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Schlichting LE, Vivier PM, Berger B, Parrillo D, Sheldrick RC. From Descriptive to Predictive: Linking Early Childhood Developmental and Behavioral Screening Results With Educational Outcomes in Kindergarten. Acad Pediatr 2022; 23:616-622. [PMID: 35940569 DOI: 10.1016/j.acap.2022.07.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/28/2022] [Accepted: 07/31/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the predictive value of a pediatric screening tool by linking 2 independent databases: an educational database that includes data from standardized academic assessments administered during kindergarten and a pediatric database that includes screening results. METHODS A database that includes results of the Survey of Well-being of Young Children (SWYC) completed during pediatric visits were linked to an educational database that includes STAR Early Literacy examinations in kindergarten. Linear multilevel regression modeling was used to examine if screening results on the developmental and behavioral sections of the most recently completed SWYC form predicted trends in the percentile rank on the STAR exam over the school year, adjusting for potential confounders. RESULTS Linking the 2 databases resulted in a sample of 586 children who were administered at least one SWYC evaluation between 24 and 48 months and completed at least one STAR Early Literacy examination in kindergarten. The sample represents a diverse population with 55% Hispanic children, 25% Non-Hispanic black children, and 91% of children receiving a subsidized lunch. After adjusting for confounders, children with a positive developmental or behavioral screen had significantly lower percentile ranks on the STAR exam. CONCLUSIONS Early developmental and behavioral screening results predicted performance on the STAR exam in kindergarten. Children with developmental and behavioral concerns may be less ready to enter kindergarten than peers without such concerns. These preliminary findings provide proof-of-principle of the potential utility of developmental screening tools in identifying children with reduced school readiness who may benefit from intervention prior to kindergarten.
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Affiliation(s)
- Lauren E Schlichting
- Hassenfeld Child Health Innovation Institute (LE Schlichting and PM Vivier), Brown University, Providence, RI.
| | - Patrick M Vivier
- Hassenfeld Child Health Innovation Institute (LE Schlichting and PM Vivier), Brown University, Providence, RI
| | - Blythe Berger
- Rhode Island Department of Health (B Berger), Providence, RI
| | | | - R Christopher Sheldrick
- Department of Health Law, Policy, and Management (RC Sheldrick), School of Public Health, Boston University, Boston, Mass
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Perazzo D, Moore R, Kasparian NA, Rodts M, Horowitz-Kraus T, Crosby L, Turpin B, Beck AF, Hutton J. Chronic pediatric diseases and risk for reading difficulties: a narrative review with recommendations. Pediatr Res 2022; 92:966-978. [PMID: 35121848 PMCID: PMC9586865 DOI: 10.1038/s41390-022-01934-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 11/02/2021] [Accepted: 12/13/2021] [Indexed: 12/03/2022]
Abstract
Literacy is a major social determinant of health, rooted in skills that develop during early childhood. Children arriving at kindergarten unprepared to learn to read are more likely to have low reading proficiency thereafter. General and health literacy are highly correlated, affecting understanding of health conditions, treatment adherence, and transition to self-care and adult healthcare services. The American Academy of Pediatrics (AAP) recommends literacy and school readiness promotion during well-visits and neurodevelopmental surveillance is emphasized across primary and subspecialty care. While genetic and environmental risk factors for reading difficulties are well-established, risks related to complex and chronic medical conditions are less appreciated and under-researched. This review applies an eco-bio-developmental framework to explore literacy across five complex chronic conditions affecting millions of children worldwide: asthma, cancer, congenital heart disease, epilepsy, and sickle cell disease. In each, integration of an efficient reading brain network may be impacted by direct factors, such as ischemia, anesthesia, and/or medications, and also indirect factors, such as altered parent-child routines, hospital stays, and missed school. By integrating literacy into care management plans for affected children, pediatric primary care and specialty providers are poised to identify risks early, target guidance and interventions, and improve academic and health outcomes. IMPACT: While genetic and environmental risk factors for reading difficulties are well-established, risks related to complex and/or chronic medical conditions such as asthma, cancer, congenital heart disease, epilepsy, and sickle cell disease are substantial, less appreciated, and under-researched. General and health literacy are highly correlated, with implications for the understanding one's health condition, treatment adherence, and transitioning to self-care, which is especially important for children with complex and/or chronic illness. Pediatric primary care and specialty providers are poised to integrate reading and literacy into care management plans for children with complex and/or chronic illness, including early screening, guidance, support, and interventions.
