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Barr KR, Hawker P, Winata T, Wang S, Smead M, Ignatius H, Kohlhoff J, Schmied V, Jalaludin B, Lawson K, Liaw ST, Lingam R, Page A, Lam-Cassettari C, Boydell K, Lin PI, Katz I, Dadich A, Raman S, Grace R, Doyle AK, McClean T, Di Mento B, Preddy J, Woolfenden S, Eapen V. Family member and service provider experiences and perspectives of a digital surveillance and service navigation approach in multicultural context: a qualitative study in identifying the barriers and enablers to Watch Me Grow-Electronic (WMG-E) program with a culturally diverse community. BMC Health Serv Res 2024; 24:978. [PMID: 39180037 PMCID: PMC11344394 DOI: 10.1186/s12913-024-11397-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 08/02/2024] [Indexed: 08/26/2024] Open
Abstract
BACKGROUND Children and families from priority populations experienced significant psychosocial and mental health issues to the COVID-19 pandemic. Yet they also faced significant barriers to service access, particularly families from culturally and linguistically diverse (CALD) backgrounds. With most child and family health nurse clinics ceasing in-person consultations due to the pandemic, many children missed out on health and developmental checks. The aim of this study was to investigate the perspectives and experiences of family members and service providers from an urban, CALD community regarding the implementation of a digital, developmental surveillance, Watch Me Grow-Electronic (WMG-E) program. METHODS Semi-structured interviews were conducted with 17 family members, service navigators, and service providers in a multicultural community in South Western Sydney, Australia. This qualitative study is an implementation evaluation which formed as part of a larger, two-site, randomised controlled trial of the WMG-E program. A reflexive thematic analysis approach, using inductive coding, was adopted to analyse the data. RESULTS Participants highlighted the comprehensive and personalised support offered by existing child and family health services. The WMG-E was deemed beneficial because the weblink was easy and quick to use and it enabled access to a service navigator who support family access to relevant services. However, the WMG-E was problematic because of technology or language barriers, and it did not facilitate immediate clinician involvement when families completed the weblink. CONCLUSIONS Families and service providers in this qualitative study found that using WMG-E empowered parents and caregivers to access developmental screening and learn more about their child's development and engage with relevant services. This beds down a new and innovative solution to the current service delivery gap and create mechanisms that can engage families currently not accessing services, and increases knowledge around navigating the health and social care services. Notwithstanding the issues that were raised by families and service providers, which include accessibility challenges for CALD communities, absence of clinical oversight during screening, and narrow scope of engagement with available services being offered, it is worth noting that improvements regarding these implementation factors must be considered and addressed in order to have longevity and sustainability of the program. TRIAL REGISTRATION The study is part of a large randomised controlled trial (Protocol No. 1.0, Version 3.1) was registered with ANZCTR (registration number: ACTRN12621000766819) on July 21st, 2021 and reporting of the trial results will be according to recommendations in the CONSORT Statement.
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Affiliation(s)
- Karlen R Barr
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Liverpool, NSW, Australia
- Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Patrick Hawker
- Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Teresa Winata
- Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
- National Disability Insurance Scheme Quality and Safeguards Commission, Parramatta, NSW, Australia
| | - Si Wang
- Research and Evaluation Group, The Salvation Army, Sydney, NSW, Australia
| | - Melissa Smead
- Murrumbidgee Local Health District, Wagga Wagga, NSW, Australia
| | - Hilda Ignatius
- South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - Jane Kohlhoff
- Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- Karitane, Carramar, NSW, Australia
| | - Virginia Schmied
- School of Nursing and Midwifery, Western Sydney University, Parramatta, NSW, Australia
| | - Bin Jalaludin
- South Western Sydney Local Health District, Liverpool, NSW, Australia
- School of Public Health and Community Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Kenny Lawson
- School of Business, Western Sydney University, Campbelltown, NSW, Australia
| | - Siaw-Teng Liaw
- WHO Collaborating Centre for eHealth, University of New South Wales, Sydney, NSW, Australia
- Population Child Health Research Group, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Raghu Lingam
- Population Child Health Research Group, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Andrew Page
- School of Medicine, Western Sydney University, Parramatta, NSW, Australia
| | - Christa Lam-Cassettari
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Liverpool, NSW, Australia
- Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Katherine Boydell
- Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- Black Dog Institute, Sydney, NSW, Australia
| | - Ping-I Lin
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Liverpool, NSW, Australia
- Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Ilan Katz
- Social Policy Research Centre, Faculty of Arts, Design, and Architecture, University of New South Wales, Sydney, NSW, Australia
| | - Ann Dadich
- School of Business, Western Sydney University, Campbelltown, NSW, Australia
| | - Shanti Raman
- South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - Rebekah Grace
- Transforming Early Education and Child Health Research Centre, Western Sydney University, Campbelltown, NSW, Australia
| | - Aunty Kerrie Doyle
- School of Medicine, Western Sydney University, Parramatta, NSW, Australia
| | | | - Blaise Di Mento
- Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - John Preddy
- Murrumbidgee Local Health District, Wagga Wagga, NSW, Australia
- Rural Clinical School, School of Clinical Medicine, University of New South Wales, Wagga Wagga, NSW, Australia
| | - Susan Woolfenden
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Sydney Local Health District, Sydney, NSW, Australia
| | - Valsamma Eapen
- Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District, Liverpool, NSW, Australia.
- Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.
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Nurse KM, Parkin PC, Keown-Stoneman CDG, Bayoumi I, Birken CS, Maguire JL, Macarthur C, Borkhoff CM. Association Between Family Income and Positive Developmental Screening Using the Infant Toddler Checklist at the 18-Month Health Supervision Visit. J Pediatr 2024; 264:113769. [PMID: 37821023 DOI: 10.1016/j.jpeds.2023.113769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/28/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE To examine the associations between several potential predictors (child biologic, social, and family factors) and a positive screen for developmental delay using the Infant Toddler Checklist (ITC) at the 18-month health supervision visit in primary care. METHODS This was a cross-sectional study of healthy children attending an 18-month health supervision visit in primary care. Parents completed a standardized questionnaire, addressing child, social, and family characteristics, and the ITC. Logistic regression analyses were used to assess the associations between predictors and a positive ITC. RESULTS Among 2188 participants (45.5% female; mean age, 18.2 months), 285 (13%) had a positive ITC and 1903 (87%) had a negative ITC. The aOR for a positive ITC for male compared with female sex was 2.15 (95% CI, 1.63-2.83; P < .001). The aOR for birthweight was 0.65 per 1 kg increase (95% CI, 0.53-0.80; P < .001). The aOR for a family income of <$40,000 compared with ≥$150,000 was 3.50 (95% CI, 2.22-5.53; P < .001), and the aOR for family income between $40,000-$79,999 compared with ≥$150,000 was 1.88 (95% CI, 1.26-2.80; P = .002). CONCLUSIONS Screening positive on the ITC may identify children at risk for the double jeopardy of developmental delay and social disadvantage and allow clinicians to intervene through monitoring, referral, and resource navigation for both child development and social needs. TRIAL REGISTRATION Clinicaltrials.gov (NCT01869530).
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Affiliation(s)
- Kimberly M Nurse
- Division of Pediatric Medicine and the Pediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Patricia C Parkin
- Division of Pediatric Medicine and the Pediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada; Department of Pediatrics, Temetry Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Charles D G Keown-Stoneman
- Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Imaan Bayoumi
- Department of Family Medicine, Queen's University, Kingston, Ontario, Canada
| | - Catherine S Birken
- Division of Pediatric Medicine and the Pediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada; Department of Pediatrics, Temetry Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jonathon L Maguire
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada; Department of Pediatrics, Temetry Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada; Department of Pediatrics, Unity Health Toronto, Toronto, Ontario, Canada; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Colin Macarthur
- Division of Pediatric Medicine and the Pediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada; Department of Pediatrics, Temetry Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Cornelia M Borkhoff
- Division of Pediatric Medicine and the Pediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada
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3
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Lyubasyuk V, Jones KL, Caesar MA, Chambers C. Vision outcomes in children with fetal alcohol spectrum disorders. Birth Defects Res 2023; 115:1208-1215. [PMID: 37461259 PMCID: PMC10862690 DOI: 10.1002/bdr2.2223] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Previous studies demonstrated that children with Fetal Alcohol Spectrum Disorders (FASD) are more likely to have vision impairments. However, existing human clinical and epidemiological investigations are few and include limited sample sizes. This study aimed to explore the association between ophthalmologic abnormalities and FASD in a sample of 5-7 year old children in the general population. METHODS This was a cross-sectional study nested in a larger study intended to estimate the prevalence of FASD in San Diego, California, conducted between 2012 and 2014. Prenatal exposure to alcohol, dysmorphology examinations, and a neurobehavioral testing battery were collected for each child and an FASD diagnosis was assigned. Parents of participating children were asked to release their child's vision screening or diagnostic records. RESULTS Vision records were obtained for 424 participants in the larger prevalence study. Of these, 53 children were classified as having FASD. A statistically significant association was found between FASD and a diagnosis of strabismus; 5/42 (11.9%) of children who were classified as having FASD had strabismus compared to 6/290 (2.1%) of children who were not classified as having FASD (p = .01). All five cases of strabismus in the FASD group occurred in 19 children classified as having partial fetal alcohol syndrome (pFAS). No association was found between FASD and vision impairment (p = .23), refractive errors (p = .66), glasses/contact lens prescription (p = .30), or having one or more ophthalmological abnormalities (p = .97). CONCLUSIONS An association between strabismus and FASD, specifically partial FAS, suggests that the effect of alcohol exposure on risk of strabismus must be severe enough to result in facial features consistent with FASD. This emphasizes the importance of vision screening in children with FASD.
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Affiliation(s)
| | - Kenneth Lyons Jones
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, California, USA
| | - Michelle Ann Caesar
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, California, USA
| | - Christina Chambers
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, California, USA
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
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Parker MG, de Cuba SE, Rateau LJ, Shea M, Sandel MT, Frank DA, Cutts DB, Heeren T, Lê-Scherban F, Black MM, Ochoa ER, Rose-Jacobs R, Garg A. Associations of household unmet basic needs and health outcomes among very low birth weight children. J Perinatol 2023; 43:364-370. [PMID: 36750715 DOI: 10.1038/s41372-023-01626-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 09/15/2022] [Accepted: 01/24/2023] [Indexed: 02/09/2023]
Abstract
OBJECTIVE We examined associations of past year household hardships (housing, energy, food, and healthcare hardships) with postnatal growth, developmental risk, health status, and hospitalization among children 0-36 months born with very low birth weight (VLBW) and the extent that these relationships differed by receipt of child supplemental security income (SSI). STUDY DESIGN We examined cross-sectional data from 695 families. Growth was measured as weight-for-age z-score change. Developmental risk was defined as ≥1 concerns on the "Parents' Evaluation of Developmental Status" screening tool. Child health status was categorized as excellent/good vs. fair/poor. Hospitalizations excluded birth hospitalizations. RESULTS Compared to children with no household hardships, odds of developmental risk were greater with 1 hardship (aOR 2.0 [1.26, 3.17]) and ≥2 hardships (aOR) 1.85 [1.18, 2.91], and odds of fair/poor child health (aOR) 1.59 [1.02, 2.49] and hospitalizations (aOR) 1.49 [1.00, 2.20] were greater among children with ≥2 hardships. In stratified analysis, associations of hardships and developmental risk were present for households with no child SSI and absent for households with child SSI. CONCLUSION Household hardships were associated with developmental risk, fair/poor health status, and hospitalizations among VLBW children. Child SSI may be protective against developmental risk among children living in households with hardships.
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Affiliation(s)
- Margaret G Parker
- Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
| | | | - Lindsey J Rateau
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA, USA
| | - Margaret Shea
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA, USA
| | - Megan T Sandel
- Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Deborah A Frank
- Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Diana B Cutts
- Department of Pediatrics, Hennepin County Medical Center, Minneapolis, MN, USA
| | - Timothy Heeren
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Félice Lê-Scherban
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Maureen M Black
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA.,RTI International, Research Triangel Park, NC, USA
| | - Eduardo R Ochoa
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Ruth Rose-Jacobs
- Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Arvin Garg
- Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA, USA
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Sheel H, Suárez L, Marsh NV. Parents' Evaluation of Developmental Status and Strength and Difficulties Questionnaire as Screening Measures for Children in India: A Scoping Review. Pediatr Rep 2023; 15:175-196. [PMID: 36976721 PMCID: PMC10055800 DOI: 10.3390/pediatric15010014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 03/29/2023] Open
Abstract
Due to the limited availability of suitable measures, screening children for developmental delays and social-emotional learning has long been a challenge in India. This scoping review examined the use of the Parents' Evaluation of Developmental Status (PEDS), PEDS: Developmental Milestones (PEDS:DM), and the Strength and Difficulties Questionnaire (SDQ) with children (<13 years old) in India. The scoping review was conducted following the Joanna Briggs Institute Protocol to identify primary research studies that examined the use of the PEDS, PEDS:DM, and SDQ in India between 1990 and 2020. A total of seven studies for the PEDS and eight studies for the SDQ were identified for inclusion in the review. There were no studies using the PEDS:DM. Two empirical studies used the PEDS, while seven empirical studies used the SDQ. This review represents the first step in understanding the use of screening tools with children in India.
