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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:archdischild-2023-326771. [PMID: 38811056 DOI: 10.1136/archdischild-2023-326771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [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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D'Aprano A, Hunter SA, Fry R, Savaglio M, Carmody S, Boffa J, Cooke L, Dent A, Docksey A, Douglas J, Dunn A, Halfpenny N, Hewett M, Lipscomb A, Manahan E, Morton B, Mosse H, Ross D, Skouteris H. 'All Aboriginal and Torres Strait Islander children should have access to the ASQ-TRAK': Shared vision of an implementation support model for the ASQ-TRAK developmental screener. Health Promot J Austr 2024; 35:433-443. [PMID: 37431858 DOI: 10.1002/hpja.773] [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: 02/09/2023] [Revised: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 07/12/2023] Open
Abstract
ISSUE ADDRESSED The ASQ-TRAK, a strengths-based approach to developmental screening, has high acceptability and utility across varied Aboriginal and Torres Strait Islander contexts. While substantive knowledge translation has seen many services utilise ASQ-TRAK, we now need to move beyond distribution and support evidence-based scale-up to ensure access. Through a co-design approach, we aimed to (1) understand community partners' perspectives of barriers and enablers to ASQ-TRAK implementation and (2) develop an ASQ-TRAK implementation support model to inform scale-up. METHODS The co-design process had four phases: (i) partnership development with five community partners (two Aboriginal Community Controlled Organisations); (ii) workshop planning and recruitment; (iii) co-design workshops; and (iv) analysis, draft model and feedback workshops. RESULTS Seven co-design meetings and two feedback workshops with 41 stakeholders (17 were Aboriginal and Torres Strait Islander), identified seven key barriers and enablers, and a shared vision - all Aboriginal and Torres Strait Islander children and their families have access to the ASQ-TRAK. Implementation support model components agreed on were: (i) ASQ-TRAK training, (ii) ASQ-TRAK support, (iii) local implementation support, (iv) engagement and communications, (v) continuous quality improvement and (vi) coordination and partnerships. CONCLUSIONS This implementation support model can inform ongoing processes necessary for sustainable ASQ-TRAK implementation nationally. This will transform the way services provide developmental care to Aboriginal and Torres Strait Islander children, ensuring access to high quality, culturally safe developmental care. SO WHAT?: Well-implemented developmental screening leads to more Aboriginal and Torres Strait Islander children receiving timely early childhood intervention services, improving developmental trajectories and optimising long-term health and wellbeing.
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Affiliation(s)
- Anita D'Aprano
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Policy and Equity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Sue-Anne Hunter
- Sue-Anne Hunter Cultural Consultant, Melbourne, Victoria, Australia
| | - Rebecca Fry
- Policy and Equity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Melissa Savaglio
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sarah Carmody
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - John Boffa
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia
| | - Louise Cooke
- Department of Education, Northern Territory Government, Darwin, Northern Territory, Australia
| | - Abigail Dent
- Aboriginal Children's Healing Team, Victorian Aboriginal Child Care Agency, Preston, Victoria, Australia
| | - Amanda Docksey
- Department of Education, Northern Territory Government, Darwin, Northern Territory, Australia
| | - Josie Douglas
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia
- Central Land Council, Alice Springs, Northern Territory, Australia
| | - Adam Dunn
- Aboriginal Team, Take Two, Berry Street, Richmond, Victoria, Australia
| | - Nick Halfpenny
- MacKillop Family Services, Melbourne, Victoria, Australia
| | - Meg Hewett
- Department of Education, Connected Beginnings Program, Darwin, Northern Territory, Australia
| | - Adrienne Lipscomb
- Aboriginal Children's Healing Team, Victorian Aboriginal Child Care Agency, Preston, Victoria, Australia
| | - Esmai Manahan
- MacKillop Family Services, Melbourne, Victoria, Australia
| | - Belinda Morton
- Department of Education, Northern Territory Government, Darwin, Northern Territory, Australia
| | - Holly Mosse
- Aboriginal Team, Take Two, Berry Street, Richmond, Victoria, Australia
- Uniting, University of Warwick, Melbourne, Victoria, Australia
| | - Dawn Ross
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Warwick Business School, University of Warwick, Coventry, UK
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Lima F, Taplin S, Maclean M, O'Donnell M. Infants entering out-of-home care: Health, developmental needs and service provision. CHILD ABUSE & NEGLECT 2024; 149:106577. [PMID: 38044250 DOI: 10.1016/j.chiabu.2023.106577] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 11/17/2023] [Accepted: 11/22/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND There are rising numbers of infants entering out-of-home care due to child protection concerns. Research has found that infants entering care are at higher risk of developmental vulnerability and poor health problems. OBJECTIVES To determine the prevalence of developmental vulnerability for children who entered care as infants, and the extent and likelihood of service provision in relation to their developmental vulnerability. PARTICIPANTS AND SETTING This study includes children who entered care before the age of 1 year for the first time between May 2010 and October 2011 in New South Wales, Australia, and who received final Children's Court care and protection orders by 30 April 2013. METHODS This is a prospective cohort study using interview data from the Pathways of Care Longitudinal Study (POCLS) as well as linked administrative child protection and health data. This study used standardised assessments (Age and Stages Questionnaire and the Brief Infant Toddler Social Emotional Assessment) included in the POCLS. Simple and multiple logistic regression analysis was conducted to investigate the likelihood of infants receiving professional services for developmental delays since placement. FINDINGS A high proportion of children who entered care as infants were identified as developmentally vulnerable through health indicators (36 %) and standardised assessments (70 %). Only 17 % of infants in care received services for developmental delay, with 20 % and 15 % of those identified as developmentally vulnerable through standardised assessments and health-related variables receiving services, respectively. CONCLUSIONS The findings point to the importance of developmental assessment of infants in care and the identification of developmental vulnerability and delays. The provision of early intervention services is essential for this group of high-risk infants and will be important in optimising their health, as well as social and emotional outcomes.
