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Borg K, Hansen BM, Klamer A, Zachariassen G. The ASQ did not predict low IQ scores when children born VPT were six years. Acta Paediatr 2024; 113:739-744. [PMID: 38084803 DOI: 10.1111/apa.17056] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/24/2023] [Accepted: 11/30/2023] [Indexed: 03/12/2024]
Abstract
AIM There is a need for methods that can provide valid assessment tools in a follow-up programme without great financial costs. This study assessed the accuracy of the 60-month Ages and Stages Questionnaire as a screening tool to predict a low intelligence quotient score at 6 years in children born very preterm. METHODS Totally, 54 children participated in a six-year follow-up study, which included an intelligence quotient test at 6 years of age and a 60-month Ages and Stages Questionnaire at four and a half or 5 years of age at respond. We used the receiver operating characteristic curve and evaluated the optimal cut-off score to predict a low intelligence quotient score. RESULTS At four and a half years, the optimal cut-off value for predicting a low intelligence quotient score was 242, with a sensitivity of 67% and a specificity of 59%. At 5 years, only one child had a low intelligence quotient score, and the analysis was not performed. CONCLUSION Our results did not support the use of the 60-month Ages and Stages Questionnaire as a valuable screening tool to predict a low intelligence quotient score in children born very preterm at 6 years of age.
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Affiliation(s)
- Kristine Borg
- H. C. Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Bo Mølholm Hansen
- Department of Paediatrics, Nordsjaellands Hospital, Hilleroed, Denmark
| | - Anja Klamer
- H. C. Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Gitte Zachariassen
- H. C. Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
- University of Southern Denmark, Odense, Denmark
- OPEN Explorative Network, Odense University Hospital, Odense, Denmark
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Yilmaz A, Cebi MN, Yilmaz G, Karacaoglu G, Aydin SN, Perk Y, Vural M. Long-term neurodevelopmental effects of exclusively high cord lactate levels in term newborn. J Matern Fetal Neonatal Med 2023; 36:2284115. [PMID: 37989542 DOI: 10.1080/14767058.2023.2284115] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/12/2023] [Indexed: 11/23/2023]
Abstract
INTRODUCTION Cord arterial blood gas analysis (ABGA) results are used as diagnostic criteria for hypoxic-ischemic encephalopathy in newborns with suspected perinatal asphyxia. This study evaluated the effect of cord ABGA lactate level on the long-term neurodevelopment of newborns without any clinical signs of perinatal asphyxia. METHODS This clinical observation study was designed among term babies born between 2018 and 2019 in our unit. Cases with a 5-min Apgar score <7 and signs of fetal distress in their antenatal follow-up were excluded. The cases (n = 1438) were divided into two groups those with high cord lactate levels (above 5 mmol/L, n = 92) and those with low lactate levels (below 2 mmol/L, n = 255). An Ages and Stages Questionnaire, Third Edition (ASQ-3) developmental screening questionnaire was sent to all parents. Patients with a chronological age between 24 and 42 months and for whom the parents fulfilled the questionnaire (low lactate group, n = 29, and high lactate group, n = 45) were evaluated. RESULTS No difference was observed between the two groups in terms of demographic characteristics such as age (p = .1669), male gender (p = .906), mother's working situation (p = .948), mother's education level (p = .828), father's education level (p = .507), and family's total income (p = .642). Mean ACQ-3 developmental screening test scores were significantly lower in the high lactate group compared to the low lactate group concerning; fine motor (40 vs. 60, p = .001), problem-solving (50 vs. 60, p = .002), and personal social development (45 vs. 60, p = .003). No difference was observed in terms of communication and gross motor total scores. DISCUSSION In general practice, routine cord ABGA is not generally recommended for patients with normal Apgar scores and no suspected hypoxia. However, in this study, we observed that cases with a normal 5-min Apgar score, no suspected perinatal asphyxia, and a cord lactate value of ≥5 fell behind their peers when evaluated with the ACQ-3 developmental screening questionnaire.