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Affiliation(s)
- Donna Perazzo
- grid.24827.3b0000 0001 2179 9593Reading and Literacy Discovery Center, Cincinnati Children’s Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Ryan Moore
- grid.24827.3b0000 0001 2179 9593The Heart Institute, Cincinnati Children’s Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Nadine A. Kasparian
- grid.24827.3b0000 0001 2179 9593The Heart Institute, Cincinnati Children’s Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH USA ,grid.24827.3b0000 0001 2179 9593Center for Heart Disease and Mental Health, Heart Institute and Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Megan Rodts
- grid.24827.3b0000 0001 2179 9593The Heart Institute, Cincinnati Children’s Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Tzipi Horowitz-Kraus
- grid.24827.3b0000 0001 2179 9593Reading and Literacy Discovery Center, Cincinnati Children’s Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH USA ,grid.24827.3b0000 0001 2179 9593Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH USA ,grid.6451.60000000121102151Educational Neuroimaging Center, Faculty of Education in Science and Technology and Faculty of Biomedical Engineering, Technion, Haifa, Israel
| | - Lori Crosby
- grid.24827.3b0000 0001 2179 9593Center for Clinical and Translational Science and Training and Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Brian Turpin
- grid.24827.3b0000 0001 2179 9593Division of Oncology, Cincinnati Children’s Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Andrew F. Beck
- grid.24827.3b0000 0001 2179 9593Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH USA ,grid.24827.3b0000 0001 2179 9593Division of Hospital Medicine, Cincinnati Children’s Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - John Hutton
- Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA. .,Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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Pereira Sapage S, Cruz-Santos A. Portuguese Early Literacy Screening Tool- RaLEPE: Pilot Study. REVISTA DE INVESTIGACIÓN EN LOGOPEDIA 2021. [DOI: 10.5209/rlog.71711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Early literacy development is an indicator of a child’s overall cognitive-linguistic development and affects their academic, social, emotional and behavioural skills. Research suggests that early detection in preschool years can have an important role in the prevention of academic failure. There is a lack of early literacy screening tools for Portuguese preschool children. This study aims to present preliminary data results of the development and validation of the Preschool Early Literacy Screening Tool (Rastreio de Literacia Emergente Pré-escolar- RaLEPE). A pilot study was carried out with a sample of 128 screenings, answered by the parents/caregivers of the Portuguese children in the target age groups. The analysis of results shown the reliability of the tool, with a very good internal consistency for RaLEPE total scale and the different sections. Therefore, preliminary results of this study indicate internal validity of the RaLEPE and confirm this as screening tool usefulness for early intervention childhood, to provide early diagnosis and contribute to early intervention for children with language and learning disorders.
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Sousa AFD, Claro MDL, Rondó PHC. SCREENING FOR NEUROPSYCHOMOTOR AND SOCIAL-EMOTIONAL DEVELOPMENT IN CHILDREN UNDER 24 MONTHS OF AGE IN THE BRAZILIAN SEMI-ARID REGION. ACTA ACUST UNITED AC 2021; 40:e2020172. [PMID: 34076203 PMCID: PMC8240621 DOI: 10.1590/1984-0462/2022/40/2020172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 09/20/2020] [Indexed: 11/22/2022]
Abstract
Objective: To screen children under 24 months of age for neuropsychomotor and social-emotional development in a municipality of the Brazilian semi-arid region, using the Survey of Well-Being of Young Children (SWYC) scale. Methods: This is a quantitative cross-sectional study with a non-probabilistic sample, involving children aged 1 to 24 months and their respective mothers, recruited from primary care services in the municipality of Picos, Piauí, Northeastern Brazil. The screening for neuropsychomotor and social-emotional development using the SWYC scale also provided information about the family context. In addition, we administered a questionnaire to assess the children’s demographic and socioeconomic factors. Descriptive data analysis was performed. Results: The sample consisted mostly of adult mothers (84.0%), with more than 8 years of schooling (83.3%), belonging to the C, D, and E socioeconomic classes (75.3%). The prevalence of suspected cases of delayed neuropsychomotor development and social-emotional changes was 12.7 and 42.2%, respectively. Conclusions: The results point to the existence of children at risk of delayed development, particularly in the social-emotional domain, reaffirming the need to adopt child development screening as a health service routine, with the implementation of appropriate intervention programs.
