliation(s)
| | - Deborah Jarvis
- Academic Unit of Radiology, The University of Sheffield, Sheffield, UK
| | - Daniel J Connolly
- Neuroradiology, Sheffield Childrens Hospital NHS Foundation Trust, Sheffield, UK
| | - Cara Mooney
- Clinical Trials Research Unit, School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Nicholas Embleton
- Newcastle Neonatal Service, Ward 35 Neonatal Unit, Royal Victoria Infirmary, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Anthony Richard Hart
- Department of Paediatric and Perinatal Neurology, Sheffield Children's NHS Foundation Trust, Sheffield, UK
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13
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Garon-Bissonnette J, Duguay G, Lemieux R, Dubois-Comtois K, Berthelot N. Maternal childhood abuse and neglect predicts offspring development in early childhood: The roles of reflective functioning and child sex. CHILD ABUSE & NEGLECT 2022; 128:105030. [PMID: 33752901 DOI: 10.1016/j.chiabu.2021.105030] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 03/01/2021] [Accepted: 03/11/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Recent evidence suggests that offspring of mothers having been exposed to childhood abuse and neglect (CA&N) are at increased risk of developmental problems and that boys are more affected by maternal CA&N than girls. Since impairments in reflective functioning (RF) have been associated with maternal CA&N and offspring development, RF could represent a key mechanism in these intergenerational risk trajectories. OBJECTIVE This study evaluated mediating (RF) and moderating (child sex) mechanisms in the association between maternal CA&N and child development. PARTICIPANTS AND SETTING In a longitudinal setting, 111 mothers completed measures during pregnancy and between 11 and 36 months postpartum. METHODS CA&N and impairments in RF were assessed during pregnancy and offspring development was measured during the longitudinal follow-up using the Ages and Stages Questionnaires (ASQ-3). Child development was operationalized in two ways: using the global score at the ASQ-3 and using a dichotomous score of accumulation of delays across domains of development. RESULTS Structural equation modeling indicated that RF mediated the association between maternal CA&N and offspring development. Child sex moderated the association between CA&N and the clustering of developmental problems (Wald = 5.88, p = 0.02), with boys being particularly likely to accumulate developmental delays when their mother experienced CA&N (RR = 2.62). Accumulation of developmental problems was associated with impairments in maternal RF in girls and with maternal exposure to CA&N in boys. CONCLUSIONS Results provide novel insights on the role of mentalization and child sex in the association between maternal CA&N and child development.
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Affiliation(s)
- Julia Garon-Bissonnette
- Department of Psychology, Université du Québec à Trois-Rivières, Canada; Centre d'études interdisciplinaires sur le développement de l'enfant et la famille, Canada; Groupe de recherche et d'intervention auprès des enfants vulnérables et négligés, Canada; Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Canada
| | - Gabrielle Duguay
- Department of Psychology, Université du Québec à Trois-Rivières, Canada; Centre d'études interdisciplinaires sur le développement de l'enfant et la famille, Canada; Groupe de recherche et d'intervention auprès des enfants vulnérables et négligés, Canada
| | - Roxanne Lemieux
- Department of Nursing Sciences, Université du Québec à Trois-Rivières, Canada; Centre d'études interdisciplinaires sur le développement de l'enfant et la famille, Canada; Groupe de recherche et d'intervention auprès des enfants vulnérables et négligés, Canada; Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Canada
| | - Karine Dubois-Comtois
- Department of Psychology, Université du Québec à Trois-Rivières, Canada; Centre d'études interdisciplinaires sur le développement de l'enfant et la famille, Canada; Groupe de recherche et d'intervention auprès des enfants vulnérables et négligés, Canada
| | - Nicolas Berthelot
- Department of Nursing Sciences, Université du Québec à Trois-Rivières, Canada; Centre d'études interdisciplinaires sur le développement de l'enfant et la famille, Canada; Groupe de recherche et d'intervention auprès des enfants vulnérables et négligés, Canada; Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Canada.
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14
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Rocha HAL, Correia LL, Leite ÁJM, Rocha SGMO, Machado MMT, Campos JS, Cunha AJLA, E Silva AC, Sudfeld CR. Undernutrition and short duration of breastfeeding association with child development: a population-based study. J Pediatr (Rio J) 2022; 98:316-322. [PMID: 34508663 PMCID: PMC9432002 DOI: 10.1016/j.jped.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To explore the relationship of undernutrition and the short duration of breastfeeding with child development of children 0-66 months of age residing in Ceará, Brazil. METHODS The authors of the present study utilized population-based data from children enrolled in the Study on Maternal and Child Health in Ceará, Brazil (PESMIC). Children's development was assessed with the Ages and Stages Questionnaire third version, validated in Brazil. Undernutrition was accessed through anthropometric measures obtained by trained staff. Breastfeeding information was obtained through the mothers' report and confirmed in the child's governmental booklet. The authors used logistic regressions adjusted for sample clusters used in PESMIC design in a theoretical model for known determinants of child development following the World Health Organization nurturing framework. RESULTS A total of 3,566 children were enrolled in the sixth PESMIC study and had their development assessed. The authors found that 8.2%, 3.0%, 2.1%, and 3.6% of children were stunted, underweight, or wasted, at the time of the interview, respectively. All studied factors were associated with a higher prevalence of child development impairment in at least one of the assessed domains. Underweight was the factor with the strongest effect, with an adjusted odds ratio (AOR) of 4,14 (2,26-7,58), p < 0.001. Breastfeeding for up to two months compared to more than six months (AOR 2,08 (1,38-3,12)) was also associated. CONCLUSIONS The authors found that undernutrition and short duration of breastfeeding are associated with development outcomes among Brazilian children. As a result, integrated nutritional programs may improve child development outcomes.
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Affiliation(s)
- Hermano A L Rocha
- Harvard T. H. Chan School of Public Health, Department of Global Health and Population, Boston, United States; Universidade Federal do Ceará, Departamento de Saúde Materno-Infantil, Fortaleza, CE, Brazil; Universidade Federal do Ceará, Departamento de Saúde Comunitária, Fortaleza, CE, Brazil.
| | - Luciano L Correia
- Universidade Federal do Ceará, Departamento de Saúde Comunitária, Fortaleza, CE, Brazil
| | - Álvaro J M Leite
- Universidade Federal do Ceará, Departamento de Saúde Materno-Infantil, Fortaleza, CE, Brazil
| | - Sabrina G M O Rocha
- Universidade Federal do Ceará, Departamento de Saúde Comunitária, Fortaleza, CE, Brazil; ISEC, Centro Universitário Unichristus, Fortaleza, CE, Brazil
| | - Márcia M T Machado
- Universidade Federal do Ceará, Departamento de Saúde Comunitária, Fortaleza, CE, Brazil
| | | | - Antonio J L A Cunha
- Universidade Federal do Rio de Janeiro, Departamento de Pediatria, Rio de Janeiro, RJ, Brazil
| | | | - Christopher R Sudfeld
- Harvard T. H. Chan School of Public Health, Department of Global Health and Population, Boston, United States
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15
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Hyperglycemia in pregnancy and developmental outcomes in children at 18–60 months of age: the PANDORA Wave 1 study. J Dev Orig Health Dis 2022; 13:695-705. [DOI: 10.1017/s2040174422000101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
This study aimed to explore the association between hyperglycemia in pregnancy (type 2 diabetes (T2D) and gestational diabetes mellitus (GDM)) and child developmental risk in Europid and Aboriginal women.
PANDORA is a longitudinal birth cohort recruited from a hyperglycemia in pregnancy register, and from normoglycemic women in antenatal clinics. The Wave 1 substudy included 308 children who completed developmental and behavioral screening between age 18 and 60 months. Developmental risk was assessed using the Ages and Stages Questionnaire (ASQ) or equivalent modified ASQ for use with Aboriginal children. Emotional and behavioral risk was assessed using the Strengths and Difficulties Questionnaire. Multivariable logistic regression was used to assess the association between developmental scores and explanatory variables, including maternal T2D in pregnancy or GDM.
After adjustment for ethnicity, maternal and child variables, and socioeconomic measures, maternal hyperglycemia was associated with increased developmental “concern” (defined as score ≥1 SD below mean) in the fine motor (T2D odds ratio (OR) 5.30, 95% CI 1.77–15.80; GDM OR 3.96, 95% CI 1.55–10.11) and problem-solving (T2D OR 2.71, 95% CI 1.05–6.98; GDM OR 2.54, 95% CI 1.17–5.54) domains, as well as increased “risk” (score ≥2 SD below mean) in at least one domain (T2D OR 5.33, 95% CI 1.85–15.39; GDM OR 4.86, 95% CI 1.95–12.10). Higher maternal education was associated with reduced concern in the problem-solving domain (OR 0.27, 95% CI 0.11–0.69) after adjustment for maternal hyperglycemia.
Maternal hyperglycemia is associated with increased developmental concern and may be a potential target for intervention so as to optimize developmental trajectories.
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Tveten KM, Strand LI, Riiser K, Nilsen RM, Dragesund T. The ability of the Ages and Stages Questionnaire (ASQ) to indicate motor difficulties in infants in primary care. Physiother Theory Pract 2022:1-7. [PMID: 35321635 DOI: 10.1080/09593985.2022.2056553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Delayed achievement of motor milestones may be an early indicator of motor difficulties. Parent-reported questionnaires may serve as an efficient, low-cost screening to identify infants in need of further clinical assessment, and thus be a helpful tool in busy health care centers. PURPOSE To examine the ability of the Ages and Stages Questionnaire, second edition (ASQ-2) to indicate motor difficulties in infants using the Infant Motor Profile (IMP) as the reference standard. METHODS A cross-sectional design was applied to examine the correlation between parent-reported data of the ASQ-2 and data from physiotherapist assessment using IMP. Included were 432 mainly low-risk infants aged 3-12 months from primary care. RESULTS Overall, ASQ-2 gross and fine motor scores did not correlate well with the IMP total or domain scores. The ASQ-2 gross motor cut point (> 2SD below the mean), showed 34.3% sensitivity and 96.7% specificity using the 15th percentile from IMP performance domain as reference standard. The positive predictive value to indicate motor difficulties was 48%. CONCLUSION The motor domains of ASQ-2 have poor ability to identify infants with motor difficulties as indicated by their IMP scores in low-risk infants.
