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Hatakenaka Y, Hachiya K, Åsberg Johnels J, Gillberg C. Harnessing the power of child development records to detect early neurodevelopmental disorders using Bayesian analysis. Acta Paediatr 2024. [PMID: 39264286 DOI: 10.1111/apa.17424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 08/15/2024] [Accepted: 09/03/2024] [Indexed: 09/13/2024]
Abstract
AIM This study aims to analyse the developmental data from public health nurses (PHNs) to identify early indicators of neurodevelopmental disorders (NDDs) in young children using Bayesian network (BN) analysis to determine factor combinations that improve diagnosis accuracy. METHODS The study cohort was 501 children who underwent health checkups at 18 and 36-month. Data included demographics, pregnancy, delivery, neonatal factors, maternal interviews, and physical and neurological findings. Diagnoses were made by paediatricians and child psychiatrists using standardised tools. Predictive accuracy was assessed by the receiver operating characteristic (ROC) curve analysis. RESULTS We identified several infant/toddler factors significantly associated with NDD diagnoses. Predictive factors included meconium-stained amniotic fluid, 1 min Apgar score, and early developmental milestones. ROC curve analysis showed varying predictive accuracies based on evaluation timing. The 10-month checkup was valid for screening but less reliable for excluding low-risk cases. The 18-month evaluation accurately identified children at NDD risk. CONCLUSION The study demonstrates the potential of using developmental records for early NDD detection, emphasising early monitoring and intervention for at-risk children. These findings could guide future infant mental health initiatives in the community.
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Affiliation(s)
- Yuhei Hatakenaka
- Faculty of Humanities and Sociologies, University of the Ryukyus, Okinawa, Japan
- Kochi Gillberg Neuropsychiatry Centre, Kochi Prefectural Medical and Welfare Centre, Kochi, Japan
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, Gothenburg, Sweden
| | - Koutaro Hachiya
- Faculty of Modern Life, Teikyo Heisei University, Tokyo, Japan
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Honda H. The necessity for a simple and reliable screening tool for developmental concerns: Validity of the ESSENCE-Q. Dev Med Child Neurol 2024. [PMID: 38801108 DOI: 10.1111/dmcn.15961] [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: 05/07/2024] [Accepted: 05/07/2024] [Indexed: 05/29/2024]
Affiliation(s)
- Hideo Honda
- Department of Child and Adolescent Developmental Psychiatry, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
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Yasumitsu-Lovell K, Thompson L, Fernell E, Eitoku M, Suganuma N, Gillberg C. Validity of the ESSENCE-Q neurodevelopmental screening tool in Japan. Dev Med Child Neurol 2024. [PMID: 38760958 DOI: 10.1111/dmcn.15956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 04/05/2024] [Accepted: 04/10/2024] [Indexed: 05/20/2024]
Abstract
AIM To assess the validity of the Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations-Questionnaire (ESSENCE-Q), a simple screening tool for neurodevelopmental problems, in Japan. METHOD Parents/caregivers completed the 11-item ESSENCE-Q for 77 612 children aged 2 years 6 months included in a national birth cohort study. Information about neurodevelopmental disorders (NDDs: autism spectrum disorder; intellectual disability and/or developmental language disorder; motor delay/motor disorder) was collected at age 3 years. Each ESSENCE-Q item was scored on a binary (0,1) scale, with a total score range of 0 to 11. Total scores and individual items were compared across children with and without NDDs. RESULTS NDDs were recorded in 854 children (1.1%). With a total ESSENCE-Q score cut-off of ≥3, receiver operating characteristic curve analysis showed an area under the curve of 0.91, with sensitivity 84.9%, specificity 84.8%, positive predictive value 5.9%, and negative predictive value 99.8%. The proportion of parental concerns at 2 years 6 months differed significantly by NDD status for communication (89.5% vs 14.2%) and general development (80.2% vs 7.4%). ESSENCE-Q total scores were moderately negatively correlated (-0.36, p < 0.001) with Japanese Ages and Stages Questionnaire scores. INTERPRETATION The parent/caregiver-completed ESSENCE-Q is useful as a tool for screening out children with neurotypical development at this early age. Further research into longer-term predictive validity will be possible as more NDD diagnoses are given as the children grow up.
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Affiliation(s)
- Kahoko Yasumitsu-Lovell
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Kochi Gillberg Neuropsychiatry Centre, Kochi, Japan
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Lucy Thompson
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Elisabeth Fernell
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Masamitsu Eitoku
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Narufumi Suganuma
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Kochi Gillberg Neuropsychiatry Centre, Kochi, Japan
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Kitazoe N, Mimoto S, Fukunaga I, Hamaguchi M, Hatakenaka Y, Gillberg C. The ESSENCE-Q: Can specialist supervision improve scoring agreement across specialist and public health nurses/nursery teachers? Acta Paediatr 2024; 113:267-275. [PMID: 37846436 DOI: 10.1111/apa.17001] [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: 06/22/2023] [Revised: 09/28/2023] [Accepted: 10/04/2023] [Indexed: 10/18/2023]
Abstract
AIM This study aimed to explore whether the supervision of community public health nurses (PHNs) and nursery school teachers (NSTs) by a specialist, familiar with Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations (ESSENCE), improved the agreement of ESSENCE-Questionnaire (ESSENCE-Q) scoring, across raters. METHODS A PHN, two NSTs, and a speech-language pathologist (SLP), familiar with ESSENCE, independently assessed 32 children. The ESSENCE-Q results were divided into the first (child 1-18) and second groups (the 19th child and the following children). Changes in score discrepancies were analysed for ESSENCE-Q cutoff scores and total ESSENCE-Q scores across raters. The SLP scores were used as a reference to evaluate sensitivity and specificity. RESULTS The total ESSENCE-Q scores of the PHN and NSTs showed higher concordance in the second group (p < 0.05). Comparisons of the differences between the PHN/NSTs and SLP in total ESSENCE-Q scores showed a significantly smaller difference in the NSTs' scores in the second group (p < 0.05). CONCLUSION The findings suggest that specialist supervision may lead to a better agreement between PHN and NSTs regarding ESSENCE-Q scores.
