1
|
Lee S, Han Y, Lim MK, Lee HJ. Impact of moderate-to-late preterm birth on neurodevelopmental outcomes in young children: Results from retrospective longitudinal follow-up with nationally representative data. PLoS One 2023; 18:e0294435. [PMID: 37972123 PMCID: PMC10653423 DOI: 10.1371/journal.pone.0294435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023] Open
Abstract
This study investigated the relationship between moderate-to-late preterm (MLPT) birth and the risk of neurodevelopmental impairments (NIs) in young children compared with the risks associated with very preterm (VPT) and full-term (FT) birth based on nationally representative large-scale population data. Retrospective follow-up was conducted over 71 months for 738,733 children who were born and participated in the Korean National Health Screening Program for Infants and Children (NHSPIC) between 2011 and 2013. Using a data linkage between the NHSPIC and Korean healthcare claim information, data on birth year, sex, delivery type, birth weight, growth abnormality, gestational age, breastfeeding history, maternal age, NIs, multiple gestation, preterm labor, premature rupture of membranes (PROM), gestational diabetes, gestational hypertension, smoking during pregnancy, and socioeconomic status were collected and included in the final analysis. Cox proportional hazards models were applied to identify the impact of gestational age on NI risk, with all variables adjusted as appropriate. Overall, 0.9% and 3.8% rates of VPT and MLPT births were identified, respectively. NI incidence was highest among VPT children (34.7%), followed by MLPT (23.9%) and FT (18.2%) children. Both VPT (hazard ratio [HR], 1.45; 95% confidence interval [CI], 1.03 to 2.05) and MLPT (HR, 1.21; 95% CI, 1.04 to 1.41) births were associated with increased NI risk. Low birth weight, PROM, and smoking during pregnancy were also associated with increased NI risk, while longer breastfeeding and higher socioeconomic status were associated with decreased risk. Special attention must be given to NIs for both VPT and MLPT children.
Collapse
Affiliation(s)
- Sangmi Lee
- Department of Nursing, College of Nursing, Dongyang University, Yeongju-si, Gyeongsangbuk-do, Republic of Korea
| | - Yuri Han
- Department of Social and Preventive Medicine, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Min Kyung Lim
- Department of Social and Preventive Medicine, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Hun Jae Lee
- Department of Social and Preventive Medicine, College of Medicine, Inha University, Incheon, Republic of Korea
| |
Collapse
|
2
|
Georg S, Genser B, Fischer J, Sachse S, De Bock F. Development and validation of a self-regulation scale within the German version of the Early Development Instrument. BMC Pediatr 2023; 23:509. [PMID: 37845613 PMCID: PMC10577983 DOI: 10.1186/s12887-023-04334-1] [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: 02/01/2023] [Accepted: 09/28/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Early childhood self-regulation (SR) is key for many health- and education-related outcomes across the life span. Kindergarten age is a crucial period for SR development, and within this developmental window, potential SR difficulties can still be compensated for (e.g., through interventions). However, efficient measurement of SR through brief, comprehensive, and easy-to-use instruments that identify SR difficulties are scarce. To address this need, we used items of an internationally applied kindergarten teacher questionnaire-the Early Development Instrument (EDI) - to develop and validate a specific SR measurement scale. METHODS The psychometric evaluation and validation of the selected SR-items was performed in data collected with the German version of the EDI (GEDI), in two independent data sets - (a) the development dataset, with 191 children, and b) the validation dataset, with 184 children. Both included three- to six-year-old children and contained retest and interrater reliability data. First, three independent raters-based on theory-selected items eligible to form a SR scale from the two SR-relevant GEDI domains "social competence" and "emotional maturity". Second, exploratory and confirmatory factor analysis using structural equation modeling examined the item structure across both data sets. This resulted in a defined SR scale, of which internal consistency, test-retest and interrater reliability, cross-validation, and concurrent validity using correlation and descriptive agreements (Bland-Altman (BA) plots) with an existing validated SR-measuring instrument (the Kindergarten Behavioral Scales) were assessed. RESULTS Confirmatory factor analysis across both data sets yielded the best fit indices with 13 of the GEDI 20 items initially deemed eligible for SR measurement, and a three-factor structure: a) behavioral response inhibition, b) cognitive inhibition, c) selective or focused attention (RMSEA: 0.019, CFI: 0.998). Psychometric evaluation of the resulting 13-item-GEDI-SR scale revealed good internal consistency (0.92), test-retest and interrater reliability (0.85 and 0.71, respectively), validity testing yielded stability across populations and good concurrent validity with the Kindergarten Behavioral Scales (Pearson correlation coefficient: mean 0.72, range 0.61 to 0.84). CONCLUSIONS The GEDI contains 13 items suitable to assess SR, either as part of regular EDI developmental monitoring or as a valid stand-alone scale. This short 13-item (G)EDI-SR scale may allow early detection of children with SR difficulties in the kindergarten setting in future and could be the basis for public health intervention planning. To attain this goal, future research should establish appropriate reference values using a representative standardization sample.
Collapse
Affiliation(s)
- Sabine Georg
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health (CPD), Division of General Medicine, Old Brewery, Heidelberg University, Röntgenstraße 7, 68167, Mannheim, Germany.
- Department of Developmental Psychology, Heidelberg University of Education, Keplerstraße 87, 69120, Heidelberg, Germany.