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Affiliation(s)
- Kine Melfald Tveten
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Liv Inger Strand
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Kirsti Riiser
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Roy Miodini Nilsen
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Tove Dragesund
- Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
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17
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Wilson P, Rush R, Charlton J, Gilroy V, McKean C, Law J. Universal language development screening: comparative performance of two questionnaires. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2021-001324. [PMID: 36053598 PMCID: PMC8739429 DOI: 10.1136/bmjpo-2021-001324] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/16/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Low language ability in early childhood is a strong predictor of later psychopathology as well as reduced school readiness, lower educational attainment, employment problems and involvement with the criminal justice system. Assessment of early language development is universally offered in many countries, but there has been little evaluation of assessment tools. We planned to compare the screening performance of two commonly used language assessment instruments. METHODS A pragmatic diagnostic accuracy study was carried out in five areas of England comparing the performance of two screening tools (Ages and Stages Questionnaire (ASQ) and Sure Start Language Measure (SSLM)) against a reference test (Preschool Language Scale, 5th edition). RESULTS Results were available for 357 children aged 23-30 months. The ASQ Communication Scale using optimal cut-off values had a sensitivity of 0.55, a specificity of 0.95 and positive and negative predictive values of 0.53 and 0.95, respectively. The SSLM had corresponding values of 0.83, 0.81, 0.33 and 0.98, respectively. Both screening tools performed relatively poorly in families not using English exclusively in the home. CONCLUSION The very widely used ASQ Communication Scale performs poorly as a language screening tool, missing over one-third of cases of low language ability. The SSLM performed better as a screening tool.
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Affiliation(s)
- Philip Wilson
- Centre for Rural Health, Institute of Applied Health Sciences, University of Aberdeen, Inverness, UK
| | - Robert Rush
- Independent statistical consultant, Edinburgh, UK
| | - Jenna Charlton
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle upon Tyne, UK
| | | | - Cristina McKean
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - James Law
- School of Education, Communication and Language Sciences, Newcastle University, Newcastle upon Tyne, UK
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18
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Hochstedler KA, Bell G, Park H, Ghassabian A, Bell EM, Sundaram R, Grantz KL, Yeung EH. Gestational Age at Birth and Risk of Developmental Delay: The Upstate KIDS Study. Am J Perinatol 2021; 38:1088-1095. [PMID: 32143225 PMCID: PMC7507972 DOI: 10.1055/s-0040-1702937] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The aim of this study is to model the association between gestational age at birth and early child development through 3 years of age. STUDY DESIGN Development of 5,868 children in Upstate KIDS (New York State; 2008-2014) was assessed at 7 time points using the Ages and Stages Questionnaire (ASQ). The ASQ was implemented using gestational age corrected dates of birth at 4, 8, 12, 18, 24, 30, and 36 months. Whether children were eligible for developmental services from the Early Intervention Program was determined through linkage. Gestational age was based on vital records. Statistical models adjusted for covariates including sociodemographic factors, maternal smoking, and plurality. RESULTS Compared with gestational age of 39 weeks, adjusted odds ratios (aOR) and 95% confidence intervals of failing the ASQ for children delivered at <32, 32-34, 35-36, 37, 38, and 40 weeks of gestational age were 5.32 (3.42-8.28), 2.43 (1.60-3.69), 1.38 (1.00-1.90), 1.37 (0.98-1.90), 1.29 (0.99-1.67), 0.73 (0.55-0.96), and 0.51 (0.32-0.82). Similar risks of being eligible for Early Intervention Program services were observed (aOR: 4.19, 2.10, 1.29, 1.20, 1.01, 1.00 [ref], 0.92, and 0.78 respectively for <32, 32-34, 37, 38, 39 [ref], 40, and 41 weeks). CONCLUSION Gestational age was inversely associated with developmental delays for all gestational ages. Evidence from our study is potentially informative for low-risk deliveries at 39 weeks, but it is notable that deliveries at 40 weeks exhibited further lower risk.
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Affiliation(s)
- Kimberly A Hochstedler
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Griffith Bell
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Hyojun Park
- Department of Sociology, Utah State University, Logan, Utah
| | - Akhgar Ghassabian
- Departments of Pediatrics, Environmental Medicine, and Population Health, New York University School of Medicine, New York, New York
| | - Erin M Bell
- Departments of Environmental Health Sciences and Epidemiology and Biostatistics, University at Albany School of Public Health, Albany, New York
| | - Rajeshwari Sundaram
- Biostatistics & Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Katherine L Grantz
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Edwina H Yeung
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
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19
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Neurodevelopmental Outcomes after Premedication with Atropine/Propofol vs Atropine/Atracurium/Sufentanil for Neonatal Intubation: 2-Year Follow-Up of a Randomized Clinical Trial. J Pediatr 2021; 231:273-277.e3. [PMID: 33301785 DOI: 10.1016/j.jpeds.2020.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/28/2020] [Accepted: 12/01/2020] [Indexed: 01/07/2023]
Abstract
This study followed 173 newborn infants in the PREmedication Trial for Tracheal Intubation of the NEOnate multicenter, double-blind, randomized controlled trial of atropine-propofol vs atropine-atracurium-sufentanil for premedication before nonemergency intubation. At 2 years of corrected age, there was no significant difference between the groups in death or risk of neurodevelopmental delay assessed with the Ages and Stages Questionnaire. Trial registration Clinicaltrials.gov: NCT01490580.
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20
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Peyton C, Msall ME, Wroblewski K, Rogers EE, Kohn M, Glass HC. Concurrent validity of the Warner Initial Developmental Evaluation of Adaptive and Functional Skills and the Bayley Scales of Infant and Toddler Development, Third Edition. Dev Med Child Neurol 2021; 63:349-354. [PMID: 33206384 PMCID: PMC7878347 DOI: 10.1111/dmcn.14737] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/12/2020] [Indexed: 11/28/2022]
Abstract
AIM To determine the concurrent validity of the Warner Initial Developmental Evaluation of Adaptive and Functional Skills (WIDEA-FS), a criterion-specified questionnaire that assesses a child's adaptive skills in everyday contexts, and the Bayley Infant and Toddler Scales of Development, Third Edition (Bayley-III). METHOD In a prospective cohort study, 431 WIDEA-FS and Bayley-III assessments were completed among 341 children, aged 10 to 36 months corrected age (158 females, 183 males; median [interquartile range] gestational age at birth 32wks [29-38]), monitored in a high-risk neonatal intensive care unit follow-up clinic. RESULTS WIDEA-FS scores were significantly associated with Bayley-III scores in all domains. Lower scores on the WIDEA-FS were significantly associated with an increased risk of adverse developmental performance on all Bayley-III scales. The association was strongest for motor and language Bayley-III scores when tested at <30 months of age, and for cognitive Bayley-III scores when tested at ≥30 months of age. INTERPRETATION The WIDEA-FS has concurrent validity with the Bayley-III and may be a useful tool in high-risk follow-up settings. WHAT THIS PAPER ADDS WIDEA-FS mobility, communication, and social cognition domains are concurrently valid in infants at high-risk for neurodevelopmental disability. Bayley-III motor, language, and cognitive composite scores are concurrently valid in the same group. The WIDEA-FS mobility and communication domains may be most clinically useful in children <30 months.
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Affiliation(s)
- Colleen Peyton
- Department of Physical Therapy and Human Movement Science and Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Michael E. Msall
- Kennedy Research Center on Intellectual and Neurodevelopmental Disabilities and Section of Developmental and Behavioral Pediatrics; University of Chicago Comer Children’s Hospital, Chicago IL
| | - Kristen Wroblewski
- Department of Public Health Services, University of Chicago, Chicago, IL
| | - Elizabeth E. Rogers
- Department of Pediatrics; UCSF Benioff Children’s Hospital, University of California San Francisco, San Francisco, CA
| | - Michael Kohn
- Department of Epidemiology & Biostatistics; University of California San Francisco, San Francisco, CA
| | - Hannah C. Glass
- Department of Pediatrics; UCSF Benioff Children’s Hospital, University of California San Francisco, San Francisco, CA
- Department of Epidemiology & Biostatistics; University of California San Francisco, San Francisco, CA
- Department of Neurology; University of California San Francisco, San Francisco, CA
- UCSF Weill Institute for Neurosciences
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21
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Madlala HP, Myer L, Malaba TR, Newell ML. Neurodevelopment of HIV-exposed uninfected children in Cape Town, South Africa. PLoS One 2020; 15:e0242244. [PMID: 33206724 PMCID: PMC7673492 DOI: 10.1371/journal.pone.0242244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 10/30/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Evidence shows that antiretroviral (ART) exposure is associated with neurodevelopmental delays in human immunodeficiency virus (HIV)-exposed uninfected (HEU) children. However, there are few insights into modifiable maternal and child factors that may play a role in improving neurodevelopment in HEU children. We used a parent-centric neurodevelopment tool, Ages & Stages Questionnaire (ASQ) to examined neurodevelopment in HEU children at 12-24 months of age, and associations with maternal and child factors. METHODS 505 HIV-infected women (initiated ART pre- or during pregnancy) with live singleton births attending primary health care were enrolled; 355 of their HEU children were assessed for neurodevelopment (gross motor, fine motor, communication, problem solving and personal-social domains) at 12-24 months using age-specific ASQ administered by a trained fieldworker. Associations with maternal and child factors were examined using logistic regression models. RESULTS Among mothers (median age 30 years, IQR, 26-34), 52% initiated ART during pregnancy; the median CD4 count was 436 cells/μl (IQR, 305-604). Most delayed neurodevelopment in HEU children was in gross (9%) and fine motor (5%) functions. In adjusted models, maternal socio-economic status (aOR 0.42, 95% CI 0.24-0.76) was associated with reduced odds of delayed gross-fine motor neurodevelopment. Maternal age ≥35 years (aOR 0.22, 95% CI 0.05-0.89) and maternal body mass index (BMI) <18.5 (aOR 6.76, 95% CI 1.06-43.13) were associated with delayed communication-problem-solving-personal-social neurodevelopment. There were no differences in odds for either domain by maternal ART initiation timing. CONCLUSIONS Delayed neurodevelopment was detected in both gross and fine motor functions in this cohort of HEU children, with strong maternal predictors that may be explored as potentially modifiable factors associated with neurodevelopment at one to two years of age.