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Affiliation(s)
- Hina Sheel
- School of Social and Health Sciences, James Cook University, 149 Sims Drive, Singapore 387380, Singapore
| | - Lidia Suárez
- School of Social and Health Sciences, James Cook University, 149 Sims Drive, Singapore 387380, Singapore
| | - Nigel V Marsh
- School of Social and Health Sciences, James Cook University, 149 Sims Drive, Singapore 387380, Singapore
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Parent Perspectives of Ear Health and the Relationship with Children's Speech and Language in the Longitudinal Study of Indigenous Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10010165. [PMID: 36670715 PMCID: PMC9857726 DOI: 10.3390/children10010165] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 12/14/2022] [Accepted: 01/12/2023] [Indexed: 01/18/2023]
Abstract
Health and well-being are holistic concepts that are perceived to be inseparable for Aboriginal and Torres Strait Islander peoples. We examined relationships between parent-reported ear symptoms for 787 Indigenous children at two time points (age 2-3 years, age 4-5 years) and two parent-reported speech and language outcomes one year later (age 5-6 years). Most parents (80.2%) reported no concern about their child's expressive language and (93.8%) receptive language. Binary logistic regression models examined ear health as a predictor of children's expressive and receptive speech and language adjusting for sociodemographic and health covariates. For children without parent-reported ear symptoms, there were lower odds of parental concern about expressive speech and language (aOR = 0.45; 95% CI 0.21-0.99) and receptive language (aOR = 0.24; 95% CI 0.09-0.62). Parents were less likely to have concerns about the child's expressive speech and language if their child was female, lived in urban or regional areas, had excellent or very good global health, or had no disability when aged 2-5 years. Since parent-reported ear health and speech and language concerns were related, Aboriginal and Torres Strait Islander children could benefit from culturally safe, strength-based, and family-centered integrated speech, language, and ear health services.
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Yunilda E, Gunardi H, Medise BE, Oswari H. The Indonesian version of Ages and Stages Questionnaire
III
accuracy compared to Bayley Scales of Infant Development
III. INFANT AND CHILD DEVELOPMENT 2022. [DOI: 10.1002/icd.2387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Erva Yunilda
- Department of Child Health, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia Jakarta Indonesia
| | - Hartono Gunardi
- Department of Child Health, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia Jakarta Indonesia
| | - Bernie Endyarni Medise
- Department of Child Health, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia Jakarta Indonesia
| | - Hanifah Oswari
- Department of Child Health, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas Indonesia Jakarta Indonesia
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Bater ML, Stark MJ, Gould JF, Anderson PJ, Collins CT. Parent concerns for child development following admission to neonatal intensive or special care: From birth to adolescence. J Paediatr Child Health 2022; 58:1539-1547. [PMID: 35661453 PMCID: PMC9540761 DOI: 10.1111/jpc.16030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 11/10/2021] [Accepted: 05/01/2022] [Indexed: 11/28/2022]
Abstract
AIM To describe the presence and nature of parent concerns regarding the development of their children admitted to Australian neonatal units (NNUs), comprising neonatal intensive care or special care. METHODS In a cross-sectional survey, mothers and fathers provided information regarding concerns for their child's development. The self-administered survey was completed by two separate cohorts; (i) parents of child graduates from Australian NNUs (n = 381); (ii) parents of infant's inpatient in two South Australian NNUs (n = 209). Data were analysed using thematic analysis and descriptive statistics. RESULTS Information was provided for 730 children. Developmental concern was reported for 39% of NNU graduates and 35% of inpatients. Children born very preterm (< 32 weeks' gestation) elicited greater parent concern than those born more mature (Cohort 1: 41% vs 36%; Cohort 2: 49% vs 22%), including in multiple developmental domains (Cohort 1: 17% vs 15%; Cohort 2: 28% vs 4%). Parents with inpatient infants were predominantly concerned about general development-milestones (19.1%) and the potential impact of medical or CNS issues (13.7%). Graduate parents commonly focused on specific domains, such as their child's speech-language (13.7%) and motor (12.9%) development. CONCLUSION Neurodevelopment is a substantial source of concern for mothers and fathers during NNU admission and childhood, particularly for children born very preterm. However, in the first year of life, developmental concerns are poorly defined. This highlights the need for clinical education resources detailing infant developmental expectations and supportive strategies for parents of these high-risk infants.
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Affiliation(s)
- Megan L Bater
- SAHMRI Women and KidsSouth Australian Health and Medical Research InstituteAdelaideSouth AustraliaAustralia,Discipline of PaediatricsAdelaide Medical School, the University of AdelaideAdelaideSouth AustraliaAustralia,Neonatal UnitWomen's and Children's HospitalAdelaideSouth AustraliaAustralia,Early Origins of HealthRobinson Research Institute, University of AdelaideAdelaideSouth AustraliaAustralia
| | - Michael J Stark
- SAHMRI Women and KidsSouth Australian Health and Medical Research InstituteAdelaideSouth AustraliaAustralia,Discipline of PaediatricsAdelaide Medical School, the University of AdelaideAdelaideSouth AustraliaAustralia,Neonatal UnitWomen's and Children's HospitalAdelaideSouth AustraliaAustralia,Early Origins of HealthRobinson Research Institute, University of AdelaideAdelaideSouth AustraliaAustralia
| | - Jacqueline F Gould
- SAHMRI Women and KidsSouth Australian Health and Medical Research InstituteAdelaideSouth AustraliaAustralia,Discipline of PaediatricsAdelaide Medical School, the University of AdelaideAdelaideSouth AustraliaAustralia,School of PsychologyUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Peter J Anderson
- Neurodevelopment ProgramTurner Institute for Brain and Mental Health & School of Psychological Sciences, Monash UniversityMelbourneVictoriaAustralia,Centre of Research Excellence in Newborn MedicineMurdoch Children's Research InstituteMelbourneVictoriaAustralia
| | - Carmel T Collins
- SAHMRI Women and KidsSouth Australian Health and Medical Research InstituteAdelaideSouth AustraliaAustralia,Discipline of PaediatricsAdelaide Medical School, the University of AdelaideAdelaideSouth AustraliaAustralia
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Çelen Yoldaş T, Şenkon OG, Karakaya J, Özmert EN. Elucidating the level of developmental risk in a busy paediatric practice clinic from a middle-income country. Child Care Health Dev 2022; 48:781-787. [PMID: 35179245 DOI: 10.1111/cch.12987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 02/10/2022] [Accepted: 02/15/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Identifying young children with serious developmental concerns is a common challenge in paediatric settings around the world. Elucidating parental concerns about their children's development is a useful predictor of developmental status. The aim of this study is to elucidate the level of developmental risk in a busy outpatient paediatric clinic using the Parents' Evaluation of Developmental Status (PEDS) and observe the associated factors in a middle-income country. METHODS Parents attending a medical appointment for their children in a paediatric outpatient clinic were asked to complete the PEDS and a questionnaire pertaining to sociodemographic details. A total of 151 parents were eligible to participate in the study. Parents also rated the ease of completion of the test with the response options being 'difficult, a little difficult, easy, very easy'. RESULTS In our total sample, 9.3% (n = 14) were at high risk, 16.6% (n = 25) were at moderate risk and the remainder were at low/no risk. Being at high or moderate risk (25.8%, n = 39) was higher in male gender (p = 0.046) and older age children (p = 0.004). Hospitalization in a neonatal intensive care unit longer than 3 days, maternal employment status/housewife, long duration of screen viewing were independent risk factors significantly associated with high or moderate risk in multivariable analyses. Among the participants, 98.7% of parents reported that the PEDS was easy or very easy to complete in the clinical setting. CONCLUSION In this study, in a cosmopolitan city of a middle-income country, a quarter of children were observed to be at high or moderate risk. The findings highlight the importance of elucidating the prevalence of developmental concerns among the population to enable families to access universal high-quality early childhood services.
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Affiliation(s)
- Tuba Çelen Yoldaş
- Department of Pediatrics, Division of Developmental Pediatrics, Gazi University Faculty of Medicine, Ankara, Turkey
| | | | - Jale Karakaya
- Department of Biostatistics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Elif Nursel Özmert
- Department of Pediatrics, Division of Developmental Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Hodgins M, Ostojic K, Hu N, Lawson KD, Samir N, Webster A, Rogers H, Henry A, Murphy E, Lingam R, Raman S, Mendoza Diaz A, Dadich A, Eapen V, Rimes T, Woolfenden S. Study protocol for a real-world evaluation of an integrated child and family health hub for migrant and refugee women. BMJ Open 2022; 12:e061002. [PMID: 36041760 PMCID: PMC10439340 DOI: 10.1136/bmjopen-2022-061002] [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: 01/12/2022] [Accepted: 08/16/2022] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Continuity of child and family healthcare is vital for optimal child health and development for developmentally vulnerable children. Migrant and refugee communities are often at-risk of poor health outcomes, facing barriers to health service attendance including cultural, language, limited health literacy, discrimination and unmet psychosocial needs. 'Integrated health-social care hubs' are physical hubs where health and social services are co-located, with shared referral pathways and care navigation. AIM Our study will evaluate the impact, implementation and cost-benefit of the First 2000 Days Care Connect (FDCC) integrated hub model for pregnant migrant and refugee women and their infants. MATERIALS AND METHODS This study has three components. Component 1 is a non-randomised controlled trial to compare the FDCC model of care with usual care. This trial will allocate eligible women to intervention and control groups based on their proximity to the Hub sites. Outcome measures include: the proportion of children attending child and family health (CFH) nurse services and completing their CFH checks to 12 months of age; improved surveillance of growth and development in children up to 12 months, post partum; improved breastfeeding rates; reduced emergency department presentations; and improved maternal well-being. These will be measured using linked medical record data and surveys. Component 2 will involve a mixed-method implementation evaluation to clarify how and why FDCC was implemented within the sites to inform future roll-out. Component 3 is a within-trial economic evaluation from a healthcare perspective to assess the cost-effectiveness of the Hubs relative to usual care and the implementation costs if Hubs were scaled and replicated. ETHICS AND DISSEMINATION Ethical approval was granted by the South Eastern Sydney Local Health District Human Research Ethics Committee in July 2021 (Project ID: 020/ETH03295). Results will be submitted for publication in peer-reviewed journals and presented at relevant conferences. TRIAL REGISTRATION NUMBER ACTRN12621001088831.
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Affiliation(s)
| | | | - Nan Hu
- UNSW, Sydney, New South Wales, Australia
| | - K D Lawson
- Western Sydney University, Sydney, New South Wales, Australia
| | - Nora Samir
- UNSW, Sydney, New South Wales, Australia
| | - Amanda Webster
- South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Helen Rogers
- South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | | | - Elisabeth Murphy
- UNSW, Sydney, New South Wales, Australia
- North Sydney Local Health District, Sydney, New South Wales, Australia
| | - Raghu Lingam
- UNSW, Sydney, New South Wales, Australia
- Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
| | - Shanti Raman
- South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | | | - Ann Dadich
- Western Sydney University, Sydney, New South Wales, Australia
| | - Valsamma Eapen
- UNSW, Sydney, New South Wales, Australia
- South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Tania Rimes
- South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Susan Woolfenden
- UNSW, Sydney, New South Wales, Australia
- Sydney Local Health District, Sydney, New South Wales, Australia
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Mukherjee SB, Verma S, Sharma S, Aneja S. Diagnostic Accuracy of Parents' Evaluation of Developmental Status (PEDS), PEDS Developmental Milestones, and PEDS Combined in Indian Children Aged Less than 2 Years. Indian J Pediatr 2022; 89:459-465. [PMID: 33620632 DOI: 10.1007/s12098-020-03651-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 12/29/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the diagnostic accuracy of Parent's Evaluation of Developmental Status (PEDS), PEDS Developmental Milestones (PEDS:DM) and PEDS Combined for developmental screening of Indian children aged less than 2 y. METHOD A hospital-based study of diagnostic accuracy was conducted over 17 mo. Children under 24 mo (n = 180) were enrolled after exclusion of severe illnesses or known neurodevelopment disorders. The index tools included standardized Hindi translations of PEDS and PEDS:DM. The reference tool was Developmental Assessment Scale for Indian Infants (DASII). Both were administered by blinded researchers. Parameters of diagnostic accuracy were computed. RESULTS There were 13 (7.2%) failures in PEDS, 119 (66.1%) in PEDS:DM and 119 (66.1%) in PEDS Combined. DASII identified 3 children with developmental delay. Sensitivity (Sn) [95% CI] of PEDS was 33.3 [0.8-90.6] and Specificity (Sp) 93.2 [88.5-96.5]. The Sn and Sp of both PEDS:DM and PEDS Combined were 100 [29.2-100] and 34.5 [27.5-42.0], respectively. CONCLUSIONS Hindi translations of PEDS, PEDS:DM and PEDS Combined are not suitable for developmental screening of children less than 2 y due to suboptimal diagnostic accuracy.