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Affiliation(s)
- Noriko Kitazoe
- Kochi Gillberg Neuropsychiatry Centre, Kochi Treatment and Welfare Center, Kochi, Japan
| | - Sae Mimoto
- Kochi Gillberg Neuropsychiatry Centre, Kochi Treatment and Welfare Center, Kochi, Japan
| | - Ichiro Fukunaga
- Kochi Gillberg Neuropsychiatry Centre, Kochi Treatment and Welfare Center, Kochi, Japan
- Chuo-Nishi Public Health and Welfare Office, Kochi Prefectural Government, Kochi, Japan
| | - Masako Hamaguchi
- Kochi Gillberg Neuropsychiatry Centre, Kochi Treatment and Welfare Center, Kochi, Japan
- The child development support programs COLORFUL PIECE, Kochi, Japan
| | - Yuhei Hatakenaka
- Kochi Gillberg Neuropsychiatry Centre, Kochi Treatment and Welfare Center, Kochi, Japan
- Faculty of Humanities and Social Sciences, University of the Ryukyus, Okinawa, Japan
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Cederlund M. Education and supervision have potential to make nursery school teachers and primary health nurses to valuable resources in the identification of children with neurodevelopmental disabilities. Acta Paediatr 2024; 113:168-169. [PMID: 37997692 DOI: 10.1111/apa.17044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 11/13/2023] [Indexed: 11/25/2023]
Affiliation(s)
- Mats Cederlund
- Sahlgrenska Academy, Neurology and Physiology, Gothenburg University, Gothenburg, Sweden
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Tanasan A, Eghalian F, Behmanesh H, Khazaei S, Farahani F, Hosseini F. Evaluation of Neurological and Auditory Development in Children with Congenital Heart Disease using Essence Q Questionnaire and Auditory Brainstem Response (ABR) Test. IRANIAN JOURNAL OF CHILD NEUROLOGY 2024; 18:43-50. [PMID: 38375124 PMCID: PMC10874519 DOI: 10.22037/ijcn.v18i.39186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 02/07/2023] [Indexed: 02/21/2024]
Abstract
Objectives The progress of cardiac surgery in children and the increase in the survival of children with Congenital Heart Disease (CHD) has led to consider another issue called a neurodevelopmental disorder. In this study, 53 children with CHD were evaluated in terms of development with the Essence Q questionnaire, Otoacoustic Emission (OAE), and Auditory Brainstem Response (ABR) regarding these patients' hearing and risk factors. The Essence Q scores were also examined. Materials & Methods In this prospective, cross-sectional study, the researchers included 53 children diagnosed with CHD. Initially, each child underwent ABR and OAE tests. Subsequently, data on potential risk factors associated with neurodevelopmental delay were collected. A trained project associate administered the Essence Q questionnaire, using parents' information as a guide. Following data collection, this study proceeded with an in-depth analysis of the information. Results Thirty-six boys (67.92%) and 17 girls (32.08%) with CHD were included in the study. The mean age of children was 26.98± 10.64 months. The mean Essence Q score for boys was 7.48± 2.57. Moreover, the average score for girls was 2.23 ± 8.11. According to this questionnaire, 39 patients (73.58%) had hyperactivity disorder, 46 patients (86.79%) had behavioral disorders, and ten patients (16.98%) had a motor delay. Unlike previous studies, all patients had normal OAE and ABR hearing. Conclusion This study demonstrated that factors such as developmental delay in the first year, a known genetic disease, and a history of seizures significantly impacted the Essence Q score. However, elements like prematurity, the use of ventilation, abnormalities on the dorsum, and the number of days post-surgery did not significantly affect the Essence Q score. Essence Q can be a reliable tool in screening for neurodevelopment in children with CHD.
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Affiliation(s)
- Asadollah Tanasan
- Department of Pediatrices, Hamadan University of Medical Sciences, Hamedan, Iran
| | - Fatemeh Eghalian
- Department of Pediatrices, Hamadan University of Medical Sciences, Hamedan, Iran
| | - Helen Behmanesh
- Departmentof Psycology, Hamadan University of Medical Sciences, Hamedan, Iran
| | - Salman Khazaei
- Research Center for Health Sciences,Hamadan University of Medical Sciences, Hamedan, Iran
| | - Farhad Farahani
- Depatment of Ear, Noise and Throath, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Firozeh Hosseini
- Department of Pediatrices, Hamadan University of Medical Sciences, Hamedan, Iran
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Rah SS, Jung M, Lee K, Kang H, Jang S, Park J, Yoon JY, Hong SB. Systematic Review and Meta-analysis: Real-World Accuracy of Children's Developmental Screening Tests. J Am Acad Child Adolesc Psychiatry 2023; 62:1095-1109. [PMID: 36592715 DOI: 10.1016/j.jaac.2022.12.014] [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: 12/20/2021] [Revised: 11/10/2022] [Accepted: 12/23/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVE This review presents a list of developmental screening tests used in clinical settings worldwide and provides a broad estimate of their accuracy (PROSPERO: CRD42021236474). METHOD Following the PRISMA Diagnostic Test Accuracy (DTA) guidelines, this review involved searching PubMed, PsycINFO, Cochrane, EMBASE, CINAHL, and Google Scholar (for manual searching). Inclusion criteria included studies published in English through 2020 that compared the accuracy of developmental screening tests against developmental diagnostic tests among children under 13 years of age. Six researchers, in pairs, independently selected the studies and extracted the data. A hierarchical model was applied to meta-analyze the diagnostic accuracy of the tests, and meta-regression was used to identify the moderators using R 4.1.3 software. RESULTS The meta-analysis included 56 studies (17 screening tests and 61 outcomes). The most frequently used screening tests were the Ages and Stages Questionnaire (ASQ), Denver Developmental Screening Test (DDST), and Parent's Evaluation of Developmental Status (PEDS). The pooled sensitivity and specificity were 0.75 (95% CI = 0.69-0.80) and 0.76 (95% CI = 0.71-0.80), and the overall diagnostic accuracy of the total outcomes (area under the curve) was 0.80. High heterogeneity was observed between the included studies with various thresholds of the tests. Participants' developmental concerns at the baseline significantly moderated the accuracy of the screening tests, resulting in double the positive predictive value and prevalence compared to those without the concerns. CONCLUSION We recommend a standardized process of validation studies for diagnostic accuracy, to ensure the effectiveness of developmental screening tests in clinical settings. STUDY PREREGISTRATION INFORMATION Accuracy of Developmental Screening Tools among Children in Real World: a Systematic Review and Meta Analysis; https://www.crd.york.ac.uk/; CRD42021236474.
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Affiliation(s)
- Sung Sil Rah
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Minho Jung
- Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyungmin Lee
- Seoul National University College of Nursing, Seoul, Republic of Korea
| | - Hannah Kang
- Seoul National University College of Nursing, Seoul, Republic of Korea
| | - Soyoung Jang
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, Seoul National University College of Nursing, Seoul, Republic of Korea
| | - Junghyun Park
- Seoul National University College of Nursing, Seoul, Republic of Korea
| | - Ju Young Yoon
- Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea
| | - Soon-Beom Hong
- Seoul National University College of Medicine, Seoul, Republic of Korea; Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.