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany.
| | - Bernd Genser
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health (CPD), Division of General Medicine, Old Brewery, Heidelberg University, Röntgenstraße 7, 68167, Mannheim, Germany
- BGStats Consulting, Schleifmühlgasse 7, 1040, Vienna, Austria
| | - Joachim Fischer
- Medical Faculty Mannheim, Center for Preventive Medicine and Digital Health (CPD), Division of General Medicine, Old Brewery, Heidelberg University, Röntgenstraße 7, 68167, Mannheim, Germany
| | - Steffi Sachse
- Department of Developmental Psychology, Heidelberg University of Education, Keplerstraße 87, 69120, Heidelberg, Germany
| | - Freia De Bock
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| |
Collapse
|
3
|
Duko B, Gebremedhin AT, Tessema GA, Alati R, Pereira G. Average treatment effect of maternal prenatal tobacco smoking on offspring developmental vulnerability in early childhood. Ann Epidemiol 2023; 78:35-43. [PMID: 36584811 DOI: 10.1016/j.annepidem.2022.12.007] [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: 08/09/2022] [Revised: 12/09/2022] [Accepted: 12/16/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Early childhood developmental vulnerability has been closely related to the predictors of relatively good health, social and educational outcomes later in adulthood. However, the impacts of prenatal tobacco exposure on childhood developmental vulnerability have been rarely examined. Further, a few of the studies that have investigated maternal prenatal tobacco smoking and child developmental vulnerability have reported mixed results and there are currently no published estimates derived from causal epidemiological methods. METHODS We conducted a retrospective population-based cohort study on the association between maternal prenatal tobacco smoking and developmental vulnerability in children born in Western Australia (WA). De-identified individual-level maternal, infant and birth records were obtained from the Midwives Notification System (MNS), a statutory record of all births in WA. WA register for Developmental Anomalies (WARDA) were also obtained from the WA Data Linkage. Records on early childhood developmental vulnerability at the median age of 5 years were obtained from the Australian Early Development Census (AEDC). We used a doubly robust estimator to estimate the causal effects. RESULTS Complete data were available for 64,558 mothers-children's pairs. Approximately 16% of children were exposed to maternal prenatal tobacco smoking. Children exposed to maternal prenatal tobacco smoking were more likely to be classified as developmentally vulnerable/at-risk on the physical health and wellbeing (RR = 1.40, 95%CI:1.36-1.45), social competence (RR = 1.42, 95%CI: 1.38-1.47), emotional maturity (RR = 1.34, 95%CI:1.30-1.39), language and cognitive skills (RR = 1.50, 95%CI:1.45-1.54), and communication skills and general knowledge (RR = 1.37, 95%CI:1.33-1.42) domains. CONCLUSION Maternal prenatal exposure to tobacco may influence early childhood developmental vulnerability. Early intervention to quit tobacco smoking before becoming pregnant could potentially reduce later childhood developmental vulnerability on multiple domains.
Collapse
Affiliation(s)
- Bereket Duko
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Bentley WA, Australia.
| | - Amanuel Tesfay Gebremedhin
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Bentley WA, Australia
| | - Gizachew Assefa Tessema
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Bentley WA, Australia; enAble Institute, Curtin University, Bentley, Western Australia, Australia
| | - Rosa Alati
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Bentley WA, Australia; Institute for Social Sciences Research, The University of Queensland, Indooroopilly, Queensland, Australia
| | - Gavin Pereira
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Bentley WA, Australia; enAble Institute, Curtin University, Bentley, Western Australia, Australia; Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, Oslo, Norway
| |
Collapse
|
4
|
Louis D, Oberoi S, Ricci MF, Pylypjuk C, Alvaro R, Seshia M, de Cabo C, Moddemann D, Lix LM, Garland A, Ruth CA. School Readiness Among Children Born Preterm in Manitoba, Canada. JAMA Pediatr 2022; 176:1010-1019. [PMID: 35939291 PMCID: PMC9361185 DOI: 10.1001/jamapediatrics.2022.2758] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 04/17/2022] [Indexed: 11/14/2022]
Abstract
Importance Children born preterm may experience learning challenges at school. However, there is a paucity of data on the school readiness of these children as they prepare to begin grade 1. Objective To examine the association between prematurity and school readiness in a population-based cohort of children. Design, Setting, and Participants This cohort study was conducted in the province of Manitoba, Canada, and involved 2 cohorts of children in kindergarten at the time of data collection. The population-based cohort included children born between January 1, 2000, and December 31, 2011, whose school readiness was assessed in kindergarten using the Early Development Instrument (EDI) data. The sibling cohort comprised children born preterm and their closest-in-age siblings born full term. Data were analyzed between March 12 and September 28, 2021. Exposures Preterm birth, defined as gestational age (GA) less than 37 weeks. Main Outcomes and Measures The primary outcome was vulnerability in the EDI, defined as a score below the tenth percentile of the Canadian population norms for any 1 or more of the 5 EDI domains (physical health and well-being, social competence, emotional maturity, language and cognitive development, and communication skills and general knowledge). Logistic regression models were used to identify the factors associated with vulnerability in the EDI. P values were adjusted for multiplicity using the Simes false discovery method. Results Of 86 829 eligible children, 63 277 were included, of whom 4352 were preterm (mean [SD] GA, 34 [2] weeks; 2315 boys [53%]) and 58 925 were full term (mean [SD] GA, 39 (1) weeks; 29 885 boys [51%]). Overall, 35% of children (1536 of 4352) born preterm were vulnerable in the EDI compared with 28% of children (16 449 of 58 925) born full term (adjusted odds ratio [AOR], 1.32; 95% CI, 1.23-1.41; P < .001]). Compared with children born full term, those born preterm had a higher percentage of vulnerability in each of the 5 EDI domains. In the population-based cohort, prematurity (34-36 weeks' GA: AOR, 1.23 [95% CI, 1.14-1.33]; <34 weeks' GA: AOR, 1.72 [95% CI, 1.48-1.99]), male sex (AOR, 2.24; 95% CI, 2.16-2.33), small for gestational age (AOR, 1.31; 95% CI, 1.23-1.40), and various maternal medical and sociodemographic factors were associated with EDI vulnerability. In the sibling cohort, EDI outcomes were similar for both children born preterm and their siblings born full term except for the communication skills and general knowledge domain (AOR, 1.39; 95% CI, 1.07-1.80) and Multiple Challenge Index (AOR, 1.43; 95% CI, 1.06-1.92), whereas male sex (AOR, 2.19; 95% CI, 1.62-2.96) and maternal age at delivery (AOR, 1.53; 95% CI, 1.38-1.70) were associated with EDI vulnerability. Conclusions and Relevance Results of this study suggest that, in a population-based cohort, children born preterm had a lower school-readiness rate than children born full term, but this difference was not observed in the sibling cohort. Child and maternal factors were associated with lack of school readiness among this population-based cohort.