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Affiliation(s)
- Fernando Lima
- Australian Centre for Child Protection, University of South Australia, Perth, WA, Australia.
| | - Stephanie Taplin
- School of Public Health, Faculty of Health, University of Technology Sydney, Canberra, ACT, Australia
| | - Miriam Maclean
- Australian Centre for Child Protection, University of South Australia, Perth, WA, Australia
| | - Melissa O'Donnell
- Australian Centre for Child Protection, University of South Australia, Perth, WA, Australia
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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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D'Aprano A, Brookes I, Browne L, Bartlett C. Uptake of the culturally appropriate ASQ-TRAK developmental screening tool in the Australian Aboriginal and Torres Strait Islander context. Child Care Health Dev 2023; 49:54-61. [PMID: 35305034 PMCID: PMC10084340 DOI: 10.1111/cch.13006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/07/2022] [Accepted: 03/10/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Recently in Australia, access to culturally safe developmental practices for Aboriginal and Torres Strait Islander families has been enhanced by the availability of a culturally appropriate developmental screening tool, the Ages and Stages Questionnaire - Talking about Raising Aboriginal Kids (ASQ-TRAK). This paper aims (i) to describe the uptake of the ASQ-TRAK developmental screening tool in Aboriginal Community Controlled Organizations and mainstream services in Australia and (ii) to explore the extent to which organizations using the ASQ-TRAK have engaged training for staff. METHODS A retrospective review of ASQ-TRAK sales and training records from January 2015 to May 2020 to determine the ASQ-TRAK distribution by jurisdiction and service type and the number of services that have engaged training. RESULTS Five hundred ASQ-TRAK kits have been distributed across 77 agencies. Of those, 100 kits (20%) have been purchased by Aboriginal Community Controlled Organizations. Most have been distributed in the Northern Territory (NT) (178, 36%), Western Australia (165, 33%) and South Australia (64, 13%). Of the 15 ASQ-TRAK training workshops, nine have been in the NT. Of the 196 practitioners trained, 25 were identified as facilitators for their organization. CONCLUSION Despite substantive research translation across Australia, with evidence of its acceptability in different contexts, most Aboriginal Community Controlled Organizations have not yet accessed the ASQ-TRAK, and most organizations have not participated in training. There is an imperative to progress knowledge translation to improve quality and accessibility of culturally appropriate developmental care. Adequately resourced ASQ-TRAK implementation support is needed to ensure sustainable implementation at scale.
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Affiliation(s)
- Anita D'Aprano
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria.,Melbourne Children's Research Institute, Melbourne, Victoria.,Menzies School of Health Research, Darwin, Northern Territory
| | - Isabel Brookes
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria
| | - Linda Browne
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria
| | - Claire Bartlett
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria.,College of Education, Charles Darwin University, Darwin, Northern Territory, Australia
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Cibralic S, Hawker P, Khan F, Mendoza Diaz A, Woolfenden S, Murphy E, Deering A, Schnelle C, Townsend S, Doyle K, Eapen V. Developmental Screening Tools Used with First Nations Populations: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15627. [PMID: 36497697 PMCID: PMC9739511 DOI: 10.3390/ijerph192315627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
Developmental surveillance and screening is recommended for all children under five years of age, especially for those from at-risk populations such as First Nations children. No review to date has, however, evaluated the use of developmental screening tools with First Nations children. This review aimed to examine and synthesise the literature on developmental screening tools developed for, or used with, First Nations populations children aged five years or younger. A PRISMA-compliant systematic review was performed in the PsychInfo, PubMed, and Embase databases. Additional searches were also undertaken. In total 444 articles were identified and 13 were included in the final review. Findings indicated that several developmental screening tools have been administered with First Nations children. Most tools, however, have only been evaluated in one study. Results also found that no studies evaluated actions taken following positive screening results. More research evaluating the accuracy, acceptability, and feasibility of using developmental screeners with First Nations children is required before widespread implementation of developmental screening in clinical settings with First Nations children is recommended.