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Overbeck G, Kragstrup J, Gørtz M, Rasmussen IS, Graungaard AH, Siersma V, de Voss S, Ertmann RK, Shahrzad S, Appel CL, Wilson P. Family wellbeing in general practice: a study protocol for a cluster-randomised trial of the web-based resilience programme on early child development. Trials 2023; 24:7. [PMID: 36597136 PMCID: PMC9810520 DOI: 10.1186/s13063-022-07045-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/20/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Social, emotional and behavioural problems in early childhood are associated with increased risk for a wide range of poor outcomes associated with substantial cost and impact on society as a whole. Some of these problems are rooted in the early mother-infant relationship and might be prevented. In Denmark, primary health care has a central role in preventive care during pregnancy and the first years of the child's life and general practice provides opportunities to promote a healthy mother-infant relationship in early parenthood. OBJECTIVE In the context of standardised antenatal and child development assessments focused on psychosocial wellbeing, we examine the impact of a complex intervention designed to improve maternal mentalisation skills, involving training of general practice clinicians and signposting towards a web-based resource. Joint main outcomes are child socio-emotional and language development at age 30 months measured by parentally reported questionnaires (Communicative Development Inventory and Strengths and Difficulties Questionnaire). METHODS The study is a cluster-randomised controlled trial based in general practices in the Capital Region and the Zealand Region of Denmark. Seventy practices were included. Practices were randomised by a computer algorithm in a ratio of 1:1 to intervention or control groups. Each practice was asked to recruit up to 30 women consecutively at their first scheduled antenatal assessment. Clinicians in both groups received one day of training in preventive antenatal and child development consultations with added focus on parental psychosocial well-being, social support, and parent-child interaction. These preventive consultations delivered in both trial arms require enhanced data recording about psychosocial factors. In intervention clinics, clinicians were asked to signpost a web page at three scheduled antenatal consultations and at four scheduled consultations when the child is 5 weeks, 5 months, 1 and 2 years. DISCUSSION We hypothesise that the intervention will increase mothers' ability to be sensitive to their child's mental state to an extent that improves the child's language and mental state at 30 months of age measured by parent-reported questionnaires. TRIAL REGISTRATION ClinicalTrials.gov NCT04129359. Registered on Oct 16 2019.
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Affiliation(s)
- Gritt Overbeck
- grid.5254.60000 0001 0674 042XUniversity of Copenhagen, Department of Public Health, Centre for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Kragstrup
- grid.5254.60000 0001 0674 042XUniversity of Copenhagen, Department of Public Health, Centre for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Mette Gørtz
- grid.5254.60000 0001 0674 042XDepartment of Economics and Center for Economic Behavior and Inequality (CEBI), University of Copenhagen, Copenhagen, Denmark
| | - Ida Scheel Rasmussen
- grid.5254.60000 0001 0674 042XUniversity of Copenhagen, Department of Public Health, Centre for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Anette Hauskov Graungaard
- grid.5254.60000 0001 0674 042XUniversity of Copenhagen, Department of Public Health, Centre for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Volkert Siersma
- grid.5254.60000 0001 0674 042XUniversity of Copenhagen, Department of Public Health, Centre for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Sarah de Voss
- grid.5254.60000 0001 0674 042XUniversity of Copenhagen, Department of Public Health, Centre for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Ruth Kirk Ertmann
- grid.5254.60000 0001 0674 042XUniversity of Copenhagen, Department of Public Health, Centre for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Sinead Shahrzad
- grid.5254.60000 0001 0674 042XUniversity of Copenhagen, Department of Public Health, Centre for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Clara Lundmark Appel
- grid.5254.60000 0001 0674 042XUniversity of Copenhagen, Department of Public Health, Centre for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Philip Wilson
- grid.5254.60000 0001 0674 042XUniversity of Copenhagen, Department of Public Health, Centre for General Practice, University of Copenhagen, Copenhagen, Denmark ,grid.7107.10000 0004 1936 7291Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland
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Pre-/perinatal reduced optimality and neurodevelopment at 1 month and 3 years of age: Results from the Japan Environment and Children's Study (JECS). PLoS One 2023; 18:e0280249. [PMID: 36630408 PMCID: PMC9833583 DOI: 10.1371/journal.pone.0280249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/17/2022] [Indexed: 01/12/2023] Open
Abstract
Neurodevelopmental disorders (NDDs) in children are associated with a complex combination of genetic and/or environmental factors. Pre-/perinatal events are major known environmental suboptimal factors, and their individual and combined contributions vary. This study investigated the association between pre-/perinatal reduced optimality and child development observed by parents at 1 month, as well as NDDs at 3 years of age (i.e., motor delay, intellectual disability, developmental language disorder, and autism spectrum disorder), in the context of the Japan Environment and Children's Study. The study also assessed whether child development at 1 month predicted NDDs at 3 years of age. Associations between 25 pre-/perinatal factors and (a) developmental concerns at 1 month of age and (b) NDDs at 3 years were analyzed (n = 71,682). Binomial regression models were used to investigate risk ratios of the developmental outcome at each time point for total pre-/perinatal reduced optimality scale scores, as well as for individual pre-/perinatal factors of the reduced optimality scale. Finally, we assessed the ability of parental observations of offspring development at 1 month to predict NDDs at 3 years. Total reduced optimality scores were positively associated with 1-month developmental concerns and 3-year NDDs, with higher scores (i.e., a reduction in optimality) associated with an increased risk of both NDDs and earlier parental concerns. Neonatal transportation, epidural analgesia, advanced maternal age, cesarean section delivery, Apgar score ≤8, and hyperbilirubinemia were identified as individual risk factors for 3-year NDDs, overlapping with 14 risk factors for 1-month developmental concerns except Apgar score ≤8. Among six developmental items assessed at 1 month of age, concerns about gross motor function and difficulty holding/trouble calming down had the strongest associations with later-diagnosed motor delay and autism spectrum disorder, respectively. Five perinatal factors and advanced maternal age were associated with NDD at 3 years of age, as were early parental developmental concerns regarding their offspring's overall development, indicating the importance of careful follow-up of offspring born with pre-/perinatal reduced optimality. The results also implicated early parental concerns, as early as 1 month, may also be a useful indicator of later NDD status.
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Landgren V, Svensson L, Knez R, Theodosiou M, Gillberg C, Fernell E, Landgren M, Johnson M. The ESSENCE-Questionnaire for Neurodevelopmental Problems - A Swedish School-Based Validation Study in 11-Year-Old Children. Neuropsychiatr Dis Treat 2022; 18:2055-2067. [PMID: 36133028 PMCID: PMC9484576 DOI: 10.2147/ndt.s374930] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/27/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To determine the prevalence of parent-rated developmental concern using the ESSENCE-Q (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations-Questionnaire, 12-items, score range 0-24) and to ascertain the predictive validity and optimal cutoff level of the instrument in a school-based sample of 11-year-old children. Methods In a cross-sectional, school-based study, participants underwent a clinical assessment by a physician and a psychologist, teachers and parents completed the SDQ (Strength and Difficulties Questionnaire), medical health records and national tests were reviewed, and parents independently completed the ESSENCE-Q. In a case-conference outcomes were defined as a) the need for further clinical work-up due to suspected neurodevelopmental problems (NDPs) and b) degree of investigator-rated symptoms/impairment from NDPs on the CGI-S (Clinical Global Impression-Severity instrument, range 1-7, 4-7 defined as clinically symptomatic). Classification and optimal cutoffs of the ESSENCE-Q were determined using ROC (Receiver Operating Characteristic) analysis. Results Out of 343 eligible children, 223 enrolled, of whom 173 (50% of all eligible) had a parent-rated ESSENCE-Q. At least one of the 12 possible concerns was reported by parents of 36% of participants. Overall, in 101 (57%) participants a work-up was warranted, and 64 (37%) were clinically symptomatic from NDPs. The AUC of the ESSENCE-Q in detecting need for work-up was 0.70 (95% confidence interval [CI] 0.63-0.77), and the AUC in detecting clinically symptomatic participants was 0.82 (95% CI 0.76-0.88). ESSENCE-Q ratings correlated positively with CGI-S scores (r=0.48, p<0.05). A cutoff of ≥3 had the highest accuracy (78%) with a negative predictive value of 82%. Ratings >6 conferred few false positives cases with positive likelihood ratios >10 and positive predictive values of 86% or more. Significance This study of the ESSENCE-Q in 11-year-old children suggests it might be an acceptable instrument for screening of NDPs in children in middle school, optimally in conjunction with other methods.