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Affiliation(s)
- Aslan Yilmaz
- Department of Neonatology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Fatih, Turkey
| | - Memnune Nur Cebi
- Department of Pediatrics, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Fatih, Turkey
| | - Gizem Yilmaz
- Department of Pediatrics, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Fatih, Turkey
| | - Gursel Karacaoglu
- Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Fatih, Turkey
| | - Sümeyye Nur Aydin
- Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Fatih, Turkey
| | - Yildiz Perk
- Department of Neonatology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Fatih, Turkey
| | - Mehmet Vural
- Department of Neonatology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Fatih, Turkey
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Manasyan A, Salas AA, Nolen T, Chomba E, Mazariegos M, Tshefu Kitoto A, Saleem S, Naqvi F, Hambidge KM, Goco N, McClure EM, Wallander JL, Biasini FJ, Goldenberg RL, Bose CL, Koso-Thomas M, Krebs NF, Carlo WA. Diagnostic accuracy of ASQ for screening of neurodevelopmental delays in low resource countries. BMJ Open 2023; 13:e065076. [PMID: 37221030 PMCID: PMC10230914 DOI: 10.1136/bmjopen-2022-065076] [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: 05/29/2022] [Accepted: 04/29/2023] [Indexed: 05/25/2023] Open
Abstract
OBJECTIVE The Bayley Scales of Infant Development (BSID) is the most used diagnostic tool to identify neurodevelopmental disorders in children under age 3 but is challenging to use in low-resource countries. The Ages and Stages Questionnaire (ASQ) is an easy-to-use, low-cost clinical tool completed by parents/caregivers that screens children for developmental delay. The objective was to determine the performance of ASQ as a screening tool for neurodevelopmental impairment when compared with BSID second edition (BSID-II) for the diagnosis of moderate-to-severe neurodevelopmental impairment among infants at 12 and 18 months of age in low-resource countries. METHODS Study participants were recruited as part of the First Bites Complementary Feeding trial from the Democratic Republic of Congo, Zambia, Guatemala and Pakistan between October 2008 and January 2011. Study participants underwent neurodevelopmental assessment by trained personnel using the ASQ and BSID-II at 12 and 18 months of age. RESULTS Data on both ASQ and BSID-II assessments of 1034 infants were analysed. Four of five ASQ domains had specificities greater than 90% for severe neurodevelopmental delay at 18 months of age. Sensitivities ranged from 23% to 62%. The correlations between ASQ communications subscale and BSID-II Mental Development Index (MDI) (r=0.38) and between ASQ gross motor subscale and BSID-II Psychomotor Development Index (PDI) (r=0.33) were the strongest correlations found. CONCLUSION At 18 months, ASQ had high specificity but moderate-to-low sensitivity for BSID-II MDI and/or PDI <70. ASQ, when administered by trained healthcare workers, may be a useful screening tool to detect severe disability in infants from rural low-income to middle-income settings. TRIAL REGISTRATION NUMBER NCT01084109.
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Affiliation(s)
- Albert Manasyan
- Department of Pediatrics, The University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
- Department of Reproductive, Maternal, Newborn, and Child Health, Center for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Ariel A Salas
- Department of Pediatrics, The University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Tracy Nolen
- Research Triangle Institute, Durham, North Carolina, USA
| | - Elwyn Chomba
- Department of Pediatrics, The University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
- University of Zambia, Lusaka, Zambia
| | - Manolo Mazariegos
- Institute of Nutrition for Central America and Panamá (INCAP), Guatemala City, Panama
| | | | | | | | - K Michael Hambidge
- University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado, USA
| | - Norman Goco
- Research Triangle Institute, Durham, North Carolina, USA
| | | | - Jan L Wallander
- Psychological Sciences and Health Sciences Research Institute, University of California Merced, Merced, California, USA
| | - Fred J Biasini
- Department of Pediatrics, The University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
| | - Robert L Goldenberg
- Department of Obstetrics and Gynecology, Columbia University, New York, New York, UK
| | - Carl L Bose
- The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Marion Koso-Thomas
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Nancy F Krebs
- University of Colorado Denver, Denver, Colorado, USA
| | - Waldemar A Carlo
- Department of Pediatrics, The University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
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Isolated CHDs and neurodevelopmental follow-up using the Bayley Scales of Infant and Toddler Development and the Ages and Stages Questionnaire at 18 and 36 months. Cardiol Young 2022; 32:390-397. [PMID: 34112277 DOI: 10.1017/s1047951121002195] [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] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To compare early neurocognitive development in children born with and without isolated CHD using the Bayley Scales of Infant and Toddler Development (3rd edition) and the Ages and Stages Questionnaire (3rd edition). METHODS Recruitment took place before birth. Women expecting fetuses with and without CHD causing disturbances in the flow of oxygenated blood to the fetal brain were included in a prospective cohort study comprising fetal MRI (previously published) and neurodevelopmental follow-up. We now present the 18- and 36-month neurodevelopmental follow-up using the Bayley Scales according to age and the 6-month-above-age Ages and Stages Questionnaire in 15 children with and 27 children without CHD. RESULTS Children with CHD had, compared with the children without CHD, an increased risk of scoring ≤ 100 in the Bayley Scales cognition category at 18 and 36 -months; relative risk 1.7 (95% confidence interval (CI): 1.0-2.8) and 3.1 (CI: 1.2-7.5), respectively. They also achieved lower scores in the 6-month-above-age Ages and Stages Questionnaires (24 and 42 months) communication; mean z-score difference -0.72 (CI: -1.4; -0.1) and -1.06 (CI: -1.8; -0.3) and gross motor; mean z-score difference: -0.87 (CI: -1.7; -0.1) and -1.22 (CI: -2.4; -0.02) categories. CONCLUSIONS The children with CHD achieved lower scores in the Bayley Scales cognition category and the Ages and Stages Questionnaire communication and gross motor categories possibly indicative of early neurodevelopmental deficiencies. We recommend early screening and monitoring for neurodevelopmental delays in children with CHD in order to improve further neurodevelopment and educational achievements.