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Affiliation(s)
| | - Patrick Hawker
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Feroza Khan
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Antonio Mendoza Diaz
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Susan Woolfenden
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Sydney Local Health District, Sydney Institute Women, Children and Their Families, Camperdown, NSW 2050, Australia
| | - Elisabeth Murphy
- New South Wales Ministry of Health, St Leonards, NSW 2065, Australia
| | - April Deering
- New South Wales Ministry of Health, St Leonards, NSW 2065, Australia
| | - Clare Schnelle
- New South Wales Ministry of Health, St Leonards, NSW 2065, Australia
| | - Sharnee Townsend
- New South Wales Ministry of Health, St Leonards, NSW 2065, Australia
| | - Kerrie Doyle
- Indigenous Health, School of Medicine, Campbelltown Campus, Western Sydney University, Sydney, NSW 2560, Australia
| | - Valsamma Eapen
- Ingham Institute, Liverpool, NSW 2170, Australia
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- South Western Sydney Local Health District, Sydney, NSW 2170, Australia
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7
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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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Luke CR, Benfer K, Mick-Ramsamy L, Ware RS, Reid N, Bos AF, Bosanquet M, Boyd RN. Early detection of Australian Aboriginal and Torres Strait Islander infants at high risk of adverse neurodevelopmental outcomes at 12 months corrected age: LEAP-CP prospective cohort study protocol. BMJ Open 2022; 12:e053646. [PMID: 34996793 PMCID: PMC8744123 DOI: 10.1136/bmjopen-2021-053646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 12/10/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Neurodevelopmental disorders (NDD), including cerebral palsy (CP), autism spectrum disorder (ASD) and foetal alcohol spectrum disorder (FASD), are characterised by impaired development of the early central nervous system, impacting cognitive and/or physical function. Early detection of NDD enables infants to be fast-tracked to early intervention services, optimising outcomes. Aboriginal and Torres Strait Islander infants may experience early life factors increasing their risk of neurodevelopmental vulnerability, which persist into later childhood, further compounding the health inequities experienced by First Nations peoples in Australia. The LEAP-CP prospective cohort study will investigate the efficacy of early screening programmes, implemented in Queensland, Australia to earlier identify Aboriginal and Torres Strait Islander infants who are 'at risk' of adverse neurodevelopmental outcomes (NDO) or NDD. Diagnostic accuracy and feasibility of early detection tools for identifying infants 'at risk' of a later diagnosis of adverse NDO or NDD will be determined. METHODS AND ANALYSIS Aboriginal and/or Torres Strait Islander infants born in Queensland, Australia (birth years 2020-2022) will be invited to participate. Infants aged <9 months corrected age (CA) will undergo screening using the (1) General Movements Assessment (GMA); (2) Hammersmith Infant Neurological Examination (HINE); (3) Rapid Neurodevelopmental Assessment (RNDA) and (4) Ages and Stages Questionnaire-Aboriginal adaptation (ASQ-TRAK). Developmental outcomes at 12 months CA will be determined for: (1) neurological (HINE); (2) motor (Peabody Developmental Motor Scales 2); (3) cognitive and communication (Bayley Scales of Infant Development III); (4) functional capabilities (Paediatric Evaluation of Disability Inventory-Computer Adaptive Test) and (5) behaviour (Infant Toddler Social and Emotional Assessment). Infants will be classified as typically developing or 'at risk' of an adverse NDO and/or specific NDD based on symptomology using developmental and diagnostic outcomes for (1) CP (2) ASD and (3) FASD. The effects of perinatal, social and environmental factors, caregiver mental health and clinical neuroimaging on NDOs will be investigated. ETHICS AND DISSEMINATION Ethics approval has been granted by appropriate Queensland ethics committees; Far North Queensland Health Research Ethics Committee (HREC/2019/QCH/50533 (Sep ver 2)-1370), the Townsville HHS Human Research Ethics Committee (HREC/QTHS/56008), the University of Queensland Medical Research Ethics Committee (2020000185/HREC/2019/QCH/50533) and the Children's Health Queensland HHS Human Research Ethics Committee (HREC/20/QCHQ/63906) with governance and support from local First Nations communities. Findings from this study will be disseminated via peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER ACTRN12619000969167.
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Affiliation(s)
- Carly R Luke
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
- Townsville Hospital and Health Service, Townsville, Queensland, Australia
| | - Katherine Benfer
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Leeann Mick-Ramsamy
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
| | - Natasha Reid
- Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Arend F Bos
- Department of Neonatology, University Medical Centre Groningen, Groningen, The Netherlands
| | - Margot Bosanquet
- Townsville Hospital and Health Service, Townsville, Queensland, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
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Connery AK, Raghunathan RS, Colbert AM, Erdodi L, Warschausky S, Huth-Bocks A, Gerry Taylor H, Raghunathan T, Berglund P, Staples AD, Lukomski A, Kirkland J, Cano J, Lajiness-O'Neill R. The influence of sociodemographic factors and response style on caregiver report of infant developmental status. Front Pediatr 2022; 10:1080163. [PMID: 36714661 PMCID: PMC9875053 DOI: 10.3389/fped.2022.1080163] [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: 10/25/2022] [Accepted: 12/12/2022] [Indexed: 01/13/2023] Open
Abstract
Caregiver report is the most feasible way to assess early childhood development but is susceptible to the influences of response style and sociodemographic factors. In a sample of 571 caregiver-infant dyads (47.8% female; 48% White), we compared caregiver reports on the Ages and Stages Questionnaire-Third Edition (ASQ-3) with reports on a novel, web-based assessment, PediaTrac™. Ratings on PediaTrac correlated with ratings on the ASQ-3 at all time points (2, 4, 6, and 9 months). Caregiver age, response style, and sociodemographic factors accounted for significant variance on both measures. Developmental reporting of early childhood skills is influenced by caregiver response style and sociodemographic factors. These influences must be considered in order to ensure the accurate identification of infant developmental status.