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Affiliation(s)
- Valdemar Landgren
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
- Department of Psychiatry, Skaraborg Hospital, Skövde, Region Västra Götaland, Sweden
| | - Leif Svensson
- Department of Pediatrics, Skaraborg Hospital, Mariestad, Region Västra Götaland, Sweden
| | - Rajna Knez
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
- Department of Pediatrics, Skaraborg Hospital, Mariestad, Region Västra Götaland, Sweden
| | - Michail Theodosiou
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Elisabeth Fernell
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Magnus Landgren
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Mats Johnson
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
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Dinkler L, Yasumitsu‐Lovell K, Eitoku M, Fujieda M, Suganuma N, Hatakenaka Y, Hadjikhani N, Bryant‐Waugh R, Råstam M, Gillberg C. Early neurodevelopmental problems and risk for avoidant/restrictive food intake disorder (ARFID) in 4-7-year-old children: A Japanese birth cohort study. JCPP ADVANCES 2022; 2:e12094. [PMID: 37431388 PMCID: PMC10242837 DOI: 10.1002/jcv2.12094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 06/17/2022] [Indexed: 11/10/2022] Open
Abstract
Background An overrepresentation of neurodevelopmental problems (NDPs) has been observed in individuals with avoidant/restrictive food intake disorder (ARFID). Previous studies on the association between ARFID and NDPs have been limited by cross-sectional data from clinical samples of small size. This study aimed to extend previous research by using prospectively collected data in a non-clinical child cohort. We examined the occurrence of early NDPs in 4-7-year-old children with suspected ARFID and how predictive early NDPs are of ARFID. Methods Data were collected via parent-report a sub-sample of the Japan Environment and Children's Study (JECS) including 3728 children born 2011-2014 in Kochi prefecture. NDPs were assessed biannually between 0.5 and 3 years of age with the Ages and Stages Questionnaire-3, at age 2.5 years with the ESSENCE-Q, and at age 1 and 3 years via parent-reported clinical diagnoses. ARFID was identified cross-sectionally (at age 4-7 years) using a newly developed screening tool. Logistic regressions were used to test association of (1) a composite early NDP risk score, (2) specific early NDPs, and (3) neurodevelopmental trajectories over time with ARFID. Results Children in the highest risk percentiles of the NDP risk score had roughly three times higher odds of having suspected ARFID; the absolute risk of later ARFID for children above the 90th percentile was 3.1%. Early NDPs (excluding early feeding problems) were more predictive of later ARFID than were early feeding problems. Specific NDPs predictive of ARFID were problems with general development, communication/language, attention/concentration, social interaction, and sleep. Neurodevelopmental trajectories of children with and without suspected ARFID started to divert after age 1 year. Conclusions The results mirror the previously observed overrepresentation of NDPs in ARFID populations. In this non-clinical child cohort, early feeding problems were common and rarely developed into ARFID; however, our findings imply that they should be monitored closely in children with high NDP risk to prevent ARFID.
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Affiliation(s)
- Lisa Dinkler
- Gillberg Neuropsychiatry CentreInstitute of Neuroscience and PhysiologyUniversity of GothenburgGothenburgSweden
- Department of Environmental MedicineKochi Medical SchoolKochi UniversityNankoku, KochiJapan
| | - Kahoko Yasumitsu‐Lovell
- Gillberg Neuropsychiatry CentreInstitute of Neuroscience and PhysiologyUniversity of GothenburgGothenburgSweden
- Department of Environmental MedicineKochi Medical SchoolKochi UniversityNankoku, KochiJapan
| | - Masamitsu Eitoku
- Department of Environmental MedicineKochi Medical SchoolKochi UniversityNankoku, KochiJapan
| | - Mikiya Fujieda
- Department of PediatricsKochi Medical SchoolKochi UniversityNankoku, KochiJapan
| | - Narufumi Suganuma
- Department of Environmental MedicineKochi Medical SchoolKochi UniversityNankoku, KochiJapan
| | - Yuhei Hatakenaka
- Gillberg Neuropsychiatry CentreInstitute of Neuroscience and PhysiologyUniversity of GothenburgGothenburgSweden
- Faculty of Humanities and Social SciencesUniversity of the RyukyusNishihara, OkinawaJapan
| | - Nouchine Hadjikhani
- Gillberg Neuropsychiatry CentreInstitute of Neuroscience and PhysiologyUniversity of GothenburgGothenburgSweden
- Athinoula A. Martinos Center for Biomedical ImagingMassachusetts General HospitalHarvard Medical SchoolCharlestownMassachusettsUSA
| | - Rachel Bryant‐Waugh
- Maudsley Centre for Child and Adolescent Eating DisordersSouth London and Maudsley NHS Foundation TrustLondonUK
- Department of Child and Adolescent PsychiatryInstitute of PsychiatryPsychology and NeuroscienceKing's College LondonLondonUK
| | - Maria Råstam
- Gillberg Neuropsychiatry CentreInstitute of Neuroscience and PhysiologyUniversity of GothenburgGothenburgSweden
- Department of Clinical Sciences LundLund UniversityLundSweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry CentreInstitute of Neuroscience and PhysiologyUniversity of GothenburgGothenburgSweden
- Department of PsychiatryKochi Medical SchoolKochi UniversityNankoku, KochiJapan
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Kattimani S, Joseph R, Mondal N, Johnson A. Predictive validity of ESSENCE Q screening tool for early detection of neurodevelopmental disorder in children. Asian J Psychiatr 2022; 73:103162. [PMID: 35605519 DOI: 10.1016/j.ajp.2022.103162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/05/2022] [Accepted: 05/08/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Neurodevelopmental disorders (NDD) are a group of conditions that typically manifest early during the child's development with lifelong consequences. Early identification using efficient screening tools can positively modify the natural history of the disorder. ESSENCE Q is a simple questionnaire to detect ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations to reflect the co-existence of NDDs in children less than five years). There are limited studies on the validity of ESSENCE Q in detecting NDDs in young children in India. METHODS We did a cross-sectional study in a tertiary care hospital to evaluate the validity of ESSENCE Q in detecting neurodevelopmental disorders. We translated the ESSENCE Q and subsequently used it to screen for NDD in 100 children aged 12-60 months. Clinical consensus diagnosis by two experienced experts was taken as the gold standard. RESULTS 23% were diagnosed as having NDD as per the clinical consensus diagnosis. Around half the children (46%) were "at-risk for NDD" based on the ESSENCE Q scale. We found an optimal cut-off for ESSENCE Q of more than or equal to 4 with a sensitivity of 96%, a specificity of 82%, and a Youden index of 0.77. CONCLUSION ESSENCE Q has good predictive validity to be used as a quick and easy screening tool to detect NDDs in young children under the age of 5 years.
