Can preschool developmental screening identify children at risk for school problems?

From Descriptive to Predictive: Linking Early Childhood Developmental and Behavioral Screening Results With Educational Outcomes in Kindergarten

OBJECTIVE

To assess the predictive value of a pediatric screening tool by linking 2 independent databases: an educational database that includes data from standardized academic assessments administered during kindergarten and a pediatric database that includes screening results.

METHODS

A database that includes results of the Survey of Well-being of Young Children (SWYC) completed during pediatric visits were linked to an educational database that includes STAR Early Literacy examinations in kindergarten. Linear multilevel regression modeling was used to examine if screening results on the developmental and behavioral sections of the most recently completed SWYC form predicted trends in the percentile rank on the STAR exam over the school year, adjusting for potential confounders.

RESULTS

Linking the 2 databases resulted in a sample of 586 children who were administered at least one SWYC evaluation between 24 and 48 months and completed at least one STAR Early Literacy examination in kindergarten. The sample represents a diverse population with 55% Hispanic children, 25% Non-Hispanic black children, and 91% of children receiving a subsidized lunch. After adjusting for confounders, children with a positive developmental or behavioral screen had significantly lower percentile ranks on the STAR exam.

CONCLUSIONS

Early developmental and behavioral screening results predicted performance on the STAR exam in kindergarten. Children with developmental and behavioral concerns may be less ready to enter kindergarten than peers without such concerns. These preliminary findings provide proof-of-principle of the potential utility of developmental screening tools in identifying children with reduced school readiness who may benefit from intervention prior to kindergarten.

Clumsiness in fine motor tasks: evidence from the quantitative drawing evaluation of children with Down Syndrome

INTRODUCTION

Drawing tests are commonly used for the clinical evaluation of cognitive capabilities in children with learning disabilities. We analysed quantitatively the drawings of children with Down Syndrome (DS) and of healthy, mental age-matched controls to characterise the features of fine motor skills in DS during a drawing task, with particular attention to clumsiness, a well-known feature of DS gross movements.

METHODS

Twenty-three children with DS and 13 controls hand-copied the figures of a circle, a cross and a square on a sheet. An optoelectronic system allowed the acquisition of the three-dimensional track of the drawing. The participants' posture and upper limb movements were analysed as well.

RESULTS

Results showed that the participants with DS tended to draw faster but with less accuracy than controls.

DISCUSSION

While clumsiness in gross movements manifests mainly as slow, less efficient movements, it manifests as high velocity and inaccurate movements in fine motor tasks such as drawing.

Incremental Validity in the Clinical Assessment of Early Childhood Development

The authors demonstrate the increment of clinical validity in early childhood assessment of physical impairment (PI), developmental delay (DD), and autism (AUT) using multiple standardized developmental screening measures such as performance measures and parent and teacher rating scales. Hierarchical regression and sensitivity/specificity analyses were used to identify the differential impact of each domain the scales measure. Significant findings include (a) self-help domains in either parent or teacher questionnaires are more significant contributors than social-emotional domains to early detection, (b) performance measures are stronger predictors than parent or teacher questionnaires in detecting physical impairment or developmental delay, and (c) parent questionnaires measuring self-help skills are a stronger predictor of autism than performance measures. These results support the combined use of parent and teacher rating scales and provide important implications in choosing instruments for different developmental disorders when time and resources are limited.

The socioeconomic and biological risk factors for developmental delay in early childhood

To investigate the biological and socioeconomic factors associated with developmental attainment in socioeconomically disadvantaged children. This study was performed at the Dr. Sami Ulus Children's Health and Diseases Training and Research Hospital, between January and December 2010. The effects of biological, socioeconomic risk factors on developmental delay were investigated in 692 children (3 months-5 years) using the Denver II. Low-level maternal education (odds ratio [OR], 11.118; 95 % CI, 4.211-29.351), low-level paternal education (OR, 2.107; 95 % CI, 1.333-3.331), low-level household income (OR, 2.673; 95 % CI, 1.098-2.549), and ≥ 3 children in the family (OR, 1.871; 95 % CI, 1.206-2.903) were strongly associated with abnormal on Denver II; biological risk factors, including birth weight, gestational age at birth, and maternal age at birth <20 years, were correlated with suspect on Denver II results based on univariate analysis. Low-level maternal education (OR, 6.281; 95 % CI, 2.193-17.989), premature birth (32-36 weeks of gestation; OR, 0.535; 95 % CI, 0.290-0.989) were strongly associated with abnormal on Denver II results, and low-level paternal education (OR, 3.088; 95 % CI, 1.521-6.268), low-level household income (OR, 1.813; 95 % CI, 1.069-3.077), low birth weight (<1,500 g; OR, 3.003; 95 % CI, 1.316-6.854), premature birth (27-31 weeks of gestation; OR, 2.612; 95 % CI, 1.086-6.286), and maternal age at birth <20 years (OR, 3.518; 95 % CI, 1.173-10.547) were strongly associated with suspect on Denver II results based on multivariate analysis.