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Affiliation(s)
- Hlengiwe P. Madlala
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, Western Cape, South Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Landon Myer
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, Western Cape, South Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Thokozile R. Malaba
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, Western Cape, South Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, Western Cape, South Africa
| | - Marie-Louise Newell
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
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22
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Li Y, Tang L, Bai Y, Zhao S, Shi Y. Reliability and validity of the Caregiver Reported Early Development Instruments (CREDI) in impoverished regions of China. BMC Pediatr 2020; 20:475. [PMID: 33046019 PMCID: PMC7549226 DOI: 10.1186/s12887-020-02367-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/29/2020] [Indexed: 11/30/2022] Open
Abstract
Background There is a great need in low- and middle- income countries for sound qualitative and monitoring tools assessing early childhood development outcomes. Although there are many instruments to measure the developmental status of infants and toddlers, their use in large scale studies is still limited because of high costs in both time and money. The Caregiver Reported Early Development Instruments (CREDI), however, were designed to serve as a population-level measure of early childhood development for children from birth to age three, and have been used in 17 low- and middle-income countries. This study aimed to examine the reliability and validity of the CREDI in China, which is still unknown. Methods The CREDI and the ASQ-3 was administered to a sample of 946 children aged 5–36 months from urban and rural communities, in which 248 children was administered with Bayley-III. Results The internal consistency of the CREDI was high, which indicates that the scale internal consistency reliability is quite good. The results also indicated that the concurrent validity of the CREDI with the Bayley-III scale was high in general. Ordinary least squares regression showed that the CREDI is highly consistent with previous widely used instruments in some key predictors (such as the home stimulation) of early childhood development level. Conclusions All the results in the current study indicate that the CREDI may be considered an appropriate instrument to measure early childhood development status on a large scale in impoverished regions of China.
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Affiliation(s)
- Ying Li
- Center for Experimental Economics in Education, Shaanxi Normal University, Xi'an, 710119, Shaanxi Province, China
| | - Lei Tang
- Center for Experimental Economics in Education, Shaanxi Normal University, Xi'an, 710119, Shaanxi Province, China
| | - Yu Bai
- School of Economics, Minzu University of China, China Institute for Vitalizing Border Areas and Enriching the People, Beijing, 100081, China.
| | - Shuhang Zhao
- Center for Experimental Economics in Education, Shaanxi Normal University, Xi'an, 710119, Shaanxi Province, China
| | - Yaojiang Shi
- Center for Experimental Economics in Education, Shaanxi Normal University, Xi'an, 710119, Shaanxi Province, China
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23
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Brown KL, Pagel C, Ridout D, Wray J, Tsang VT, Anderson D, Banks V, Barron DJ, Cassidy J, Chigaru L, Davis P, Franklin R, Grieco L, Hoskote A, Hudson E, Jones A, Kakat S, Lakhani R, Lakhanpaul M, McLean A, Morris S, Rajagopal V, Rodrigues W, Sheehan K, Stoica S, Tibby S, Utley M, Witter T. Early morbidities following paediatric cardiac surgery: a mixed-methods study. HEALTH SERVICES AND DELIVERY RESEARCH 2020. [DOI: 10.3310/hsdr08300] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background
Over 5000 paediatric cardiac surgeries are performed in the UK each year and early survival has improved to > 98%.
Objectives
We aimed to identify the surgical morbidities that present the greatest burden for patients and health services and to develop and pilot routine monitoring and feedback.
Design and setting
Our multidisciplinary mixed-methods study took place over 52 months across five UK paediatric cardiac surgery centres.
Participants
The participants were children aged < 17 years.
Methods
We reviewed existing literature, ran three focus groups and undertook a family online discussion forum moderated by the Children’s Heart Federation. A multidisciplinary group, with patient and carer involvement, then ranked and selected nine key morbidities informed by clinical views on definitions and feasibility of routine monitoring. We validated a new, nurse-administered early warning tool for assessing preoperative and postoperative child development, called the brief developmental assessment, by testing this among 1200 children. We measured morbidity incidence in 3090 consecutive surgical admissions over 21 months and explored risk factors for morbidity. We measured the impact of morbidities on quality of life, clinical burden and costs to the NHS and families over 6 months in 666 children, 340 (51%) of whom had at least one morbidity. We developed and piloted methods suitable for routine monitoring of morbidity by centres and co-developed new patient information about morbidities with parents and user groups.
Results
Families and clinicians prioritised overlapping but also different morbidities, leading to a final list of acute neurological event, unplanned reoperation, feeding problems, renal replacement therapy, major adverse events, extracorporeal life support, necrotising enterocolitis, surgical infection and prolonged pleural effusion. The brief developmental assessment was valid in children aged between 4 months and 5 years, but not in the youngest babies or 5- to 17-year-olds. A total of 2415 (78.2%) procedures had no measured morbidity. There was a higher risk of morbidity in neonates, complex congenital heart disease, increased preoperative severity of illness and with prolonged bypass. Patients with any morbidity had a 6-month survival of 81.5% compared with 99.1% with no morbidity. Patients with any morbidity scored 5.2 points lower on their total quality of life score at 6 weeks, but this difference had narrowed by 6 months. Morbidity led to fewer days at home by 6 months and higher costs. Extracorporeal life support patients had the lowest days at home (median: 43 days out of 183 days) and highest costs (£71,051 higher than no morbidity).
Limitations
Monitoring of morbidity is more complex than mortality, and hence this requires resources and clinician buy-in.
Conclusions
Evaluation of postoperative morbidity provides important information over and above 30-day survival and should become the focus of audit and quality improvement.
Future work
National audit of morbidities has been initiated. Further research is needed to understand the implications of feeding problems and renal failure and to evaluate the brief developmental assessment.
Funding
This project was funded by the NIHR Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 30. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Katherine L Brown
- Heart and Lung Division, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Christina Pagel
- Clinical Operational Research Unit, University College London, London, UK
| | - Deborah Ridout
- Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Jo Wray
- Heart and Lung Division, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Victor T Tsang
- Heart and Lung Division, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - David Anderson
- Departments of Paediatric Intensive Care, Cardiology and Cardiac Surgery, Evelina London Children’s Hospital, London, UK
| | - Victoria Banks
- Heart and Lung Division, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - David J Barron
- Departments of Intensive Care and Paediatric Cardiac Surgery, Birmingham Children’s Hospital, Birmingham, UK
| | - Jane Cassidy
- Departments of Intensive Care and Paediatric Cardiac Surgery, Birmingham Children’s Hospital, Birmingham, UK
| | - Linda Chigaru
- Heart and Lung Division, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Peter Davis
- Departments of Intensive Care and Paediatric Cardiac Surgery, Bristol Royal Hospital for Children, Bristol, UK
| | - Rodney Franklin
- Paediatric Cardiology Department, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Luca Grieco
- Clinical Operational Research Unit, University College London, London, UK
| | - Aparna Hoskote
- Heart and Lung Division, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Emma Hudson
- Department of Applied Health Research, University College London, London, UK
| | - Alison Jones
- Departments of Intensive Care and Paediatric Cardiac Surgery, Birmingham Children’s Hospital, Birmingham, UK
| | - Suzan Kakat
- Heart and Lung Division, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Rhian Lakhani
- Departments of Paediatric Intensive Care, Cardiology and Cardiac Surgery, Evelina London Children’s Hospital, London, UK
| | - Monica Lakhanpaul
- Population, Policy and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, UK
- Community Child Health, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Andrew McLean
- Department of Intensive care, Royal Hospital for Children, Glasgow, UK
| | - Steve Morris
- Department of Applied Health Research, University College London, London, UK
| | - Veena Rajagopal
- Heart and Lung Division, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Warren Rodrigues
- Department of Intensive care, Royal Hospital for Children, Glasgow, UK
| | - Karen Sheehan
- Departments of Intensive Care and Paediatric Cardiac Surgery, Bristol Royal Hospital for Children, Bristol, UK
| | - Serban Stoica
- Departments of Intensive Care and Paediatric Cardiac Surgery, Bristol Royal Hospital for Children, Bristol, UK
| | - Shane Tibby
- Departments of Paediatric Intensive Care, Cardiology and Cardiac Surgery, Evelina London Children’s Hospital, London, UK
| | - Martin Utley
- Clinical Operational Research Unit, University College London, London, UK
| | - Thomas Witter
- Departments of Paediatric Intensive Care, Cardiology and Cardiac Surgery, Evelina London Children’s Hospital, London, UK
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24
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Fauls JR, Thompson BL, Johnston LM. Validity of the Ages and Stages Questionnaire to identify young children with gross motor difficulties who require physiotherapy assessment. Dev Med Child Neurol 2020; 62:837-844. [PMID: 32043571 DOI: 10.1111/dmcn.14480] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/22/2019] [Indexed: 11/29/2022]
Abstract
AIM To determine if the Ages and Stages Questionnaire, Third Edition Gross Motor domain (ASQ-3-GM) score is predictive of motor performance on the Alberta Infant Motor Scale (AIMS) and/or Neurological, Sensory, Motor, Developmental Assessment (NSMDA). METHOD This was a cross-sectional study involving analysis of a 1-year consecutive clinical sample of data obtained from children attending a specialist public outpatient service. Participants were 84 children aged 0 to 5 years (mean age 24.9mo, SD 18.4mo; 50 males, 34 females) referred for physiotherapy assessment of gross motor skills in a tertiary child development service. Parents completed the ASQ-3 questionnaire and children were assessed using the AIMS (if aged 0-18mo) and/or NSMDA (all children). To determine possible relationships between ASQ-3-GM scores with AIMS and NSMDA scores, we calculated Spearman's rank correlation coefficients. To determine validity of the ASQ-3-GM 'refer for further assessment' ('refer') cut-off score to identify gross motor difficulties we calculated frequency distributions and crosstab analyses. RESULTS ASQ-3-GM scores correlated with AIMS centile rank (r=0.697, p<0.001) and NSMDA motor performance classification (r=-0.548, p<0.001). The ASQ-3-GM 'refer' cut-off had 77% sensitivity, 91% specificity, and 95% positive predictive value (PPV) to identify children that scored ≤10th centile on the AIMS and 57% sensitivity, 92% specificity, and 97% PPV to identify children with at least minimal dysfunction on the NSMDA. INTERPRETATION The ASQ-3-GM 'refer' cut-off score is a valid predictor of gross motor difficulties in young children. WHAT THIS PAPER ADDS The Ages and Stages Questionnaire, Third Edition Gross Motor domain (ASQ-3-GM) score is valid to identify gross motor difficulties in young children. The ASQ-3-GM 'refer' cut-off had 95% positive predictive value (PPV) for children that scored ≤10th centile on the Alberta Infant Motor Scale. The ASQ-3-GM 'refer' cut-off had 97% PPV for at least minimal dysfunction on the Neurological, Sensory, Motor, Developmental Assessment.