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Abrishami M, Boskabadi H, Abrishami M, Shekarchian F, Khadem-Rezaiyan M, Shoeibi N. Growth and neurodevelopmental status in patients with retinopathy of prematurity treated with intravitreal bevacizumab: a case-control study. Int J Retina Vitreous 2021; 7:68. [PMID: 34784985 PMCID: PMC8594208 DOI: 10.1186/s40942-021-00340-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 10/18/2021] [Indexed: 12/03/2022] Open
Abstract
Background The current study aimed to evaluate growth and neurodevelopmental status in patients with retinopathy of prematurity (ROP) treated with intravitreal bevacizumab (IVB). Methods This historical cohort study was conducted on neonates with ROP who were treated with IVB and age and birth weight-matched controls who did not need IVB. Apgar score less than five, history of blood transfusion and history of infectious diseases were among exclusion criteria. Indirect ophthalmoscopic examinations were performed till complete retinal vascularization. Growth and neurodevelopmental status were evaluated by Age and Stages Questionnaire (ASQ) at the ages of 6, 12, and 18 months. Developmental milestones were assessed in five areas (gross motor, fine motor, personal-social status, problem-solving, and relationship) and overall issues. Results A total of 34 cases and 36 controls were included in the present study. Birth weight and corrected gestational age were not statistically different between the groups. In a follow-up period of 18 months, bevacizumab was effective as a primary treatment in the treatment of severe cases of ROP. There was no significant difference between the two groups regarding the five areas and overall issues in follow-up intervals (P > 0.05). Conclusions The obtained results did not show any growth and neurodevelopmental differences between treatment-naïve infants and those receiving IVB for the treatment of ROP.
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Affiliation(s)
- Majid Abrishami
- Eye Research Center, Mashhad University of Medical Sciences, Qarani Blvd, 9195965919, Mashhad, Iran
| | - Hassan Boskabadi
- Neonatal Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mojtaba Abrishami
- Eye Research Center, Mashhad University of Medical Sciences, Qarani Blvd, 9195965919, Mashhad, Iran
| | - Farid Shekarchian
- Eye Research Center, Mashhad University of Medical Sciences, Qarani Blvd, 9195965919, Mashhad, Iran
| | - Majid Khadem-Rezaiyan
- Clinical Research Development Unit, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nasser Shoeibi
- Eye Research Center, Mashhad University of Medical Sciences, Qarani Blvd, 9195965919, Mashhad, Iran.
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Losbar JL, Montjaux N, Ehlinger V, Germany L, Arnaud C, Tscherning C. Early discharge and hospital-assisted home care is associated with better neurodevelopmental outcome in preterm infants. Early Hum Dev 2021; 161:105451. [PMID: 34507020 DOI: 10.1016/j.earlhumdev.2021.105451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 06/24/2021] [Accepted: 08/09/2021] [Indexed: 11/26/2022]
Abstract
AIMS To compare hospital-assisted neonatal home care and standard hospital care for preterm newborns on neurodevelopment at 2 years corrected age, as well as duration of hospitalization, breastmilk rates, and readmissions before 1 year. METHODS This observational study enrolled 415 inborn neonates <34+ 6 weeks that received home care (2008 to 2015) in the French University Hospital of Toulouse and 3186 neonates from the national cohort of infants discharged in 2011 that received standard hospital neonatal care (EPIPAGE 2). Neurodevelopment at 2 years was assessed with the Ages and Stages Questionnaire-3 (ASQ-3). RESULTS At two years corrected age, infants in home care had 61% less risk of overall low ASQ ≤220 (OR = 0.4 [0.3-0.5], p < 0.001) and 31-80% less risk of low scores in four out of five domains compared to standard care. Home care was associated with shorter hospital stays (- 9 days; p < 0.001), higher breastmilk rates at final discharge (OR = 3.6 [2.8-4.6], p < 0.001 for singletons and OR = 2.3 [1.6-3.1], p < 0.001 for multiples), and more breastmilk feeding for at least six months (OR = 1.8 [1.3-2.3], p < 0.001 for singletons, OR = 3.6 [2.1-6.3], p < 0.001 for multiples). Readmissions also occurred less frequently with home care than with standard care, except for twins (OR = 0.7 [0.6-0.8], p < 0.001). CONCLUSION Hospital-assisted neonatal home care for preterm infants was associated with better neurodevelopment at 2 years corrected age, shorter duration of hospitalization, and higher rates of breastmilk feeding at 6 months.
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Affiliation(s)
| | - Nathalie Montjaux
- Department of Neonatal Medicine, Children's Hospital, Toulouse, France
| | - Virginie Ehlinger
- Center for Epidemiology and Research in POPulation health (CERPOP), Toulouse University, Inserm, UPS, Toulouse, France
| | - Laurence Germany
- INSERM, UMR 1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), F-94807, Villejuif, France
| | - Catherine Arnaud
- Center for Epidemiology and Research in POPulation health (CERPOP), Toulouse University, Inserm, UPS, Toulouse, France; Clinical Epidemiology Unit, Toulouse University Hospital, Toulouse, France
| | - Charlotte Tscherning
- Université de Toulouse III, Toulouse, France; Division of Neonatology, Sidra Medecine, Weill Cornell Medical College, Doha, Qatar; Centre of Physiopathology Toulouse-Purpan (CPTP), Inserm, CNRS, University of Toulouse, France
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7
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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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Schou KV, Ekelund CK, Jensen LN, Nørgaard LN, Søgaard K, Rode L, Tabor A, Sundberg K. Short-Term Flow Changes in Monochorionic Survivor Twins after Ultrasound-Guided Umbilical Cord Occlusion. Fetal Diagn Ther 2019; 47:45-53. [PMID: 31195393 DOI: 10.1159/000500021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 03/27/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine hemodynamic changes by Doppler ultrasound of the living fetus during 24 h after umbilical cord occlusion (UCO) in monochorionic diamniotic (MCDA) twin pregnancies. METHOD We conducted a prospective observational study on fetuses undergoing UCO from 2015 to 2017. Doppler parameters peak systolic velocity (PSV) and umbilical pulsatility index (PI) were obtained in the middle cerebral artery (MCA), umbilical artery (UA) and ductus venosus (DV) before and right after UCO, and at 1, 3, 6, 12, and 24 h after. We used multiple of the median (MoM) to adjust for gestational age. Spaghetti plots visualized flow changes over time. Mixed model adjusting for paired longitudinal data compared the values at different time points. RESULTS A total of 16 women were included. MCA-PSV dropped within the first hour after surgery from 0.91 to 0.82 MoM (p = 0.08). MCA-PI and UA-PI increased in the first hour from 0.75 to 0.91 MoM (p = 0.02) and 0.94 to 0.98 MoM (p = 0.22), respectively. The DV-PIV increased to 1.14 MoM 3 h after surgery (p = 0.07). The spaghetti plots illustrated the small changes within the first hours and showed a stabilization of flow measurements near initial values 24 h after UCO. CONCLUSION Within the first hours after UCO the circulation of the survivor twin undergoes small hemodynamic changes.