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Affiliation(s)
- Amy K Connery
- Children's Hospital Colorado, Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO, United States
| | - Radhika S Raghunathan
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Alison M Colbert
- Children's Hospital Colorado, Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO, United States
| | - Laszlo Erdodi
- Psychology, University of Windsor, Ontario, ON, Canada
| | - Seth Warschausky
- Physical Medicine and Rehabilitation, Michigan Medicine, Ann Arbor, MI, United States
| | - Alissa Huth-Bocks
- Pediatrics, Case Western Reserve University, University Hospitals, Cleveland, OH, United States
| | - H Gerry Taylor
- Abigail Wexner Research Institute at Nationwide Children's Hospital, and Pediatrics, The Ohio State University, Columbus, OH, United States
| | | | - Patricia Berglund
- Institute of Social Research, University of Michigan, Ann Arbor, MI, United States
| | - Angela D Staples
- Psychology, Eastern Michigan University, Ypsilanti, MI, United States
| | - Angela Lukomski
- Nursing, Eastern Michigan University, Ypsilanti, MI, United States
| | - Jazmine Kirkland
- Pediatrics, Case Western Reserve University, University Hospitals, Cleveland, OH, United States
| | - Jennifer Cano
- Psychology, Eastern Michigan University, Ypsilanti, MI, United States
| | - Renee Lajiness-O'Neill
- Physical Medicine and Rehabilitation, Michigan Medicine, Ann Arbor, MI, United States.,Psychology, Eastern Michigan University, Ypsilanti, MI, United States
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10
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Colbert AM, Connery AK, Lamb MM, Bauer D, Olson D, Paniagua-Avila A, Martínez MA, Arroyave P, Hernández S, Mirella Calvimontes D, Bolaños GA, El Sahly HM, Muñoz FM, Asturias EJ. Caregiver rating of early childhood development: Reliability and validity of the ASQ-3 in rural Guatemala. Early Hum Dev 2021; 161:105453. [PMID: 34530320 DOI: 10.1016/j.earlhumdev.2021.105453] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 06/20/2021] [Accepted: 08/19/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Although performance-based assessment of early childhood development is preferred, there are a number of limitations to this methodology in low resource settings (LRSs). Hence, clinicians and researchers often rely on caregiver report screening tools. The Ages and Stages Questionnaire 3 (ASQ) is one of the most widely used caregiver report measures globally. Adequate psychometric properties have been demonstrated in high income settings, especially when used in older children, high- risk children, or those with severe neurodevelopmental delays. However, its utility is more variable within very young children and for use in LRSs. METHODS The reliability and validity of the ASQ was determined for children ages 0-5 years living in rural Guatemala. Internal consistency and test-retest reliability were assessed, as well as concurrent and predictive validity. Sensitivity, specificity, positive and negative predictive values related to performance-based developmental assessment (Mullen Scales of Early Learning; MSEL) and growth status (i.e. stunting) were also calculated. RESULTS Internal consistency reliability for the ASQ was adequate, except when results were limited by small sample size. Test-retest reliability ranged from low to moderate (r = 0.08-0.43; p < 0.05-0.01). However, there was significant variability in mean scores over time across ASQ domain scores. In terms of validity, the ASQ did not discriminate adequately between children who performed within or below age-expectations on performance-based developmental testing or those with and without stunting. CONCLUSIONS The ASQ did not demonstrate adequate psychometric properties in rural Guatemala, consistent with concerns documented in other LRSs. These results indicate that existing caregiver report screening measures of early childhood development should be utilized with caution in LRSs, and alternative methods for assessment or in the development and utilization of caregiver report measures should be considered.
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Affiliation(s)
- Alison M Colbert
- Department of Rehabilitation, School of Medicine, University of Colorado, Children's Hospital Colorado, Aurora, CO, United States.
| | - Amy K Connery
- Department of Rehabilitation, School of Medicine, University of Colorado, Children's Hospital Colorado, Aurora, CO, United States
| | - Molly M Lamb
- Department of Rehabilitation, School of Medicine, University of Colorado, Children's Hospital Colorado, Aurora, CO, United States
| | - Desiree Bauer
- Department of Rehabilitation, School of Medicine, University of Colorado, Children's Hospital Colorado, Aurora, CO, United States
| | - Daniel Olson
- Department of Rehabilitation, School of Medicine, University of Colorado, Children's Hospital Colorado, Aurora, CO, United States
| | - Alejandra Paniagua-Avila
- Department of Rehabilitation, School of Medicine, University of Colorado, Children's Hospital Colorado, Aurora, CO, United States
| | - María Alejandra Martínez
- Department of Rehabilitation, School of Medicine, University of Colorado, Children's Hospital Colorado, Aurora, CO, United States
| | - Paola Arroyave
- Department of Rehabilitation, School of Medicine, University of Colorado, Children's Hospital Colorado, Aurora, CO, United States
| | - Sara Hernández
- Department of Rehabilitation, School of Medicine, University of Colorado, Children's Hospital Colorado, Aurora, CO, United States
| | - D Mirella Calvimontes
- Department of Rehabilitation, School of Medicine, University of Colorado, Children's Hospital Colorado, Aurora, CO, United States
| | - Guillermo A Bolaños
- Department of Rehabilitation, School of Medicine, University of Colorado, Children's Hospital Colorado, Aurora, CO, United States
| | - Hana M El Sahly
- Department of Rehabilitation, School of Medicine, University of Colorado, Children's Hospital Colorado, Aurora, CO, United States
| | - Flor M Muñoz
- Department of Rehabilitation, School of Medicine, University of Colorado, Children's Hospital Colorado, Aurora, CO, United States
| | - Edwin J Asturias
- Department of Rehabilitation, School of Medicine, University of Colorado, Children's Hospital Colorado, Aurora, CO, United States
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11