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Affiliation(s)
- Sharmila Banerjee Mukherjee
- Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, Bangla Sahib Road, New Delhi, 110001, India.
| | - Sangeeta Verma
- Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, Bangla Sahib Road, New Delhi, 110001, India
| | - Suvasini Sharma
- Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, Bangla Sahib Road, New Delhi, 110001, India
| | - Satinder Aneja
- Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, Bangla Sahib Road, New Delhi, 110001, India
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Schonhaut L, Maturana A, Cepeda O, Serón P. Predictive Validity of Developmental Screening Questionnaires for Identifying Children With Later Cognitive or Educational Difficulties: A Systematic Review. Front Pediatr 2021; 9:698549. [PMID: 34900855 PMCID: PMC8651980 DOI: 10.3389/fped.2021.698549] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 10/12/2021] [Indexed: 11/13/2022] Open
Abstract
Context: Parent/caregiver completing developmental screening questionnaires (DSQs) for children before 5 years of age is currently recommended. The DSQs recommended by the American Academy of Pediatrics (AAP) are the Ages and Stages Questionnaires (ASQ), Parents' Evaluation of Developmental Status (PEDS), and the Survey of Well-being of Young Children (SWYC). Nevertheless, their predictive validity has not been well-established. Objective: To assess in the current literature, the value of AAP-recommended DSQs (ASQ, PEDS, SWYC) administered between 0 and 5 years of age, for predicting long-term cognitive achievement and/or school performance (CA/SP), after 1 year or more of evaluation and at/or after age 5 years, in the general population. Data Sources: Cochrane, MEDLINE PubMed, CINAHL, EMBASE, Web of Science, Scielo, and Scopus databases (until March 2021). Study Selection: Two authors selected the studies. Forward and backward citation follow-up was done; authors of DSQ were contacted to identify additional studies. Data Extraction: Cohorts were identified, and authors of selected studies were contacted to corroborate and complete extracted data. Results: Thirty-two publications, corresponding to 10 cohorts, were included. All cohorts used ASQ. Only cohort using PEDS was identified but did not meet the inclusion criteria. No cohorts conducted with SWYC were identified. Associations between ASQ and CA/SP were extracted for eight cohorts. The odds ratios were >3, and the area under the curve was 0.66-0.87. A trade-off between sensitivity and specificity was observed. Limitations: Heterogeneity in population characteristics and in DSQ adaptations. Conclusions: A positive association between ASQ and later CA/SP was found in different social, cultural, and economic settings. Additional studies are necessary to determine the impact factors in the predictive capacity of DSQs. Systematic Review Registration: PROSPERO, identifier: CRD42020183883.
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Affiliation(s)
- Luisa Schonhaut
- Departamento de Pediatría, Clínica Alemana, Santiago, Chile
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Andres Maturana
- Departamento de Pediatría, Clínica Alemana, Santiago, Chile
- Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
- Departamento de Desarrollo Académico e Investigación, Clínica Alemana, Santiago, Chile
| | - Olenkha Cepeda
- Departamento de Desarrollo Académico e Investigación, Clínica Alemana, Santiago, Chile
| | - Pamela Serón
- Departamento Medicina Interna y Centro de excelencia CIGES, Universidad de La Frontera, Temuco, Chile
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Oo NNL, Ng DCC, Ostbye T, Allen JC, Agarwal PK, Yeleswarapu SP, Chong SL, Guo X, Chan YH. Novel two-tiered developmental screening programme for Singaporean toddlers: a quality improvement report. BMJ Open Qual 2021; 10:bmjoq-2020-001327. [PMID: 34711585 PMCID: PMC8557273 DOI: 10.1136/bmjoq-2020-001327] [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] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 10/15/2021] [Indexed: 11/03/2022] Open
Abstract
Early identification of developmental delays with timely intervention, especially before the age of 3 years, can improve child development. In Singapore, however, diagnosis and intervention for developmental delays occur at a median age of 44 months. As early detection and intervention depends on an effective developmental screening programme, we aimed to improve the detection of developmental delays before the age of 3 years in a primary care setting. We did this by implementing a novel two-tiered screening programme which uses three standardised screening tools (Parents' Evaluation of Developmental Status, PEDS-Developmental Milestones and Ages and Stages Questionnaire-3). We used quality improvement methods to integrate and optimise this two-tiered programme into the existing 9-month and 18-month screening schedule, with an additional screening at 30 months to replace the pre-existing 36-month screening of the National Child Health Surveillance Programme. A total of three Plan-Do-Study-Act cycles were performed to ensure programme feasibility and sustainability. They focused on adequately training the primary care nurses, targeting an 80% screening rate and aiming for 20 min screening tool administration time per child. We assessed the proportion of children referred to the child development units after positive screening for developmental concerns under the new programme, with a pre-post and with-without intervention comparison, and reviewed the screening rates and screening tool administration time. The proportion of 18-month old children referred for developmental concerns improved from 3.5%-7.1% over a 6-month period. For those who received further assessment by developmental specialists after the two-tiered screening, 100% received a definitive diagnosis of developmental delays, similar to the situation before programme introduction. Our quality improvement efforts facilitated successful integration of the two-tiered programme into the pre-existing screening schedule with minimal impact to the clinic workflow. While we highlight challenges in implementation that need to be addressed, our findings support a potential nationwide adoption of the two-tiered programme.
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Doove BM, Feron FJM, van Os J, Drukker M. Preschool Communication: Early Identification of Concerns About Preschool Language Development and Social Participation. Front Public Health 2021; 8:546536. [PMID: 33585376 PMCID: PMC7874213 DOI: 10.3389/fpubh.2020.546536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 12/31/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Adverse communication development in preschool children is a risk factor influencing child health and well-being with a negative impact on social participation. Language and social skills develop and maintain human adaptability over the life course. However, the accuracy of detecting language problems in asymptomatic children in primary care needs to be improved. Therefore, it is important to identify concerns about language development as a risk factor for child health. The association between parental and professional caregivers' concerns about language development and the level of preschool social participation was assessed, as well as the possible mediating/moderating effect of the perception of social competence. In addition, validity and predictive value of parental and professional caregivers' concerns about language development were tested. Methods: To identify emerging concerns about development and social participation, a community sample of 341 preschool children was systematically assessed with a comprehensive preventive child health care "toolkit" of instruments, including parent-completed tools like the Parents' Evaluation of Developmental Status (PEDS) and child competence Visual Analog Scales (VAS). At baseline, children were aged 3 years and at follow-up ~4 years. Results: There was a statistically significant association between parental and professional caregivers' concerns about language development and the level of preschool social participation, with a mediating effect of child social competence at the age of 3 years as well as 4 years. Negative predictive value of parental and professional caregiver language concerns at the age of 3 and 4 years were 99 and 97%, respectively. Furthermore, this article showed that while some preschool children grow out of language problems, others may develop them. Conclusion: Short but valid pediatric primary care tools like the PEDS and child competence VAS can support monitoring and early identification of concerns about language development and social competence as a risk factor for preschool social participation. Personalized health care requires continued communication between parents, professional caregivers and preventive child health care about parental and professional caregiver perceptions concerning preschool language development as well as the perception of a child's social competence.
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Affiliation(s)
- Bernice M Doove
- Youth Health Care Division, Regional Public Health Service South Limburg, Heerlen, Netherlands.,Department of Social Medicine, Care and Public Health Research Institute, School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
| | - Frans J M Feron
- Department of Social Medicine, Care and Public Health Research Institute, School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
| | - Jim van Os
- King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom.,Department of Psychiatry and Psychology, MHeNS School for Mental Health and NeuroScience, Maastricht University Medical Centre, Maastricht, Netherlands.,Department Psychiatry, Brain Center Rudolf Magnus, Utrecht University Medical Centre, Utrecht, Netherlands
| | - Marjan Drukker
- Department of Psychiatry and Psychology, MHeNS School for Mental Health and NeuroScience, Maastricht University Medical Centre, Maastricht, Netherlands
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15
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Jain K, Solomon J, Ramachandran S. Knowledge, attitude and practices on developmental surveillance and screening among health professionals in Indian health care settings: An exploratory sequential mixed methods study. J Pediatr Rehabil Med 2021; 14:55-63. [PMID: 33492251 DOI: 10.3233/prm-190649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The purpose of this study was to assess the knowledge, attitude and practices of health care professionals in pediatric settings on developmental surveillance and screening programs and also to identify the barriers and facilitators during its implementation. METHODS The data were collected from health professionals involved in pediatric developmental care, practicing in various hospitals, clinics and nursing homes in a suburban city on west coast of Southern India. The study involved cross-sectional exploratory sequential mixed method design which included a quantitative questionnaire survey on health professionals (n= 52) followed by qualitative face-to-face interviews with chosen respondents who participated in the survey (n= 8). The survey data are reported with descriptive statistics, and interview data are subjected to inductive content analysis for deriving codes, categories and themes. RESULTS The study results indicate that health professionals involved in pediatric developmental care in Indian health care settings have fair knowledge and a favorable attitude towards the use of developmental surveillance and screening. Furthermore, the facilitators and barriers of implementation have been reported. The strategies outlined by interview respondents to improve adherence to implementation have been discussed. CONCLUSIONS The practice of developmental surveillance and screening is limited despite favorable knowledge and attitude among health professionals in pediatric developmental care and is dependent on health care organizational setup.
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Developmental Concerns of Parents and Unmet Healthcare Needs in Low-and Middle-Income Countries: Please Mind the Gap! Indian J Pediatr 2021; 88:5-6. [PMID: 33191489 DOI: 10.1007/s12098-020-03568-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 11/06/2020] [Indexed: 10/23/2022]
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Çelen Yoldaş T, Özmert EN, Bayazıt Y, Tanrıkulu B, Yetim H, Çakır B. Developmental Concerns, Parental Perceptions and Missed Opportunities from Different Levels of Health Centers in a Middle-Income Country. Indian J Pediatr 2021; 88:16-22. [PMID: 32385780 DOI: 10.1007/s12098-020-03302-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 04/08/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the concerns the parents have with the development of their children and related conditions and investigate how often these concerns are addressed at all levels of the healthcare system. Determining parental perceptions of these issues and highlighting missed opportunities is valuable for improving healthcare services. METHODS A total of 451 parents attending a medical appointment for their children in outpatient clinics at tertiary, secondary and primary health centers were administered a questionnaire comprised of 45 questions pertaining to their concerns regarding the development of their children and related conditions, including sociodemographic characteristics, practices supporting child development, information resources and personal opinions, such as whether they had sufficient information. RESULTS The parents of 130 children (28.8%) reported at least one developmental concern. Less than half of the concerned parents had visited a health center for these concerns. The area of greatest concern was language development, but the concerns differed based on setting. Among the related factors, having insufficient information (p = 0.000, OR: 0.375, CI: 0.24-0.58) and not playing with the child (p = 0.029, OR: 0.563, CI: 0.33-0.94) increased the risk of having developmental concerns. Only 15.5% of children were followed up in a developmental and behavioral manner. CONCLUSIONS The authors observed many concerns and missed opportunities to address them at all levels of health centers. Family physicians were more effective at eliciting these issues than pediatricians. These issues need to be addressed in the health system with consideration of its complexity and integrated culture.
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Affiliation(s)
- Tuba Çelen Yoldaş
- Department of Pediatrics, Division of Developmental and Behavioral Pediatrics, Hacettepe University Faculty of Medicine, 06410, Ankara, Turkey.
| | - Elif Nursel Özmert
- Department of Pediatrics, Division of Developmental and Behavioral Pediatrics, Hacettepe University Faculty of Medicine, 06410, Ankara, Turkey
| | - Yıldırım Bayazıt
- Altındağ Müzeyyen Şükrü İlhan Family Health Center, Ankara, Turkey
| | | | - Hasan Yetim
- Çankaya No:6 Family Health Center, Ankara, Turkey
| | - Banu Çakır
- Department of Public Health, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Faruk T, King C, Muhit M, Islam MK, Jahan I, Baset KU, Badawi N, Khandaker G. Screening tools for early identification of children with developmental delay in low- and middle-income countries: a systematic review. BMJ Open 2020; 10:e038182. [PMID: 33234622 PMCID: PMC7684835 DOI: 10.1136/bmjopen-2020-038182] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 10/19/2020] [Accepted: 10/30/2020] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To systematically review, identify and report the screening tools used for early identification of developmental delay in low- and middle-income countries. DESIGN Systematic review. DATA SOURCES Four bibliographic databases: Medline (1946 to 13 July 2020), Embase (1974 to 13 July 2020), Scopus (1823 to 11 July 2020) and PsycINFO (1987 to July week 1 2020). ELIGIBILITY CRITERIA Peer-reviewed original articles published in English addressing validated culturally sensitive developmental screening tools among children aged <5 years were included in this review. DATA EXTRACTION AND SYNTHESIS One author (CK, medical librarian) developed the search strategy. Three authors conducted the database search (phase I: CK; phase II: IJ and MKI). Three authors (TF, IJ and MKI) independently screened the title and abstracts. TF, MKI and GK independently performed the full-text review of the screened articles. During each step of the study selection process, disagreements were resolved through discussion. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was used to guide the systematic review. Data extraction and analysis were performed using MS Excel. Meta-analysis was not possible due to heterogeneity of the study findings. RESULTS We identified 3349 articles, of which 18 studies from 10 countries, reporting 16 screening tools, were selected for qualitative synthesis. Six cultural contexts were explored. Twelve general, two motor and two speech-language tools were identified. Seven of them found to be parent-completed ones. Five screening tools (American Speech-Language and Hearing Association, Guide for Monitoring Child Development, Infant Neurological International Battery, New Delhi-Development Screening Questionnaire and Woodside Screening Technique) reported relatively higher sensitivity (82.5%-100%) and specificity (83%-98.93%). CONCLUSIONS Limited number of culturally sensitive developmental screening tools were validated for children aged <5 years in low- and middle-income countries. Revising existing screening tools in different ethnic and cultural settings and subsequent validation with normative value should be a research priority.