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Affiliation(s)
- Katrine Vasehus Schou
- Center of Fetal Medicine, Department of Obstetrics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark, .,Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark,
| | - Charlotte Kvist Ekelund
- Center of Fetal Medicine, Department of Obstetrics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Lisa Neerup Jensen
- Center of Fetal Medicine, Department of Obstetrics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Lone Nikoline Nørgaard
- Center of Fetal Medicine, Department of Obstetrics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kirsten Søgaard
- Center of Fetal Medicine, Department of Obstetrics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Line Rode
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Gentofte, Denmark
| | - Ann Tabor
- Center of Fetal Medicine, Department of Obstetrics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Karin Sundberg
- Center of Fetal Medicine, Department of Obstetrics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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Plomgaard AM, Alderliesten T, van Bel F, Benders M, Claris O, Cordeiro M, Dempsey E, Fumagalli M, Gluud C, Hyttel-Sorensen S, Lemmers P, Pellicer A, Pichler G, Greisen G. No neurodevelopmental benefit of cerebral oximetry in the first randomised trial (SafeBoosC II) in preterm infants during the first days of life. Acta Paediatr 2019; 108:275-281. [PMID: 29908039 PMCID: PMC6585779 DOI: 10.1111/apa.14463] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/20/2018] [Accepted: 06/13/2018] [Indexed: 11/30/2022]
Abstract
AIM Cerebral hypoxia has been associated with neurodevelopmental impairment. We studied whether reducing cerebral hypoxia in extremely preterm infants during the first 72 hours of life affected neurological outcomes at two years of corrected age. METHODS In 2012-2013, the phase II randomised Safeguarding the Brains of our smallest Children trial compared visible cerebral near-infrared spectroscopy (NIRS) monitoring in an intervention group and blinded NIRS monitoring in a control group. Cerebral hypoxia was significantly reduced in the intervention group. We followed up 115 survivors from eight European centres at two years of corrected age, by conducting a medical examination and assessing their neurodevelopment with the Bayley Scales of Infant and Toddler Development, Second or Third Edition, and the parental Ages and Stages Questionnaire (ASQ). RESULTS There were no differences between the intervention (n = 65) and control (n = 50) groups with regard to the mean mental developmental index (89.6 ± 19.5 versus 88.4 ± 14.7, p = 0.77), ASQ score (215 ± 58 versus 213 ± 58, p = 0.88) and the number of children with moderate-to-severe neurodevelopmental impairment (10 versus six, p = 0.58). CONCLUSION Cerebral NIRS monitoring was not associated with long-term benefits or harm with regard to neurodevelopmental outcome at two years of corrected age.
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Affiliation(s)
- Anne M. Plomgaard
- Department of Neonatology; Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
| | - Thomas Alderliesten
- Wilhelmina Children's Hospital; University Medical Center Utrecht; Utrecht The Netherlands
| | - Frank van Bel
- Wilhelmina Children's Hospital; University Medical Center Utrecht; Utrecht The Netherlands
| | - Manon Benders
- Wilhelmina Children's Hospital; University Medical Center Utrecht; Utrecht The Netherlands
| | - Olivier Claris
- Department of Neonatology; Hospices Civils de Lyon; Claude Bernard University; Lyon France
| | - Malaika Cordeiro
- Department of Neonatology; La Paz University Hospital; Madrid Spain
| | | | - Monica Fumagalli
- NICU; Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico; Università degli Studi di Milano; Milan Italy
| | - Christian Gluud
- Copenhagen Trial Unit; Centre for Clinical Intervention Research; Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
| | - Simon Hyttel-Sorensen
- Department of Neonatology; Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
| | - Petra Lemmers
- Wilhelmina Children's Hospital; University Medical Center Utrecht; Utrecht The Netherlands
| | - Adelina Pellicer
- Department of Neonatology; La Paz University Hospital; Madrid Spain
| | - Gerhard Pichler
- Department of Pediatrics; Research Unit for Neonatal Micro- and Macrocirculation; Medical University of Graz; Graz Austria
| | - Gorm Greisen
- Department of Neonatology; Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
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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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Singh A, Yeh CJ, Boone Blanchard S. Ages and Stages Questionnaire: a global screening scale. BOLETIN MEDICO DEL HOSPITAL INFANTIL DE MEXICO 2017; 74:5-12. [PMID: 29364814 DOI: 10.1016/j.bmhimx.2016.07.008] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 05/21/2016] [Accepted: 07/07/2016] [Indexed: 11/28/2022] Open
Abstract
With standardized screening tools, research studies have shown that developmental disabilities can be detected reliably and with validity in children as young as 4 months of age by using the instruments such as the Ages and Stages Questionnaire. In this review, we will focus on one tool, the Ages and Stages Questionnaire, to illustrate the usefulness of developmental screening across the globe.