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Affiliation(s)
- Shivanand Kattimani
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research(JIPMER), Puducherry, India.
| | - Rini Joseph
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research(JIPMER), Puducherry, India.
| | - Nivedita Mondal
- Department of Neonatology, Women and Children Hospital, Jawaharlal Institute of Postgraduate Medical Education and Research(JIPMER), Puducherry, India.
| | - Allen Johnson
- Department of Radiodiagnosis, All India Institute of Medical Sciences(AIIMS), Bhopal, India.
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Sainsbury WJ, Carrasco K, Whitehouse AJO, McNeil L, Waddington H. Age of Diagnosis for Co-occurring Autism and Attention Deficit Hyperactivity Disorder During Childhood and Adolescence: a Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00309-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Abstract
Early identification and intervention are recognised as important elements of the clinical pathway for autism spectrum disorder (ASD). Children with ASD and attention deficit hyperactivity disorder (ADHD) may be diagnosed at a different age than children who only have one of these diagnoses. This systematic review aimed to identify the age at which children were diagnosed with both ASD and ADHD. Of the 9552 articles screened, 12 were included in the review. The findings suggest that ASD is typically diagnosed later when ADHD is present, and ADHD is typically diagnosed earlier when ASD is present. Further research is needed to understand the factors impacting a delayed ASD diagnosis and an earlier ADHD diagnosis when the two conditions co-occur.
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14
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Nygren G, Linnsand P, Hermansson J, Dinkler L, Johansson M, Gillberg C. Feeding Problems Including Avoidant Restrictive Food Intake Disorder in Young Children With Autism Spectrum Disorder in a Multiethnic Population. Front Pediatr 2021; 9:780680. [PMID: 34966704 PMCID: PMC8710696 DOI: 10.3389/fped.2021.780680] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 11/19/2021] [Indexed: 11/13/2022] Open
Abstract
We examined feeding problems, including Avoidant Restrictive Food Intake Disorder (ARFID), in preschool children with Autism Spectrum Disorder (ASD). Data were collected from a prospective longitudinal study of 46 children with ASD in a multiethnic, low resource area in Gothenburg, Sweden. Feeding problems were found in 76% of the children with ASD, and in 28%, the criteria for ARFID were met. The study highlights early onset age, the heterogeneity of feeding problems, and the need for multidisciplinary assessments in ASD as well as in feeding problems, and also the need for further elaboration of feeding disorder classifications in children.
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Affiliation(s)
- Gudrun Nygren
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Child and Adolescent Specialist Centre, SV Hospital Group, Gothenburg, Sweden
| | - Petra Linnsand
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Child and Adolescent Specialist Centre, SV Hospital Group, Gothenburg, Sweden
| | - Jonas Hermansson
- Child and Adolescent Specialist Centre, SV Hospital Group, Gothenburg, Sweden
| | - Lisa Dinkler
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maria Johansson
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Child and Adolescent Specialist Centre, SV Hospital Group, Gothenburg, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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15
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Marinopoulou M, Billstedt E, Lin P, Hallerbäck M, Bornehag C. Number of words at age 2.5 years is associated with intellectual functioning at age 7 years in the SELMA study. Acta Paediatr 2021; 110:2134-2141. [PMID: 33686710 DOI: 10.1111/apa.15835] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/19/2021] [Accepted: 03/05/2021] [Indexed: 11/30/2022]
Abstract
AIM We examined the association between the number of words used at age 2.5 years and deficits in intellectual functioning at age 7 years, in 549 children, and whether such association is confirmed by parental concern about the child's development. METHODS Parental reports of how many words their children used at age 2.5 years were analysed for the association to intellectual functioning (assessed with Wechsler Intelligence Scale for Children - Fourth Edition,WISC-IV) at age 7 years using linear regression, adjusting for sex, maternal education level, parental IQ and smoking during pregnancy. Parental concern at age 7 years was examined with the Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations-Questionnaire (ESSENCE-Q). RESULTS Adjusted linear regression showed that use of 50 words or fewer at age 2.5 years, relative to use of more than 50 words, was associated with lower scores of Full-scale IQ (B = 7.27, p = 0.001), verbal comprehension (B = 8.53, p < 0.001), working memory (B = 9.04, p < 0.001) and perceptual reasoning (B = 4.21, p = 0.045), in the WISC-IV, at age 7 years. Parental concern was more common in the group that used 50 words or fewer (Mann-Whitney U test, p = 0.011). CONCLUSION This easily accessible measure of number of words seems to be a valuable marker for intellectual functioning later in life.
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Affiliation(s)
- Maria Marinopoulou
- Gillberg Neuropsychiatry Centre Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Child and Adolescent Habilitation Region Värmland Karlstad Sweden
| | - Eva Billstedt
- Gillberg Neuropsychiatry Centre Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Child Neuropsychiatric Clinic Sahlgrenska University Hospital Gothenburg Sweden
| | - Ping‐I Lin
- School of Psychiatry University of New South Wales Sydney NSW Australia
- South Western Sydney Local Health District Warwick Farm NSW Australia
| | - Maria Hallerbäck
- School of Medical Sciences Örebro University Örebro Sweden
- Child and Adolescent Psychiatry Region Värmland Karlstad Sweden
| | - Carl‐Gustaf Bornehag
- Karlstad University Karlstad Sweden
- Icahn School of Medicine at Mount Sinai New York NY USA
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16
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Cederlund M. Parent Questionnaires in the Evaluation of Pre-School Children Referred for Neuropsychiatric Assessment. J Autism Dev Disord 2021; 52:1742-1751. [PMID: 34003428 PMCID: PMC8938387 DOI: 10.1007/s10803-021-05080-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2021] [Indexed: 11/26/2022]
Abstract
One-hundred twenty-four pre-school children referred for assessment to a neuropsychiatric team were included in this study of the Autism Behavior Checklist (ABC), ESSENCE-Q, and Conners Abbreviated Parent-Teacher Rating Scale (CAPRS). All three questionnaires showed a good correlation towards severity of symptoms in ASD. The ABC questionnaire was, as has been shown in earlier research less accurate in identifying individuals with ASD having an IQ within the normal range. However the ESSENCE-Q, and the CAPRS proved to identify children with difficulties needing further assessment regardless of intellectual ability. The CAPRS showed a good correlation to severity in ASD indicating difficulties in the regulation of activity and behavior likely to be connected to ASD in pre-school children.
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Affiliation(s)
- Mats Cederlund
- NU Hospital Organisation in Trollhättan, Trollhättan, Sweden.
- Cereb AB, Södergatan 11D, 25218, Helsingborg, Sweden.