Collapse
Affiliation(s)
- Deepak Louis
- Section of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Sapna Oberoi
- Division of Pediatric Hematology/Oncology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - M. Florencia Ricci
- Neonatal Follow up Program, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Christy Pylypjuk
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ruben Alvaro
- Section of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Mary Seshia
- Section of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Cecilia de Cabo
- Section of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Diane Moddemann
- Neonatal Follow up Program, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lisa M. Lix
- Department of Community Health Sciences, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Allan Garland
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Medicine, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Chelsea A. Ruth
- Section of Neonatology, Department of Pediatrics and Child Health, Rady Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| |
Collapse
|
5
|
Early Neurodevelopmental Outcomes after Previable Preterm Prelabour Rupture of Membranes (pPPROM). Case Rep Pediatr 2022; 2022:3428841. [PMID: 36193210 PMCID: PMC9526558 DOI: 10.1155/2022/3428841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/23/2022] [Indexed: 11/22/2022] Open
Abstract
Objective To describe the early neurodevelopmental outcomes following fetal exposure to previable preterm prelabour rupture of membranes (pPPROM). Methods This was a secondary analysis of a subgroup of neonates born following pPPROM from a retrospective cohort study (2009–2015). Surviving infants who underwent standardized neurodevelopmental evaluation at 18–24 months corrected age (CA) between 2017 and 2019 were eligible for inclusion. Data abstracted from hospital charts were linked to prospectively collected developmental outcomes stored in an electronic database from a regional neonatal follow-up clinic. The primary outcome was Bayley-III composite scores (compared to the population mean 100, standard deviation (SD) 15). Secondary outcomes included presence of cerebral palsy, vision loss, hearing impairment, and requirement of rehabilitation therapy. Descriptive statistics were used to present results. Results 25.7% (19/74) of neonates born after pPPROM survived to hospital discharge, but only 21.6% (16/74) survived to 18–24 months CA. Of these, 9 infants were eligible for follow-up at the regional clinic and 7 had developmental outcomes stored in the electronic database. Infants exposed to pPPROM exhibited Bayley-III scores more than 1 SD below the population mean across all three domains: cognitive 84.9 (SD 12.2); motor 82.3 (SD 11.5); and language 66.4 (SD 18.9). There were particular deficiencies in language development with 71% (5/7) scoring more than 2 SDs below the population mean. There were no cases of cerebral palsy. Conclusions Only 1 in 5 infants born following expectantly managed pPPROM survived to 18–24 months CA. These infants born after pPPROM had significantly lower Bayley-III scores and particular deficiencies in language development. Better understanding of early neurodevelopmental challenges following pPPROM will help refine counselling of families contemplating expectant management and provide insights into the postnatal educational resources required to improve long-term developmental outcomes for these children.
Collapse
|
6
|
Vanderloo LM, Janus M, Omand JA, Keown-Stoneman CDG, Borkhoff CM, Duku E, Mamdani M, Lebovic G, Parkin PC, Simpson JR, Tremblay MS, Maguire JL, Birken CS. Children's screen use and school readiness at 4-6 years: prospective cohort study. BMC Public Health 2022; 22:382. [PMID: 35197009 PMCID: PMC8864975 DOI: 10.1186/s12889-022-12629-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 01/18/2022] [Indexed: 11/25/2022] Open
Abstract
Background The primary aim of this study was to determine if screen use in early childhood is associated with overall vulnerability in school readiness at ages 4 to 6 years, as measured by the Early Development Instrument (EDI). Secondary aims were to: (1) determine if screen use was associated with individual EDI domains scores, and (2) examine the association between screen use and EDI domains scores among a subgroup of high screen users. Methods This prospective cohort study was carried out using data from young children participating in a large primary care practice-based research network in Canada. Logistic regression analyses were run to investigate the association between screen use and overall vulnerability in school readiness. Separate linear regression models examined the relationships between children’s daily screen use and each separate continuous EDI domain. Results A total of 876 Canadian participants participated in this study. Adjusted logistic regression revealed an association between increased screen use and increased vulnerability in school readiness (p = 0.05). Results from adjusted linear regression demonstrated an association between higher screen use and reduced language and cognitive development domain scores (p = 0.004). Among high screen users, adjusted linear regression models revealed associations between increased screen use and reduced language and cognitive development (p = 0.004) and communication skills and general knowledge domain scores (p = 0.042). Conclusions Screen use in early childhood is associated with increased vulnerability in developmental readiness for school, with increased risk for poorer language and cognitive development in kindergarten, especially among high users. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12629-8.
Collapse
Affiliation(s)
- Leigh M Vanderloo
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, 686 Bay Street, ON, M5G 0A4, Toronto, Canada.