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Affiliation(s)
- John R Fauls
- The University of Queensland, St Lucia, Queensland, Australia.,Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia
| | - Bronwyn L Thompson
- Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia
| | - Leanne M Johnston
- The University of Queensland, St Lucia, Queensland, Australia.,Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia
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25
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Clark H, Nair K, Veldhuizen S, Campbell W, Rivard L, Rodriguez MC, Cairney J. Validity of the Early Years Check-In (EYCI) in a Cross-Sectional Sample of Families. Front Pediatr 2020; 8:157. [PMID: 32426305 PMCID: PMC7212364 DOI: 10.3389/fped.2020.00157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 03/20/2020] [Indexed: 11/13/2022] Open
Abstract
Background: The objective of the present study was to develop and test the validity of the Early Years Check-In (EYCI), a new tool that measures parent and educator concerns regarding children's development. The study examined the EYCI's agreement with 3rd edition of the Bayley Scales of Infant and Toddler Development (BSID-III) an established measure of child development. Two possible thresholds were explored: one to identify children with a probable delay, and another to identify children at the borderline functioning threshold. Methods: Parents of children aged 18 to 42 months were recruited from childcare settings across Ontario, Canada. The study proceeded in two phases. Phase I, intended to pilot the measure, included 49 children. Phase II, a test of the validity of the final version, included 199 children. Parents and educators completed the EYCI for the child, while a blinded assessor completed the BSID-III. Results: The EYCI demonstrated good sensitivity and specificity (86 and 82%, respectively) as a parent-completed tool that identifies children with a probable delay. However, the positive predictive value (15%) suggests the EYCI is likely to over identify children. When identifying children who demonstrated borderline delay, the EYCI demonstrated good sensitivity (80%) but poor specificity (49%). Results from educator-completed EYCIs were poor for both probable and borderline delay. Conclusions: While further research is required, the EYCI shows promise as a parent-completed tool, particularly to identify more-severe cases of delay. Results with educators were poor overall. Future research investigating accuracy of educators in different types of early childcare centres is needed.
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Affiliation(s)
- Heather Clark
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Kalpana Nair
- Faculty of Health Sciences, School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Scott Veldhuizen
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Wenonah Campbell
- Faculty of Health Sciences, School of Rehabilitation Science, Institute of Applied Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Lisa Rivard
- Faculty of Health Sciences, School of Rehabilitation Science, Institute of Applied Health Sciences, McMaster University, Hamilton, ON, Canada
| | - M. Christine Rodriguez
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - John Cairney
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, QLD, Australia
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Ouellet-Scott N, Gagnon M, Fortin P, Girouard-Chantal É, Peckre P, Martini R, Lambert J, Luu TM, Simard MN. Screening for mild to moderate motor impairments in very preterm children: Utility of parent questionnaires. Early Hum Dev 2020; 141:104940. [PMID: 31862628 DOI: 10.1016/j.earlhumdev.2019.104940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 11/15/2019] [Accepted: 12/10/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Nellie Ouellet-Scott
- Research Center, Centre Hospitalier Universitaire Ste-Justine, Montreal, Canada; School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Mélanie Gagnon
- Research Center, Centre Hospitalier Universitaire Ste-Justine, Montreal, Canada; School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Pascale Fortin
- Research Center, Centre Hospitalier Universitaire Ste-Justine, Montreal, Canada; School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Élise Girouard-Chantal
- Research Center, Centre Hospitalier Universitaire Ste-Justine, Montreal, Canada; School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Perrine Peckre
- Research Center, Centre Hospitalier Universitaire Ste-Justine, Montreal, Canada
| | - Rose Martini
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
| | - Jean Lambert
- School of Public Health, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Thuy Mai Luu
- Research Center, Centre Hospitalier Universitaire Ste-Justine, Montreal, Canada; Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada
| | - Marie-Noëlle Simard
- Research Center, Centre Hospitalier Universitaire Ste-Justine, Montreal, Canada; School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada.
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27
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Schonhaut L, Pérez M, Armijo I, Maturana A. Comparison between Ages & Stages Questionnaire and Bayley Scales, to predict cognitive delay in school age. Early Hum Dev 2020; 141:104933. [PMID: 31775095 DOI: 10.1016/j.earlhumdev.2019.104933] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 11/15/2019] [Accepted: 11/19/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compare the predictive value of the Spanish Ages & Stages Questionnaire third edition adapted for Chilean population (ASQ-Cl) and the Bayley Scale of Infant and Toddler Development 3rd edition (Bayley-III) for cognitive delay at school age, and to identify the domain predictors. METHODOLOGY Data were collected from 306 term and preterm children of medium-high socio-economic level enrolled in a prospective cohort study. Developmental outcomes at 8, 18 and 30 months were assessed via the ASQ-Cl and Bayley-III; at 6-8 years cognitive development was assessed using the Wechsler Intelligence Scale for Children (WISC-III). The area under the curve (AUC), sensitivity, specificity and predictive values were calculated, and logistic regression analysis was used. RESULTS Of 227 children studied, 6.6% had cognitive delay. ASQ-Cl and Bayley-III generate equivalent AUC [0.77 and 0.80]. Sensitivity 67% and 53%; specificity of 72% and 88%, positive predictive value of 14% and 24%, negative predictive values of 97% and 96% respectively. Greater predictive validity was obtained at 30 months assessment. Deficit in the communication and gross motor skills and problem-solving domains of the ASQ-Cl and all the Bayley-III domains were significantly associated with cognitive delay. CONCLUSIONS ASQ-Cl can be used to identify children at risk for cognitive delay at 6-8 years of age, being comparable with the Bayley-III. Some domains of ASQ-Cl and all domains of Bayley-III were significant predictors for cognitive delay. These results support the use of ASQ-Cl as a screening tool for developmental delay.
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Affiliation(s)
- Luisa Schonhaut
- Clinica Alemana, Santiago, Chile; Faculty of Medicine, Universidad del Desarrollo, Santiago, Chile.
| | - Marcela Pérez
- Clinica Alemana, Santiago, Chile; Faculty of Medicine, Universidad del Desarrollo, Santiago, Chile
| | - Iván Armijo
- Faculty of Psychology, Universidad del Desarrollo, Santiago, Chile
| | - Andrés Maturana
- Clinica Alemana, Santiago, Chile; Faculty of Medicine, Universidad del Desarrollo, Santiago, Chile
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Hart AR, Embleton ND, Bradburn M, Connolly DJA, Mandefield L, Mooney C, Griffiths PD. Accuracy of in-utero MRI to detect fetal brain abnormalities and prognosticate developmental outcome: postnatal follow-up of the MERIDIAN cohort. THE LANCET CHILD & ADOLESCENT HEALTH 2019; 4:131-140. [PMID: 31786091 PMCID: PMC6988445 DOI: 10.1016/s2352-4642(19)30349-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/15/2019] [Accepted: 10/17/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND In utero MRI (iuMRI) detects fetal brain abnormalities more accurately than ultrasonography and provides additional clinical information in around half of pregnancies. We aimed to study whether postnatal neuroimaging after age 6 months changes the diagnostic accuracy of iuMRI and its ability to predict developmental outcome. METHODS Families enrolled in the MERIDIAN study whose child survived to age 3 years were invited to have a case note review and assessment of developmental outcome with the Bayley Scales of Infant and Toddler Development, the Ages and Stages Questionnaire, or both. A paediatric neuroradiologist, masked to the iuMRI results, reviewed the postnatal neuroimaging if the clinical report differed from iuMRI findings. Diagnostic accuracy was recalculated. A paediatric neurologist and neonatologist categorised participants' development as normal, at risk, or abnormal, and the ability of iuMRI and ultrasonography to predict developmental outcome were assessed. FINDINGS 210 participants had case note review, of whom 81 (39%) had additional investigations after age 6 months. The diagnostic accuracy of iuMRI remained higher than ultrasonography (proportion of correct cases was 529 [92%] of 574 vs 387 [67%] of 574; absolute difference 25%, 95% CI 21 to 29; p<0·0001). Developmental outcome data were analysed in 156 participants, and 111 (71%) were categorised as normal or at risk. Of these 111 participants, prognosis was normal or favourable for 56 (51%) using ultrasonography and for 76 (69%) using iuMRI (difference in specificity 18%, 95% CI 7 to 29; p=0·0008). No statistically significant difference was seen in infants with abnormal outcome (difference in sensitivity 4%, 95% CI -10 to 19; p=0·73). INTERPRETATION iuMRI remains the optimal tool to identify fetal brain abnormalities. It is less accurate when used to predict developmental outcome, although better than ultrasonography for identifying children with normal outcome. Further work is needed to determine how the prognostic abilities of iuMRI can be improved. FUNDING National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Anthony R Hart
- Department of Paediatric and Perinatal Neurology, Sheffield Children's Hospital NHS Foundation Trust, Ryegate Children's Centre, Sheffield, UK
| | - Nicholas D Embleton
- Newcastle Neonatal Service, Ward 35 Neonatal Unit, Royal Victoria Infirmary, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Michael Bradburn
- Clinical Trials Research Unit, School Health and Related Research, University of Sheffield, Sheffield, UK
| | - Daniel J A Connolly
- Department of Paediatric Neuroradiology, Sheffield Children's Hospital NHS Foundation Trust, Western Bank, Sheffield, UK
| | - Laura Mandefield
- Clinical Trials Research Unit, School Health and Related Research, University of Sheffield, Sheffield, UK
| | - Cara Mooney
- Clinical Trials Research Unit, School Health and Related Research, University of Sheffield, Sheffield, UK.