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Zupan B, Campbell-Woods N, Thompson H. Scoping review: Language assessment practices for Aboriginal and Torres Strait Islander children in Australia and guidelines for clinical practice. Aust J Rural Health 2021; 29:879-895. [PMID: 34496107 DOI: 10.1111/ajr.12766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 04/30/2021] [Accepted: 05/15/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Speech pathologists play an important role in differentiating language difference from disorder in Aboriginal and Torres Strait Islander children. However, speech pathologists report that they lack culturally appropriate resources and feel under-prepared, which suggests that culturally safe ways of working and available evidence often do not align. OBJECTIVE The aim of this scoping review was to explore how the language abilities of Aboriginal and Torres Strait Islander children are being assessed, the ways in which assessments are being adapted and the context in which results are being interpreted within the published literature. The studies were also evaluated for components of cultural safety using the Cultural Formulation model. DESIGN A comprehensive and systematic search of the literature was undertaken; hand searching was also conducted. To be eligible for inclusion, studies needed to have been conducted in Australia and include receptive and/or expressive language assessment of Aboriginal and Torres Strait Islander children. FINDINGS Combined, the identified studies included 438 Aboriginal and Torres Strait Islander children, though only 419 were independent samples. A total of 352 studies were initially identified, 10 of which were retained for this review. Data extraction included participant characteristics, assessment tools and procedures, reported outcomes and factors related to cultural safety according to the Cultural Formulation model. CONCLUSION Overall, studies showed that standardised language assessments do not accurately represent the language abilities of Aboriginal and Torres Strait Islander children. If used, they should be used alongside other non-standardised tasks and/or scoring should be adapted. Considerations for increasing cultural safety when assessing the language abilities of Aboriginal and Torres Strait Islander children are outlined.
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Affiliation(s)
- Barbra Zupan
- Speech Pathology, Central Queensland University, Rockhampton, QLD, Australia
| | | | - Hannah Thompson
- Speech Pathology, Central Queensland University, Rockhampton, QLD, Australia
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12
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Rousseau M, Dionne C, Savard RT, Schonhaut L, Londono M. Translation and Cultural Adaptation of the Ages and Stages Questionnaires (ASQ) Worldwide: A Scoping Review. J Dev Behav Pediatr 2021; 42:490-501. [PMID: 33990508 DOI: 10.1097/dbp.0000000000000940] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 12/17/2020] [Indexed: 01/28/2023]
Abstract
OBJECTIVE This scoping review aims to provide a data mapping and narrative synthesis of the available peer-reviewed scientific literature on the translation and cultural adaptation processes relative to the Ages and Stages Questionnaires (ASQ) as reported by the authors. It also seeks to paint an overall portrait of the implementation of the translated and culturally adapted ASQ worldwide. METHODS Articles published between 1995 and May 11, 2018, were identified via systematic searches of peer-reviewed literature carried out using CINAHL, Scopus, MEDLINE, Education Source, PsycINFO, and ERIC. The articles included in the qualitative synthesis were coded based on an extraction form developed for the study. RESULTS In the 46 articles surveyed, 37 different cultural adaptations were identified in 29 languages and 27 countries. Translations were included in 33 cultural adaptations, and language modifications were reported in 18 adaptations. The forward-backward translation method was reported in 25 cases. The authors declared having made cultural content, language, visual, and/or conceptual modifications in 26 adaptations. Cultural content modifications were reported in 24 adaptations. At least one method (pilot study, individual interview, survey or focus group with respondents) was reported in 24 adaptations. CONCLUSION Cultural modifications were relatively minor and were, in general, made to establish equivalence with the source version. As well, the processes used to translate and culturally adapt the ASQ varied widely based on the types of methods. Additional work should be conducted to document the process of this crucial phase.
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Affiliation(s)
- Michel Rousseau
- Department of Psychoeducation, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Carmen Dionne
- Department of Psychoeducation, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Roselyne T Savard
- Department of Psychoeducation, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Luisa Schonhaut
- Department of Pediarics, Clinica Alemana-Facultad de Medicina Universidad del Desarrollo, Santiago, Chile
| | - Maria Londono
- Department of Psychoeducation, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
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13
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Johansen K, Jeyaseelan D, Chan YP, Simpson S, O'Keefe M, D'Aprano A. Acceptability of the culturally adapted ASQ-TRAK developmental screening tool to caregivers of Aboriginal children. J Paediatr Child Health 2020; 56:1946-1951. [PMID: 32815624 DOI: 10.1111/jpc.15099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/25/2020] [Accepted: 06/30/2020] [Indexed: 11/28/2022]
Abstract
AIM The Ages and Stages Questionnaire-Talking about Raising Aboriginal Kids (ASQ-TRAK) culturally adapted developmental screening tool is widely used in Australian Aboriginal communities. However, there has been limited exploration of the tool's acceptability to caregivers. The aim of the study is to determine the acceptability of the ASQ-TRAK developmental screening tool to caregivers of Aboriginal children in urban, regional and remote South Australia. METHODS Caregivers of Aboriginal children completed a survey regarding acceptability of the ASQ-TRAK. Convenience samples of caregivers were invited to a telephone interview. RESULTS Ninety-two caregivers completed the survey (96% response). Acceptability (92%) and caregiver satisfaction (73%) were high. Families perceived the screen as easy to use and understand, strengths-based and providing valuable information about their child's development. CONCLUSIONS The ASQ-TRAK tool was highly acceptable to caregivers in Aboriginal communities in South Australia. The study highlights the importance of culturally safe practice and supports ASQ-TRAK implementation. Broader use and further evaluation of the ASQ-TRAK in Aboriginal communities needs consideration.