| | - Magdalena Janus
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Jessica A Omand
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, 686 Bay Street, ON, M5G 0A4, Toronto, Canada
| | - Charles D G Keown-Stoneman
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Dalla Lana Faculty of Public Health, University of Toronto, Toronto, ON, Canada
| | - Cornelia M Borkhoff
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, 686 Bay Street, ON, M5G 0A4, Toronto, Canada.,Dalla Lana Faculty of Public Health, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Eric Duku
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Muhammad Mamdani
- Dalla Lana Faculty of Public Health, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Unity Health Toronto, Toronto, ON, Canada.,Department of Medicine, Temetry Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Gerald Lebovic
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Patricia C Parkin
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, 686 Bay Street, ON, M5G 0A4, Toronto, Canada.,Dalla Lana Faculty of Public Health, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Medicine, Temetry Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Division of Paediatric Medicine, Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, ON, Canada
| | - Janis Randall Simpson
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research, CHEO Research Institute, Ottawa, ON, Canada
| | - Jonathon L Maguire
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Medicine, Temetry Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Department of Pediatrics, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Catherine S Birken
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, 686 Bay Street, ON, M5G 0A4, Toronto, Canada.,Dalla Lana Faculty of Public Health, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Medicine, Temetry Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Division of Paediatric Medicine, Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, ON, Canada
| |
Collapse
|
7
|
Morton S, Curran M, Barry O'Gorman M. Adverse Childhood Experiences, Domestic Violence and Substance Misuse: An Action Research Study on Routine Enquiry and Practice Responses. Front Psychiatry 2022; 13:892849. [PMID: 35903635 PMCID: PMC9314750 DOI: 10.3389/fpsyt.2022.892849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
The long-term impacts of Adverse Childhood Experiences (ACEs) are of increasing interest to researchers and practitioners, including the effectiveness of screening for ACEs to improve health and social outcomes. Despite a focus on implementing such practices, there has been little focus on ACEs experiences for women experiencing domestic violence and substance use, or consideration of practice responses around ACEs routine enquiry for domestic violence and related services. The Irish study discussed in this paper used an action research approach to implement ACEs routine enquiry within a domestic violence service for women accessing the service (n = 60), while also utilizing co-operative inquiry groups for practitioners both within the organization (n = 10) and with those working in associated fields of infant mental health, child protection, substance misuse and welfare and community support (n = 7). Of the 60 women who completed the ACEs routine enquiry in the study, over one-half (58 per cent) reported experiencing at least two ACEs in their childhood, including one-third of all respondents reporting experiencing four or more; service users reported significant levels of overlap between direct child maltreatment and adverse home environments. Reported parental substance misuse with the home environment was substantially higher than in general population studies. These findings offered early indications of both ACEs prevalence as well the types of ACEs that most define the experiences of the women presenting to a domestic violence service that supports women with substance misuse and other related issues. This paper discusses the ways in which the co-operative inquiry groups used this information and other processes to enhance practitioner, organizational, and inter-agency understanding and service responses. The practitioners felt that this form of ACEs routine enquiry, while not an end in itself, was a useful tool to engage women in conversations about trauma and intergenerational patterns and a basis for developing trauma-informed interventions. We conclude with discussion about: considerations of the risks of "individualizing" women's traumatic experiences; skills and supports for practitioners; and resource implications.
Collapse
Affiliation(s)
- Sarah Morton
- School of Social Policy, Social Work and Social Justice, University College Dublin, Dublin, Ireland
| | - Megan Curran
- Center on Poverty and Social Policy, School of Social Work, Columbia University, New York, NY, United States
| | | |
Collapse
|
8
|
Halfon N, Aguilar E, Stanley L, Hotez E, Block E, Janus M. Measuring Equity From The Start: Disparities In The Health Development Of US Kindergartners. Health Aff (Millwood) 2021; 39:1702-1709. [PMID: 33017235 DOI: 10.1377/hlthaff.2020.00920] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Racialized disparities in health and well-being begin early in life and influence lifelong health outcomes. Using the Early Development Instrument-a population-level early childhood health measure-this article examines potential health inequities with regard to neighborhood income and race/ethnicity in a convenience sample of 183,717 kindergartners in ninety-eight US school districts from 2010 to 2017. Our findings demonstrate a distinct income-related outcome gradient. Thirty percent of children in the lowest-income neighborhoods were vulnerable in one or more domains of health development, compared with 17 percent of children in higher-income settings. Significantly higher rates of income-related Early Development Instrument vulnerability-defined as children falling below the tenth-percentile cutoff on any Early Development Instrument domain-were demonstrated for Black/African American and Hispanic/Latinx children. These findings underscore the utility of the Early Development Instrument as a way for communities to measure child health equity gaps and inform the design, implementation, and performance of multisector place-based child health initiatives. More broadly, results indicate that for the US to make significant headway in decreasing lifelong health inequities, it is important to achieve health equity by early childhood.
Collapse
Affiliation(s)
- Neal Halfon
- Neal Halfon is a professor of pediatrics at the Geffen School of Medicine; a professor of health policy and management at the Fielding School of Public Health; and a professor of public policy at the Luskin School of Public Affairs, all at the University of California Los Angeles (UCLA), and is director of the UCLA Center for Healthier Children, Families, and Communities, in Los Angeles, California
| | - Efren Aguilar
- Efren Aguilar is the geographic information systems lead at the Center for Healthier Children, Families, and Communities at UCLA
| | - Lisa Stanley
- Lisa Stanley is a project director for the Transforming Early Childhood Community Systems at the Center for Healthier Children, Families, and Communities at UCLA
| | - Emily Hotez
- Emily Hotez is a project scientist at the Center for Healthier Children, Families, and Communities at UCLA
| | - Eryn Block
- Eryn Block is a maternal and child health research fellow in the Department of Health Policy and Management at the Fielding School of Public Health at UCLA
| | - Magdalena Janus
- Magdalena Janus is a professor of psychiatry and behavioural neurosciences at McMaster University, in Hamilton, Ontario, Canada
| |
Collapse
|
9
|
Duncan RJ, Duncan GJ, Stanley L, Aguilar E, Halfon N. The Kindergarten Early Development Instrument Predicts Third Grade Academic Proficiency. EARLY CHILDHOOD RESEARCH QUARTERLY 2020; 53:287-300. [PMID: 32699465 PMCID: PMC7375399 DOI: 10.1016/j.ecresq.2020.05.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
School readiness skills predict later educational achievement, health, and social-emotional outcomes. Measures of school readiness can provide valuable information to assess both the impact of strategies and policies that prepare children for school as well as informing strategies for improving children's educational trajectories across their school years. The Early Development Instrument (EDI) is a measure of school readiness skills based on teacher-reported observational recall. It has been used extensively in Canada and Australia and is in the early stages of adoption in a number of U.S. cities. The current study uses data from roughly 3,000 children followed longitudinally from kindergarten through third grade from 7 school districts in Orange County, California. The study assesses whether EDI ratings in kindergarten predict third grade proficiency in mathematics and English Language Arts on state assessments. Ratings on the EDI were strongly associated with proficiency in both academic areas, even in the presence of controls for child-level factors and neighborhood fixed effects. Among its components, ratings on the language and cognitive development, communication skills and general knowledge, and social competence domains strongly differentiated children's likelihood of later proficiency in both academic areas. Implications for improving comprehensive early childhood education and schooling policies based on indicators of school readiness are discussed.