| | - Paul D Griffiths
- Academic Unit of Radiology, University of Sheffield, Royal Hallamshire Hospital, Sheffield, UK
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Prevalence and socioeconomic determinants of development delay among children in Ceará, Brazil: A population-based study. PLoS One 2019; 14:e0215343. [PMID: 31689294 PMCID: PMC6830766 DOI: 10.1371/journal.pone.0215343] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 10/22/2019] [Indexed: 11/19/2022] Open
Abstract
Objective To assess the prevalence of child development delay and to identify socioeconomic determinants. Study design We conducted a population-based cross-sectional study of children 2 to 72 months of age residing in the state of Ceará, Brazil. In total, 3200 households were randomly selected for participation in the study and had child development assessed with the Ages and Stages Questionnaire (ASQ) version 3. Development delay was defined as a score of less than -2 standard deviations below the median of the Brazilian ASQ standard. We present population-level prevalence of delay in five development domains and assess socioeconomic determinants. Results A total of 3566 children completed the ASQ development assessment of which 9.2% (95% CI: 8.1–10.5) had at least one domain with development delay. The prevalence of delay increased with age in all domains and males were at higher risk for communication, gross motor and personal-social development delays as compared to females (p-values <0.05). We found robust associations of indicators of socioeconomic status with risk of development delay; increasing monthly income and higher social class were associated with reduced risk of delay across all domains (28,2% in the poorest and 21,2% in richest for any delay, p-values <0.05 for all domains). In addition, children in poor households that participated in conditional cash transfer (CCT) programs appeared to have reduced risk of delay as compared to children from households that were eligible, but did not participate, in CCT programs. Conclusions There is a relatively high population-level prevalence of development delay in at least one domain among children 0–6 years of age in Ceará, Brazil. Integrated child development, social support, and poverty reduction interventions may reduce the population-level prevalence of development delay in Ceará and similar settings.
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The psychometric properties of the Ages and Stages Questionnaires-3 in Arabic: Cross-sectional observational study. Early Hum Dev 2019; 136:33-38. [PMID: 31299551 DOI: 10.1016/j.earlhumdev.2019.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 06/25/2019] [Accepted: 06/25/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND Screening for developmental delay is recommended for pediatricians, yet validated screening tools in Arabic are scarce. AIMS Assess the reliability, validity, sensitivity and specificity of the Arabic ASQ-3 in detecting developmental delays in children aged 4-33 months. STUDY DESIGN Cross-sectional observational study. SUBJECTS A sample of 491 children from all Lebanese governorates from five age groups (4, 10, 18, 27 and 33 months). OUTCOME MEASURES Internal consistency using Cronbach's alpha (Cα), convergent construct validity using Pearson Correlation Coefficient (CC) comparing ASQ-3 in Arabic (A-ASQ-3) to Bayley scale for infant development (BSID-III) scores were computed. A subset sample (n = 35) underwent assessment with BSID-III for convergent validity, and sensitivity and specificity. A-ASQ-3 scores were compared to the US mean cutoff scores. RESULTS Subjects' mean age was 17.75 ± 10.6 months. Cα was 0.85; Pearson CC showed positive moderate correlation between A-ASQ-3 gross and fine motor scores and BSID-III composite motor scores (r = 0.42, p = 0.002; r = 0.39, p = 0.004, respectively); and positive moderate correlation between A-ASQ-3 problem solving and BSID-III cognitive scores (r = 0.43, p = 0.001). A-ASQ-3 had 100% sensitivity and 50% specificity for cognitive scores; 60% sensitivity and 70% specificity for motor scores. CONCLUSION A-ASQ-3 has adequate reliability and validity for the tested age groups. It is plausible that this would hold true for the rest of the questionnaires. Further testing is needed to make the five clusters more aligned with the US sample scores and to improve the sensitivity and specificity.
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Hutton JS, Justice L, Huang G, Kerr A, DeWitt T, Ittenbach RF. The Reading House: A Children's Book for Emergent Literacy Screening During Well-Child Visits. Pediatrics 2019; 143:peds.2018-3843. [PMID: 31147486 DOI: 10.1542/peds.2018-3843] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/26/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The American Academy of Pediatrics recommends literacy promotion and developmental assessment during well-child visits. Emergent literacy skills are well defined, and the use of early screening has the potential to identify children at risk for reading difficulties and guide intervention before kindergarten. METHODS The Reading House (TRH) is a children's book designed to screen emergent literacy skills. These are assessed by sharing the book with the child and using a 9-item, scripted scoring form. Get Ready to Read! (GRTR) is a validated measure shown to predict reading outcomes. TRH and GRTR were administered in random order to 278 children (mean: 43.1 ± 5.6 months; 125 boys, 153 girls) during well-child visits at 7 primary care sites. Parent, child, and provider impressions of TRH were also assessed. Analyses included Rasch methods, Spearman-ρ correlations, and logistic regression, including covariates age, sex, and clinic type. RESULTS Psychometric properties were strong, including item difficulty and reliability. Internal consistency was good for new measures (rCo- α = 0.68). The mean TRH score was 4.2 (±2.9; range: 0-14), and mean GRTR was 11.1 (±4.4; range: 1-25). TRH scores were positively correlated with GRTR scores (r s = 0.66; high), female sex, private practice, and child age (P < .001). The relationship remained significant controlling for these covariates (P < .05). The mean TRH administration time was 5:25 minutes (±0:55; range: 3:34-8:32). Parent, child, and provider impressions of TRH were favorable. CONCLUSIONS TRH is a feasible, valid, and enjoyable means by which emergent literacy skills in 3- and 4-year-old children can be directly assessed during primary care.
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Affiliation(s)
- John S Hutton
- Divisions of General and Community Pediatrics and .,Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center and College of Medicine, University of Cincinnati, Cincinnati, Ohio; and
| | - Laura Justice
- Schoenbaum Family Center and Crane Center for Early Childhood Research and Policy, The Ohio State University, Columbus, Ohio
| | | | - Amy Kerr
- Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center and College of Medicine, University of Cincinnati, Cincinnati, Ohio; and
| | - Thomas DeWitt
- Divisions of General and Community Pediatrics and.,Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center and College of Medicine, University of Cincinnati, Cincinnati, Ohio; and
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The reliability and validity of Bayley-III cognitive scale in China's male and female children. Early Hum Dev 2019; 129:71-78. [PMID: 30711715 DOI: 10.1016/j.earlhumdev.2019.01.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 01/13/2019] [Accepted: 01/22/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Since publication in 2006, the Bayley-III scale has been used widely in pediatric populations worldwide; however, there have been very few studies which examined the usefulness and the potential sex differences in a Chinese context. AIMS To assess the reliability and validity of the Bayley-III cognitive scale, and detect possible sex differences in term children so as to provide evidence for clinical and research use in China. STUDY DESIGN Cross-sectional study PARTICIPANTS AND OUTCOME MEASURES: Of the 1589 children from 3 healthcare institutions that were initially recruited, a total of 1444 children were included in the final analysis. We randomly selected 5-10% children from the total sample to evaluate the test-retest, inter-rater and criteria-related reliability in order to meet the psychometric criteria of Bayley-III scale. Inter-item consistency, test-retest and inter-rater reliability of the scale were estimated using Split-half method and Intra-class Correlation Coefficient (ICC). The content validity was evaluated by the Item-level Content Validity Index (I-CVI). The Mann-Kendall trend test was performed to assess trends of cognitive development, and post-hos Least Significant Difference test was used to detect age-appropriateness of items. RESULTS Six developmental pediatricians were trained to administer the Bayley-III cognitive scale. Inter-item consistency (n = 1444) with Guttman split-half coefficient was above 0.8, while test-retest (n = 144) and inter-rater reliability (n = 74) had good to excellent ICCs of over 0.9. The criteria-related validity (n = 74) of Bayley-III was acceptable, and associations with Gesell Developmental Schedules (GDS) were mainly above 0.8. The raw score of Bayley-III scale in total subjects (n = 1444) showed an increased trend across all months of age (p < 0.05), and only the score in age group of 35M16D to 36M15D declined in females (p < 0.05, n = 722). Female children presented a higher score than male children in all subjects and in the 18-23 months age group (p < 0.05). CONCLUSIONS Our findings provide important evidence that the Bayley-III cognitive scale is a valid measurement which could be used in Chinese population, as well as the consideration of sex differences when used in a Chinese context.
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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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Lamsal R, Dutton DJ, Zwicker JD. Using the ages and stages questionnaire in the general population as a measure for identifying children not at risk of a neurodevelopmental disorder. BMC Pediatr 2018; 18:122. [PMID: 29614989 PMCID: PMC5883588 DOI: 10.1186/s12887-018-1105-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 03/27/2018] [Indexed: 01/01/2023] Open
Abstract
Background Early detection of neurodevelopmental disorders (NDDs) enables access to early interventions for children. We assess the Ages and Stages Questionnaire (ASQ)’s ability to identify children with a NDD in population data. Method Children 4 to 5 years old in the National Longitudinal Survey of Children and Youth (NLSCY) from cycles 5 to 8 were included. The sensitivity, specificity, positive and negative predictive values were calculated for the ASQ at 24, 27, 30, 33, 36 and 42 months. Fixed effects regression analyses assessed longitudinal associations between domain scores and child age. Results Specificity for the ASQ was high with 1SD or 2SD cutoffs, indicating good accuracy in detecting children who will not develop a NDD, however the sensitivity varied over time points and cut-offs. Sensitivity for the 1 SD cutoff at 24 months was above the recommended value of 70% for screening. Differences in ASQ domains scores between children with and without NDD increases with age. Conclusions The high specificity and negative predictive values of the ASQ support its use in identifying children who are not at the risk of developing a NDD. The capacity of the ASQ to identify children with a NDD in the general population is limited except for the ASQ-24 months with 1SD and can be used to identify children at risk of NDD. Electronic supplementary material The online version of this article (10.1186/s12887-018-1105-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ramesh Lamsal
- School of Public Policy, University of Calgary, 906 8th Ave SW, Calgary, Canada
| | - Daniel J Dutton
- School of Public Policy, University of Calgary, 906 8th Ave SW, Calgary, Canada
| | - Jennifer D Zwicker
- School of Public Policy, University of Calgary, 906 8th Ave SW, Calgary, Canada. .,Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada.