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Affiliation(s)
- Ajay Singh
- College of Education and Technology, Eastern New Mexico University, Portales, New Mexico, USA.
| | - Chia Jung Yeh
- Department of Human Development and Family Science, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, USA
| | - Sheresa Boone Blanchard
- Department of Human Development and Family Science, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, USA
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Singh A, Yeh CJ, Boone Blanchard S. Ages and Stages Questionnaire: a global screening scale. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.bmhime.2016.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kjærgaard J, Stensballe LG, Birk NM, Nissen TN, Foss KT, Thøstesen LM, Pihl GT, Andersen A, Kofoed PE, Pryds O, Greisen G. Lack of a Negative Effect of BCG-Vaccination on Child Psychomotor Development: Results from the Danish Calmette Study - A Randomised Clinical Trial. PLoS One 2016; 11:e0154541. [PMID: 27123570 PMCID: PMC4849633 DOI: 10.1371/journal.pone.0154541] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 03/29/2016] [Indexed: 11/18/2022] Open
Abstract
Objectives To assess the non-specific effect of Bacillus Calmette-Guérin (BCG) vaccination at birth on psychomotor development. Design This is a pre-specified secondary outcome from a randomised, clinical trial. Setting Maternity units and paediatric wards at three university hospitals in Denmark. Participants Children born at gestational age (GA) 32 weeks and above. All women planning to give birth at the three sites were invited during the recruitment period. Out of 4262 randomised children, 144 were premature (GA < 37 weeks). There were 2129 children (71 premature) randomised to BCG and 2133 randomised (73 premature) to the control group. Interventions BCG vaccination 0.05 ml was given intradermally in the upper left arm at the hospital within seven days of birth. Children in the control group did not receive any intervention. Parents were not blinded to allocation. Main outcome measures Psychomotor development measured using Ages and Stages Questionnaire (ASQ) completed by the parents at 12 months. Additionally, parents of premature children (gestational age < 37 weeks) completed an ASQ at 6 and 22 months. Developmental assessment was available for 3453/4262 (81%). Results The mean difference in ASQ score at 12 months adjusted for age and prematurity was -0.7 points (BCG vs. control, 95% confidence interval; -3.7 to 2.4), p = 0.67, corresponding to an effect size of Cohen’s d = -0.015 (-0.082 to 0.052). The mean difference in ASQ score for premature children at 22 months was -7.8 points (-20.6 to 5.0, p = 0.23), d = -0.23 (-0.62 to 0.15). Conclusions A negative non-specific effect of BCG vaccination at birth on psychomotor development was excluded in term children. Trial Registration ClinicalTrials.gov NCT01694108
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Affiliation(s)
- Jesper Kjærgaard
- The Department of Paediatrics and Adolescent Medicine, Juliane Marie Centret, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- The Neonatal Department, Juliane Marie Centret, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- * E-mail:
| | - Lone Graff Stensballe
- The Department of Paediatrics and Adolescent Medicine, Juliane Marie Centret, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Nina Marie Birk
- Department of Paediatrics 460, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | | | - Kim Thestrup Foss
- Department of Neurology, Copenhagen University Hospital Herlev, Herlev, Denmark
| | | | - Gitte Thybo Pihl
- Department of Paediatrics, Kolding Hospital, University of Southern Denmark, Kolding, Denmark
| | - Andreas Andersen
- Research Center for Vitamins and Vaccines (CVIVA), Bandim Health Project, Statens Serum Institut, Artillerivej 5, Copenhagen, Denmark
| | - Poul-Erik Kofoed
- Department of Paediatrics, Kolding Hospital, University of Southern Denmark, Kolding, Denmark
| | - Ole Pryds
- Department of Paediatrics 460, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Gorm Greisen
- The Neonatal Department, Juliane Marie Centret, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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Lando A, Kure Østergaard K, Greisen G. Comparing minimally invasive and proactive initial management of extremely preterm infants. Acta Paediatr 2014; 103:827-32. [PMID: 24750177 PMCID: PMC4271678 DOI: 10.1111/apa.12661] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 02/17/2014] [Accepted: 04/15/2014] [Indexed: 11/28/2022]
Abstract
AIM In 2005, we changed our minimally invasive departmental policy for infants born before 26 weeks of gestation to a proactive approach. This included structured guidelines as well as intubation and surfactant in the delivery room, if the parents agreed. The aim of this study was to evaluate the effect of this change of policy. METHOD We compared the Ages and Stages Questionnaire (ASQ) scores, mortality rates and use of mechanical ventilation before (1999-2003) and after (2005-2011) the introduction of the new policy. RESULTS Twenty-two per cent of 61 infants in the before group had an ASQ z-score of <-2 standard deviation at 18 months' corrected age, compared with 26% of 55 infants in the after group. Mortality decreased from 46% to 36% (p = 0.06) and the use of mechanical ventilation at any time during admission increased from 64% to 87% (p < 0.0001). CONCLUSION We demonstrated that changing our policy to a proactive approach to the initial care of infants born before 26 weeks did not result in a major increase in psychomotor deficit. However, the use of mechanical ventilation increased significantly and survival tended to improve.