CONCLUSION

Socioeconomic risk factors were observed to be as important as biological risk factors in the development of children aged 3 months-5 years.

Developmental screening in context: adaptation and standardization of the Denver Developmental Screening Test-II (DDST-II) for Sri Lankan children

BACKGROUND

Developmental problems in children can be alleviated to a great extent with early detection and intervention through periodic screening for developmental delays during pre-school ages. Currently, there is no established system for developmental screening of children in Sri Lanka. Although some developmental norms, which are similar to those of Denver Developmental Screening Test-II (DDST-II), have been introduced into the Sri Lankan Child Health Developmental Record (CHDR), those norms have not been standardized to the Sri Lankan child population. The aim of this research was to establish Sri Lankan norms for DDST-II and to test the universal and regional applicability of developmental screening tests by comparing the Sri Lankan norms with the norms of DDST-II and DDST-Singapore norms, the geographically nearest standardization of DDST-II. The norms were also compared with the milestones already available in the CHDR.

METHODS

DDST-II was adapted and standardized on a sample of 4251 Sri Lankan children aged 0-80 months. Thirteen public health nursing sisters were trained to collect the data as part of their routine work. The 25th, 50th, 75th and 90th percentile ages of acquiring each developmental milestone were then calculated using logistic regression.

RESULTS

The Denver Developmental Screening Test for Sri Lankan Children (DDST-SL) was created. Most of the established DDST-SL norms were different to the comparable norms in DDST-II, DDST-Singapore and the CHDR.

CONCLUSIONS

In view of the results of the study, it is imperative that developmental screening tests are used in context and are adapted and standardized to the populations in question before utilization.

Standardized tests of handwriting readiness: a systematic review of the literature

AIM

To establish if there are psychometrically sound standardized tests or test items to assess handwriting readiness in 5- and 6-year-old children on the levels of occupations activities/tasks and performance.

METHOD

Electronic databases were searched to identify measurement instruments. Tests were included in a systematic review if: (1) participants are 5 and 6 years old, (2) the focus was on handwriting readiness, and (3) the measurement was standardized. In the second step a further electronic search was undertaken for selected relevant measurement instruments to evaluate the content, psychometric properties, and feasibility of these instruments.

RESULTS

The search identified 1113 citations. In the final selection 39 articles with information about 12 tests were included. The content, feasibility, and psychometric properties of these 12 tests were evaluated and none of the instruments was satisfactory, according to the specific criteria.

INTERPRETATION

None of the instruments include all necessary components to evaluate writing readiness. Therefore, the development of an all encompassing assessment is necessary to test handwriting readiness and to make tailored interventions possible.

A new approach for the quantitative evaluation of drawings in children with learning disabilities

A new method for a quantitative and objective description of drawing and for the quantification of drawing ability in children with learning disabilities (LD) is hereby presented. Twenty-four normally developing children (N) (age 10.6 ± 0.5) and 18 children with learning disabilities (LD) (age 10.3 ± 2.4) took part to the study. The drawing tasks were chosen among those already used in clinical daily experience (Denver Developmental Screening Test). Some parameters were defined in order to quantitatively describe the features of the children's drawings, introducing new objective measurements beside the subjective standard clinical evaluation. The experimental set-up revealed to be valid for clinical application with LD children. The parameters highlighted the presence of differences in the drawing features of N and LD children. This paper suggests the applicability of this protocol to other fields of motor and cognitive valuation, as well as the possibility to study the upper limbs position and muscle activation during drawing.