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Affiliation(s)
- Kimberly Johansen
- Women's and Children's Health Network, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Deepa Jeyaseelan
- Women's and Children's Health Network, Women's and Children's Hospital, Adelaide, South Australia, Australia.,Child Development Unit, Women's and Children's Health Network, Adelaide, South Australia, Australia
| | - Yee P Chan
- Women's and Children's Health Network, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Samantha Simpson
- Melbourne Graduate School of Education, University of Melbourne, Melbourne, Victoria, Australia
| | - Maree O'Keefe
- Child Development Unit, Women's and Children's Health Network, Adelaide, South Australia, Australia.,Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Anita D'Aprano
- Melbourne Graduate School of Education, University of Melbourne, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Population Health Theme, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
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14
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Chando S, Craig JC, Burgess L, Sherriff S, Purcell A, Gunasekera H, Banks S, Smith N, Banks E, Woolfenden S. Developmental risk among Aboriginal children living in urban areas in Australia: the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). BMC Pediatr 2020; 20:13. [PMID: 31931753 PMCID: PMC6956483 DOI: 10.1186/s12887-019-1902-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 12/23/2019] [Indexed: 12/05/2022] Open
Abstract
Background Most Australian Aboriginal children are on track with their development, however, the prevalence of children at risk of or with a developmental or behavioural problem is higher than in other children. Aboriginal child development data mostly comes from remote communities, whereas most Aboriginal children live in urban settings. We quantified the proportion of participating children at moderate and high developmental risk as identified by caregivers’ concerns, and determined the factors associated with developmental risk among urban Aboriginal communities. Methods Study methods were co-designed and implemented with four participating urban Aboriginal Community Controlled Health Services in New South Wales, Australia, between 2008 and 2012. Caregiver-reported data on children < 8 years old enrolled in a longitudinal cohort study (Study of Environment on Aboriginal Resilience and Child Health: SEARCH) were collected by interview. The Parents’ Evaluation of Developmental Status (PEDS) was used to assess developmental risk through report of caregiver concerns. Odds ratios (OR) were calculated using multinomial logistic regression to investigate risk factors and develop a risk prediction model. Results Of 725 children in SEARCH with PEDS data (69% of eligible), 405 (56%) were male, and 336 (46%) were aged between 4.5 and 8 years. Using PEDS, 32% were at high, 28% moderate, and 40% low/no developmental risk. Compared with low/no risk, factors associated with high developmental risk in a mutually-adjusted model, with additional adjustment for study site, were male sex (OR 2.42, 95% confidence intervals 1.62–3.61), being older (4.5 to < 8 years versus < 3 years old, 3.80, 2.21–6.54), prior history of ear infection (1.95, 1.21–3.15), having lived in 4 or more houses versus one house (4.13, 2.04–8.35), foster care versus living with a parent (5.45, 2.32–12.78), and having a caregiver with psychological distress (2.40, 1.37–4.20). Conclusion In SEARCH, 40% of urban Aboriginal children younger than 8 years were at no or low developmental risk. Several factors associated with higher developmental risk were modifiable. Aboriginal community-driven programs to improve detection of developmental problems and facilitate early intervention are needed.
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Affiliation(s)
| | - Jonathan C Craig
- University of Sydney, Sydney, Australia.,Flinders University, Adelaide, Australia
| | - Leonie Burgess
- Sax Institute, Sydney, Australia.,Australian National University, Canberra, Australia
| | - Simone Sherriff
- University of Sydney, Sydney, Australia.,Sax Institute, Sydney, Australia
| | | | - Hasantha Gunasekera
- University of Sydney, Sydney, Australia.,Sydney Children's Hospitals Network, Sydney, Australia
| | - Sandra Banks
- Tharawal Aboriginal Medical Service, Campbelltown, Australia
| | - Natalie Smith
- Riverina Medical and Dental Corporation, Wagga Wagga, Australia
| | - Emily Banks
- Australian National University, Canberra, Australia
| | - Sue Woolfenden
- Sydney Children's Hospitals Network, Sydney, Australia. .,University of New South Wales, School of Women and Children's Health, Sydney, Australia.