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Affiliation(s)
- A Lando
- Department of Neonatology The Juliane Marie Centre University Hospital Copenhagen, Rigshospitalet Copenhagen Denmark
| | - K Kure Østergaard
- Department of Neonatology The Juliane Marie Centre University Hospital Copenhagen, Rigshospitalet Copenhagen Denmark
| | - G Greisen
- Department of Neonatology The Juliane Marie Centre University Hospital Copenhagen, Rigshospitalet Copenhagen Denmark
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Filgueiras A, Pires P, Maissonette S, Landeira-Fernandez J. Psychometric properties of the Brazilian-adapted version of the Ages and Stages Questionnaire in public child daycare centers. Early Hum Dev 2013; 89:561-76. [PMID: 23507472 DOI: 10.1016/j.earlhumdev.2013.02.005] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Revised: 11/03/2012] [Accepted: 02/12/2013] [Indexed: 11/17/2022]
Abstract
Well-designed screening assessment instruments that can evaluate child development in public daycare centers represent an important resource to help improve the quality of these programs, as an early detection method for early developmental delay. The Ages and Stages Questionnaire, 3rd edition (ASQ-3), comprises a series of 21 questionnaires designed to screen developmental performance in the domains of communication, gross motor skills, fine motor skills, problem solving, and personal-social ability in children aged 2 to 66 months. The purpose of the present work was to translate and adapt all of the ASQ-3 questionnaires for use in Brazilian public child daycare centers and to explore their psychometric characteristics with both Classical Test Theory and Rating Scale analyses from the Rasch model family. A total of 18 Ages & Stages Questionnaires - Brazilian translation (ASQ-BR) questionnaires administered at intervals from 6 to 60 months of age were analyzed based on primary caregiver evaluations of 45,640 children distributed in 468 public daycare centers in the city of Rio de Janeiro. The results indicated that most of the ASQ-BR questionnaires had adequate internal consistency. Exploratory factor analyses yielded a one-factor solution for each domain of all of the ASQ-BR questionnaires. The only exception was the personal-social domain in some of the questionnaires. Item Response Theory based on Rating Scale analysis (infit and outfit mean squares statistics) indicated that only 44 of 540 items showed misfit problems. In summary, the ASQ-BR questionnaires are psychometrically sound developmental screening instruments that can be easily administered by primary caregivers.
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Schonhaut L, Armijo I, Schönstedt M, Alvarez J, Cordero M. Validity of the ages and stages questionnaires in term and preterm infants. Pediatrics 2013; 131:e1468-74. [PMID: 23629619 DOI: 10.1542/peds.2012-3313] [Citation(s) in RCA: 188] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND This study assessed the concurrent validity of the parent-completed developmental screening measure Ages and Stages Questionnaires, Third Edition (ASQ-3) compared with the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) in children born term, late preterm, or extremely preterm at 8, 18, or 30 months of corrected gestational ages (CGA). METHODS Data were collected from 306 term and preterm children ages 8, 18, and 30 months' CGA recruited from an ambulatory well-child clinic in Santiago, Chile. Parents completed the ASQ-3 in their homes, and afterward a trained professional administered the Bayley-III in a clinic setting. On the ASQ-3, the presence of any domain screened <2 SDs below the mean area score was considered a positive screen (indicating failure or delay). A Bayley-III score less than ≤1 SD indicated mild or severe delay. RESULTS ASQ-3 showed adequate psychometric properties (75% sensitivity and 81% specificity) and modest agreement with the Bayley-III (r = 0.56). Sensitivity, specificity, and correlations between measures improved with testing age and in children who were born extremely preterm. CONCLUSIONS Considering its psychometric properties, the ASQ-3 can be recommended for routine use in screening low-risk children at 8, 18, and 30 months' CGA and is advisable to be included in follow-up programs for children with biological risk factors such as those born preterm.
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Affiliation(s)
- Luisa Schonhaut
- Department of Pediatrics, Clínica Alemana, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile.
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Vandborg PK, Hansen BM, Greisen G, Jepsen M, Ebbesen F. Follow-up of neonates with total serum bilirubin levels ≥ 25 mg/dL: a Danish population-based study. Pediatrics 2012; 130:61-6. [PMID: 22732176 DOI: 10.1542/peds.2011-2760] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To study if severe hyperbilirubinemia in infants with no or minor neurologic symptoms in the neonatal period affects children's development at the age of 1 to 5 years. METHODS Controlled descriptive follow-up study of a national cohort of Danish children. The exposed group consisted of all live-born infants in Denmark from 2004 to 2007 with a gestational age ≥ 35 weeks and severe hyperbilirubinemia in the neonatal period, defined as at least 1 measure of total serum bilirubin level ≥ 25 mg/dL during the first 3 weeks of life. The exposed group of 206 children was matched with a control group of 208 children. The Ages and Stages Questionnaire (ASQ), a method of evaluating the child's development, was filled in by parents. Main outcome measure was effect size of ASQ total score. Statistical analyses comprised a matched analysis of 102 pairs and a nonmatched regression analysis of all participants. RESULTS The response rate was 79% (n = 162 of 206) in the study group and 70% (n = 146 of 208) in the control group. Neither the matched nor the nonmatched analysis showed any statistically significant differences between the groups; the effect size of the total score was 0.04 (-0.24 to 0.32) and -0.04 (-0.26 to 0.19), respectively. CONCLUSIONS Using the parent-completed ASQ, we found no evidence of developmental delay in children aged between 1 and 5 years with severe neonatal hyperbilirubinemia compared with a matched control group.