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Affiliation(s)
- Tasnuva Faruk
- Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh
- Department of Public Health, Independent University Bangladesh, Dhaka, Bangladesh
| | - Catherine King
- The Children's Hospital at Westmead Clinical School, The Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Mohammad Muhit
- Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh
- CSF Global, Dhaka, Bangladesh
| | - Md Kafiul Islam
- Department of Electrical and Electronic Engineering, Independent University Bangladesh, Dhaka, Bangladesh
| | - Israt Jahan
- Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh
- CSF Global, Dhaka, Bangladesh
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Kamran Ul Baset
- Department of Public Health, Independent University Bangladesh, Dhaka, Bangladesh
- Road Safety and Driving School, BRAC, Dhaka, Bangladesh
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, New South Wales, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Gulam Khandaker
- Asian Institute of Disability and Development, University of South Asia, Dhaka, Bangladesh
- CSF Global, Dhaka, Bangladesh
- Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Queensland, Australia
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Dugan J, Booshehri LG, Phojanakong P, Patel F, Brown E, Bloom S, Chilton M. Effects of a trauma-informed curriculum on depression, self-efficacy, economic security, and substance use among TANF participants: Evidence from the Building Health and Wealth Network Phase II. Soc Sci Med 2020; 258:113136. [DOI: 10.1016/j.socscimed.2020.113136] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/22/2020] [Accepted: 06/06/2020] [Indexed: 01/08/2023]
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Ayer C, Eapen V, Overs B, Descallar J, Jalaludin B, Eastwood JG, Dissanayake C, Williams K, Murphy E, Woolfenden S. Risk factors for non-participation in a universal developmental surveillance program in a population in Australia. AUST HEALTH REV 2020; 44:512-520. [PMID: 32731919 DOI: 10.1071/ah18236] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 05/09/2019] [Indexed: 11/23/2022]
Abstract
Objectives This study examined the risk factors for non-participation in a developmental surveillance program in a population in south-west Sydney with a high proportion of culturally diverse and socioeconomically disadvantaged people. Methods Data from 850 and 625 12- and 18-month-old children respectively from the Watch Me Grow (WMG) birth cohort were used for this study. Logistic regression models were used to assess risk factors for 12- and 18-month non-attendance at Well Child Visits, as well as non-completion of the developmental surveillance questionnaire Parents' Evaluation of Developmental Status (PEDS) in the child's personal health record (PHR). Results Independent risk factors for non-attendance at Well Child Visits were female sex of the child (odds ratio (OR) 12 months 1.5; 95% confidence interval (CI) 1.0-2.3), mother's country of birth Australia (OR 18 months 1.8; 95% CI 1.2-2.7), annual household income less than A$25001 (OR 12 months 1.8; 95% CI 1.0-3.2) and residing in a socioeconomically disadvantaged neighbourhood (OR 12 months 1.7; 95% CI 1.1-2.5). Independent risk factors for non-completion of PEDS in those who did not attend the Well Child Visit compared with those who did attend and did complete PEDS were household annual income at birth less than A$25001 (OR 12 months 3.9; 95% CI 1.9-8.1) and residing in a socioeconomically disadvantaged neighbourhood (OR 12 months 2.1 (95% CI 1.2-3.7) and OR 18 months 2.0 (95% CI 1.2-3.6)). Conclusions In this population, children exposed to socioeconomic disadvantage are less likely to have attended a Well Child Visit and to have a completed PEDS in their PHR at 12 and/or 18 months of age. What is known about the topic? Developmental problems are common in early childhood, and children from socioeconomically disadvantaged households are at higher risk. Universal developmental surveillance programs may be effective at early identification of children at risk of developmental problems. Early childhood interventions, when accessed, can lessen the effects of developmental problems in later years. What does this paper add? This paper highlights that children exposed to socioeconomic disadvantage in early childhood who are at higher risk of having developmental problems are also at higher risk of missing out on early identification by non-participation in universal developmental surveillance. What are the implications for practitioners? A more equitable model of developmental surveillance should include a framework of proportionate universalism to ensure optimal engagement of high-risk population groups.
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Affiliation(s)
- Chandra Ayer
- Royal Far West, PO Box 52, Manly, NSW 1655, Australia; and Kogarah Diagnostic Assessment Service, St George Hospital, 90 Railway Parade, Kogarah, NSW 2217, Australia; and Corresponding author.
| | - Valsamma Eapen
- Psychiatry Research and Teaching Unit, School of Psychiatry, UNSW, Level 1, Mental Health Centre, Liverpool Hospital, corner Forbes and Campbell Streets, Liverpool, NSW 2170, Australia. ; and Academic Unit of Child Psychiatry, Ingham Institute of Applied Medical Research, PO Box 3151 (Westfields), Liverpool, NSW 2170, Australia; and South Western Sydney Clinical School, Faculty of Medicine, UNSW, Liverpool Hospital, Liverpool, NSW 2170, Australia
| | | | - Joseph Descallar
- South Western Sydney Clinical School, Faculty of Medicine, UNSW, Liverpool Hospital, Liverpool, NSW 2170, Australia; and Ingham Institute of Applied Medical Research, PO Box 3151 (Westfields), Liverpool, NSW 2170, Australia. ;
| | - Bin Jalaludin
- Ingham Institute of Applied Medical Research, PO Box 3151 (Westfields), Liverpool, NSW 2170, Australia. ; ; and School of Public Health and Community Medicine, UNSW, Sydney, NSW 2052, Australia
| | - John Graeme Eastwood
- Ingham Institute of Applied Medical Research, PO Box 3151 (Westfields), Liverpool, NSW 2170, Australia. ; ; and Community Paediatrics, Sydney Local Health District, Level 11 KGV Building, Missenden Road, Camperdown, NSW 2050, Australia. ; and School of Public Health, Menzies Centre for Health Policy, University of Sydney, Edward Ford Building, A27 Fisher Road, Sydney, NSW 2006, Australia; and School of Medicine, Griffith University, Parklands Drive, Southport, Gold Coast, Qld 4222, Australia; and School of Women's and Children's Health, UNSW, Sydney, NSW 2052, Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, La Trobe University, Kingsbury Drive, Bundoora, Vic. 3083, Australia.
| | - Katrina Williams
- Department of Paediatrics, Melbourne Medical School, The University of Melbourne, Melbourne, Vic. 3010, Australia; and Present address: Department of Paediatrics, Monash University, School of Clinical Sciences, Level 5, Monash Children's Hospital, 246 Clayton Road, Clayton, Vic. 3168, Australia.
| | - Elisabeth Murphy
- NSW Ministry of Health, Child, Youth and Family Health Services, PO Box 4007, Royal North Shore LPO, St Leonards, NSW 2065, Australia.
| | - Susan Woolfenden
- School of Women's and Children's Health, UNSW, Sydney, NSW 2052, Australia; and Department of Community Paediatrics, Sydney Children's Hospital Network, High Street, Randwick, NSW 2031, Australia.
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Is parent engagement with a child health home-based record influenced by early child development and first-born status? hypotheses from a high-income countries’ perspective. Med Hypotheses 2020; 137:109605. [DOI: 10.1016/j.mehy.2020.109605] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 01/24/2020] [Indexed: 11/20/2022]
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Chando S, Craig JC, Burgess L, Sherriff S, Purcell A, Gunasekera H, Banks S, Smith N, Banks E, Woolfenden S. Developmental risk among Aboriginal children living in urban areas in Australia: the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). BMC Pediatr 2020; 20:13. [PMID: 31931753 PMCID: PMC6956483 DOI: 10.1186/s12887-019-1902-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 12/23/2019] [Indexed: 12/05/2022] Open
Abstract
Background Most Australian Aboriginal children are on track with their development, however, the prevalence of children at risk of or with a developmental or behavioural problem is higher than in other children. Aboriginal child development data mostly comes from remote communities, whereas most Aboriginal children live in urban settings. We quantified the proportion of participating children at moderate and high developmental risk as identified by caregivers’ concerns, and determined the factors associated with developmental risk among urban Aboriginal communities. Methods Study methods were co-designed and implemented with four participating urban Aboriginal Community Controlled Health Services in New South Wales, Australia, between 2008 and 2012. Caregiver-reported data on children < 8 years old enrolled in a longitudinal cohort study (Study of Environment on Aboriginal Resilience and Child Health: SEARCH) were collected by interview. The Parents’ Evaluation of Developmental Status (PEDS) was used to assess developmental risk through report of caregiver concerns. Odds ratios (OR) were calculated using multinomial logistic regression to investigate risk factors and develop a risk prediction model. Results Of 725 children in SEARCH with PEDS data (69% of eligible), 405 (56%) were male, and 336 (46%) were aged between 4.5 and 8 years. Using PEDS, 32% were at high, 28% moderate, and 40% low/no developmental risk. Compared with low/no risk, factors associated with high developmental risk in a mutually-adjusted model, with additional adjustment for study site, were male sex (OR 2.42, 95% confidence intervals 1.62–3.61), being older (4.5 to < 8 years versus < 3 years old, 3.80, 2.21–6.54), prior history of ear infection (1.95, 1.21–3.15), having lived in 4 or more houses versus one house (4.13, 2.04–8.35), foster care versus living with a parent (5.45, 2.32–12.78), and having a caregiver with psychological distress (2.40, 1.37–4.20). Conclusion In SEARCH, 40% of urban Aboriginal children younger than 8 years were at no or low developmental risk. Several factors associated with higher developmental risk were modifiable. Aboriginal community-driven programs to improve detection of developmental problems and facilitate early intervention are needed.
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Affiliation(s)
| | - Jonathan C Craig
- University of Sydney, Sydney, Australia.,Flinders University, Adelaide, Australia
| | - Leonie Burgess
- Sax Institute, Sydney, Australia.,Australian National University, Canberra, Australia
| | - Simone Sherriff
- University of Sydney, Sydney, Australia.,Sax Institute, Sydney, Australia
| | | | - Hasantha Gunasekera
- University of Sydney, Sydney, Australia.,Sydney Children's Hospitals Network, Sydney, Australia
| | - Sandra Banks
- Tharawal Aboriginal Medical Service, Campbelltown, Australia
| | - Natalie Smith
- Riverina Medical and Dental Corporation, Wagga Wagga, Australia
| | - Emily Banks
- Australian National University, Canberra, Australia
| | - Sue Woolfenden
- Sydney Children's Hospitals Network, Sydney, Australia. .,University of New South Wales, School of Women and Children's Health, Sydney, Australia.
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Schickedanz A, Halfon N. Evolving Roles for Health Care in Supporting Healthy Child Development. THE FUTURE OF CHILDREN 2020; 30:143-164. [PMID: 33875912 PMCID: PMC8053141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Health care reaches more children under age three in the United States than any other family-facing system and represents the most common entry point for developmental assessment of and services for children. In this article, Adam Schickedanz and Neal Halfon examine how well the child health care system promotes healthy child development early in life. They also review children's access to health care through insurance coverage, the health care system's evolution in response to scientific and technical advances, and the shifting epidemiology of health and developmental risk. The authors find that the health care system is significantly underperforming because it is constrained by antiquated conventions, insufficient resources, and outmoded incentive structures inherent in the traditional medical model that still dominates pediatric care. These structural barriers, organization challenges, and financial constraints limit the system's ability to adequately recognize, respond to, and, most importantly, prevent adverse developmental outcomes at the population level. To achieve population-level progress in healthy child development, Schickedanz and Halfon argue that pediatric care will need to transform itself and go beyond simply instituting incremental clinical process improvement. This will require taking advantage of opportunities to deliver coordinated services that bridge sectors and focusing not only on reducing developmental risk and responding to established developmental disability but also on optimizing healthy child development before developmental vulnerabilities arise. New imperatives for improved population health, along with the growing recognition among policy makers and practitioners of the social and developmental determinants of health, have driven recent innovations in care models, service coordination, and coverage designs. Yet the available resources and infrastructure are static or shrinking, crowded out by rising overall health care costs and other policy priorities. The authors conclude that child health systems are at a crossroads of conflicting priorities and incentives, and they explore how the health system might successfully respond to this impasse.
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Affiliation(s)
- Adam Schickedanz
- Adam Schickedanz is an assistant professor in residence in the Department of Pediatrics at the David Geffen School of Medicine at the University of California, Los Angeles. Neal Halfon is the founding director of the Center for Healthier Children, Families and Communities; a professor of pediatrics in the David Geffen School of Medicine; a professor of health policy and management in the Fielding School of Public Health; and a professor of public policy in the Luskin School of Public Affairs, all at the University of California, Los Angeles
| | - Neal Halfon
- Adam Schickedanz is an assistant professor in residence in the Department of Pediatrics at the David Geffen School of Medicine at the University of California, Los Angeles. Neal Halfon is the founding director of the Center for Healthier Children, Families and Communities; a professor of pediatrics in the David Geffen School of Medicine; a professor of health policy and management in the Fielding School of Public Health; and a professor of public policy in the Luskin School of Public Affairs, all at the University of California, Los Angeles
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24
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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.