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15
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D'Aprano A, Johnston H, Jarman R, Jeyaseelan D, Chan YP, Johansen K, Finch S. Practitioners' perceptions of the ASQ-TRAK developmental screening tool for use in Aboriginal children: A preliminary survey. J Paediatr Child Health 2020; 56:94-101. [PMID: 31132192 DOI: 10.1111/jpc.14502] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 05/03/2019] [Accepted: 05/07/2019] [Indexed: 11/30/2022]
Abstract
AIM To determine health practitioners' experience of using the culturally adapted Ages and Stages Questionnaire - Talking about Raising Aboriginal Kids (ASQ-TRAK) and the Ages and Stages Questionnaire-3 (ASQ-3) with Australian Aboriginal families and their perception about parents' acceptability and understanding of the instruments. METHODS We surveyed a convenience sample of practitioners who had used both the ASQ-TRAK and the ASQ-3 developmental screening tools with Aboriginal children in the Northern Territory and South Australia. We compared their experience and perception about parents' acceptability and understanding of both instruments. RESULTS All 38 respondents used the ASQ-3 and 35 the ASQ-TRAK; 100% rated the ASQ-TRAK as more acceptable and easier to understand for parents compared with 68% (P < 0.001) and 52.6% (P < 0.001), respectively, for the ASQ-3. A greater proportion of respondents were satisfied using the ASQ-TRAK (100%) than the ASQ-3 (65.7%) (P = 0.003). A higher proportion indicated that the ASQ-TRAK was respectful (85.3% compared with ASQ-3 27.8%, P < 0.001), culturally relevant (70.6% compared to 16.2%, P < 0.001) and engaging (76.5% compared to 16.2%, P < 0.001). Qualitative exploration of respondents' comments supported the quantitative findings. The ASQ-TRAK was considered more culturally appropriate, engaging and useful. CONCLUSIONS Our findings demonstrate that the culturally adapted ASQ-TRAK is preferred to the ASQ-3 by health practitioners in the Australian Aboriginal context. Failing to address cultural and linguistic factors and applying measurement tools developed for one population to another, is problematic in any setting. While further research is required to explore parents' experience directly, these data provide support for the ASQ-TRAK to be used in this context.
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Affiliation(s)
- Anita D'Aprano
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Policy and Equity Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Menzies School of Health Research, Centre for Child Development and Education, Darwin, Northern Territory, Australia
| | - Hannah Johnston
- Office of Disability, Top End Remote, Department of Health, Northern Territory Government, Darwin, Northern Territory, Australia
| | - Rebecca Jarman
- Centre for Disease Control, Department of Health, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Deepa Jeyaseelan
- Women's and Children's Health Network, Women's and Children's Hospital, Adelaide, South Australia, Australia.,Child and Family Health Service, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Yee Pei Chan
- Women's and Children's Health Network, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Kimberly Johansen
- Women's and Children's Health Network, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Sue Finch
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
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16
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Sánchez-Vincitore LV, Schaettle P, Castro A. Validation of the Malawi Developmental Assessment Tool for children in the Dominican Republic: Preliminary results. PLoS One 2019; 14:e0221162. [PMID: 31415641 PMCID: PMC6695133 DOI: 10.1371/journal.pone.0221162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 07/31/2019] [Indexed: 11/18/2022] Open
Abstract
Background This study initiated the validation process of a translated and adapted version of the Malawi Developmental Assessment Tool (MDAT) for children in the Dominican Republic (DR). Like Malawi before the development of the MDAT, the DR did not have early childhood development (ECD) tools explicitly designed for low-resource areas that are also valid assessments of child development. We chose MDAT because it underwent a rigorous validation process and retained measurements of test items that were culturally adaptable from the Denver Developmental Screening Test II. We aimed to test the internal consistency and inter-rater reliability of the MDAT in children under the age of two years living in low-income neighborhoods in Santo Domingo in 2017. Methods and findings Forty-two children from 2 to 24 months of age (mean = 11.26, SD = 6.37, boys = 22, girls = 20) and their corresponding caregiver participated in the study. We conducted a cross-sectional, pre-experimental study. The primary outcome measure was an index of ECD, as assessed by the Dominican adaptation of the MDAT. The tool evaluates children in four domains: social, fine motor, language, and gross motor. To determine internal consistency, we obtained Spearman-Brown split-half reliability for each sub-scale. The results showed a good consistency (>.6) for social, fine motor, and gross motor, and an acceptable consistency (>.5) for language. Second, to test the inter-rater reliability, we conducted a Kendall’s Taub test of independence for both the general scale and each sub-scale. Significant rτ scores ranged from .923 to .966, indicating appropriate inter-rater reliability. Third, we correlated the age variable with each subscale to determine if the development scale followed a progression of abilities that are expected to increase with maturation. The age variable correlated positively with all the subscales (social r = .887, p < .001; fine motor r = .799, p < .001; language r = .834, p < .001; gross motor r = .805, p < .001), indicating that the older the child, the better scores in the development measurements, as expected. There were no adverse events. This study, however, has multiple limitations. We did not gather information about socioeconomic position, which is an important variable when assessing child development; however, all participants lived in a low-income neighborhood. Given that this is the first ECD tool specific to the Dominican Republic, norm-referenced scores for the Dominican population do not yet exist. This study sample size is insufficient to make inferences about the national population. Conclusions This study represents the first attempt to obtain a valid tool to screen for development milestones in children living in poverty in the DR. More research is needed to refine the instrument. The availability of the tool will enable impact evaluations of ECD intervention programs and the development of evidence-based public policies in the DR.