Collapse
|
10
|
Georg S, Bosle C, Fischer JE, De Bock F. Psychometric properties and contextual appropriateness of the German version of the Early Development Instrument. BMC Pediatr 2020; 20:339. [PMID: 32646399 PMCID: PMC7346437 DOI: 10.1186/s12887-020-02191-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 06/02/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Assessing the early development of children at a population level in educational settings, may be useful for public health and policy decision making. In this study, we evaluated the psychometric properties and the contextual appropriateness of a German language version of the Early Development Instrument (EDI), a survey-based instrument originally developed in Canada, which assesses developmental vulnerability for children in preschool settings. METHODS Sixty preschool teachers from six preschool organizations (22% of organizations contacted) in three cities in southwest Germany participated. They administered a German version of the EDI (GEDI) to 225 children (51% of eligible children). We assessed internal consistency, test-retest and interrater reliability. Preschool teachers assisted in determining face-validity by reviewing item coverage and comprehensibility. Exploratory factor analysis (EFA) was used to evaluate convergent validity. Concurrent validity was measured using correlations and agreements (Bland-Altman plots) between GEDI and other validated instrument scores. Additionally, we compared associations between GEDI domain scores and sociodemographic characteristics with similar associations in EDI studies worldwide. RESULTS GEDI domains showed good to excellent internal consistency (0.73 < α > 0.99) and moderate to good test-retest and interrater reliability (0.50 to 0.81 and 0.48 to 0.71, respectively [p-value < 0.05]). Face validity was considered acceptable. EFA showed a factor structure similar to the original EDI. Correlations (range: 0.32 to 0.67) and agreements between GEDI scores and other German language instruments suggested good external reliability. Scoring within the lowest 10th percentile was strongly associated with age. CONCLUSIONS Our psychometric assessment suggests good reliability and consistency of the GEDI. Differences in the age distribution of children, pedagogical objectives and educational system features of German preschools require future work to determine score thresholds indicative of vulnerability. Aside from dropping selected items from the original EDI that were inconsistent with features of the German educational system, the distribution of values in the language and cognitive development domain also suggested that context-specific cut-offs must be established for the German version. Such efforts are needed to account for relevant contextual differences between the educational systems.
Collapse
Affiliation(s)
- Sabine Georg
- Mannheim Institute of Public Health, Social and Preventive Medicin, Medical Faculty Mannheim of the Ruprecht-Karls-University Heidelberg, Ludolf-Krehl-Straße 7-11, 68167 Mannheim, Germany
| | - Catherin Bosle
- Mannheim Institute of Public Health, Social and Preventive Medicin, Medical Faculty Mannheim of the Ruprecht-Karls-University Heidelberg, Ludolf-Krehl-Straße 7-11, 68167 Mannheim, Germany
| | - Joachim E. Fischer
- Mannheim Institute of Public Health, Social and Preventive Medicin, Medical Faculty Mannheim of the Ruprecht-Karls-University Heidelberg, Ludolf-Krehl-Straße 7-11, 68167 Mannheim, Germany
| | - Freia De Bock
- Mannheim Institute of Public Health, Social and Preventive Medicin, Medical Faculty Mannheim of the Ruprecht-Karls-University Heidelberg, Ludolf-Krehl-Straße 7-11, 68167 Mannheim, Germany
- Federal Centre for Health Education, Maarweg 149-161, 50625 Cologne, Germany
| |
Collapse
|
11
|
Delgado DA, Michelon RC, Gerzson LR, Almeida CSD, Alexandre MDG. Avaliação do desenvolvimento motor infantil e sua associação com a vulnerabilidade social. FISIOTERAPIA E PESQUISA 2020. [DOI: 10.1590/1809-2950/18047027012020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO O objetivo deste estudo foi avaliar o desenvolvimento motor de crianças de quatro a 17 meses e investigar sua associação com fatores de risco sociodemográficos. Estudo transversal, descritivo, composto por crianças de quatro a 17 meses provenientes da unidade de internação pediátrica de um hospital público de Porto Alegre (RS), clinicamente estáveis e com alta breve prevista. Para a avaliação dos fatores de risco sociodemográficos foi utilizado um questionário elaborado pelas pesquisadoras, que abordou fatores biológicos, sociais e ambientais. Para a avaliação do desenvolvimento motor foi utilizada a Alberta Infant Motor Scale na versão traduzida, adaptada e validada para a população brasileira. Para a análise estatística foi utilizado o teste t de Student e o teste qui-quadrado, com nível de significância de 5% (p≤0,05). De um total de 110 crianças avaliadas, o desempenho motor se mostrou aquém do esperado em mais da metade delas (63,6%, n=70). Houve associação estatisticamente significativa entre o desenvolvimento motor e vacinas atrasadas (p=0,005), convivência com tabagistas em casa (p=0,047) e recebimento de benefício socioeconômico (p=0,036). Conclui-se que esses fatores sociais podem estar associados a fatores de risco ao desenvolvimento motor de crianças de quatro a 17 meses.
Collapse
|
12
|
Cuomo B, Joosten A, Vaz S. Scoping review on noticing concerns in child development: a missing piece in the early intervention puzzle. Disabil Rehabil 2019; 43:2663-2672. [PMID: 31885294 DOI: 10.1080/09638288.2019.1707296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Between 13 and 32% of children in developed nations are at-risk for developmental delays. In order to identify concerns, there is a need to understand the mechanisms that facilitate becoming aware of it. AIM A scoping review was conducted to understand this process of "noticing", through existing literature on parent experiences. METHODS Records from major academic databases and grey literature sources were searched using key terms. Thematic analysis was then conducted to synthesise findings. RESULTS Twenty papers meeting inclusion were identified. Noticing a delay was found to be an interplay between who notices - parents or other - and how they do so. How concerns are noticed was through two mechanisms: knowledge of child development, and comparison with other children. CONCLUSIONS This review highlights the nuanced complexity of noticing concerns with a child's development. Understanding how this process occurs and the key ingredients that enable it is vital to supporting early detection of developmental delays.Implications for rehabilitationNoticing developmental delays is a complex process that evolves over time, derived of 'who' notices and 'how' this occurs.When asking parents about child development, professionals need to listen for both bolder "aha moments" as well as more subtle "niggling" comments as indicators of parental concerns.Building baseline parental knowledge of developmental milestones may facilitate noticing of atypical development.Encouraging parents to engage in social opportunities with other children promotes both positive child development and enables developmental monitoring through use of comparison.