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Abstract
UNLABELLED Introduction The objective of this study was to prospectively validate the "Brief Developmental Assessment", which is a new early recognition tool for neurodevelopmental abnormalities in children with heart disease that was developed for use by cardiac teams. METHODS This was a prospective validation study among a representative sample of 960 pre-school children with heart disease from three United Kingdom tertiary cardiac centres who were analysed grouped into five separate age bands. RESULTS The "Brief Developmental Assessment" was successfully validated in the older four age bands, but not in the youngest representing infants under the age of 4 months, as pre-set validation thresholds were met - lower 95% confidence limit for the correlation coefficient above 0.75 - in terms of agreement of scores between two raters and with an external measure the "Mullen Scales of Early Learning". On the basis of American Association of Pediatrics Guidelines, which state that the sensitivity and specificity of a developmental screening tool should fall between 70 and 80%, "Brief Developmental Assessment" outcome of Red meets this threshold for detection of Mullen scores >2 standard deviations below the mean. CONCLUSION The "Brief Developmental Assessment" may be used to improve the quality of assessment of children with heart disease. This will require a training package for users and a guide to action for abnormal results. Further research is needed to determine how best to deploy the "Brief Developmental Assessment" at different time points in children with heart disease and to determine the management strategy in infants younger than 4 months old.
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Liu S, Wang Z, Zhao C, Huang X, Liang X, Wang X, Lu S, Scherpbier RW. Effects of early comprehensive interventions on child neurodevelopment in poor rural areas of China: a moderated mediation analysis. Public Health 2018; 159:116-122. [PMID: 29576227 DOI: 10.1016/j.puhe.2018.02.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 12/21/2017] [Accepted: 02/12/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES To examine the effects of early comprehensive interventions on home environment and child neurodevelopment among children younger than 3 years in poor rural areas of China, as well as the underlying mediating and moderating mechanisms. STUDY DESIGN Non-randomized intervention study was conducted among 216 children aged 0-3 years in Shanxi province of China. Based on a 2 × 2 factor design, children in Lin and Fenxi County were assigned to an intervention group with duration less than 1 year (n = 26) or an intervention group with duration longer than 1 year (n = 82), while children in Fangshan County served as a control group with duration less than 1 year (n = 30) or a control group with duration longer than 1 year (n = 78). METHODS The control group received national public health services (NPHS), while the intervention group received NPHS plus comprehensive interventions covering health, nutrition, early psychosocial stimulation, and child protection. Home environment (Infant-Toddler Home Observation for Measurement of the Environment [HOME]) and child neurodevelopment (Ages and Stages Questionnaire [ASQ]) were measured by observation and interview with mothers after the intervention program. RESULTS The intervention group showed significantly higher overall HOME, organization, learning materials, and involvement than the control group, only for a duration longer than 1 year. Children in the intervention group performed better in overall ASQ, fine motor, problem-solving, and personal-social than children in the control group. Moderated mediation analyses indicated that there were significantly indirect effects of treatment on overall ASQ through overall HOME, organization, and involvement only when the duration was longer than 1 year. CONCLUSIONS Early comprehensive interventions longer than 1 year improve home environment and promote child neurodevelopment among children younger than 3 years in poor rural areas. What is more, effects of early comprehensive interventions longer than 1 year on child neurodevelopment were mediated by home environment.
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Affiliation(s)
- S Liu
- Beijing Key Laboratory of Learning and Cognition, Research Center for Child Development, School of Psychology, Capital Normal University, Beijing, China
| | - Z Wang
- Beijing Key Laboratory of Learning and Cognition, Research Center for Child Development, School of Psychology, Capital Normal University, Beijing, China
| | - C Zhao
- UNICEF China Office, Beijing, China
| | - X Huang
- UNICEF China Office, Beijing, China
| | - X Liang
- Beijing Key Laboratory of Learning and Cognition, Research Center for Child Development, School of Psychology, Capital Normal University, Beijing, China
| | - X Wang
- Department of Child, Adolescent and Women's Health, School of Public Health, Peking University Health Science Center, China
| | - S Lu
- Beijing Key Laboratory of Learning and Cognition, Research Center for Child Development, School of Psychology, Capital Normal University, Beijing, China.
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Veldhuizen S, Rivard L, Cairney J. Relative age effects in the Movement Assessment Battery for Children-2: age banding and scoring errors. Child Care Health Dev 2017; 43:752-757. [PMID: 28295480 DOI: 10.1111/cch.12459] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 02/26/2017] [Indexed: 11/28/2022]
Abstract
AIM The Movement Assessment Battery for Children-2 (MABC-2) uses age-grouped scoring, which will result in relative motor functioning being overestimated for some children and underestimated for others. In this paper, we measure these errors and discuss their consequences. METHOD We pool data from two validation studies to obtain a sample of 278 children assessed with the MABC-2 (mean (SD) age: 5 years, 0 months (9.6 months); 142 female). We used regression to measure the association between standard score and relative age, and used these results to estimate misclassification rates at the MABC-2's recommended thresholds. RESULTS Movement Assessment Battery for Children-2 scores were distributed as expected (mean (SD) = 10.4 (2.8)). We estimated that the standard score varied by 2.76 units (0.92 SDs) per year of relative age. Depending on threshold and age bandwidth, this implies overall misclassification rates from 9% to 23%. INTERPRETATION Relative age differences in MABC-2 scores led to substantial systematic error for young children. These errors can affect MABC-2 validity, longitudinal stability and agreement with other tools, which may reduce the appropriateness of care offered to children. Scoring approaches that may reduce or eliminate these errors are outlined.
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Affiliation(s)
- S Veldhuizen
- Infant and Child Health (INCH) Lab, Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - L Rivard
- CanChild Centre for Studies in Childhood Disability, McMaster University, Hamilton, Canada
| | - J Cairney
- Infant and Child Health (INCH) Lab, Department of Family Medicine, McMaster University, Hamilton, ON, Canada.,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada
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Pierrat V, Marchand-Martin L, Arnaud C, Kaminski M, Resche-Rigon M, Lebeaux C, Bodeau-Livinec F, Morgan AS, Goffinet F, Marret S, Ancel PY. Neurodevelopmental outcome at 2 years for preterm children born at 22 to 34 weeks' gestation in France in 2011: EPIPAGE-2 cohort study. BMJ 2017; 358:j3448. [PMID: 28814566 PMCID: PMC5558213 DOI: 10.1136/bmj.j3448] [Citation(s) in RCA: 288] [Impact Index Per Article: 41.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Objectives To describe neurodevelopmental outcomes at 2 years corrected age for children born alive at 22-26, 27-31, and 32-34 weeks' gestation in 2011, and to evaluate changes since 1997.Design Population based cohort studies, EPIPAGE and EPIPAGE-2.Setting France.Participants 5567 neonates born alive in 2011 at 22-34 completed weeks' gestation, with 4199 survivors at 2 years corrected age included in follow-up. Comparison of outcomes reported for 3334 (1997) and 2418 (2011) neonates born alive in the nine regions participating in both studies.Main outcome measures Survival; cerebral palsy (2000 European consensus definition); scores below threshold on the neurodevelopmental Ages and Stages Questionnaire (ASQ; at least one of five domains below threshold) if completed between 22 and 26 months corrected age, in children without cerebral palsy, blindness, or deafness; and survival without severe or moderate neuromotor or sensory disabilities (cerebral palsy with Gross Motor Function Classification System levels 2-5, unilateral or bilateral blindness or deafness). Results are given as percentage of outcome measures with 95% confidence intervals.Results Among 5170 liveborn neonates with parental consent, survival at 2 years corrected age was 51.7% (95% confidence interval 48.6% to 54.7%) at 22-26 weeks' gestation, 93.1% (92.1% to 94.0%) at 27-31 weeks' gestation, and 98.6% (97.8% to 99.2%) at 32-34 weeks' gestation. Only one infant born at 22-23 weeks survived. Data on cerebral palsy were available for 3599 infants (81.0% of the eligible population). The overall rate of cerebral palsy at 24-26, 27-31, and 32-34 weeks' gestation was 6.9% (4.7% to 9.6%), 4.3% (3.5% to 5.2%), and 1.0% (0.5% to 1.9%), respectively. Responses to the ASQ were analysed for 2506 children (56.4% of the eligible population). The proportion of children with an ASQ result below threshold at 24-26, 27-31, and 32-34 weeks' gestation were 50.2% (44.5% to 55.8%), 40.7% (38.3% to 43.2%), and 36.2% (32.4% to 40.1%), respectively. Survival without severe or moderate neuromotor or sensory disabilities among live births increased between 1997 and 2011, from 45.5% (39.2% to 51.8%) to 62.3% (57.1% to 67.5%) at 25-26 weeks' gestation, but no change was observed at 22-24 weeks' gestation. At 32-34 weeks' gestation, there was a non-statistically significant increase in survival without severe or moderate neuromotor or sensory disabilities (P=0.61), but the proportion of survivors with cerebral palsy declined (P=0.01).Conclusions In this large cohort of preterm infants, rates of survival and survival without severe or moderate neuromotor or sensory disabilities have increased during the past two decades, but these children remain at high risk of developmental delay.