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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
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25
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Lim J, Sarkozy V, Perkins D, Van Muster KA, Woolfenden S. Letter to the editor. J Paediatr Child Health 2019; 55:1513. [PMID: 31846158 DOI: 10.1111/jpc.14653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 09/01/2019] [Accepted: 09/16/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Jeanette Lim
- Department of Community and Child Health, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Vanessa Sarkozy
- Department of Community and Child Health, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Deborah Perkins
- Department of Community and Child Health, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Kerri-Anne Van Muster
- Department of Community and Child Health, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Susan Woolfenden
- Department of Community and Child Health, Sydney Children's Hospital, Sydney, New South Wales, Australia
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26
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Chambers CD, Coles C, Kable J, Akshoomoff N, Xu R, Zellner JA, Honerkamp-Smith G, Manning MA, Adam MP, Jones KL. Fetal Alcohol Spectrum Disorders in a Pacific Southwest City: Maternal and Child Characteristics. Alcohol Clin Exp Res 2019; 43:2578-2590. [PMID: 31688971 DOI: 10.1111/acer.14213] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 09/23/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND There are limited data on the characteristics of children with fetal alcohol spectrum disorders (FASD) and their mothers from the general population in the United States. METHODS During the 2012 and 2013 academic years, first-grade children in a large urban Pacific Southwest city were invited to participate in a study to estimate the prevalence of FASD. Children who screened positive on weight, height, or head circumference ≤25th centile or on parental report of developmental concerns were selected for evaluation, along with a random sample of those who screened negative. These children were examined for dysmorphology and neurobehavior and their mothers or collateral sources were interviewed. Children were classified as fetal alcohol syndrome (FAS), partial fetal alcohol syndrome (pFAS), alcohol-related neurodevelopmental disorder (ARND), or No FASD. RESULTS A total of 854 children were evaluated; 5 FAS, 44 pFAS, 44 ARND, and 761 No FASD. Children with FAS or pFAS were more likely to have dysmorphic features, and 32/49 (65.3%) of those met criteria for neurobehavioral impairment on cognitive measures with or without behavioral deficits. In contrast, 28/44 (63.6%) of children with ARND met criteria on behavioral measures alone. Mothers of FASD children were more likely to recognize pregnancy later, be unmarried, and report other substance use or psychiatric disorders, but did not differ on age, socioeconomic status, education, or parity. Mothers of FASD children reported more drinks/drinking day each trimester. The risk of FASD was elevated with increasing number of drinks/drinking day prior to pregnancy recognition, even at the level of 1 drink per day (adjusted odds ratio 3.802, 95% confidence interval 1.634, 8.374). CONCLUSIONS Data from this general population sample in a large urban region in the United States demonstrate the variability of expression of FASD and point to risk and protective factors for mothers in this setting.
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Affiliation(s)
- Christina D Chambers
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, California.,Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, La Jolla, California
| | - Claire Coles
- Department of Psychiatry, School of Medicine, Emory University, Atlanta, Georgia.,Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia
| | - Julie Kable
- Department of Psychiatry, School of Medicine, Emory University, Atlanta, Georgia.,Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia
| | - Natacha Akshoomoff
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California San Diego, La Jolla, California
| | - Ronghui Xu
- Department of Family Medicine and Public Health, School of Medicine, University of California San Diego, La Jolla, California.,Department of Mathematics, University of California San Diego, La Jolla, California
| | - Jennifer A Zellner
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, California
| | - Gordon Honerkamp-Smith
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, California
| | - Melanie A Manning
- Departments of Pathology and Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Margaret P Adam
- Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington
| | - Kenneth Lyons Jones
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, California
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27
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Kiing JSH, Neihart M, Chan YH. Teachers' role in identifying young children at risk for developmental delay and disabilities: Usefulness of the Parents Evaluation of Developmental Status tool. Child Care Health Dev 2019; 45:637-643. [PMID: 31209902 DOI: 10.1111/cch.12693] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/05/2019] [Accepted: 06/07/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Identifying children with developmental delays and disabilities more effectively will require the participation of others such as preschool teachers who often have extended contact with the child in their first few years. We wished to determine how preschool teachers' reports of concerns compared with norming data from the Parents Evaluation of Developmental Status (PEDS). METHODS A total of 1,357 English responses from teachers of nine preschool centres were analyzed and matched with expected rates of concerns from the U.S. norming sample. RESULTS The preschool teachers' reporting of rates of concerns fell within the range of scores reported in norming studies from parent reports in the United States. Teachers were most concerned about children's language and behaviours. CONCLUSIONS The preschool teacher reports of concerns are similar to expected parents PEDS ratings in the United States. Preschool teachers can screen children's development. There may be a role for the PEDS to be used as a developmental screener by preschool teachers for monitoring of developmental status. Further studies on the PEDS are recommended in the Singapore context.
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Affiliation(s)
- Jennifer S H Kiing
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
| | - Maureen Neihart
- Psychological Studies Academic Group, National Institute of Education Singapore, Singapore
| | - Yiong-Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University Health System, Singapore
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28
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Doove B, Feron J, Feron F, van Os J, Drukker M. Validation of short instruments assessing parental and caregivers' perceptions on child health and development for personalized prevention. Clin Child Psychol Psychiatry 2019; 24:608-630. [PMID: 30628460 DOI: 10.1177/1359104518822673] [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] [Indexed: 01/14/2023]
Abstract
Systematically exploring parental as well as other caregivers' concerns is a main component in preventive child health care (PCHC) for family-centred practice and personalized health care. To facilitate communication and early identification of emerging mental health problems, a PCHC toolkit based on short instruments was developed. This article investigates the reliability and validity of (1) two visual analogue scales (VAS) to assess parent-reported 'parenting' and 'child behaviour', (2) a professional caregiver-reported VAS to assess 'child competence' and (3) the parents' evaluation of developmental status (PEDS) in Dutch PCHC. Parents as well as child care, kindergarten and preschool teachers completed instruments in a community-based sample of children (N = 346) aged 3 years at baseline. The three VAS and PEDS were associated with standardized questionnaires assessing the same constructs. Overall predictive accuracy showed: good to excellent for 'parenting' VAS, fair to good for 'child behaviour' VAS and poor for 'child competence' VAS. The PEDS, 'parenting' VAS and 'child behaviour' VAS, demonstrated high sensitivity at various cut-off points of index test and reference standard. At follow-up, approximately 1 year later, results were similar. Although the 'child competence' VAS scored lower on one aspect of validity, the PEDS and the different VAS are reliable, valid and useful as brief monitoring tools in daily Dutch PCHC practice.
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Affiliation(s)
- Bernice Doove
- 1 Well-Child Care Centre, Preventive Child Health Care Division, Envida, The Netherlands.,2 Department of Social Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, The Netherlands
| | | | - Frans Feron
- 2 Department of Social Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, The Netherlands.,4 Youth Health Care Division, Regional Public Health Service South Limburg, The Netherlands
| | - Jim van Os
- 5 Department of Psychiatry and Psychology, MHeNS School for Mental Health and NeuroScience, Maastricht University Medical Centre, The Netherlands.,6 King's Health Partners and Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.,7 Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands
| | - Marjan Drukker
- 5 Department of Psychiatry and Psychology, MHeNS School for Mental Health and NeuroScience, Maastricht University Medical Centre, The Netherlands
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29
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Yamaoka Y, Bard DE. Positive Parenting Matters in the Face of Early Adversity. Am J Prev Med 2019; 56:530-539. [PMID: 30772146 PMCID: PMC10954083 DOI: 10.1016/j.amepre.2018.11.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 11/06/2018] [Accepted: 11/07/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION A negative relationship between adverse childhood experiences and both physical and mental health in adulthood is well established, as is the positive impact of parenting on child development and future health. However, few studies have investigated unique influences of adverse childhood experiences and positive parenting together within a large, diverse early childhood sample. METHODS The study used data on all children aged 0-5 years (n=29,997) from the National Survey of Children's Health 2011/2012 to examine effects of positive parenting practices and adverse childhood experiences on early childhood social-emotional skills and general development. All analyses were performed in 2017 and 2018. RESULTS More than a third of the sample reported experiencing at least one adverse childhood experience. More than a fourth (26.7%) met study criteria for social-emotional deficits, and 26.2% met criteria for developmental delay risks. The number of adverse childhood experiences exhibited negative marginal associations with social-emotional deficits and developmental delay risks, whereas the number of positive parenting practices showed independent protective effects. Risks associated with an absence of positive parenting were often greater than those of four or more adverse childhood experiences, even among no/low adversity families. The population attributable fractions for social-emotional deficits and developmental delay risks were 17.3% and 13.9% (translating to prevalence reductions of 4.5% and 3.6%) when adopting all positive parenting practices and 4.5% and 7.2% (prevalence reductions of 1.2% and 1.9%) when eliminating adverse childhood experiences. CONCLUSIONS The number of adverse childhood experiences was associated with both social-emotional deficits and developmental delay risks in early childhood; however, positive parenting practices demonstrated robust protective effects independent of the number of adverse childhood experiences. This evidence further supports promotion of positive parenting practices at home, especially for children exposed to high levels of adversity.
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Affiliation(s)
- Yui Yamaoka
- Section of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - David E Bard
- Section of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
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30
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Phillips SP, Jiang M, Lakkadghatwala R, Wang S. Assessing wellness in the well-child check: What about social and emotional development? CANADIAN FAMILY PHYSICIAN MEDECIN DE FAMILLE CANADIEN 2019; 65:e113-e120. [PMID: 30867191 PMCID: PMC6515966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To determine whether Canadian children aged 4 to 6 received well-child checks; to explore the nature of these checkups in a large family practice; and to examine the merit of using parent questionnaires about child resilience as a means of introducing a discussion about social and emotional development into this checkup. DESIGN Three-part mixed-methods study, using data derived from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), chart reviews of a family practice, and semistructured interviews with parents. SETTING Primary care practices associated with CPCSSN, and a large primary care practice in Kingston, Ont. PARTICIPANTS Patients who were born between 2008 and 2011, and a sample of parents whose children were between the ages of 6 and 9. METHODS International Classification of Diseases, version 9, codes from CPCSSN records were used to identify the prevalence of well-child checks in the 4-to-6 age group. Then 110 randomly selected charts from a large family practice were audited for inclusion of behavioural and social assessments of those aged 4 to 6. Finally, randomly selected parents from the same practice were invited to pilot-test the PERIK (Positive development and resilience in kindergarten) resilience questionnaire, interviewed about its merit, and asked to recall whether the identified areas of child development had been included in previous well-child checkups. MAIN FINDINGS Data from CPCSSN indicated that 11% of Canadian children aged 4 to 6 had had an explicit well-child check by their family physician. Among the reviewed charts from the one practice, social context was documented for 45% of them, but social and behavioural development was usually not recorded. The 42 parents interviewed found the PERIK questionnaire useful, but not perfect, for opening discussions about aspects of child development that they had not realized were central to the child's future health. CONCLUSION This study offers an initial approach to exploring resilience in children and therefore addressing recognized and alterable predictors of adult well-being. Early social and emotional development predicts resilience that, in turn, foreshadows future health. The PERIK questionnaire facilitated discussions that could add tremendous value to the well-child checks of children aged 4 to 6.
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Affiliation(s)
- Susan P Phillips
- Family physician and Professor and Director in the Centre for Studies in Primary Care at Queen's University in Kingston, Ont.
| | | | | | - Sheila Wang
- Family medicine resident at Queen's University at the time the research was done
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31
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Marlow M, Servili C, Tomlinson M. A review of screening tools for the identification of autism spectrum disorders and developmental delay in infants and young children: recommendations for use in low- and middle-income countries. Autism Res 2019; 12:176-199. [DOI: 10.1002/aur.2033] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 06/08/2018] [Accepted: 06/27/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Marguerite Marlow
- Department of Psychology; Stellenbosch University; Stellenbosch South Africa
| | - Chiara Servili
- Department of Mental Health and Substance Abuse; World Health Organization; Geneva Switzerland
| | - Mark Tomlinson
- Department of Psychology; Stellenbosch University; Stellenbosch South Africa
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32
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McLeod S, Crowe K, McCormack J, White P, Wren Y, Baker E, Masso S, Roulstone S. Preschool children's communication, motor and social development: Parents' and educators' concerns. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 20:468-482. [PMID: 28418261 DOI: 10.1080/17549507.2017.1309065] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 03/10/2017] [Accepted: 03/16/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE During early childhood, it is important to identify which children require intervention before they face the increased demands of school. This study aimed to: (1) compare parents' and educators' concerns, (2) examine inter-rater reliability between parents' and educators' concerns and (3) determine the group difference between level of concern and children's performance on clinical testing. METHOD Parents and educators of 1205 4- to 5-year-old children in the Sound Start Study completed the Parents' Evaluation of Developmental Status. Children whose parents/educators were concerned about speech and language underwent direct assessment measuring speech accuracy (n = 275), receptive vocabulary (n = 131) and language (n = 274). RESULT More parents/educators were concerned about children's speech and expressive language, than behaviour, social-emotional, school readiness, receptive language, self-help, fine motor and gross motor skills. Parents' and educators' responses were significantly correlated (except gross motor). Parents' and educators' level of concern about expressive speech and language was significantly correlated with speech accuracy on direct assessment. Educators' level of concern was significantly correlated with a screening measure of language. Scores on a test of receptive vocabulary significantly differed between those with concern and those without. CONCLUSION Children's communication skills concerned more parents and educators than other aspects of development and these concerns generally aligned with clinical testing.