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Affiliation(s)
| | - Maísa de Lima Claro
- Universidade Federal do Piauí, Campus Senador Helvídio Nunes de Barros, Picos, PI, Brazil
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Henrikson NB, Blasi PR, Dorsey CN, Mettert KD, Nguyen MB, Walsh-Bailey C, Macuiba J, Gottlieb LM, Lewis CC. Psychometric and Pragmatic Properties of Social Risk Screening Tools: A Systematic Review. Am J Prev Med 2019; 57:S13-S24. [PMID: 31753276 DOI: 10.1016/j.amepre.2019.07.012] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 07/24/2019] [Accepted: 07/25/2019] [Indexed: 01/15/2023]
Abstract
CONTEXT Health systems increasingly are exploring implementation of standardized social risk assessments. Implementation requires screening tools both with evidence of validity and reliability (psychometric properties) and that are low cost, easy to administer, readable, and brief (pragmatic properties). These properties for social risk assessment tools are not well understood and could help guide selection of assessment tools and future research. EVIDENCE ACQUISITION The systematic review was conducted during 2018 and included literature from PubMed and CINAHL published between 2000 and May 18, 2018. Included studies were based in the U.S., included tools that addressed at least 2 social risk factors (economic stability, education, social and community context, healthcare access, neighborhood and physical environment, or food), and were administered in a clinical setting. Manual literature searching was used to identify empirical uses of included screening tools. Data on psychometric and pragmatic properties of each tool were abstracted. EVIDENCE SYNTHESIS Review of 6,838 unique citations yielded 21 unique screening tools and 60 articles demonstrating empirical uses of the included screening tools. Data on psychometric properties were sparse, and few tools reported use of gold standard measurement development methods. Review of pragmatic properties indicated that tools were generally low cost, written for low-literacy populations, and easy to administer. CONCLUSIONS Multiple low-cost, low literacy tools are available for social risk screening in clinical settings, but psychometric data are very limited. More research is needed on clinic-based screening tool reliability and validity as these factors should influence both adoption and utility. SUPPLEMENT INFORMATION This article is part of a supplement entitled Identifying and Intervening on Social Needs in Clinical Settings: Evidence and Evidence Gaps, which is sponsored by the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services, Kaiser Permanente, and the Robert Wood Johnson Foundation.
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Affiliation(s)
- Nora B Henrikson
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington; School of Public Health, University of Washington, Seattle, Washington.
| | - Paula R Blasi
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Caitlin N Dorsey
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Kayne D Mettert
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Matthew B Nguyen
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | | | - Jennifer Macuiba
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Laura M Gottlieb
- School of Medicine, University of California-San Francisco, San Francisco, California
| | - Cara C Lewis
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
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Hutton JS, Justice L, Huang G, Kerr A, DeWitt T, Ittenbach RF. The Reading House: A Children's Book for Emergent Literacy Screening During Well-Child Visits. Pediatrics 2019; 143:peds.2018-3843. [PMID: 31147486 DOI: 10.1542/peds.2018-3843] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/26/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The American Academy of Pediatrics recommends literacy promotion and developmental assessment during well-child visits. Emergent literacy skills are well defined, and the use of early screening has the potential to identify children at risk for reading difficulties and guide intervention before kindergarten. METHODS The Reading House (TRH) is a children's book designed to screen emergent literacy skills. These are assessed by sharing the book with the child and using a 9-item, scripted scoring form. Get Ready to Read! (GRTR) is a validated measure shown to predict reading outcomes. TRH and GRTR were administered in random order to 278 children (mean: 43.1 ± 5.6 months; 125 boys, 153 girls) during well-child visits at 7 primary care sites. Parent, child, and provider impressions of TRH were also assessed. Analyses included Rasch methods, Spearman-ρ correlations, and logistic regression, including covariates age, sex, and clinic type. RESULTS Psychometric properties were strong, including item difficulty and reliability. Internal consistency was good for new measures (rCo- α = 0.68). The mean TRH score was 4.2 (±2.9; range: 0-14), and mean GRTR was 11.1 (±4.4; range: 1-25). TRH scores were positively correlated with GRTR scores (r s = 0.66; high), female sex, private practice, and child age (P < .001). The relationship remained significant controlling for these covariates (P < .05). The mean TRH administration time was 5:25 minutes (±0:55; range: 3:34-8:32). Parent, child, and provider impressions of TRH were favorable. CONCLUSIONS TRH is a feasible, valid, and enjoyable means by which emergent literacy skills in 3- and 4-year-old children can be directly assessed during primary care.
