Expanding Our View of Context: The Bio-ecological Environment and Development

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.

Socioeconomic status and health: youth development and neomaterialist and psychosocial mechanisms

There is substantial debate in the field of epidemiology over the theoretical underpinnings of socioeconomic status (SES)-disease mechanisms in the developed world. In particular, it has been debated whether psychosocial mechanisms are important in understanding these relationships, compared with material influences. Within an interdisciplinary context, this review synthesizes the youth development and resilience literatures in examination of this hypothesis. This review provides evidence that both classes of mechanisms are critical to understanding and addressing SES-disease mechanisms over the lifecourse. Research findings demonstrating the effects of these classes of factors point to the complicated and dynamic nature of how SES may impact disease. In the epidemiologic literature, investigators predominantly consider the cumulative impact of biological insults over time. A developmental perspective, however, provides evidence of the importance of psychosocial influences early in life on socioeconomic and health trajectories over the lifecourse. Future epidemiologic research should consider cumulative and developmental influences of early adversity--both psychosocial and material--on later health. This perspective may be particularly relevant to appropriately evaluating the impact of selection and causation in research on SES and disease and will also hopefully provide clarity to this ongoing theoretical debate.

Child Development and the Physical Environment

Characteristics of the physical environment that influence child development are discussed. Topics include behavioral toxicology, noise, crowding, housing and neighborhood quality, natural settings, schools, and day care settings. Socioemotional, cognitive, motivation, and psychophysiological outcomes in children and youths are reviewed. Necessary methodological and conceptual advances are introduced as well.