Collapse
Affiliation(s)
- Belinda Cuomo
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia.,CoLab (the Minderoo Foundation), Telethon Kids Institute, Perth, Western Australia, Australia
| | - Annette Joosten
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia.,School of Allied Health, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Sharmila Vaz
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| |
Collapse
|
13
|
Birken CS, Omand JA, Nurse KM, Borkhoff CM, Koroshegyi C, Lebovic G, Maguire JL, Mamdani M, Parkin PC, Randall Simpson J, Tremblay MS, Duku E, Reid-Westoby C, Janus M. Fit for School Study protocol: early child growth, health behaviours, nutrition, cardiometabolic risk and developmental determinants of a child's school readiness, a prospective cohort. BMJ Open 2019; 9:e030709. [PMID: 31748293 PMCID: PMC6886995 DOI: 10.1136/bmjopen-2019-030709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION School readiness is a multidimensional construct that includes cognitive, behavioural and emotional aspects of a child's development. School readiness is strongly associated with a child's future school success and well-being. The Early Development Instrument (EDI) is a reliable and valid teacher-completed tool for assessing school readiness in children at kindergarten age. A substantial knowledge gap exists in understanding how early child growth, health behaviours, nutrition, cardiometabolic risk and development impact school readiness. The primary objective was to determine if growth patterns, measured by body mass index trajectories in healthy children aged 0-5 years, are associated with school readiness at ages 4-6 years (kindergarten age). Secondary objectives were to determine if other health trajectories, including health behaviours, nutrition, cardiometabolic risk and development, are associated with school readiness at ages 4-6 years. This paper presents the Fit for School Study protocol. METHODS AND ANALYSIS This is an ongoing prospective cohort study. Parents of children enrolled in the The Applied Health Research Group for Kids (TARGet Kids!) practice-based research network are invited to participate in the Fit for School Study. Child growth, health behaviours, nutrition, cardiometabolic risk and development data are collected annually at health supervision visits and linked to EDI data collected by schools. The primary and secondary analyses will use a two-stage process: (1) latent class growth models will be used to first determine trajectory groups, and (2) generalised linear mixed models will be used to examine the relationship between exposures and EDI results. ETHICS AND DISSEMINATION The research ethics boards at The Hospital for Sick Children, Unity Health Toronto and McMaster University approved this study, and research ethics approval was obtained from each school board with a student participating in the study. The findings will be presented locally, nationally and internationally and will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT01869530.
Collapse
Affiliation(s)
- Catherine S Birken
- Division of Paediatric Medicine and the Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Nutritional Sciences, Faculty of Medicine, Universtiy of Toronto, Toronto, Ontario, Canada
| | - Jessica A Omand
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Kim M Nurse
- Division of Paediatric Medicine and the Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada
| | - Cornelia M Borkhoff
- Division of Paediatric Medicine and the Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Christine Koroshegyi
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Gerald Lebovic
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- The HUB Health Research Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Jonathon L Maguire
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Nutritional Sciences, Faculty of Medicine, Universtiy of Toronto, Toronto, Ontario, Canada
- The HUB Health Research Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Department of Paediatrics, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Muhammad Mamdani
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- The HUB Health Research Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Department of Paediatrics, St. Michael's Hospital, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Patricia C Parkin
- Division of Paediatric Medicine and the Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Janis Randall Simpson
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research, Children's Hospital of Eastern Ontario Research Institute, Healthy Active Living and Obesity Research, Ottawa, Ontario, Canada
- Department of Paediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Eric Duku
- The Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Caroline Reid-Westoby
- The Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Magdalena Janus
- The Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
14
|
Dea C, Gauvin L, Fournier M, Goldfeld S. Does Place Matter? An International Comparison of Early Childhood Development Outcomes between the Metropolitan Areas of Melbourne, Australia and Montreal, Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16162915. [PMID: 31416243 PMCID: PMC6720425 DOI: 10.3390/ijerph16162915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 07/24/2019] [Accepted: 07/28/2019] [Indexed: 11/17/2022]
Abstract
There is strong consensus about the importance of early childhood development (ECD) for improving population health and closing the health inequity gap. Environmental features and public policies across sectors and jurisdictions are known to influence ECD. International comparisons provide valuable opportunities to better understand the impact of these ecological determinants on ECD. This study compared ECD outcomes between metropolitan Melbourne (Australia) and Montreal (Canada), and contrasted disparities across demographic and socioeconomic characteristics. Methods: Population wide surveys using the Early Development Instrument (EDI) were conducted among 4–6 years-old children in both Montreal and Melbourne in 2012, measuring five domains of ECD: 1-Physical Health/Well-Being (PHYS); 2-Social Competence (SOC); 3-Emotional Maturity (EMOT); 4-Language/Cognitive Development (COGN); and 5-Communication Skills/General Knowledge (COMM). Descriptive analyses of summary EDI indicators and domain indicators (including median scores and interquartile ranges) were compared between metropolitan areas, using their respective 95% confident intervals (CIs). Analyses were performed using Stata software (v14). Results: The proportion of children developmentally vulnerable in at least one domain of ECD was 26.8% (95% CIs: 26.2, 27.3) in Montreal vs. 19.2% (95% CIs: 18.8, 19.5) in Melbourne. The Melbourne advantage was greatest for EMOT and COGN (11.5% vs. 6.9%; 13.0% vs. 5.8%). In both Montreal and Melbourne, boys, immigrants, children not speaking the language of the majority at home, and those living in the most deprived areas were at greater risk of being developmentally vulnerable. Relative risks as a function of home language and area-level deprivation subgroups were smaller in Montreal than in Melbourne. Conclusion: This study shows that Melbourne’s children globally experience better ECD outcomes than Montreal’s children, but that inequity gaps are greater in Melbourne for language and area-level deprivation subgroups. Further research is warranted to identify the environmental factors, policies, and programs that account for these observed differences.