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Tanaka S, Komagome A, Iguchi-Sherry A, Nagasaka A, Yuhi T, Higashida H, Rooksby M, Kikuchi M, Arai O, Minami K, Tsuji T, Tsuji C. Participatory Art Activities Increase Salivary Oxytocin Secretion of ASD Children. Brain Sci 2020; 10:brainsci10100680. [PMID: 32992507 PMCID: PMC7599610 DOI: 10.3390/brainsci10100680] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/24/2020] [Accepted: 09/25/2020] [Indexed: 01/01/2023] Open
Abstract
Autism spectrum disorder (ASD) occurs in 1 in 160 children worldwide. Individuals with ASD tend to be unique in the way that they comprehend themselves and others, as well as in the way that they interact and socialize, which can lead to challenges with social adaptation. There is currently no medication to improve the social deficit of children with ASD, and consequently, behavioral and complementary/alternative intervention plays an important role. In the present pilot study, we focused on the neuroendocrinological response to participatory art activities, which are known to have a positive effect on emotion, self-expression, sociability, and physical wellbeing. We collected saliva from 12 children with ASD and eight typically developed (TD) children before and after a visual art-based participatory art workshop to measure the levels of oxytocin, a neuropeptide involved in a wide range of social behaviors. We demonstrated that the rate of increase in salivary oxytocin following art activities in ASD children was significantly higher than that in TD children. In contrast, the change rate of salivary cortisol after participatory art activities was similar between the two groups. These results suggest that the beneficial effects of participatory art activities may be partially mediated by oxytocin release, and may have therapeutic potential for disorders involving social dysfunction.
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Affiliation(s)
- Sanae Tanaka
- Division of Integrated Art and Sciences and Local Community Support, Research Center for Child Mental Development, Kanazawa University, Kanazawa 920-8640, Japan;
| | - Aiko Komagome
- The COI Site, Tokyo University of the Arts Tokyo 110-8714, Japan; (A.K.); (O.A.)
| | | | - Akiko Nagasaka
- Department of Childhood Care and Education, Faculty of Social Work, Kinjo University, Hakusan 924-8511, Japan;
| | - Teruko Yuhi
- Department of Basic Research on Social Recognition, Research Center for Child Mental Development, Kanazawa University, Kanazawa 920-8640, Japan; (T.Y.); (H.H.); (K.M.); (T.T.)
| | - Haruhiro Higashida
- Department of Basic Research on Social Recognition, Research Center for Child Mental Development, Kanazawa University, Kanazawa 920-8640, Japan; (T.Y.); (H.H.); (K.M.); (T.T.)
| | - Maki Rooksby
- Adverse Childhood Experiences (ACE) Lab, Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK;
- Social Brain in Action Lab, Institute of Neuroscience and Psychology, University of Glasgow, Glasgow G12 8QB, UK
| | - Mitsuru Kikuchi
- Department of Psychiatry and Neurobiology, Graduate School of Medical Science, Kanazawa University, Kanazawa 920-8640, Japan;
| | - Oko Arai
- The COI Site, Tokyo University of the Arts Tokyo 110-8714, Japan; (A.K.); (O.A.)
| | - Kana Minami
- Department of Basic Research on Social Recognition, Research Center for Child Mental Development, Kanazawa University, Kanazawa 920-8640, Japan; (T.Y.); (H.H.); (K.M.); (T.T.)
- Department of Health Development Nursing, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-0942, Japan
| | - Takahiro Tsuji
- Department of Basic Research on Social Recognition, Research Center for Child Mental Development, Kanazawa University, Kanazawa 920-8640, Japan; (T.Y.); (H.H.); (K.M.); (T.T.)
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
| | - Chiharu Tsuji
- Department of Basic Research on Social Recognition, Research Center for Child Mental Development, Kanazawa University, Kanazawa 920-8640, Japan; (T.Y.); (H.H.); (K.M.); (T.T.)
- Correspondence: or
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18
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Poulsen CD, Wilson P, Graungaard AH, Overbeck G. Dealing with parental concerns: A study of GPs' practice. PATIENT EDUCATION AND COUNSELING 2020; 103:S0738-3991(20)30238-X. [PMID: 32507713 DOI: 10.1016/j.pec.2020.04.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 04/20/2020] [Accepted: 04/25/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To investigate patterns of GPs' exploration and termination of dialogues about parental concerns in preventive child health assessments. METHODS Interactional microanalysis of video recordings of 32 preventive child health assessments using conversation analysis. RESULTS The GPs asked parents about concerns, but most concerns disclosed by parents were still left unexplored at the end of the consultation. Termination of dialogues about concerns could be achieved effectively by GPs through letting the biomedical agenda dominate or addressing the child directly. The parents generally cooperated with the various approaches to handling concerns. CONCLUSION GPs displayed initial attentiveness towards emotional concerns but did not always follow through with subsequent exploration; many concerns raised were left unexplored. However, the same GP could employ both non-exploratory and exploratory practice within individual consultations. PRACTICE IMPLICATIONS Preventive child heath assessments offer an opportunity for parents to raise concerns about their children's development. Improved understanding of the conversational mechanisms through which concerns are examined or sidelined could allow clinicians to maximise the effectiveness of their preventive consultations.
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Affiliation(s)
- Caroline Dorothea Poulsen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Denmark.
| | - Philip Wilson
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Denmark; Centre for Rural Health, Institute of Applied Health Sciences, University of Aberdeen, Scotland, United Kingdom
| | - Anette Hauskov Graungaard
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Denmark
| | - Gritt Overbeck
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Denmark
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19
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Hatakenaka Y, Maeda M, Ninomiya H, Hachiya K, Fernell E, Gillberg C. ESSENCE-Q obtained in routine Japanese public child health check-ups may be a valuable tool in neurodevelopmental screening. Acta Paediatr 2020; 109:764-773. [PMID: 31545530 DOI: 10.1111/apa.15029] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 09/17/2019] [Accepted: 09/20/2019] [Indexed: 11/29/2022]
Abstract
AIM Our aim was to extend the validity of a questionnaire developed for screening and identifying early symptomatic syndromes eliciting neurodevelopmental clinical examinations-questionnaire (ESSENCE-Q) in young children. METHODS Early symptomatic syndromes eliciting neurodevelopmental clinical examinations-questionnaire data for 207 children, living in Aki City, Japan, in 2014-2015, were obtained from mothers, public health nurses and psychologists at 20- and 40-month routine check-ups at child healthcare centres. These were checked against subsequent ESSENCE diagnoses made by physicians. Receiver operating characteristic curves were constructed, and the area under the curves was compared. Sensitivity, specificity, positive predictive values (PPVs) and negative predictive values were calculated at optimal cut-off values. The clinical utility index was also calculated. RESULTS When the ESSENCE-Q was used by public health nurses, it demonstrated good validity, in terms of high sensitivity and high NPVs, at the 20-month check-up, but not at 40 months. Psychologists demonstrated good validity at both ages, but mothers did not. Good negative utility indexes, indicating screening accuracy, were obtained from the psychologists at both check-ups and from nurses at 20 months. CONCLUSION The ESSENCE-Q results used by nurses and psychologists showed good validity. Future studies should confirm the effectiveness of this tool to identify children in need of clinical detailed neurodevelopmental assessment.