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Affiliation(s)
- Sharynne McLeod
- a School of Teacher Education, Charles Sturt University , Bathurst , Australia
| | - Kathryn Crowe
- a School of Teacher Education, Charles Sturt University , Bathurst , Australia
| | - Jane McCormack
- a School of Teacher Education, Charles Sturt University , Bathurst , Australia
| | - Paul White
- b University of the West of England , Bristol , UK
| | - Yvonne Wren
- c Speech and Language Therapy Research Unit , Bristol , UK
- d University of Bristol , Bristol , UK , and
| | - Elise Baker
- e Communication Sciences and Disorders, The University of Sydney , Sydney , Australia
| | - Sarah Masso
- a School of Teacher Education, Charles Sturt University , Bathurst , Australia
| | - Sue Roulstone
- b University of the West of England , Bristol , UK
- c Speech and Language Therapy Research Unit , Bristol , UK
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33
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Garg P, Ha MT, Eastwood J, Harvey S, Woolfenden S, Murphy E, Dissanayake C, Williams K, Jalaludin B, McKenzie A, Einfeld S, Silove N, Short K, Eapen V. Health professional perceptions regarding screening tools for developmental surveillance for children in a multicultural part of Sydney, Australia. BMC FAMILY PRACTICE 2018; 19:42. [PMID: 29609547 PMCID: PMC5879732 DOI: 10.1186/s12875-018-0728-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 03/19/2018] [Indexed: 11/13/2022]
Abstract
Background Encouraging early child development and the early identification of developmental difficulties is a priority. The Ministry of Health in the Australian State of New South Wales (NSW), has recommended a program of developmental surveillance using validated screening questionnaires, namely, the Parents’ Evaluation of Development Status (PEDS) and Ages and Stages Questionnaire (ASQs), however, the use of these tools has remained sub-optimal. A longitudinal prospective birth cohort “Watch Me grow” study was carried out in the South Western Sydney (SW) region of NSW to ascertain the uptake as well as the strategies and the resources required to maximise engagement in the surveillance program. This paper reports on a qualitative component of the study examining the attitudes, enablers and barriers to the current developmental surveillance practices, with reference to screening tools, amongst health professionals. Methods Qualitative data from 37 primary health care providers in a region of relative disadvantage in Sydney was analysed. Results The major themes that emerged from the data were the “difficulties/problems” and “positives/benefits” of surveillance in general, and “specificity” of the tools which were employed. Barriers of time, tool awareness, knowledge and access of referral pathways, and services were important for the physician providers, while the choice of screening tools and access to these tools in other languages were raised as important issues by Child and Family Health Nurses (CFHN). The use of these tools by health professionals was also influenced by what the professionals perceived as the parents’ understanding of their child’s development. While the PEDS and ASQs was utilised by CFHNs, both General Practitioners (GPs) and paediatricians commented that they lacked awareness of developmental screening tools and highlighted further training needs. Conclusions The results highlight the practical challenges to, and limited knowledge and uptake of, the use of recommended screening tools as part of developmental surveillance. There is a need for further research regarding the most effective integrated models of care which will allow for a better collaboration between parents and service providers and improve information sharing between different professionals such as CFHNs GPs, Practices nurses and Paediatricians involved in screening and surveillance programs.
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Affiliation(s)
- Pankaj Garg
- Department of Community Paediatrics, Liverpool Hospital, Liverpool, NSW, Australia.,School of Women's and Children's Health, UNSW, Sydney, Australia.,School of Medicine, University of Sydney, Sydney, Australia.,Specialist Disability Health Team, Fairfield, Australia.,Ingham Institute of Applied Medicine, Liverpool, Australia
| | - My Trinh Ha
- ICAMHS, South Western Sydney Local Health District, Sydney, NSW, Australia.,University of Western Sydney, Sydney, Australia
| | - John Eastwood
- School of Women's and Children's Health, UNSW, Sydney, Australia.,School of Public Health, University of Sydney, Sydney, NSW, Australia.,Ingham Institute of Applied Medicine, Liverpool, NSW, Australia.,School of Medicine, Griffith University, Gold Coast, QLD, Australia.,Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, Sydney, Australia
| | - Susan Harvey
- School of Nursing and Midwifery, Griffiths University, Brisbane, QLD, Australia
| | - Sue Woolfenden
- Sydney Children's Hospital Network (Randwick), Randwick, Australia.,UNSW, Sydney, Australia
| | | | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, VIC, Australia
| | - Katrina Williams
- Royal Children's Hospital, Melbourne, VIC, Australia.,University of Melbourne, Melbourne, Australia.,Murdoch Childrens Research Institute, Melbourne, Australia
| | - Bin Jalaludin
- NSW Ministry of Health, Sydney, Australia.,South Western Sydney Local Health District, Sydney, NSW, Australia
| | - Anne McKenzie
- Child and Family Health Nursing, Primary and Community Health, South Western Sydney Local Health District, Sydney, NSW, Australia
| | - Stewart Einfeld
- Centre for Disability Research and Policy and Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Natalie Silove
- The Children's Hospital at Westmead, Westmead, NSW, Australia.,University of Sydney, Sydney, Australia
| | - Kate Short
- University of Sydney, Sydney, Australia.,Liverpool Hospital, South Western Sydney LHD, Liverpool, NSW, Australia
| | - Valsamma Eapen
- School of Medicine, Griffith University, Gold Coast, QLD, Australia. .,UNSW, ICAMHS, South Western Sydney LHD, Sydney, NSW, Australia. .,Chair, Infant Child and Adolescent Psychiatry, University of New South Wales, Head, Academic Unit of Child Psychiatry, South West Sydney (AUCS), ICAMHS, Mental Health Centre, L1, Liverpool Hospital, Elizabeth Street, Liverpool, Sydney, NSW, 2170, Australia.
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May PA, Chambers CD, Kalberg WO, Zellner J, Feldman H, Buckley D, Kopald D, Hasken JM, Xu R, Honerkamp-Smith G, Taras H, Manning MA, Robinson LK, Adam MP, Abdul-Rahman O, Vaux K, Jewett T, Elliott AJ, Kable JA, Akshoomoff N, Falk D, Arroyo JA, Hereld D, Riley EP, Charness ME, Coles CD, Warren KR, Jones KL, Hoyme HE. Prevalence of Fetal Alcohol Spectrum Disorders in 4 US Communities. JAMA 2018; 319:474-482. [PMID: 29411031 PMCID: PMC5839298 DOI: 10.1001/jama.2017.21896] [Citation(s) in RCA: 477] [Impact Index Per Article: 79.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
IMPORTANCE Fetal alcohol spectrum disorders are costly, life-long disabilities. Older data suggested the prevalence of the disorder in the United States was 10 per 1000 children; however, there are few current estimates based on larger, diverse US population samples. OBJECTIVE To estimate the prevalence of fetal alcohol spectrum disorders, including fetal alcohol syndrome, partial fetal alcohol syndrome, and alcohol-related neurodevelopmental disorder, in 4 regions of the United States. DESIGN, SETTING, AND PARTICIPANTS Active case ascertainment methods using a cross-sectional design were used to assess children for fetal alcohol spectrum disorders between 2010 and 2016. Children were systematically assessed in the 4 domains that contribute to the fetal alcohol spectrum disorder continuum: dysmorphic features, physical growth, neurobehavioral development, and prenatal alcohol exposure. The settings were 4 communities in the Rocky Mountain, Midwestern, Southeastern, and Pacific Southwestern regions of the United States. First-grade children and their parents or guardians were enrolled. EXPOSURES Alcohol consumption during pregnancy. MAIN OUTCOMES AND MEASURES Prevalence of fetal alcohol spectrum disorders in the 4 communities was the main outcome. Conservative estimates for the prevalence of the disorder and 95% CIs were calculated using the eligible first-grade population as the denominator. Weighted prevalences and 95% CIs were also estimated, accounting for the sampling schemes and using data restricted to children who received a full evaluation. RESULTS A total of 6639 children were selected for participation from a population of 13 146 first-graders (boys, 51.9%; mean age, 6.7 years [SD, 0.41] and white maternal race, 79.3%). A total of 222 cases of fetal alcohol spectrum disorders were identified. The conservative prevalence estimates for fetal alcohol spectrum disorders ranged from 11.3 (95% CI, 7.8-15.8) to 50.0 (95% CI, 39.9-61.7) per 1000 children. The weighted prevalence estimates for fetal alcohol spectrum disorders ranged from 31.1 (95% CI, 16.1-54.0) to 98.5 (95% CI, 57.5-139.5) per 1000 children. CONCLUSIONS AND RELEVANCE Estimated prevalence of fetal alcohol spectrum disorders among first-graders in 4 US communities ranged from 1.1% to 5.0% using a conservative approach. These findings may represent more accurate US prevalence estimates than previous studies but may not be generalizable to all communities.
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Affiliation(s)
- Philip A. May
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill
- University of New Mexico, Center on Alcoholism, Substance Abuse and Addictions, Albuquerque
| | - Christina D. Chambers
- University of California San Diego School of Medicine, La Jolla
- Rady Children's Hospital–San Diego, San Diego, California
| | - Wendy O. Kalberg
- University of New Mexico, Center on Alcoholism, Substance Abuse and Addictions, Albuquerque
| | | | - Haruna Feldman
- University of California San Diego School of Medicine, La Jolla
| | - David Buckley
- University of New Mexico, Center on Alcoholism, Substance Abuse and Addictions, Albuquerque
| | - David Kopald
- University of California San Diego School of Medicine, La Jolla
| | - Julie M. Hasken
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill
| | - Ronghui Xu
- University of California San Diego School of Medicine, La Jolla
| | | | - Howard Taras
- University of California San Diego School of Medicine, La Jolla
| | | | | | | | | | - Keith Vaux
- University of California San Diego School of Medicine, La Jolla
| | - Tamison Jewett
- Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Amy J. Elliott
- Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | | | | | - Daniel Falk
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland
| | - Judith A. Arroyo
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland
| | - Dale Hereld
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland
| | - Edward P. Riley
- San Diego State University, Center for Behavioral Teratology, San Diego, California
| | - Michael E. Charness
- VA Boston Healthcare System, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Boston University School of Medicine, Boston, Massachusetts
| | | | - Kenneth R. Warren
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland
| | - Kenneth Lyons Jones
- University of California San Diego School of Medicine, La Jolla
- Rady Children's Hospital–San Diego, San Diego, California
| | - H. Eugene Hoyme
- University of Arizona College of Medicine, Tucson
- Sanford Research, University of South Dakota Sanford School of Medicine, Vermillion
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Eapen V, Walter A, Guan J, Descallar J, Axelsson E, Einfeld S, Eastwood J, Murphy E, Beasley D, Silove N, Dissanayake C, Woolfenden S, Williams K, Jalaludin B, The 'Watch Me Grow' Study Group. Maternal help-seeking for child developmental concerns: Associations with socio-demographic factors. J Paediatr Child Health 2017; 53:963-969. [PMID: 28661061 DOI: 10.1111/jpc.13607] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 03/27/2017] [Accepted: 04/17/2017] [Indexed: 11/28/2022]
Abstract
AIM To examine socio-demographic factors associated with maternal help-seeking for child developmental concerns in a longitudinal birth cohort study. An understanding of these factors is critical to improving uptake of services to maximise early identification and intervention for developmental concerns. METHODS A birth cohort was recruited from the post-natal wards of two teaching hospitals and through community nurses in South Western Sydney, Australia, between November 2011 and April 2013. Of the 4047 mothers approached, 2025 consented to participate (response rate = 50%). Socio-demographic and service use information was collected after the child's birth and when the child was 18 months of age. Sources of help were divided into three categories (formal health services, other formal services and informal supports) and compound variables were created by summing the number of different sources identified by mothers. RESULTS Significantly more sources of help were intended to be used and/or actually accessed by mothers born in Australia, whose primary language was English, with higher levels of education and annual household income, and among mothers of first-born children. CONCLUSIONS Developmental concerns are known to increase with increased psychosocial adversity. Our findings of reduced intent to access and use of services by socio-economically disadvantaged families and those from culturally and linguistically diverse backgrounds suggests that an inverse care effect is in operation whereby those children with the greatest health needs may have the least access to services. Possible explanations for this, and recommendations for improving service accessibility for these populations through targeted and culturally appropriate services, are discussed.
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Affiliation(s)
- Valsamma Eapen
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.,Academic Unit of Child Psychiatry South West Sydney (AUCS), South Western Sydney Local Health District, Liverpool Hospital, Sydney, New South Wales, Australia.,Ingham Institute for Applied Medical Research, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Amelia Walter
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.,Academic Unit of Child Psychiatry South West Sydney (AUCS), South Western Sydney Local Health District, Liverpool Hospital, Sydney, New South Wales, Australia
| | - Jane Guan
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Joseph Descallar
- Ingham Institute for Applied Medical Research, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Emma Axelsson
- Academic Unit of Child Psychiatry South West Sydney (AUCS), South Western Sydney Local Health District, Liverpool Hospital, Sydney, New South Wales, Australia.,Research School of Psychology, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Stewart Einfeld
- Centre for Disability Research and Policy, University of Sydney, Sydney, New South Wales, Australia
| | - John Eastwood
- Ingham Institute for Applied Medical Research, South Western Sydney Local Health District, Sydney, New South Wales, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Elisabeth Murphy
- Office of Kids and Families, NSW Ministry of Health, Child and Family Health, Sydney, New South Wales, Australia.,Child Health, School of Medicine, University of Notre Dame, Sydney, New South Wales, Australia
| | - Deborah Beasley
- Office of Kids and Families, NSW Ministry of Health, Child and Family Health, Sydney, New South Wales, Australia
| | - Natalie Silove
- Child Development Unit, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Cheryl Dissanayake
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Sue Woolfenden
- Community Child Health, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Katrina Williams
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Developmental Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Bin Jalaludin
- Ingham Institute for Applied Medical Research, South Western Sydney Local Health District, Sydney, New South Wales, Australia
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Johansen K, Persson K, Sonnander K, Magnusson M, Sarkadi A, Lucas S. Clinical utility of the Structured Observation of Motor Performance in Infants within the child health services. PLoS One 2017; 12:e0181398. [PMID: 28723929 PMCID: PMC5517004 DOI: 10.1371/journal.pone.0181398] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 07/02/2017] [Indexed: 11/25/2022] Open
Abstract
AIM This study aimed to evaluate the clinical utility of the Structured Observation of Motor Performance in Infants (SOMP-I) when used by nurses in routine child healthcare by analyzing the nurses' SOMP-I assessments and the actions taken when motor problems were suspected. METHOD Infants from three child health centers in Uppsala County, Sweden, were consecutively enrolled in a longitudinal study. The 242 infants were assessed using SOMP-I by the nurse responsible for the infant as part of the regular well-child visits at as close to 2, 4, 6 and 10 months of age as possible. The nurses noted actions taken such as giving advice, scheduling an extra follow-up or referring the infant to specialized care. The infants' motor development was reassessed at 18 months of age through review of medical records or parental report. RESULTS The assessments of level of motor development at 2 and 10 months showed a distribution corresponding to the percentile distribution of the SOMP-I method. Fewer infants than expected were assessed as delayed at 4 and 6 months or deficient in quality at all assessment ages. When an infant was assessed as delayed in level or deficient in quality, the likelihood of the nurse taking actions increased. This increased further if both delay and quality deficit were found at the same assessment or if one or both were found at repeated assessments. The reassessment of the motor development at 18 months did not reveal any missed infants with major motor impairments. INTERPRETATION The use of SOMP-I appears to demonstrate favorable clinical utility in routine child healthcare as tested here. Child health nurses can assess early motor performance using this standardized assessment method, and using the method appears to support them the clinical decision-making.