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Affiliation(s)
- Laura V. Sánchez-Vincitore
- Neurocognition and Psychophysiology Laboratory, Universidad Iberoamericana (UNIBE), Santo Domingo, Dominican Republic
| | - Paul Schaettle
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
| | - Arachu Castro
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
- * E-mail:
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17
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Lee IL, Purbrick B, Barzi F, Brown A, Connors C, Whitbread C, Moore E, Kirkwood M, Simmonds A, van Dokkum P, Death E, Svenson S, Graham S, Hampton V, Kelaart J, Longmore D, Titmuss A, Boyle J, Brimblecombe J, Saffery R, D'Aprano A, Skilton MR, Ward LC, Corpus S, Chitturi S, Thomas S, Eades S, Inglis C, Dempsey K, Dowden M, Lynch M, Oats J, McIntyre HD, Zimmet P, O'Dea K, Shaw JE, Maple-Brown LJ. Cohort Profile: The Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) Study. Int J Epidemiol 2019; 47:1045-1046h. [PMID: 29618003 DOI: 10.1093/ije/dyy046] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- I-Lynn Lee
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Brydie Purbrick
- Department of Obstetrics and Gynaecology, Royal Darwin Hospital, Darwin, NT, Australia
| | - Federica Barzi
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Alex Brown
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,Sansom Institute of Health Research, University of South Australia, Adelaide, SA, Australia
| | | | - Cherie Whitbread
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia.,Endocrinology Department, Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia
| | - Elizabeth Moore
- Public Health Unit, Aboriginal Medical Services Alliance of Northern Territory, Darwin, NT, Australia
| | - Marie Kirkwood
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Alison Simmonds
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Paula van Dokkum
- Aboriginal Health Domain, Baker Heart and Diabetes Institute, Alice Springs, NT, Australia
| | - Elizabeth Death
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Stacey Svenson
- Aboriginal Health Domain, Baker Heart and Diabetes Institute, Alice Springs, NT, Australia
| | - Sian Graham
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Vanya Hampton
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Joanna Kelaart
- Aboriginal Health Domain, Baker Heart and Diabetes Institute, Alice Springs, NT, Australia
| | - Danielle Longmore
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Angela Titmuss
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Jacqueline Boyle
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia.,Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Julie Brimblecombe
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Richard Saffery
- Cancer and Disease Epigenetics, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Anita D'Aprano
- Melbourne Graduate School of Education, University of Melbourne, Melbourne, VIC, Australia
| | - Michael R Skilton
- Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, University of Queensland, Brisbane, QLD, Australia
| | - Sumaria Corpus
- Clinical Services, Danila Dilba Health Service, Darwin, NT, Australia
| | - Shridhar Chitturi
- Endocrinology Department, Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia
| | - Sujatha Thomas
- Department of Obstetrics and Gynaecology, Royal Darwin Hospital, Darwin, NT, Australia
| | - Sandra Eades
- Clinical and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | | | - Karen Dempsey
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia
| | | | - Michael Lynch
- Pathology Network, Top End Health and Hospital Services, Darwin, NT, Australia
| | - Jeremy Oats
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Harold D McIntyre
- Faculty of Medicine, Mater Medical Research Institute, University of Queensland, Brisbane, QLD, Australia
| | - Paul Zimmet
- Monash University, Medicine, Nursing and Health Sciences, Melbourne, VIC, Australia
| | - Kerin O'Dea
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia.,Sansom Institute of Health Research, University of South Australia, Adelaide, SA, Australia
| | - Jonathan E Shaw
- Clinical and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Louise J Maple-Brown
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, NT, Australia.,Endocrinology Department, Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia
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Developmental delay in the Amazon: The social determinants and prevalence among rural communities in Peru. PLoS One 2017; 12:e0186263. [PMID: 29023517 PMCID: PMC5638337 DOI: 10.1371/journal.pone.0186263] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 09/28/2017] [Indexed: 11/19/2022] Open
Abstract
The consequences of poor child development are becoming increasingly recognized. Programs are being put in place around the world to improve child development by providing healthy and stimulating environments for children. However, these programs often have limited reach and little is known about the prevalence of developmental delay in under-developed communities. The current study set-out to better understand the prevalence of developmental delay in rural communities in the Amazon region of Peru. Also, it explores social determinants that are associated with any delay. Cross-sectional study by evaluating developmental delay in children under 4 years utilizing Ages and Stages Questionnaire (ASQ-3). Additionally, conducting a social determinants questionnaire answered by caretakers to identify social drivers for developmental delay. The data was analyzed with multi-variant analysis to measure association. The prevalence of developmental delay in the Amazonian communities was 26.7% (19.3% in communication, 11.4% in gross motor skills, 8% in both) (N = 596). The multivariate logistic regression analysis revealed significant associations between developmental delay and; level of education (OR 0.64, p = 0.009), age of mother during child's birth (OR 0.96, p = 0.002), visits by community health agents (OR 0.73, p = 0.013), and river as primary water source (OR 2.39, p = 0.001). The social determinants questionnaire revealed that 39% of the mothers had their first child before the age of 17, nearly half stopped going to school before the age of 12 (52%), 29% gave birth at home, 13% breast fed for less than 7 months, and 50% of the children had diarrhea in the last month. There is still a great need to improve the conditions for child development in the Amazon region of Peru. One-fourth of the children suffer from developmental delay, which will likely impede their potentials for life unless something is done. The impact of education, age of mother at birth of the child, community health agents, and access to clean drinking water were important findings. Improvements can be made in these areas to create a large, cost-effective impact on the well-being of the communities.
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