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Affiliation(s)
- Pernille Kure Vandborg
- Department of Paediatrics, Aalborg Hospital, Aarhus University Hospital, 9000 Aalborg, Denmark.
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Ages and Stages Questionnaires: feasibility of postal surveys for child follow-up. Early Hum Dev 2011; 87:671-6. [PMID: 21640526 DOI: 10.1016/j.earlhumdev.2011.05.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2010] [Revised: 04/01/2011] [Accepted: 05/12/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND The Ages and Stages Questionnaire (ASQ), completed by parents and caregivers, has been shown to be an accurate tool for screening children who need further developmental assessment. AIMS To assess the feasibility of using the French Canadian translation of the ASQ in an epidemiological cohort of children from the French general population. STUDY DESIGN Follow-up study by postal questionnaire at 12 and 36 months, using the ASQ. SUBJECTS 339 French families recruited at the birth of their child in 2006 in two hospitals in the Paris suburbs. OUTCOME MEASURE Response rates and French ASQ results at 12 and 36 months. The ASQ was scored as indicated in the manual. RESULTS A high response rate of 79% was observed at the children's 1st and 3rd birthdays. Parents were enthusiastic about participating; half of them wrote comments on the questionnaires, most of them positive. Low scores at the 12-month assessment were associated with birth characteristics such as prematurity and transfer to the neonatology unit after birth, whereas at 36 months they tended to be associated with both birth and family socio-demographic characteristics. CONCLUSIONS Use of the French ASQ in a research cohort appears feasible as response rates were high. Moreover, known links between child development measured by ASQ and birth and social characteristics were observed. However, further French studies are needed to understand differences observed in 12-month ASQ gross motor scores compared with US norms. For research purposes, further analysis of the ASQ in innovative, quantitative approaches, is needed.
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Woodward BJ, Papile LA, Lowe JR, Laadt VL, Shaffer ML, Montman R, Watterberg KL. Use of the Ages and Stages Questionnaire and Bayley Scales of Infant Development-II in neurodevelopmental follow-up of extremely low birth weight infants. J Perinatol 2011; 31:641-6. [PMID: 21311498 PMCID: PMC3139816 DOI: 10.1038/jp.2011.1] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
OBJECTIVE For infants born with extremely low birth weight (ELBW), we examined the (1) correlation between results on the Ages and Stages Questionnaire (ASQ) and the Bayley Scales of Infant Development-II (BSID-II) at 18 to 22 months corrected age; (2) degree to which earlier ASQ assessments predict later BSID-II results; (3) impact of ASQ use on follow-up study return rates. STUDY DESIGN ASQ data were collected at 4, 8, 12 and 18 to 22 months corrected age. The BSID-II was completed at 18 to 22 months corrected age. ASQ and BSID-II 18 to 22 month sensitivity and specificity were examined. Ability of earlier ASQs to predict later BSID-II scores was examined through linear regression analyses. RESULT ASQ sensitivity and specificity at 18 to 22 months were 73 and 65%, respectively. Moderate correlation existed between earlier ASQ and later BSID-II results. CONCLUSION For extremely low birth weight infant assessment, the ASQ cannot substitute for the BSID-II, but seems to improve tracking success.
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Affiliation(s)
- Barbara J Woodward
- Department of Psychiatry and Behavioral Sciences, The Children’s Hospital of Denver, Denver, Colorado
| | - Lu-Ann Papile
- Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Jean R Lowe
- Division of Neonatology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Virginia L Laadt
- Division of Neonatology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Michele L Shaffer
- Departments of Public Health Sciences and Pediatrics, Penn State College of Medicine, Hershey, Pennsylvania
| | - Rebecca Montman
- General Clinical Research Center, University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Kristi L Watterberg
- Division of Neonatology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
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Chiu SH, DiMarco MA. A pilot study comparing two developmental screening tools for use with homeless children. J Pediatr Health Care 2010; 24:73-80. [PMID: 20189059 DOI: 10.1016/j.pedhc.2009.01.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2008] [Revised: 12/15/2008] [Accepted: 01/11/2009] [Indexed: 10/20/2022]
Abstract
Homelessness and poverty can present serious health issues for children, including those associated with developmental delays. Early identification and intervention may decrease risk associated with delayed development. Parent-completed measures have been used to help screen for children's development, but little is known about how they may enhance early detection with homeless children. The primary aims of this pilot study were to describe growth and developmental characteristics of homeless children and to compare a parent-completed measure with professionally-conducted developmental screening results. A prospective, comparative study was conducted with 20 homeless mothers and their 21 children. Health professionals used the Denver Developmental Screening Test II, identifying nine children with possible language delay. Mothers completed the Ages and Stages Questionnaires and identified three areas of concern: fine motor (n = 9), communication/language (n = 4), and problem solving (n = 4). The percentage agreement between these two tools was strongest in gross motor (95%) and personal social development (95%) but weakest in language development (67%). While it is essential for all children, developmental screening is particularly crucial for homeless children because of increased risks related to poverty and homelessness. Nurses and nurse practitioners are in a unique position to assess applicability of such instruments and to provide critically needed interventions for these children.
