1
|
Segre G, Clavenna A, Roberti E, Scarpellini F, Cartabia M, Pandolfini C, Tessarollo V, Costantino I, Bonati M. Pediatrician and parental evaluation of child neurodevelopment at 2 years of age. BMC Pediatr 2024; 24:137. [PMID: 38388376 PMCID: PMC10882900 DOI: 10.1186/s12887-024-04616-2] [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: 05/09/2023] [Accepted: 02/02/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The early identification of infants with a risk for neurodevelopmental disorders in the first few years of life is essential for better developmental outcomes. Screenings should be carried out by combining the family pediatricians' and parents' perspectives, the two fundamental sources of information on children's health. The present study has three aims: (a) to test the feasibility of parent-report instruments to detect warning signs in their children's development; (b) to ascertain whether there is an agreement between the family pediatricians' (FP) clinical judgments of warning signs and the parental perceptions; (c) to determine whether there is a link between parents' distress and child development. METHODS Within the NASCITA birth cohort, in addition to the family pediatrician's clinical evaluation with routine tools, the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) was completed by parents to assess the child's language, social skills, behavior, and sensory areas. Parents were also asked to complete the Parenting Stress Index, Short Form (PSI-SF) to verify the magnitude of stress in the parent-child system. Univariate and multivariate analyses were performed to evaluate the association between child and parental characteristics and the presence of warning signs. RESULTS The follow-up assessment was completed for 435 infants: 69 (15.8%) presented warning signs: 43 in the pediatrician's assessment and 36 in the M-CHAT-R (10 in both). A total of 16 children (14 with warning signs) received a diagnosis after a specialist evaluation. Being male (OR 2.46, 95%CI: 1.23-4.91) and having sleep disorders (OR 2.43, 95% CI 1.17-5.04) was associated with a greater likelihood of warning signs in the multivariate analysis, while reading aloud was a protective factor (not exposed versus exposed (OR = 3.14; 95% CI 1.60-6.17). For 73 children (18.4%), at least one parent tested positive for PSI-SF. An increased prevalence of parental distress was observed in children with warning signs (OR 2.36, 95% CI 1.27-4.37). CONCLUSIONS Integrating physician and parental perspectives during well-child visits and in clinical practice appears feasible and can improve the identification of children at risk of developmental disorders.
Collapse
Affiliation(s)
- Giulia Segre
- Laboratory of Epidemiology of Developing Age, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, Milan, 20156, Italy
| | - Antonio Clavenna
- Laboratory of Epidemiology of Developing Age, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, Milan, 20156, Italy
| | - Elisa Roberti
- Laboratory of Epidemiology of Developing Age, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, Milan, 20156, Italy
| | - Francesca Scarpellini
- Laboratory of Epidemiology of Developing Age, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, Milan, 20156, Italy
- Centro Psicodiagnostico Italiano, Milan, Italy
| | - Massimo Cartabia
- Laboratory of Epidemiology of Developing Age, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, Milan, 20156, Italy
| | - Chiara Pandolfini
- Laboratory of Epidemiology of Developing Age, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, Milan, 20156, Italy
| | - Valeria Tessarollo
- Child Neuropsychiatry Unit, Department of Health Sciences, San Paolo Hospital, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy
| | - Ilaria Costantino
- Child Neuropsychiatry Unit, Department of Health Sciences, San Paolo Hospital, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy
| | - Maurizio Bonati
- Laboratory of Epidemiology of Developing Age, Department of Medical Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, Milan, 20156, Italy.