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Affiliation(s)
- Kine Johansen
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Uppsala University Children’s Hospital, Uppsala, Sweden
| | - Kristina Persson
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Karin Sonnander
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Margaretha Magnusson
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Anna Sarkadi
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Steven Lucas
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Uppsala University Children’s Hospital, Uppsala, Sweden
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Ireland P, Horridge KA. The Health, Functioning and Wellbeing Summary Traffic Light Communication Tool: a survey of families' views. Dev Med Child Neurol 2017; 59:661-664. [PMID: 28009058 DOI: 10.1111/dmcn.13370] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2016] [Indexed: 11/29/2022]
Abstract
AIM To ascertain families' views about the utility of the Health, Functioning and Wellbeing Summary (HFWS) in positively supporting communication in clinics. METHOD The HFWS was co-developed with families and members of the multidisciplinary team. A sequential convenience sample of 60 families who attended clinics in Sunderland, UK in 2015 agreed to participate and answered eight questions about their views on the tool's usefulness. Data were recorded and analysed in Microsoft Excel. RESULTS All families agreed that they had been able to discuss everything they had wanted to discuss with the doctor. All of the serious concerns that they had recorded on the HFWS had been addressed in the consultation. Most (58 out of 60; 97%) reported that the tool was easy to understand and complete, and 57 out of 60 (95%) reported that it helped them to gather their thoughts about what they wanted to discuss. Consultations that used the tool were thought to better address the needs of 49 out of 60 families (87.1%), than those in which it was not used. INTERPRETATION The HFWS was acceptable to most families surveyed, improved communication from their perspective, and ensured that the issues that mattered most to them were addressed in medical consultations. The tool has been translated into a number of other languages. Its acceptability and utility in other settings requires further study.
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Affiliation(s)
- Peter Ireland
- Newcastle University Medical School, Newcastle upon Tyne, UK
| | - Karen A Horridge
- Paediatric Disability Team, Sunderland Royal Hospital, Sunderland, UK
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Bourke-Taylor H, Pallant J, Cordier R. Child’s Challenging Behaviour Scale, Version 2 (CCBS–2): Psychometric Evaluation With Young Children. Am J Occup Ther 2017; 71:7104220010p1-7104220010p10. [DOI: 10.5014/ajot.2017.021733] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
OBJECTIVE. In this article, we evaluate psychometric properties of the Child’s Challenging Behaviour Scale, Version 2 (CCBS–2) with mothers of young, typically developing children.
METHOD. A cross-sectional mail survey with Australian mothers (N = 337) included the CCBS–2, the Depression Anxiety Stress Scales, and the Parents’ Evaluation of Developmental Status scale.
RESULTS. Internal consistency was good, and no gender differences in CCBS–2 scores were significant. Significant results included differences between CCBS–2 scores: among children grouped according to age, among children grouped according to pre– and post–school entry, among mothers grouped according to extent of any symptom type, and between this sample and a previously collected age-matched sample of children with disabilities.
CONCLUSION. Of the properties tested, results support sound psychometrics. The CCBS–2 can be used to differentiate children according to age, school entry, and disability as well as to identify families for potential services in behavior management and mental health.
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Affiliation(s)
- Helen Bourke-Taylor
- Helen Bourke-Taylor, PhD, is Associate Professor, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Peninsula Campus, Frankston, Victoria, Australia;
| | - Julie Pallant
- Julie Pallant, PhD, is Adjunct Associate Professor, Menzies Health Institute Queensland, School of Nursing and Midwifery, Griffith University, South Brisbane, Queensland, Australia
| | - Reinie Cordier
- Reinie Cordier, PhD, is Associate Professor, School of Occupational Therapy and Social Work, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
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Chunsuwan I, Hansakunachai T, Pornsamrit S. Parent Evaluation of Developmental Status (PEDS) in screening: The Thai experience. Pediatr Int 2016; 58:1277-1283. [PMID: 27285278 DOI: 10.1111/ped.13055] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 02/19/2016] [Accepted: 04/11/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Parent Evaluation of Developmental Status (PEDS) is a feasible developmental screening tool but it is not commonly used in Thailand. To examine the potential of PEDS as a screening tool, PEDS was implemented in well-child visits to identify the prevalence of developmental problems, characteristic parental concerns and comments, and to compare it with pediatrician developmental evaluation using Parent Evaluation of Developmental Status: Developmental Milestones, assessment level (PEDS: DM-AL). METHODS Participants were 266 children at the 9, 18 and 30 month health checkups as well as their parents. The PEDS questionnaire (Thai version) was first used for parents, and then the children were evaluated by pediatricians using PEDS: DM-AL. RESULTS Using PEDS, 12% and 34% of children were classified as high and moderate risk for developmental and social-emotion disorders. The most common concerns were behavioral problems, social-emotion problems and expressive language. On PEDS: DM-AL, 24% of children had delay in at least one domain of development. When PEDS screening was compared with PEDS: DM-AL, being in the PEDS high-risk group had 27.7% sensitivity and 93.0% specificity. If being in the moderate or high-risk group was used instead, the sensitivity was enhanced to 67.7%, with 60.7% specificity. CONCLUSIONS Implementation of PEDS in well-child visits could enhance early detection of developmental problems, but many Thai parents were unable to mention their concerns about delayed abilities in the correct PEDS question. Therefore, to ensure higher sensitivity, criteria for referral should be adjusted and a second stage developmental evaluation may be incorporated with PEDS.
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Affiliation(s)
- Issarapa Chunsuwan
- Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | - Tippawan Hansakunachai
- Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
| | - Suntaree Pornsamrit
- Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
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40
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Maleka BK, Van Der Linde J, Glascoe FP, Swanepoel DW. Developmental Screening—Evaluation of an m-Health Version of the Parents Evaluation Developmental Status Tools. Telemed J E Health 2016; 22:1013-1018. [DOI: 10.1089/tmj.2016.0007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Boledi K. Maleka
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - Jeannie Van Der Linde
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | | | - De Wet Swanepoel
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
- Ear Sciences Centre, School of Surgery, The University of Western Australia, Nedlands, Australia
- Australia Ear Science Institute Australia, Subiaco, Australia
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41
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Ide-Okochi A, Tadaka E. A hybrid concept analysis of children of concern: Japanese healthcare professionals' views of children at a high risk of developmental disability. BMC Pediatr 2016; 16:171. [PMID: 27793129 PMCID: PMC5084414 DOI: 10.1186/s12887-016-0715-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 10/25/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The new Diagnostic and Statistical Manual of Mental Disorders (fifth edition, DSM-5) redefined the boundaries of autism as a spectrum. It has been reported that the number of schoolchildren with undiagnosed developmental disorders (DDs) has risen in Japan. Such children referred to as kininaru-kodomo (KK, "children of concern") by healthcare professionals fall into a gray area. Therefore, KK are often overlooked at infant medical checkups. This leaves KK without necessary medical care and special needs education. It is urgent to explore the KK concept to enable professionals to properly assess and provide for the healthcare needs of these children at a high risk of DD, ideally with early intervention. METHODS A hybrid model of concept analysis was conducted. Working definitions were obtained from a systematic literature review in the theoretical phase. Subsequent in-depth personal interviews initiated in the fieldwork phase corroborated and refined the concept. These qualitative data were integrated in the final analytical phase to yield the practice-based real definition of KK in clinical settings. RESULTS Three themes emerged regarding KK children: children who require special care, children whose special healthcare needs are owing to both individual and environmental factors, and children waiting for the development of a new support system for them or their parents. CONCLUSIONS This study implies that KK are children who require special support because of individual and environmental factors. The concept of KK is considered useful for keeping children with undiagnosed DDs and/or other healthcare needs connected with support networks. It is strongly recommended that a screening tool be developed that reflects the concept of children at a high risk of DD so that children in this gray area may receive necessary support even before diagnosis.
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Affiliation(s)
- Ayako Ide-Okochi
- Graduate School of Nursing, School of Medicine, Yokohama City University, 9-3 Fukuura, Kanazawa-ku, 236-0004, Kanagawa, Japan.
| | - Etsuko Tadaka
- Graduate School of Nursing, School of Medicine, Yokohama City University, 9-3 Fukuura, Kanazawa-ku, 236-0004, Kanagawa, Japan
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42
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Massart R, Suderman MJ, Nemoda Z, Sutti S, Ruggiero AM, Dettmer AM, Suomi SJ, Szyf M. The Signature of Maternal Social Rank in Placenta Deoxyribonucleic Acid Methylation Profiles in Rhesus Monkeys. Child Dev 2016; 88:900-918. [PMID: 27739069 DOI: 10.1111/cdev.12640] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The effects of social status on human health can be modeled in captive cohorts of nonhuman primates. This study shows that maternal social rank is associated with broad changes in DNA methylation in placentae of rhesus monkeys (N = 10). Differentially methylated genes between social ranks are enriched in signaling pathways playing major roles in placenta physiology. Moreover, the authors found significant overlaps with genes whose expression was previously associated with social rank in adult rhesus monkeys (Tung et al., 2012) and whose methylation was associated with perinatal stress in newborn humans and rhesus monkeys (Nieratschker et al., 2014). These results are consistent with the hypothesis that system-wide epigenetic changes in multiple tissues are involved in long-term adaptations to the social environment.
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Woolfenden S, Eapen V, Jalaludin B, Hayen A, Kemp L, Dissanyake C, Hendry A, Axelsson E, Overs B, Eastwood J, Črnčec R, McKenzie A, Beasley D, Murphy E, Williams K. Prevalence and factors associated with parental concerns about development detected by the Parents' Evaluation of Developmental Status (PEDS) at 6-month, 12-month and 18-month well-child checks in a birth cohort. BMJ Open 2016; 6:e012144. [PMID: 27609853 PMCID: PMC5020845 DOI: 10.1136/bmjopen-2016-012144] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Early identification of developmental vulnerability is vital. This study aimed to estimate the prevalence of moderate or high developmental risk on the Parents' Evaluation of Developmental Status (PEDS) at 6-month, 12-month and 18-month well-child checks; identify associated risk factors; and examine documentation of the PEDS at well-child checks. DESIGN, PARTICIPANTS A prospective birth cohort of 2025 children with 50% of those approached agreeing to participate. Demographic data were obtained via questionnaires and linked electronic medical records. Telephone interviews were conducted with parents to collect PEDS data. PRIMARY AND SECONDARY OUTCOMES Multiple logistic regression analyses identified risk factors for moderate or high developmental risk on the PEDS. A Cumulative Risk Index examined the impact of multiple risk factors on developmental risk and documentation of the PEDS at the well-child checks. RESULTS Of the original cohort, 792 (39%) had 6-month, 649 (32%) had 12-month and 565 (28%) had 18-month PEDS data. Parental concerns indicating moderate or high developmental risk on the PEDS were 27% (95% CI 24 to 30) at 6 months, 27% (95% CI 24 to 30) at 12 months and 33% (95% CI 29 to 37) at 18 months. Factors associated with moderate or high developmental risk were perinatal risk (OR 12 months: 1.7 (95% CI 1.1 to 2.7)); maternal Middle Eastern or Asian nationality (OR 6 months: 1.6 (95% CI 1.1 to 2.4)), (OR 12 months: 1.7 (95% CI 1.1 to 2.7)); and household disadvantage (OR 6 months: 1.5 (95% CI 1.0 to 2.2). As the number of risk factors increased the odds increased for high or moderate developmental risk and no documentation of the PEDS at well-child checks. CONCLUSIONS Children with multiple risk factors are more likely to have parental concerns indicating developmental vulnerability using the PEDS and for these concerns to not be documented.