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Affiliation(s)
- Yuhei Hatakenaka
- Faculty of Humanities and Sociologies University of the Ryukyus Nishihara Okinawa Japan
- Kochi Gillberg Neuropsychiatry Centre Kochi Prefectural Medical and Welfare Centre Kochi Japan
- Gillberg Neuropsychiatry Centre Sahlgrenska Academy Gothenburg Sweden
| | - Masato Maeda
- Kochi Gillberg Neuropsychiatry Centre Kochi Prefectural Medical and Welfare Centre Kochi Japan
- Department of Paediatrics Kochi Prefectural Aki General Hospital Aki Kochi Japan
| | - Hitoshi Ninomiya
- Kochi Gillberg Neuropsychiatry Centre Kochi Prefectural Medical and Welfare Centre Kochi Japan
- Faculty of Science and Engineering Department of Civil and Environmental Engineering Toyo University Kawagoe Saitama Japan
| | | | - Elisabeth Fernell
- Gillberg Neuropsychiatry Centre Sahlgrenska Academy Gothenburg Sweden
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Reilly C, Atkinson P, Memon A, Jones C, Dabydeen L, Helen Cross J, Das KB, Gillberg C, Neville BGR, Scott RC. Autism, ADHD and parent-reported behavioural difficulties in young children with epilepsy. Seizure 2019; 71:233-239. [PMID: 31425870 DOI: 10.1016/j.seizure.2019.08.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/30/2019] [Accepted: 08/07/2019] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To provide data on the prevalence of Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder (ADHD), and parent reported behaviour difficulties in young children with epilepsy, and to compare results with children with neurodisability (neurodevelopmental/neurological difficulties) without epilepsy. METHOD Children with epilepsy (1-7 years, n = 48) and children with neurodisability (1-7 years, n = 48) matched for gender, chronological and developmental age underwent psychological assessment. Parents completed measures of behaviour including the Strengths and Difficulties Questionnaire (SDQ). DSM-5 diagnoses of ASD and ADHD were made at consensus case conferences. Factors associated with child behaviour were analysed using linear regression. RESULTS Of the children with epilepsy, 18% met ASD criteria and 40% met ADHD criteria (corresponding figures in the non-epilepsy group were 41% and 27%). A large proportion (76%-78%) in both groups scored in the at-risk range on the SDQ and frequently had difficulties across multiple behavioural domains. Children with epilepsy had more concerns expressed regarding attention and mood. None of the epilepsy factors were significantly associated with scores on the behavioural measures. SIGNIFICANCE Young children with epilepsy had a very high level of parent reported behavioural difficulties and a high risk for ADHD and ASD highlighting the need for comprehensive multidisciplinary assessment. Behavioural concerns were not greater than for other children with non-epilepsy related neurodisability with the exception of attention and mood. Epilepsy related factors were not associated with child behaviour, suggesting that seizures per se do not confer a unique risk for behavioural difficulties.
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Affiliation(s)
- Colin Reilly
- Research Department, Young Epilepsy, Lingfield, Surrey, RH7 6PW, UK; UCL Great Ormond Street Institute of Child Health (ICH), 30 Guilford Street, London, WC1N 1EH, UK.
| | - Patricia Atkinson
- Child Development Centre, Crawley Hospital, West Green Drive, Crawley, RH11 7DH, West Sussex, UK
| | - Ayesha Memon
- Child Development Centre, Crawley Hospital, West Green Drive, Crawley, RH11 7DH, West Sussex, UK
| | - Chloe Jones
- Research Department, Young Epilepsy, Lingfield, Surrey, RH7 6PW, UK
| | - Lyvia Dabydeen
- Research Department, Young Epilepsy, Lingfield, Surrey, RH7 6PW, UK
| | - J Helen Cross
- Research Department, Young Epilepsy, Lingfield, Surrey, RH7 6PW, UK; UCL Great Ormond Street Institute of Child Health (ICH), 30 Guilford Street, London, WC1N 1EH, UK; Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London, WC1N 3JH, UK
| | - Krishna B Das
- UCL Great Ormond Street Institute of Child Health (ICH), 30 Guilford Street, London, WC1N 1EH, UK; Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London, WC1N 3JH, UK
| | - Christopher Gillberg
- Research Department, Young Epilepsy, Lingfield, Surrey, RH7 6PW, UK; UCL Great Ormond Street Institute of Child Health (ICH), 30 Guilford Street, London, WC1N 1EH, UK; Gillberg Neuropsychiatry Centre, University of Gothenburg, Kungsgatan 12, Gothenburg, Sweden
| | - Brian G R Neville
- Research Department, Young Epilepsy, Lingfield, Surrey, RH7 6PW, UK; UCL Great Ormond Street Institute of Child Health (ICH), 30 Guilford Street, London, WC1N 1EH, UK
| | - Rod C Scott
- UCL Great Ormond Street Institute of Child Health (ICH), 30 Guilford Street, London, WC1N 1EH, UK; Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London, WC1N 3JH, UK; Department of Neurological Sciences, University of Vermont College of Medicine, Burlington, VT, USA
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21
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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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22
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Reilly C, Atkinson P, Memon A, Jones C, Dabydeen L, Cross JH, Das KB, Gillberg C, Neville BG, Scott RC. Child and parental sleep in young children with epilepsy: A population-based case-control study. Epilepsia Open 2018; 3:383-391. [PMID: 30187009 PMCID: PMC6119759 DOI: 10.1002/epi4.12241] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To determine the prevalence of parent-reported sleep problems in young children with epilepsy and their parents, and to compare findings with those in a non-epilepsy-related neurodisability (neurodevelopmental/neurological difficulties) group. METHOD Parents of young children (1-7 years) with epilepsy (n = 48 [91% ascertainment]) completed the Child Sleep Habits Questionnaire (CSHQ). Parents (mothers and fathers) also completed the Pittsburgh Sleep Quality Index (PSQI) and the Iowa Fatigue Scale (IFS) in relation to their own functioning. The responses of parents of children with epilepsy were compared with parents of developmental-, age-, and gender-matched children with nonepilepsy-related neurodisability (n = 48). RESULTS There was not a significant difference in the proportion of children with epilepsy and the children with neurodisability scoring in the at-risk range on the CSHQ (81% vs. 71% respectively) (p = 0.232). 62% of mothers and 44% of fathers of children with epilepsy had 'poor quality sleep' on the PSQI; there was not a significant difference between mothers of children with epilepsy and those of children with neurodisability (p = 0.526) or IFS (p = 0.245) total scores. However, mothers of children with epilepsy had significantly more difficulties on the productivity subscale of the IFS (p = 0.004). There were no significant differences between fathers' scores on either measure. In the epilepsy group, child behavioral problems (p = 0.001) were independently associated with child sleep difficulties and maternal mental health problems were associated with parental sleep difficulties (p = 0.04) and fatigue (p = 0.018). SIGNIFICANCE Young children with epilepsy and their parents have a high rate of sleep difficulties. There is a need to develop effective interventions for this population, taking into consideration of the role of child behavioral problems and parental mental health difficulties.