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Affiliation(s)
- John S Hutton
- Divisions of General and Community Pediatrics and .,Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center and College of Medicine, University of Cincinnati, Cincinnati, Ohio; and
| | - Laura Justice
- Schoenbaum Family Center and Crane Center for Early Childhood Research and Policy, The Ohio State University, Columbus, Ohio
| | | | - Amy Kerr
- Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center and College of Medicine, University of Cincinnati, Cincinnati, Ohio; and
| | - Thomas DeWitt
- Divisions of General and Community Pediatrics and.,Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center and College of Medicine, University of Cincinnati, Cincinnati, Ohio; and
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Iyer S, Do D, Akshoomoff N, Malcarne VL, Hattrup K, Berger SP, Gahagan S, Needlman R. Development of a Brief Screening Tool for Early Literacy Skills in Preschool Children. Acad Pediatr 2019; 19:464-470. [PMID: 30453093 DOI: 10.1016/j.acap.2018.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 11/09/2018] [Accepted: 11/12/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Preschool children develop early literacy skills (ELS) needed for reading acquisition. Screening for delayed ELS could trigger interventions to prevent reading problems. OBJECTIVE To develop a brief screening test for ELS delays, the Early Literacy Skills Assessment Tool (ELSAT). METHODS This study included 4-year-old, typically developing, English language-predominant children attending preschool. The ELSAT comprised 63 items relating to 3 main ELS domains and was piloted with 21 children. After we excluded items that were nondiscriminatory, 57 items remained and were administered to 96 children. Items were compared with reference measures of ELS (Get Ready to Read-Revised), and language (Peabody Picture Vocabulary Test-4 and Phonological Awareness from the Comprehensive Test of Phonological Processing-2). Within-domain reliability was calculated for each of the 3 ELS domains and item correlations between all ELSAT items and the reference measures were calculated. RESULTS A final set of 10 items was retained that represented all 3 ELS domains and that maximized correlations with reference measures. Cronbach alpha for the refined 10-item ELSAT was 0.868; correlations between individual items and a composite of the reference measures ranged from 0.409 to 0.617 (all Ps < .01). In a receiver operating characteristic curve analysis, a cut-off score of ≤5 predicted a below-average score for any of the reference measures with sensitivity of 90%, specificity of 71.4%, and area under the curve of 0.872. CONCLUSIONS The 10-item ELSAT shows strong psychometric properties and with further validation may prove valuable in screening preschool children for ELS delays.
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Affiliation(s)
- Sai Iyer
- Developmental-Behavioral Pediatrics, Department of Pediatrics, University of California (S Iyer), Los Angeles; Department of Pediatrics, Northwestern University Feinberg School of Medicine (SPBerger), Chicago, Ill.
| | - Diana Do
- Graduate School of Public Health, San Diego State University (D Do)
| | - Natacha Akshoomoff
- Department of Psychiatry, University of California, San Diego (N Akshoomoff)
| | - Vanessa L Malcarne
- Department of Psychology, San Diego State University (VL Malcarne and K Hattrup)
| | - Kate Hattrup
- Department of Psychology, San Diego State University (VL Malcarne and K Hattrup)
| | - Susan P Berger
- Department of Pediatrics, University of California, SanDiego (S Iyer and S Gahagan), San Diego, Calif
| | - Sheila Gahagan
- Department of Pediatrics, Northwestern University Feinberg School of Medicine (SPBerger), Chicago, Ill
| | - Robert Needlman
- Department of Pediatrics, MetroHealth Medical Center, CaseWestern Reserve University (R Needlman), Cleveland, Ohio
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