| |
Collapse
|
2
|
Strelitz J. Public health for paediatricians: promoting good health for children in the early years. Arch Dis Child Educ Pract Ed 2018; 103:50-53. [PMID: 28615183 DOI: 10.1136/archdischild-2016-311462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 04/21/2017] [Indexed: 11/03/2022]
Affiliation(s)
- Jason Strelitz
- Dartington Social Research Unit, Totnes, UK.,Public Health, London Boroughs of Islington and Camden, London, UK
| |
Collapse
|
3
|
Affiliation(s)
| | - Peter L Duffy
- 2015-2016 Vice-President of SCAI Chair, SCAI Advocacy and Government Relations Committee,Reid Heart Center, FirstHealth of the Carolinas, Pinehurst, NC
| |
Collapse
|
4
|
Wong PD, Dave MG, Tulloch T, Feldman ML, Ford-Jones EL, Parkin PC, Tetley A, Moodie RG. Community health centres: Potential opportunities for community paediatrics. From interprofessional clinical care to board governance. Paediatr Child Health 2015; 20:12-4. [PMID: 25722635 DOI: 10.1093/pch/20.1.12] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2014] [Indexed: 11/13/2022] Open
Affiliation(s)
- Peter D Wong
- Rexdale Community Health Centre; ; Community Paediatrics, Division of Paediatric Medicine, Department of Paediatrics, University of Toronto
| | - Malini G Dave
- Black Creek Community Health Centre; ; Emergency Medicine, The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto
| | - Trisha Tulloch
- Barbara Black Community Health Centre, Ajax; ; Concurrent Youth Unit, Centre for Addiction and Mental Health, Department of Paediatrics, University of Toronto
| | - Mark L Feldman
- Continuing Education, Department of Paediatrics; ; Community Paediatrics and Integrated Medical Education; ; Faculty of Medicine, University of Toronto, The Hospital for Sick Children & Saint Joseph's Health Centre
| | | | - Patricia C Parkin
- The Applied Research Group for Kids (TARGetKids!); ; Paediatric Outcomes Research Team, Department of Paediatrics, Hospital for Sick Children
| | | | - Rosemary G Moodie
- Division of Neonatology, Department of Paediatrics, University of Toronto, Toronto, Ontario
| |
Collapse
|
5
|
Webb E. Commentary on the ISSOP policy statement on the UNCRC and health. Child Care Health Dev 2014; 40:4-6. [PMID: 24588352 DOI: 10.1111/cch.12115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/25/2013] [Indexed: 11/29/2022]
Affiliation(s)
- E Webb
- IMEM, School of Medicine, Cardiff University, Cardiff, Wales, UK
| |
Collapse
|
7
|
Abstract
From a developmental perspective, optimal speech and language outcome is indisputably the primary motivation for neonatal hearing screening of infants with congenital or early-onset hearing loss (PCHL). This paper additionally outlines more broadly the potential value of early hearing detection and intervention in resource-poor countries against the backdrop of limitations of primary prevention of PCHL based on a review of literature from low-income and middle-income countries with per capita incomes of approximately US$6000 or less. It establishes the scientific and developmental foundation for priority consideration for neonatal hearing screening and intervention in any global initiatives for effective early childhood development programmes in resource-limited countries. It also highlights approaches to addressing the various challenges to implementing effective early hearing detection and intervention programmes, and concludes with a discussion on the pivotal role of paediatricians in facilitating timely referral for requisite tests and (re)habilitative services especially for infants with established risk factors.
Collapse
Affiliation(s)
- Bolajoko O Olusanya
- Director, Healthy Start Initiative, 286A Corporation Drive, Dolphin Estate, Ikoyi, Lagos, Box 75130 VI, Nigeria.
| |
Collapse
|
8
|
Abstract
This first Pediatrics Perspectives column on global health joins the monthly rotation with other columns on medical history, graduate medical education, and medical student education. It makes good sense to add global health to the rotation. After all, the future of our world depends on the health and well-being of all its children. Medical history will be determined by the global health issues facing children today, and surely our education programs must broaden their content to include worldwide issues to meet the demands of future pediatric practice. It has been said by many pediatricians that any disease found on this planet is no farther than a plane ride from your local hospital. Clearly, the world is a very small place for all its inhabitants, and every day, travel continues to bring us closer. Global Health Perspectives will bring issues to the readership that will stimulate our thinking about strategies and initiatives to improve child health in the broadest context. For our initial column, Drs Cabral and Soares de Moura have traced the recent history of global child health, sharing perspectives that should cause each of us to think about the future of humankind.
Collapse
|