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Affiliation(s)
- Colin Reilly
- Research DepartmentYoung EpilepsySurreyUnited Kingdom
- UCL Great Ormond Street Institute of Child Health (ICH)LondonUnited Kingdom
| | | | - Ayesha Memon
- Child Development CentreCrawley HospitalCrawleyUnited Kingdom
| | - Chloe Jones
- Research DepartmentYoung EpilepsySurreyUnited Kingdom
| | | | - J. Helen Cross
- Research DepartmentYoung EpilepsySurreyUnited Kingdom
- UCL Great Ormond Street Institute of Child Health (ICH)LondonUnited Kingdom
- Great Ormond Street Hospital for Children NHS TrustLondonUnited Kingdom
| | - Krishna B. Das
- UCL Great Ormond Street Institute of Child Health (ICH)LondonUnited Kingdom
- Great Ormond Street Hospital for Children NHS TrustLondonUnited Kingdom
| | - Christopher Gillberg
- Research DepartmentYoung EpilepsySurreyUnited Kingdom
- UCL Great Ormond Street Institute of Child Health (ICH)LondonUnited Kingdom
- Gillberg Neuropsychiatry CentreUniversity of GothenburgGothenburgSweden
| | - Brian G.R. Neville
- Research DepartmentYoung EpilepsySurreyUnited Kingdom
- UCL Great Ormond Street Institute of Child Health (ICH)LondonUnited Kingdom
| | - Rod C. Scott
- UCL Great Ormond Street Institute of Child Health (ICH)LondonUnited Kingdom
- Great Ormond Street Hospital for Children NHS TrustLondonUnited Kingdom
- Department of Neurological SciencesUniversity of Vermont College of MedicineBurlingtonVermontU.S.A
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Stevanovic D, Knez R, Zorcec T, Anderluh M, Kodrič J, Petrov P, Hadžagić Ćatibušić F, Deljković A, Brkic Cvetkovic S, Vrljičak Davidovic N, Kuzmanić Šamija R, Đorić A, Gillberg C. ESSENCE-Q: Slavic language versions for developmental screening in young children. Neuropsychiatr Dis Treat 2018; 14:2141-2148. [PMID: 30197517 PMCID: PMC6112800 DOI: 10.2147/ndt.s171359] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations - Questionnaire (ESSENCE-Q) was developed as a brief screener to identify children with developmental concerns who might have neurodevelopmental disorders (NDDs). This study aimed to translate the ESSENCE-Q into south Slavic languages, namely, Bosnian, Bulgarian, Croatian, Macedonian, Montenegrin, Serbian, and Slovenian, and to evaluate its psychometric properties for screening purposes in clinical settings. PATIENTS AND METHODS In the study, the ESSENCE-Q was completed for 251 "typically developing" children and 200 children with 1 or more diagnosed NDDs, all aged 1-6 years. Internal consistency and construct validity were tested first, followed by generating receiver operating characteristic curves and the area under the curve. Optimal cutoff values were then explored. RESULTS The Cronbach's α coefficients were 0.91, 0.88, and 0.86 for ESSENCE-Q parent-completed form, and the telephone and direct interview forms administered by trained nurse or specialist, respectively. The 3 versions produced area under the curve values (95% confidence interval): 0.96 (0.93-0.99), 0.91 (0.86-0.95), and 0.91 (0.86-0.97), respectively. An optimal cutoff for ESSENCE-Q parent-completed form was found to be ≥3 points, while for the telephone and direct interviews, it was ≥5 points. CONCLUSION We found adequate measurement properties of the south Slavic languages versions of the ESSENCE-Q as a screener for NDDs in clinical settings. This study provided additional data supporting sound psychometric properties of the ESSENCE-Q.
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Affiliation(s)
- Dejan Stevanovic
- Psychiatry Department, Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia,
| | - Rajna Knez
- Department of Child and Adolescent Psychiatry, Skaraborgs Hospital, Skövde, Sweden.,Department of Psychiatry and Psychological Medicine, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Tatjana Zorcec
- Developmental Department, University Children's Hospital, Skopje, Macedonia
| | - Marija Anderluh
- Department of Child Psychiatry, University Children's Hospital, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Jana Kodrič
- Department of Child Psychiatry, University Children's Hospital, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Petar Petrov
- Department of Child and Adolescent Psychiatry, University Hospital St Marina, Varna, Bulgaria
| | | | - Azra Deljković
- Psychiatry Department, Mental Health Center Pljevlja, Pljevlja, Montenegro
| | - Slavica Brkic Cvetkovic
- Psychiatry Department, Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia,
| | | | | | - Ana Đorić
- Center of Applied Psychology, Faculty of Humanity and Social Sciences, University of Rijeka, Rijeka, Croatia
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24
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Hatakenaka Y, Ninomiya H, Billstedt E, Fernell E, Gillberg C. ESSENCE-Q - used as a screening tool for neurodevelopmental problems in public health checkups for young children in south Japan. Neuropsychiatr Dis Treat 2017; 13:1271-1280. [PMID: 28546752 PMCID: PMC5436770 DOI: 10.2147/ndt.s132546] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Screening for developmental disorders is an important task for Child Health Care. The concept of ESSENCE (early symptomatic syndromes eliciting neurodevelopmental clinical examinations) was created to cover all types of early developmental disorders and the ESSENCE-Questionnaire (ESSENCE-Q containing 12 questions with possible total scores ranging from 0 to 22) was developed as a tool for early detection of these disorders. The aim of this study was to perform a validation study in a public health situation in Japan. METHODS The psychometric properties of the ESSENCE-Q, completed by mothers, public health nurses (PHNs), and psychologists at 18-month (n=143 children) and 36-month (n=149 children) checkups were evaluated in a small city of Japan. Results were validated against clinical ESSENCE diagnoses. Receiver operating characteristic curves were generated and compared by using the area under the curve (AUC). Optimal cutoff values were explored. RESULTS At the 18-month checkup, AUC by mothers was 0.72, by PHNs 0.86, and by psychologists 0.82. An optimal cutoff was 3 with a high negative predictive value (NPV). At the 36-month checkup, AUC by mothers was 0.57, by PHNs 0.82, and by psychologists 0.87. Optimal cutoff was 2 with high NPV. CONCLUSION The ESSENCE-Q completed by PHNs and psychologists had good diagnostic validity. The results suggested that almost all children scoring under cutoff would not have any ESSENCE problems/diagnoses.
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Affiliation(s)
- Yuhei Hatakenaka
- Kochi Gillberg Neuropsychiatry Centre, Kochi Prefectural Medical and Welfare Center, Kochi, Japan.,Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hitoshi Ninomiya
- Integrated Centre for Advanced Medical Technologies, Kochi University Medical School, Kochi, Japan
| | - Eva Billstedt
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Elisabeth Fernell
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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25
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Thomaidis L, Choleva A, Kyprianou M. Age-related issues of instruments screening for autism in young children. Neuropsychiatr Dis Treat 2016; 12:3093-3095. [PMID: 27980411 PMCID: PMC5147410 DOI: 10.2147/ndt.s121946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Loretta Thomaidis
- Second Department of Paediatrics, Developmental Assessment Unit, "P. & A. Kyriakou" Children's Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Antigoni Choleva
- Second Department of Paediatrics, Developmental Assessment Unit, "P. & A. Kyriakou" Children's Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Miltiades Kyprianou
- Second Department of Paediatrics, Developmental Assessment Unit, "P. & A. Kyriakou" Children's Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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