Screening of Neurodevelopmental Delays in Four Communities of Mexico and Cuba

Early-onset developmental impairments among infants attending the routine immunization clinic at the University College Hospital, Ibadan, Nigeria

Developmental disorders are frequently overlooked in the developing countries, particularly in sub-Saharan Africa. Early identification of developmental delays (DDs) is critical to optimal outcomes. This study set out to determine the proportion of children who are at risk of DDs among infants attending immunization clinics at the University College Hospital, Ibadan, Nigeria. Infants 6 weeks to 12 months of age (median age 6 months) who presented for routine immunization were screened for DDs using the Ages and Stages Questionnaire. A total of 587 infants [312 (53.2%) males] were enrolled. A total of 198 (33.7%) children showed signs of DDs. For the domains of communication skills, fine motor skills, gross motor skills, problem solving/cognition skills and personal/social skills, the prevalences of DDs were 7.5%, 15.0%, 10.7%, 14.1% and 14.8%, respectively, and 14.3% had global DDs. Factors that significantly predicted DDs included prematurity (odds ratio [OR] 2.64 [95% confidence interval {CI} 1.45 to 2.05]) and a history of perinatal asphyxia (OR 1.74 [95% CI 1.77 to 2.49]). There is a need to incorporate routine developmental screening into the Nigerian healthcare system for timely recognition of DDs and prompt interventions.

Gender and geographic differences in the prevalence of reportable childhood speech and language disability in Taiwan

Speech and language disability (SLD) is not uncommon in children. However, data at the national level are limited, and geographic differences are seldom evaluated. Starting from 1980, the local governments in Taiwan has begun to certify disabled residents for providing various services and report cases to the central government according to the law, and the central government maintains a registry of reported cases, which provides a unique opportunity for studying SLD at the national level. Using the registry data from 2004 to 2010, we calculated the prevalence of SLD by age, gender, and geographic area and assessed the changes over time. Because the government discourages the certification under 3 years of age, we excluded cases under 3 years old from the analyses. We found that from 2004 to 2010 the registered cases between 3 and 17 years old increased from 1418 to 1637 per year, and the prevalence generally increased every year in all age groups except in 12-14 years of age. In each year there were more boy cases than girl cases, and the prevalence rate ratio increased from 1.50 to 1.83 (p < 0.05 in all years), with an increasing trend over time (p < 0.01). A higher prevalence was observed in the rural areas over the years, and the prevalence rate ratio increased from 1.35 to 1.71 (p < 0.05 in all years), with an increasing trend over time (p < 0.01). Further studies identifying the risk factors contributed to the increases might help the prevention of SLD in the future.

What assessments evaluate use of hands in infants? A literature review

AIM

To identify assessments, applicable to infants aged 3 months to 12 months, measuring hand function, and to discuss their usefulness in assessing infants at risk of developing unilateral cerebral palsy (CP).

METHOD

Instruments described in two previous systematic reviews were scrutinized for inclusion of fine motor components. Additionally, a new literature search was performed in Medline, PsychInfo, PubMed, and Cinahl (2007-2013) to identify newly developed assessments of infant motor functioning.

RESULTS

Five assessments from the two previous systematic reviews included fine motor components but only three provided separate measures of fine motor performance: the Peabody Developmental Motor Scales--version 2 (PDMS-2), the Bayley Scale of Infant and Toddler Development--version III, and the Posture and Fine Motor Assessment of Infants, each of which provided measures of the preferred hand only. From 531 papers retrieved, 10 new assessments were found, three of which met our inclusion criteria: the Infant Motor Profile (IMP), the Grasping and Reaching Assessment of Brisbane (GRAB), and the Hand Assessment for Infants (HAI). Only the GRAB and the HAI provide measures relevant for assessing infants at risk of developing unilateral cerebral palsy; however, both measures are still under construction.

INTERPRETATION

No currently available assessment for infants aged 3 to 12 months old measures aspects of hand function suitable for quantifying asymmetry between hands or quality of bimanual performance.

[Comparative analysis of child development screening tools designed and validated in Mexico]

BACKGROUND

In recent years a number of child development screening tools have been developed in Mexico; however, their properties have not been compared. The objective of this review was to compare the report quality and risk bias of the screening tools developed and validated in Mexico in their published versions.

METHODS

A search was conducted in databases, gray literature and cross references. The resultant tests were compared and analyzed using STARD, QUADAS and QUADAS-2 criteria.

RESULTS

"Valoración Neuroconductual del Desarrollo del Lactante" (VANEDELA), "Evaluación del Desarrollo Infantil or EDI" (CDE in English), "Prueba de Tamiz del Neurodesarrollo infantil" (PTNI), "Cartillas de Vigilancia para identificar alteraciones en el Desarrollo del Lactante" (CVDL) and "Indicadores de riesgo del Perfil de Conductas de Desarrollo" (INDIPCD-R) were included for the comparison. No test fulfilled all STARD items. The most complete in their methodological description were VANEDELA and EDI. The areas lacking more data on the reports were recruiting and patient selection (VANEDELA, PTNI, CVDL, INDIPCD-R). In QUADAS evaluation, all had some risk bias, but some serious concerns of risk bias were raised by patient sampling and by the choice of gold standard in two tests (PTNI, INDIPCD-R).

CONCLUSIONS

Child development screening tests created and validated in Mexico have variable report quality and risk bias. The test with the best validation report quality is VANEDELA and the one with the lowest risk of bias is EDI.