Collapse
Affiliation(s)
- Catherine Dea
- Department of Social & Preventive Medicine, École de santé publique, Université de Montréal, Montréal, QC H3N 1X9, Canada
- Direction Régionale de Santé Publique, Centre Intégré Universitaire de Santé et Services Sociaux du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC H2L 1M3, Canada
| | - Lise Gauvin
- Department of Social & Preventive Medicine, École de santé publique, Université de Montréal, Montréal, QC H3N 1X9, Canada
- Health Innovation and Evaluation Hub, Centre de recherche du CHUM, Montréal, QC H2X 0A9, Canada
| | - Michel Fournier
- Direction Régionale de Santé Publique, Centre Intégré Universitaire de Santé et Services Sociaux du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC H2L 1M3, Canada
| | - Sharon Goldfeld
- Centre for Community Child Health, Murdoch Children's Research Institute, & Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne VIC 3052, Australia.
| |
Collapse
|
15
|
Rossen L, Tzoumakis S, Kariuki M, Laurens KR, Butler M, Chilvers M, Harris F, Carr VJ, Green MJ. Timing of the first report and highest level of child protection response in association with early developmental vulnerabilities in an Australian population cohort. CHILD ABUSE & NEGLECT 2019; 93:1-12. [PMID: 31026680 DOI: 10.1016/j.chiabu.2019.04.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/16/2019] [Accepted: 04/08/2019] [Indexed: 05/24/2023]
Abstract
BACKGROUND Childhood maltreatment is associated with early childhood developmental vulnerabilities. However, the extent to which higher levels of child protection responses confer benefit to developmental competencies, and the impact of earlier timing of first reports in relation to early childhood vulnerability remains unclear. OBJECTIVE We examined associations between early developmental vulnerabilities and (1) the highest level of child protection response (where OOHC was deemed the highest response among other types of reports/responses), and (2) the developmental timing of the first child protection report. PARTICIPANTS AND SETTING Participants included 67,027 children from the New South Wales Child Development Study, of whom 10,944 were reported to child protection services up to age 5 years. METHODS A series of Multinomial Logistic Regressions were conducted to examine focal associations. RESULTS Children with substantiated maltreatment reports showed the strongest odds of vulnerability on three or more developmental domains (adjusted OR = 4.90; 95% CI = 4.13-5.80); children placed in OOHC showed slightly better physical, cognitive and communication competencies (adjusted ORs from 1.83 to 2.65) than those with substantiated reports that did not result in OOHC placements (adjusted OR from 2.77 to 3.67), when each group was compared to children with no child protection reports. Children with first maltreatment reports occurring in the first 18 months of life showed the strongest likelihood of developmental vulnerabilities on three or more developmental domains (adjusted OR = 3.56; 95% CI = 3.15-4.01) relative to children with no child protection reports. CONCLUSION Earlier reports of maltreatment may signal the need for targeted remediation of early developmental competencies to mitigate early developmental difficulties.
Collapse
Affiliation(s)
- Larissa Rossen
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Stacy Tzoumakis
- School of Social Sciences, University of New South Wales, Sydney, Australia
| | - Maina Kariuki
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Kristin R Laurens
- School of Psychiatry, University of New South Wales, Sydney, Australia; School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | - Merran Butler
- NSW Department of Family and Community Services, NSW, Australia
| | | | - Felicity Harris
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Vaughan J Carr
- School of Psychiatry, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia; Department of Psychiatry, Monash University, Melbourne, Australia
| | - Melissa J Green
- School of Psychiatry, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia.
| |
Collapse
|
16
|
Bentley JP, Roberts CL, Bowen JR, Martin AJ, Morris JM, Nassar N. Planned Birth Before 39 Weeks and Child Development: A Population-Based Study. Pediatrics 2016; 138:peds.2016-2002. [PMID: 27940704 DOI: 10.1542/peds.2016-2002] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/20/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To investigate the association of gestational age and mode of birth with early child development. METHODS Population-based record linkage cohort study was conducted among 153 730 live-born infants of ≥32 weeks' gestation with developmental assessments at school age, in New South Wales, Australia, 2002 to 2007. Children were assessed in 5 domains: physical health and well-being, language and cognition, social competence, emotional maturity, and general knowledge and communication. Children scoring in the bottom 10% of national domains were considered developmentally vulnerable, and children developmentally vulnerable for ≥2 domains were classified as developmentally high risk (DHR), the primary outcome. Robust multivariable Poisson models were used to obtain individual and combined adjusted relative risks (aRRs) of gestational age and mode of birth for DHR children. RESULTS Overall, 9.6% of children were DHR. The aRR (95% confidence interval) of being DHR increased with decreasing gestational age (referent: 40 weeks); 32 to 33 weeks 1.25 (1.08-1.44), 34 to 36 weeks 1.26 (1.18-1.34), 37 weeks 1.17 (1.10-1.25), 38 weeks 1.06 (1.01-1.10), 39 weeks 0.98 (0.94-1.02), ≥41 weeks 0.99 (0.94-1.03), and for labor induction or prelabor cesarean delivery (planned birth; referent: vaginal birth after spontaneous labor), 1.07 (1.04-1.11). The combined aRR for planned birth was 1.26 (1.18-1.34) at 37 weeks and 1.13 (1.08-1.19) at 38 weeks. CONCLUSIONS Early (at <39 weeks) planned birth is associated with an elevated risk of poor child development at school age. The timing of planned birth is modifiable, and strategies to inform more judicious decision-making are needed to ensure optimal child health and development.