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Affiliation(s)
- Véronique Pierrat
- Obstetrical, Perinatal, and Pediatric Epidemiology Team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (U1153), INSERM, Paris, France; Paris Descartes University, Paris, France
- CHU Lille, Department of Neonatal Medicine, Jeanne de Flandre Hospital, F-59000 Lille, France
| | - Laetitia Marchand-Martin
- Obstetrical, Perinatal, and Pediatric Epidemiology Team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (U1153), INSERM, Paris, France; Paris Descartes University, Paris, France
| | - Catherine Arnaud
- INSERM UMR 1027, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Monique Kaminski
- Obstetrical, Perinatal, and Pediatric Epidemiology Team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (U1153), INSERM, Paris, France; Paris Descartes University, Paris, France
| | - Matthieu Resche-Rigon
- Biostatistics and Medical Information Department, AP-HP Saint-Louis Hospital, Paris, France
| | - Cécile Lebeaux
- Obstetrical, Perinatal, and Pediatric Epidemiology Team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (U1153), INSERM, Paris, France; Paris Descartes University, Paris, France
| | - Florence Bodeau-Livinec
- Obstetrical, Perinatal, and Pediatric Epidemiology Team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (U1153), INSERM, Paris, France; Paris Descartes University, Paris, France
- École des Hautes Études en Santé Publique (EHESP), Rennes, France
| | - Andrei S Morgan
- Obstetrical, Perinatal, and Pediatric Epidemiology Team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (U1153), INSERM, Paris, France; Paris Descartes University, Paris, France
| | - François Goffinet
- Obstetrical, Perinatal, and Pediatric Epidemiology Team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (U1153), INSERM, Paris, France; Paris Descartes University, Paris, France
- Maternité Port-Royal, Université Paris Descartes, Groupe Hospitalier Cochin Broca Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, DHU Risques et Grossesse, Paris, France
| | - Stéphane Marret
- Department of Neonatal Pediatrics, Intensive care, and Neuropediatrics, Rouen University Hospital, Rouen, France
- Research Unit U1245, Institute for Research and Innovation in Biomedicine, Rouen, France
| | - Pierre-Yves Ancel
- Obstetrical, Perinatal, and Pediatric Epidemiology Team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (U1153), INSERM, Paris, France; Paris Descartes University, Paris, France
- Clinical Research Unit, Center for Clinical Investigation P1419, Cochin Broca Hôtel-Dieu Hospital, Paris, France
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Agarwal PK, Shi L, Daniel LM, Yang PH, Khoo PC, Quek BH, Zheng Q, Rajadurai VS. Prospective evaluation of the Ages and Stages Questionnaire 3rd Edition in very-low-birthweight infants. Dev Med Child Neurol 2017; 59:484-489. [PMID: 27882544 DOI: 10.1111/dmcn.13307] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/21/2016] [Indexed: 11/27/2022]
Abstract
AIM To evaluate the predictive and concurrent diagnostic agreement of the Ages and Stages Questionnaire 3rd Edition (ASQ-3) with the Bayley Scales of Infant and Toddler Development 3rd Edition (Bayley-III) in infants born preterm and very-low-birthweight (PT/VLBW; ≤1250g). METHOD We evaluated 141 PT/VLBW infants (68 males, 73 females) born at the KK Women's and Children's Hospital between January 2010 and December 2011, to determine predictive and concurrent diagnostic agreement between the ASQ-3 at 9, 12, 18, and 24 months corrected age and Bayley-III at 24 months. Cut-offs on the ASQ-3 at 24 months were estimated by receiver operating characteristic curves. RESULTS Sixty (43%) and 25 (18%) failed in any domain of the ASQ-3 and Bayley-III (<70) respectively. A negative predictive value (NPV) >98% was achieved for the motor domain from 9 months, and >90% for the communication domain and the overall results at 24 months. Optimal referral ASQ-3 score at 24 months to achieve 100% NPV was 243. INTERPRETATION In PT/VLBW infants, ASQ-3 screening at 24 months can reduce the need for costly psychometric assessments in children with normal results. Clinicians can be assured of normal motor development at 9 months using the ASQ-3, but should continue to screen children on other domains.
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Affiliation(s)
- Pratibha K Agarwal
- Department of Neonatology, KK Women's and Children's Hospital, Singapore
| | - Luming Shi
- Department of Epidemiology, Singapore Clinical Research Institute, Singapore
| | - Lourdes M Daniel
- Department of Child Development, KK Women's and Children's Hospital, Singapore
| | - Phey Hong Yang
- Department of Child Development, KK Women's and Children's Hospital, Singapore
| | - Poh Choo Khoo
- Department of Neonatology, KK Women's and Children's Hospital, Singapore
| | - Bin Huey Quek
- Department of Neonatology, KK Women's and Children's Hospital, Singapore
| | - Qishi Zheng
- Department of Epidemiology, Singapore Clinical Research Institute, Singapore
| | - Victor S Rajadurai
- Department of Neonatology, KK Women's and Children's Hospital, Singapore
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Veldhuizen S, Bedard C, Rodriguez C, Cairney J. Psychological distress and parent reporting on child health: The case of developmental delay. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 63:11-17. [PMID: 28242393 DOI: 10.1016/j.ridd.2017.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 02/14/2017] [Accepted: 02/15/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND Caregiver-completed screening questionnaires are a common first step in the identification of developmental delay. A caregiver's mood and anxiety level, however, may affect how he or she perceives and reports possible problems. AIMS In this article, we consider the association between caregiver distress and the accuracy of the Ages and Stages Questionnaire (ASQ), a widely-used screen. METHODS AND PROCEDURES Our sample includes 857 parent-child dyads drawn from the Psychometric Assessment of the NDDS Study (PANS) and the NDDS Alternate Responses Study (NARS). Parents completed the ASQ and the K6, a brief measure of generalized distress. Children were assessed using the Bayley Scales of Infant and Child Development (BSID). We divided children on BSID result and used logistic regression to examine how distress influenced the ASQ's accuracy in each group. RESULTS Of our 857 children, 9% had at least one domain below -2 standard deviations on the BSID, and 17.3% had positive ASQ results. Caregiver distress predicted a positive ASQ substantially and significantly more strongly among BSID-positive children than among others. This translates into slightly reduced ASQ specificity but greatly improved sensitivity among caregivers with higher distress. CONCLUSIONS At low to moderate levels of distress, greater distress is associated with greater ASQ accuracy.
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Affiliation(s)
- Scott Veldhuizen
- INfant and Child Health (INCH) Lab, Department of Family Medicine, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada.
| | - Chloe Bedard
- INfant and Child Health (INCH) Lab, Department of Epidemiology and Biostatistics, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada.
| | - Christine Rodriguez
- INfant and Child Health (INCH) Lab, Department of Family Medicine, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada.
| | - John Cairney
- INfant and Child Health (INCH) Lab, Department of Family Medicine, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada.
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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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Velikonja T, Edbrooke-Childs J, Calderon A, Sleed M, Brown A, Deighton J. The psychometric properties of the Ages & Stages Questionnaires for ages 2-2.5: a systematic review. Child Care Health Dev 2017; 43:1-17. [PMID: 27554865 DOI: 10.1111/cch.12397] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/27/2016] [Accepted: 07/31/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Early identification of children with potential development delay is essential to ensure access to care. The Ages & Stages Questionnaires (ASQ) is used as population outcome indicators in England as part of the 2.5-year review. METHOD The aim of this article was to systematically review the worldwide evidence for the psychometric properties of the ASQ third edition (ASQ-3TM ) and the Ages & Stages Questionnaires®: Social-Emotional (ASQ:SE). Eight electronic databases and grey literature were searched for original research studies available in English language, which reported reliability, validity or responsiveness of the ASQ-3TM or ASQ:SE for children aged between 2 and 2.5 years. Twenty studies were included. Eligible studies used either the ASQ-3TM or the ASQ:SE and reported at least one measurement property of the ASQ-3TM and/or ASQ:SE. Data were extracted from all papers identified for final inclusion, drawing on Cochrane guidelines. RESULTS Using 'positive', 'intermediate' and 'negative' criteria for evaluating psychometric properties, results showed 'positive' reliability values in 11/18 instances reported, 'positive' sensitivity values in 13/18 instances reported and 'positive' specificity values in 19/19 instances reported. CONCLUSIONS Variations in age or language versions used, quality of psychometric properties and quality of papers resulted in heterogeneous evidence. It is important to consider differences in cultural and contextual factors when measuring child development using these indicators. Further research is very likely to have an important impact on the interpretation of the ASQ-3TM and ASQ:SE psychometric evidence.
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Affiliation(s)
- T Velikonja
- Evidence Based Practice Unit, University College London and Anna Freud Centre, London, UK
| | - J Edbrooke-Childs
- Evidence Based Practice Unit, University College London and Anna Freud Centre, London, UK
| | - A Calderon
- Evidence Based Practice Unit, University College London and Anna Freud Centre, London, UK
| | - M Sleed
- Evidence Based Practice Unit, University College London and Anna Freud Centre, London, UK
| | - A Brown
- School of Psychology, University of Kent, Kent, UK
| | - J Deighton
- Evidence Based Practice Unit, University College London and Anna Freud Centre, London, UK
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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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Comparing the Results of Developmental Screening of 4 to 60-Month-Old Children in Tehran Using Parents Evaluation of Developmental Status and Ages and Stages Questionnaires. IRANIAN JOURNAL OF PEDIATRICS 2016. [DOI: 10.5812/ijp.6179] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Issues in Screening for Developmental Delay or Disorders. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2016. [DOI: 10.1007/s40474-016-0089-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Valla L, Janson H, Wentzel-Larsen T, Slinning K. Analysing four Norweigian population-based samples using the six-month version of the Ages and Stages Questionnaire showed few relevant clinical differences. Acta Paediatr 2016; 105:924-9. [PMID: 27096700 DOI: 10.1111/apa.13439] [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] [Received: 12/16/2015] [Revised: 02/19/2016] [Accepted: 04/18/2016] [Indexed: 11/28/2022]
Abstract
AIM We investigated whether there were clinically relevant differences in the area mean scores of the six-month Ages and Stages Questionnaire (ASQ) between four Norwegian population-based samples. METHODS Area mean scores and standard deviations (SDs) were investigated for the five developmental areas of the ASQ: communication, gross motor, fine motor, problem solving and personal-social. Sample sizes varied from 166 to 1192 and the ASQ was completed on paper or by computer. ASQ scores in the four samples were compared using ANOVA and Tukey's procedure was used to adjust for multiple comparisons. RESULTS The ASQ mean area scores were generally similar in the four data sets, with few clinically relevant differences, defined as a mean difference of greater than five points, which is the smallest increment in area score, or an effect size of >0.5 in absolute value. All the clinically relevant differences occurred when samples used a modified ASQ administration format. Several additional minor differences were statistically significant, which was expected due to the large samples. CONCLUSION These results support the original Norwegian normative findings for the ASQ six-month form and the ASQ's use as a low-cost developmental screening tool in Norway, at least when the original format is administered.