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Affiliation(s)
- Sheau-Huey Chiu
- Department of Women's, Children's, & Family Nursing, College of Nursing, University of Florida, Gainesville, FL 32610-0187, USA.
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Support for the global feasibility of the Ages and Stages Questionnaire as developmental screener. Early Hum Dev 2009; 85:443-7. [PMID: 19356866 DOI: 10.1016/j.earlhumdev.2009.03.001] [Citation(s) in RCA: 147] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2008] [Revised: 03/03/2009] [Accepted: 03/18/2009] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To investigate the psychometric properties of the Dutch version of the 48 months Ages and Stages Questionnaire (D_ASQ_48). DESIGN Prospective cohort study of a community-based sample of children born in 2002 and 2003 whose parents filled out the D_ASQ_48 and a questionnaire on school status at 60 months. The ASQ was translated into Dutch and back-translated into English by three independent translators. SETTING Well Child Centers covering 25% of the Netherlands. PARTICIPANTS Parents of 1510 preterm and 562 term children born in 2002-2003 attending routine Well Child visits at age 45-50 months. MAIN OUTCOME MEASURES Reliability, validity and mean population scores for D_ASQ_48 compared to other countries. RESULTS Mean population scores for the D_ASQ_48 were mostly similar to those in the USA, Norway and Korea. Exceptions (effect sizes of difference >0.5) were problem solving (USA) and fine motor (Korea). Reliability was good for the total score (Cronbach alpha 0.79) and acceptable for all domains (0.61-0.74). As expected, infants born at gestational age <32 weeks, children from low income families, of low educated mothers, and boys were more likely to fail on several domains (odds ratios, OR ranging from 1.5 to 4.9). The only unexpected association concerned children from one-parent families. Sensitivity to predict special education at five years of age was 89% and specificity 80%. CONCLUSIONS The good psychometric properties of the Dutch ASQ_48 and the small differences when compared to other countries support its usefulness in the early detection of developmental problems amongst children worldwide.
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Lindsay NM, Healy GN, Colditz PB, Lingwood BE. Use of the Ages and Stages Questionnaire to predict outcome after hypoxic-ischaemic encephalopathy in the neonate. J Paediatr Child Health 2008; 44:590-5. [PMID: 19012632 DOI: 10.1111/j.1440-1754.2008.01388.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Infants who suffer hypoxic-ischaemic encephalopathy (HIE) at birth are at increased risk of developmental disability. In this at-risk population, reliable, inexpensive and early identification of those children who are likely to require formal developmental assessment and intervention is needed. AIM To evaluate the ability of the Ages and Stages Questionnaire (ASQ) to detect developmentally delayed children in an Australian population of infants who suffered HIE at birth. METHODS Fifty-five children who survived HIE were followed until 12-14 months of age. Test characteristics were calculated to examine the ability of the ASQ to appropriately identify developmentally delayed infants against this study's 'gold standard': the Bayley Scales of Infant Development II. RESULTS Comparing the ASQ with the Bayley Scales of Infant Development II, the questionnaire had the following test characteristics: sensitivity 92%, specificity 95%, positive predictive value 92%, negative predictive value 95% when used to detect severe developmental delay; and sensitivity 67%, specificity 93%, positive predictive value 92%, negative predictive value 68% when used to detect both severe and mild developmental delay. However, the ASQ used at standard cut-offs failed to detect any of the children with mild delay. CONCLUSIONS The ASQ is extremely effective for the detection of severe developmental delay in children who have suffered HIE at birth. Its capacity to identify those with milder delay is limited. The ability of the test to detect only those with severe developmental delay means that the ASQ is of little value as a screening tool in this population.
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Affiliation(s)
- Natalie M Lindsay
- Perinatal Research Centre, The University of Queensland, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
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Abstract
AIM To explore the construct validity of the ASQ in relation to premature birth; maternal age, completeness of the family and level of education; and the child's gender. METHODS Norwegian mothers' evaluations of 1172 children who completed age appropriate ASQs twice were statistically analysed by means of univariate and multivariate methods. RESULTS The developmental level of girls is on average higher than that of boys at both assessments and there is a substantial increase between follow-up assessments in all ASQ scores except for gross motor skills. The mother's level of education; whether the child was born prematurely or at full-term; and the interaction between the child's gender and his/her mother's level of education are important factors relating to the child's developmental status in both assessments. CONCLUSION The results that were derived by means of the Ages and Stages Questionnaires concerning the impact of maternal socio-demographical factors, the child's gender, and premature birth upon early childhood development largely confirm the findings in the literature supporting the construct validity of the ASQ. The ASQ was found to be an effective diagnostic tool of developmental delay and/or disturbances. The development of gender dependent norms is recommended.
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Affiliation(s)
- Jörg Richter
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway.
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