Collapse
Affiliation(s)
- Jason P Bentley
- Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, New South Wales, Australia; .,Sydney Medical School Northern and.,Menzies Centre for Health Policy, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Christine L Roberts
- Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, New South Wales, Australia.,Sydney Medical School Northern and
| | - Jenny R Bowen
- Department of Neonatology, Royal North Shore Hospital, St Leonards, New South Wales, Australia; and
| | - Andrew J Martin
- School of Education, The University of New South Wales, Sydney, New South Wales, Australia
| | - Jonathan M Morris
- Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, New South Wales, Australia.,Sydney Medical School Northern and
| | - Natasha Nassar
- Menzies Centre for Health Policy, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
17
|
Curtin M, Browne J, Staines A, Perry IJ. The Early Development Instrument: an evaluation of its five domains using Rasch analysis. BMC Pediatr 2016; 16:10. [PMID: 26792078 PMCID: PMC4721060 DOI: 10.1186/s12887-016-0543-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 01/08/2016] [Indexed: 01/12/2023] Open
Abstract
Background Early childhood development is a multifaceted construct encompassing physical, social, emotional and intellectual competencies. The Early Development Instrument (EDI) is a population-level measure of five domains of early childhood development on which extensive psychometric testing has been conducted using traditional methods. This study builds on previous psychometric analysis by providing the first large-scale Rasch analysis of the EDI. The aim of the study was to perform a definitive analysis of the psychometric properties of the EDI domains within the Rasch paradigm. Methods Data from a large EDI study conducted in a major Irish urban centre were used for the analysis. The unidimensional Rasch model was used to examine whether the EDI scales met the measurement requirement of invariance, allowing responses to be summated across items. Differential item functioning for gender was also analysed. Results Data were available for 1344 children. All scales apart from the Physical Health and Well-Being scale reliably discriminated between children of different levels of ability. However, all the scales also had some misfitting items and problems with measuring higher levels of ability. Differential item functioning for gender was particularly evident in the emotional maturity scale with almost one-third of items (9 out of 30) on this scale biased in favour of girls. Conclusion The study points to a number of areas where the EDI could be improved.
Collapse
Affiliation(s)
- Margaret Curtin
- Department of Epidemiology and Public Health, University College Cork, Floor 4, Western Gateway Building, Cork, Ireland.
| | - John Browne
- Department of Epidemiology and Public Health, University College Cork, Floor 4, Western Gateway Building, Cork, Ireland
| | - Anthony Staines
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Ivan J Perry
- Department of Epidemiology and Public Health, University College Cork, Floor 4, Western Gateway Building, Cork, Ireland
| |
Collapse
|
18
|
Duc NHC. Developmental risk factors in Vietnamese preschool-age children: Cross-sectional survey. Pediatr Int 2016; 58:14-21. [PMID: 26189718 DOI: 10.1111/ped.12748] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 01/09/2015] [Accepted: 06/15/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Early childhood development (ECD) strongly influences children's basic learning, school success, economic participation, social citizenry and health. Although some risk factors related to childhood development are documented, further exploration is necessary considering various sociodemographic, nutritional, and psychosocial factors. This study investigated factors affecting ECD in Vietnamese preschoolers. METHODS We used data from the representative, cross-sectional round of the Vietnam Multiple Indicator Clusters Survey 2011. Early Childhood Development Index questionnaires were administered to mothers of all children aged 36-59 months in the household (n = 1459). Descriptive statistics and multivariate logistic regression were used in the analysis. RESULTS In Vietnam, 17.2% of children did not reach their full developmental potential within the first 5 years. Children who had been breast-fed (AOR, 2.78; 95%CI: 1.28-6.02), attended preschool (AOR, 1.75; 95%CI: 1.28-2.39), were of major ethnicity (AOR, 2.41; 95%CI: 1.55-3.74), had a mother with secondary or higher education (AOR, 1.69; 95%CI: 1.19-2.38) and had relatives who engaged with them in four or more activities that promote learning (AOR, 1.55; 95%CI: 1.13-2.14) were more likely to have a normal developmental trajectory. Furthermore, children who experienced physical punishment and stunting were 0.69-fold (95%CI: 0.51-0.95) and 0.71-fold (95%CI: 0.51-0.98) less likely to be on track for ECD, respectively. CONCLUSIONS The risk factors associated with delayed ECD were low level of maternal education; family ethnicity; lack of preschool attendance; relatives who did not engage with them in learning; physical punishment; not being breast-fed; and stunting.
Collapse
Affiliation(s)
- Nguyen Huu Chau Duc
- Department of International Health and Medicine, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan.,Department of Pediatrics, Hue University of Medicine and Pharmacy, Vietnam
| |
Collapse
|
19
|
Curtin M, Baker D, Staines A, Perry IJ. Are the special educational needs of children in their first year in primary school in Ireland being identified: a cross-sectional study. BMC Pediatr 2014; 14:52. [PMID: 24552187 PMCID: PMC3936996 DOI: 10.1186/1471-2431-14-52] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 02/13/2014] [Indexed: 11/10/2022] Open
Abstract
Background If the window of opportunity presented by the early years is missed, it becomes increasingly difficult to create a successful life-course. A biopsychosocial model of special educational need with an emphasis on participation and functioning moves the frame of reference from the clinic to the school and the focus from specific conditions to creating supportive environments cognisant of the needs of all children. However, evidence suggests that an emphasis on diagnosed conditions persists and that the needs of children who do not meet these criteria are not identified. The Early Development Instrument (EDI) is a well-validated, teacher-completed population-level measure of five domains of child development. It is uniquely placed, at the interface between health and education, to explore the developmental status of children with additional challenges within a typically developing population. The aim of this study was to examine the extent to which the special educational needs of children in their first year of formal education have been identified. Methods This cross-sectional study was conducted in Ireland in 2011. EDI (teacher completed) scores were calculated for 1344 children. Data were also collected on special needs and on children identified by the teacher as needing assessment. Mean developmental scores were compared using one-way ANOVA. Results Eighty-three children in the sample population (6.2%) had identified special educational needs. A further 132 children were judged by the teacher as needing assessment. Children with special needs had lower mean scores than typically developing children, in all five developmental domains. Children considered by the teacher as needing assessment also had lower scores, which were not significantly different from those of children with special needs. Speech, emotional or behavioural difficulties were the most commonly reported problems among children needing further assessment. There was also a social gradient among this group. Conclusions A small but significant number of children have not had their needs adequately assessed. Teacher observation is an effective means of identifying children with a level of impairment which prevents them from fully participating in their educational environment and could be integrated into a multi-disciplinary approach to meeting the needs of all children.
Collapse
Affiliation(s)
- Margaret Curtin
- Department of Epidemiology and Public Health, University College Cork, Floor 4, Western Gateway Building, Cork, Ireland.
| | | | | | | |
Collapse
|