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Affiliation(s)
- Lisbeth Valla
- National Network for Infant Mental Health in Norway; Center for Child and Adolescent Mental Health; Eastern and Southern Norway; Oslo Norway
| | - Harald Janson
- The Norwegian Center for Child Behavioral Development; Oslo Norway
| | - Tore Wentzel-Larsen
- Center for Child and Adolescent Mental Health; Eastern and Southern Norway; Oslo Norway
- Norwegian Center for Violence and Traumatic Stress Studies; Oslo Norway
| | - Kari Slinning
- National Network for Infant Mental Health in Norway; Center for Child and Adolescent Mental Health; Eastern and Southern Norway; Oslo Norway
- Department of Psychology; University of Oslo; Oslo Norway
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Boyede G, Eley B, Donald K. Preliminary Validation of a New Developmental Screening Tool for Neurodevelopmental Delay in HIV-Infected South African Children. J Child Neurol 2016; 31:145-52. [PMID: 25979901 DOI: 10.1177/0883073815585351] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 04/11/2015] [Indexed: 11/16/2022]
Abstract
Screening for developmental delays among HIV-infected children is not routine in most pediatric HIV clinics in Africa because of the lack of locally adaptable, simple, sensitive and rapid screening tools. The Division of Developmental Pediatrics of the Red Cross War Memorial Children's Hospital developed a tool for rapid screening of moderate to severe global developmental delays among HIV-infected children aged 9 to 36 months. The diagnostic accuracy of the novel screening tool was evaluated. Forty-seven HIV-infected children aged 9 to 36 months were screened using the Red Cross War Memorial Children's Hospital developmental screening tool. Full developmental assessments of same children were performed using the Bayley Scales of Infant and Toddler Development, Third Edition. The Red Cross War Memorial Children's Hospital tool's sensitivity was 78.5%, specificity 54.6%, positive predictive value was 42.6%, and negative predictive value was 85.4%. The Red Cross War Memorial Children's Hospital screening tool was adequately sensitive and therefore recommended for screening of moderate to severe developmental delays among HIV-infected children.
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Affiliation(s)
- Gbemisola Boyede
- Division of Developmental Pediatrics, Department of Pediatrics and Child Health, University of Cape Town, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | - Brian Eley
- Division of Paediatric Infectious Diseases, Department of Paediatrics and Child Health, University of Cape Town, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | - Kirsty Donald
- Division of Developmental Pediatrics, Department of Pediatrics and Child Health, University of Cape Town, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
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Bresnahan M, Hornig M, Schultz AF, Gunnes N, Hirtz D, Lie KK, Magnus P, Reichborn-Kjennerud T, Roth C, Schjølberg S, Stoltenberg C, Surén P, Susser E, Lipkin WI. Association of maternal report of infant and toddler gastrointestinal symptoms with autism: evidence from a prospective birth cohort. JAMA Psychiatry 2015; 72:466-74. [PMID: 25806498 PMCID: PMC4939710 DOI: 10.1001/jamapsychiatry.2014.3034] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
IMPORTANCE Gastrointestinal (GI) comorbidities are frequently described in association with autism spectrum disorder (ASD). However, the prevalence of GI disturbances and the age at which such problems first appear are unclear, and their specificity for ASD compared with other neurodevelopmental disorders is uncertain. OBJECTIVE To compare maternal report of GI symptoms during the first 3 years of life in children with ASD, developmental delay (DD), and typical development (TD). DESIGN, SETTING, AND PARTICIPANTS This large prospective cohort study consists of participants in the Norwegian Mother and Child Cohort Study. During a 10-year period (January 1, 1999, through December 31, 2008), women throughout Norway were recruited at the first prenatal ultrasonographic visit (approximately 18 weeks' gestation). The study enrolled 95,278 mothers, 75,248 fathers, and 114,516 children. Our analyses are based on MoBa data released through October 1, 2013, and NPR diagnoses registered through December 31, 2012, and include children born from January 1, 2002, through December 31, 2008, with completed age 18- and 36-month questionnaires. EXPOSURES We defined 3 groups of children: children with ASD (n = 195), children with DD and delayed language and/or motor development (n = 4636), and children with TD (n = 40 ,95). MAIN OUTCOMES AND MEASURES The GI symptoms were based on maternal report of constipation, diarrhea, and food allergy/intolerance. RESULTS Children with ASD were at significantly increased odds of maternally reported constipation (adjusted odds ratio [aOR], 2.7; 95% CI, 1.9-3.8; P < .001) and food allergy/intolerance (aOR, 1.7; 95% CI, 1.1-2.6; P = .01) in the 6- to 18-month-old age period and diarrhea (aOR, 2.3; 95% CI, 1.5-3.6; P < .001), constipation (aOR, 1.6; 95% CI, 1.2-2.3; P < .01), and food allergy/intolerance (aOR, 2.0; 95% CI, 1.3-3.1; P < .01) in the 18- to 36-month-old age period compared with children with TD. Similar results for these symptom categories were observed in comparisons with children with DD, but ORs were slightly lower. Mothers of children with ASD were significantly more likely to report 1 or more GI symptom in either the 6- to 18-month or the 18- to 36-month-old age period and more than twice as likely to report at least 1 GI symptom in both age periods compared with mothers of children with TD or DD. CONCLUSIONS AND RELEVANCE In this large prospective cohort, maternally reported GI symptoms are more common and more often persistent during the first 3 years of life in children with ASD than in children with TD or DD.
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Affiliation(s)
- Michaeline Bresnahan
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York2New York State Psychiatric Institute, New York
| | - Mady Hornig
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York3The Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York
| | - Andrew F. Schultz
- The Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York
| | - Nina Gunnes
- Norwegian Institute of Public Health, Oslo, Norway
| | - Deborah Hirtz
- National Institute of Neurological Disorders and Stroke, Bethesda, Maryland
| | | | - Per Magnus
- Norwegian Institute of Public Health, Oslo, Norway
| | - Ted Reichborn-Kjennerud
- Norwegian Institute of Public Health, Oslo, Norway6Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Christine Roth
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York4Norwegian Institute of Public Health, Oslo, Norway
| | | | | | - Pål Surén
- Norwegian Institute of Public Health, Oslo, Norway
| | - Ezra Susser
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York2New York State Psychiatric Institute, New York
| | - W. Ian Lipkin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York3The Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, New York
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Bentzley JP, Coker-Bolt P, Moreau NG, Hope K, Ramakrishnan V, Brown T, Mulvihill D, Jenkins D. Kinematic measurement of 12-week head control correlates with 12-month neurodevelopment in preterm infants. Early Hum Dev 2015; 91:159-64. [PMID: 25621433 PMCID: PMC4324091 DOI: 10.1016/j.earlhumdev.2015.01.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 12/31/2014] [Accepted: 01/04/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Although new interventions treating neonatal brain injury show great promise, our current ability to predict clinical functional outcomes is poor. Quantitative biomarkers of long-term neurodevelopmental outcome are critically needed to gauge treatment efficacy. Kinematic measures derived from commonly used developmental tasks may serve as early objective markers of future motor outcomes. AIM To develop reliable kinematic markers of head control at 12week corrected gestational age (CGA) from two motor tasks: head lifting in prone and pull-to-sit. STUDY DESIGN AND SUBJECTS Prospective observational study of 22 preterm infants born between 24 and 34weeks of gestation. OUTCOME MEASURES Bayley Scales of Infant Development III (Bayley) motor scores. RESULTS Intrarater and interrater reliability of prone head lift angles and pull-to-sit head angles were excellent. Prone head lift angles at 12week CGA correlated with white matter NAA/Cho, concurrent Test of Infant Motor Performance (TIMP) scores, and 12-month Bayley motor scores. Head angles during pull-to-sit at 12-week CGA correlated with TIMP scores. CONCLUSIONS Poor ability to lift the head in prone and an inability to align the head with the trunk during the pull-to-sit task were associated with poorer future motor outcome scores. Kinematic measurements of head control in early infancy may serve as reliable objective quantitative markers of future motor impairment and neurodevelopmental outcome.
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Affiliation(s)
- Jessica P Bentzley
- Department of Pediatrics, Medical University of South Carolina, SC, United States
| | - Patty Coker-Bolt
- Division of Occupation Therapy, College of Health Professions, Medical University of South Carolina, SC, United States.
| | - Noelle G Moreau
- Department of Physical Therapy, School of Allied Health, Louisiana State University Health Sciences Center - New Orleans, United States
| | - Kathryn Hope
- Division of Occupation Therapy, College of Health Professions, Medical University of South Carolina, SC, United States
| | | | - Truman Brown
- Department of Radiology and Radiological Sciences, Medical University of South Carolina, SC, United States
| | - Denise Mulvihill
- Department of Pediatrics, Medical University of South Carolina, SC, United States
| | - Dorothea Jenkins
- Department of Pediatrics, Medical University of South Carolina, SC, United States
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Hunter LR, Myszkowski MR, Johnson SK, Rostad PV, Weaver AL, Lynch BA. Comparing the Clinical Utility of the Infant Developmental Inventory With the Ages and Stages Questionnaire at 9-Month Well-Child Visits. J Prim Care Community Health 2014; 6:193-8. [PMID: 25424742 DOI: 10.1177/2150131914560228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The purpose of our study was to compare the clinical utility of administering 2 recommended developmental screening instruments, the Infant Developmental Inventory (IDI) and the Ages and Stages Questionnaire (ASQ), at 9-month well-child visits in paper format. METHODS Outcomes of the 2 screens, including correct completion and interpretation by clinician, time of visit, and screen outcome were compared. RESULTS Out of 33 children administered the ASQ and with documented scores, 12 (36.4%) did not receive passing scores, while 5 (12.2%) of the 41 children administered the IDI did not receive passing scores (P = .014). Out of 41 IDI screens, 12 (29.3%) were completed incorrectly, while there were no ASQ screens completed incorrectly (P < .001) by caregivers. CONCLUSION In our pilot study, the ASQ is more often completed correctly by caregivers and identifies more children at risk for delay as compared with the IDI. Additional larger scale studies are needed to evaluate the usefulness of developmental screening tools when used within primary care practice.
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Affiliation(s)
| | | | - Shirley K Johnson
- Department of Nursing, College of Nursing and Health Sciences, Winona State University, Winona, MN, USA
| | - Paulette V Rostad
- Division of Community Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Amy L Weaver
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, USA
| | - Brian A Lynch
- Division of Community Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
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