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Affiliation(s)
- Susan Woolfenden
- Sydney Children's Hospitals Network, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
| | - Valsamma Eapen
- Academic Unit of Child Psychiatry, South West Sydney Local Health District (AUCS), Sydney, New South Wales, Australia
- School of Psychiatry & Ingham Institute, University of New South Wales, Sydney, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
| | - Bin Jalaludin
- Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
- Epidemiology Group, Healthy People and Places Unit, South Western Sydney Local Health District, Sydney, New South Wales, Australia
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Andrew Hayen
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Lynn Kemp
- School of Nursing and Midwifery, University of Western Sydney, Penrith South DC, New South Wales, Australia
| | - Cheryl Dissanyake
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, South Australia, Australia
| | - Alexandra Hendry
- Early Years Research Group, Ingham Institute, Sydney South West Local Health District, Sydney, New South Wales, Australia
| | - Emma Axelsson
- Academic Unit of Child Psychiatry, South West Sydney Local Health District (AUCS), Sydney, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
- Research School of Psychology, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Bronwyn Overs
- Academic Unit of Child Psychiatry, South West Sydney Local Health District (AUCS), Sydney, New South Wales, Australia
| | - John Eastwood
- Community Paediatrics, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Rudi Črnčec
- Academic Unit of Child Psychiatry, South West Sydney Local Health District (AUCS), Sydney, New South Wales, Australia
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Anne McKenzie
- Sydney South West Local Health District, Australia,Sydney, New South Wales, Australia
| | - Deborah Beasley
- Office of Kids and Families (NSW Health), North Sydney, New South Wales, Australia
| | - Elisabeth Murphy
- Office of Kids and Families (NSW Health), North Sydney, New South Wales, Australia
| | - Katrina Williams
- Department of Paediatrics, University of Melbourne, Melbourne, South Australia, Australia
- Developmental Medicine, Royal Children's Hospital, Melbourne, South Australia, Australia
- Murdoch Children's Research Institute, Melbourne, South Australia, Australia
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Sun J, Patel F, Kirzner R, Newton-Famous N, Owens C, Welles SL, Chilton M. The Building Wealth and Health Network: methods and baseline characteristics from a randomized controlled trial for families with young children participating in temporary assistance for needy families (TANF). BMC Public Health 2016; 16:583. [PMID: 27421287 PMCID: PMC4947340 DOI: 10.1186/s12889-016-3233-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 06/16/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Families with children under age six participating in the Temporary Assistance for Needy Families Program (TANF) must participate in work-related activities for 20 h per week. However, due to financial hardship, poor health, and exposure to violence and adversity, families may experience great difficulty in reaching self-sufficiency. The purpose of this report is to describe study design and baseline findings of a trauma-informed financial empowerment and peer support intervention meant to mitigate these hardships. METHODS We conducted a randomized controlled trial of a 28-week intervention called Building Wealth and Health Network to improve financial security and maternal and child health among caregivers participating in TANF. Participants, recruited from County Assistance offices in Philadelphia, PA, were randomized into two intervention groups (partial and full) and one control group. Participants completed questionnaires at baseline to assess career readiness, economic hardship, health and wellbeing, exposure to adversity and violence, and interaction with criminal justice systems. RESULTS Baseline characteristics demonstrate that among 103 participants, there were no significant differences by group. Mean age of participants was 25 years, and youngest child was 30 months. The majority of participants were women (94.2 %), never married (83.5 %), unemployed (94.2 %), and without a bank account (66.0 %). Many reported economic hardship (32.0 % very low household food secure, 65.0 % housing insecure, and 31.1 % severe energy insecure), and depression (57.3 %). Exposure to adversity was prevalent, where 38.8 % reported four or more Adverse Childhood Experiences including abuse, neglect and household dysfunction. In terms of community violence, 64.7 % saw a seriously wounded person after an incident of violence, and 27.2 % had seen someone killed. Finally, 14.6 % spent time in an adult correctional institution, and 48.5 % of the fathers of the youngest child spent time in prison. CONCLUSIONS Baseline findings demonstrate that caregivers participating in TANF have suffered significant childhood adversity, adult violence exposure, and poverty-related stressors that can limit workforce success. High prevalence of housing and food insecurity, exposure to adversity, violence and criminal justice systems demands comprehensive programming to support families. Trauma-informed approaches to career readiness such as the Building Wealth and Health Network offer opportunities for potential success in the workforce. TRIAL REGISTRATION This study is retrospectively registered with ClinicalTrials.gov. The Identifier is: NCT02577705 The Registration date is October 13, 2015.
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Affiliation(s)
- Jing Sun
- />Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, 2213 McElderry St, Room M139, Baltimore, MD 21205 USA
| | - Falguni Patel
- />Department of Health Management and Policy, Drexel University Dornsife School of Public Health, 3600 Market Street, 7th Floor, Philadelphia, PA 19104 USA
| | | | - Nijah Newton-Famous
- />Department of Health Management and Policy, Drexel University Dornsife School of Public Health, 3600 Market Street, 7th Floor, Philadelphia, PA 19104 USA
| | - Constance Owens
- />Department of Health Management and Policy, Drexel University Dornsife School of Public Health, 3600 Market Street, 7th Floor, Philadelphia, PA 19104 USA
| | - Seth L. Welles
- />Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, 3215 Market Street, 5th Floor, Room 535, Philadelphia, PA 19104 USA
| | - Mariana Chilton
- />Department of Health Management and Policy, Drexel University Dornsife School of Public Health, 3600 Market Street, 7th Floor, Philadelphia, PA 19104 USA
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Thomas RE, Spragins W, Mazloum G, Cronkhite M, Maru G. Rates of detection of developmental problems at the 18-month well-baby visit by family physicians' using four evidence-based screening tools compared to usual care: a randomized controlled trial. Child Care Health Dev 2016; 42:382-93. [PMID: 27061302 DOI: 10.1111/cch.12333] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 02/02/2016] [Accepted: 02/04/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Early and regular developmental screening can improve children's development through early intervention but is insufficiently used. Most developmental problems are readily evident at the 18-month well-baby visit. This trial's purpose is to: (1) compare identification rates of developmental problems by GPs/family physicians using four evidence-based tools with non-evidence based screening, and (2) ascertain whether the four tools can be completed in 10-min pre-visit on a computer. METHODS We compared two approaches to early identification via random assignment of 54 families to either: 'usual care' (informal judgment including ad-hoc milestones, n = 25); or (2) 'Evidence-based' care (use of four validated, accurate screening tools, n = 29), including: the Parents' Evaluation of Developmental Status (PEDS), the PEDS-Developmental Milestones (PEDS-DM), the Modified Checklist for Autism in Toddlers (M-CHAT) and PHQ9 (maternal depression). RESULTS In the 'usual care' group four (16%) and in the evidence-based tools group 18 (62%) were identified as having a possible developmental problem. In the evidence-based tools group three infants were to be recalled at 24 months for language checks (no specialist referrals made). In the 'usual care' group four problems were identified: one child was referred for speech therapy, two to return to check language at 24 months and a mother to discuss depression. All forms were completed on-line within 10 min. CONCLUSIONS Despite higher early detection rates in the evidence-based care group, there were no differences in referral rates between evidence-based and usual-care groups. This suggests that clinicians: (1) override evidence-based screening results with informal judgment; and/or (2) need assistance understanding test results and making referrals. Possible solutions are improve the quality of information obtained from the screening process, improved training of physicians, improved support for individual practices and acceptance by the regional health authority for overall responsibility for screening and creation of a comprehensive network.
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Affiliation(s)
- R E Thomas
- Family Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - W Spragins
- Independent Research Consultant, Calgary, Alberta, Canada
| | - G Mazloum
- Foothills Family Practice, Alberta, Canada
| | | | - G Maru
- Children's Hospital, Calgary, Alberta and Independent Research Consultant, Calgary, Alberta, Canada
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46
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Woolfenden S, Eapen V, Axelsson E, Hendry A, Jalaludin B, Dissanayake C, Overs B, Descallar J, Eastwood J, Einfeld S, Silove N, Short K, Beasley D, Črnčec R, Murphy E, Williams K. Who is our cohort: recruitment, representativeness, baseline risk and retention in the "Watch Me Grow" study? BMC Pediatr 2016; 16:46. [PMID: 27013220 PMCID: PMC4806415 DOI: 10.1186/s12887-016-0582-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 03/14/2016] [Indexed: 11/13/2022] Open
Abstract
Background The “Watch Me Grow” (WMG) study examines the current developmental surveillance system in South West Sydney. This paper describes the establishment of the study birth cohort, including the recruitment processes, representativeness, follow-up and participants’ baseline risk for future developmental risk. Methods Newborn infants and their parents were recruited from two public hospital postnatal wards and through child health nurses during the years 2011–2013. Data was obtained through a detailed participant questionnaire and linked with the participant’s electronic medical record (EMR). Representativeness was determined by Chi-square analyses of the available clinical, psychosocial and sociodemographic EMR data, comparing the WMG participants to eligible non-participants. Reasons for non-participation were also elicited. Participant characteristics were examined in six, 12, and 18-month follow-ups. Results The number of infants recruited totalled 2,025, with 50 % of those approached agreeing to participate. Reasons for parents not participating included: lack of interest, being too busy, having plans to relocate, language barriers, participation in other research projects, and privacy concerns. The WMG cohort was broadly representative of the culturally diverse and socially disadvantaged local population from which it was sampled. Of the original 2025 participants enrolled at birth, participants with PEDS outcome data available at follow-up were: 792 (39 %) at six months, 649 (32 %) at 12 months, and 565 (28 %) at 18 months. Participants with greater psychosocial risk were less likely to have follow-up outcome data. Almost 40 % of infants in the baseline cohort were exposed to at least two risk factors known to be associated with developmental risk. Conclusions The WMG study birth cohort is a valuable resource for health services due to the inclusion of participants from vulnerable populations, despite there being challenges in being able to actively follow-up this population.
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Affiliation(s)
- Susan Woolfenden
- Sydney Children's Hospitals Network, Sydney, Australia. .,University of New South Wales, Sydney, Australia.
| | - Valsamma Eapen
- Academic Unit of Child Psychiatry, South West Sydney Local Health District (AUCS), Sydney, Australia.,School of Psychiatry & Ingham Institute, University of New South Wales, Sydney, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Emma Axelsson
- Academic Unit of Child Psychiatry, South West Sydney Local Health District (AUCS), Sydney, Australia.,School of Psychiatry & Ingham Institute, University of New South Wales, Sydney, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Alexandra Hendry
- Early Years Research Group, Ingham Institute, Sydney South West Local Health District, Sydney, Australia
| | - Bin Jalaludin
- Ingham Institute for Applied Medical Research, Liverpool, Australia.,Epidemiology Group, Healthy People and Places Unit, South Western Sydney Local Health District, Sydney, Australia.,School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, Australia
| | - Bronwyn Overs
- Academic Unit of Child Psychiatry, South West Sydney Local Health District (AUCS), Sydney, Australia.,School of Psychiatry & Ingham Institute, University of New South Wales, Sydney, Australia
| | - Joseph Descallar
- Ingham Institute for Applied Medical Research, Liverpool, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
| | - John Eastwood
- Ingham Institute for Applied Medical Research, Liverpool, Australia.,Community Paediatrics, South Western Sydney Local Health District, Sydney, Australia
| | - Stewart Einfeld
- Centre for Disability Research and Policy, Brain & Mind Research Institute, University of Sydney, Sydney, Australia
| | - Natalie Silove
- Sydney Children's Hospitals Network, Sydney, Australia.,School of Psychiatry & Ingham Institute, University of New South Wales, Sydney, Australia.,Discipline of Paediatrics and Child Health, University of Sydney, Sydney, Australia
| | - Kate Short
- University of New South Wales, Sydney, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia.,Speech Pathology Unit, Liverpool Hospital, Sydney, Australia
| | | | - Rudi Črnčec
- Academic Unit of Child Psychiatry, South West Sydney Local Health District (AUCS), Sydney, Australia.,School of Psychiatry & Ingham Institute, University of New South Wales, Sydney, Australia
| | | | - Katrina Williams
- Department of Paediatrics, University of Melbourne, Sydney, Australia.,Developmental Medicine, Royal Children's Hospital, Sydney, Australia.,Murdoch Children's Research Institute, Sydney, Australia
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Koç Ö, Kavuncuoğlu S, Ramoğlu MG, Aldemir E, Aktalay A, Eras Z. School Performance and Neurodevelopment of Very Low Birth Weight Preterm Infants: First Report From Turkey. J Child Neurol 2016; 31:170-6. [PMID: 26012506 DOI: 10.1177/0883073815587028] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 04/21/2015] [Indexed: 11/16/2022]
Abstract
Very low birth weight preterm infants are under significant risk of neurologic, developmental, and somatic problems. In this study, 90 infants born with a birth weight <1500 g and/or with a gestational age <32 weeks were evaluated after the first year of elementary school to assess neurodevelopment. The Wechsler Intelligence Scale for Children-Revised (WISC-R) test, Pediatric Symptom Checklist, and Parent Evaluation of Developmental Status were performed. Mental retardation, cerebral palsy, blindness, epilepsy, and posthemorrhagic hydrocephaly incidences were 14%, 7%, 2%, 5%, and 2%, respectively. The WISC-R score of 32 patients (35.5%) were below 85. Perinatal asphyxia, abnormal neurologic examination, and delayed or impaired speech correlated significantly with low WISC-R scores. Education and income of the father had positive impact on WISC-R scores (P = .042 and P = .026). Parents' concern and presence of cognitive problems were correlated (P = .026). Environmental factors, as well as the prevention of morbidity, affected school performance positively.
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Affiliation(s)
- Özden Koç
- Department of Pediatrics, Bakırköy Gynecology & Obstetrics and Children's Education Hospital, İstanbul, Turkey
| | - Sultan Kavuncuoğlu
- Department of Neonatology, Bakırköy Gynecology & Obstetrics and Children's Education Hospital, İstanbul, Turkey
| | - Mehmet G Ramoğlu
- Department of Pediatrics, Bakırköy Gynecology & Obstetrics and Children's Education Hospital, İstanbul, Turkey Department of Pediatric Cardiology, Ankara University Medical Faculty, Ankara, Turkey
| | - Esin Aldemir
- Department of Neonatology, Bakırköy Gynecology & Obstetrics and Children's Education Hospital, İstanbul, Turkey
| | - Ayşegül Aktalay
- Department of Child Psychology, Bakırköy Gynecology & Obstetrics and Children's Education Hospital, İstanbul, Turkey
| | - Zeynep Eras
- Developmental Behavioral Pediatrics Unit, Department of Neonatology, Zekai Tahir Burak Women Health and Education Hospital, Ankara, Turkey
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