History Information's are Indispensable in Developmental Assessment of Children

An Overview of Pediatric Approaches to Child with Developmental Delay Especially if There is Suspicion of ASD in First Few Years of Life

To be a pediatrician means that one encounters many serious childhood health problems and one finds many ways to help families cope with these problems. Symptoms in children can be discrete, and the responsibility of the pediatrician to distinguish normal development from pathological. We are facing a new era in the developmental assessment of children. A cluster of neurodevelopmental disorders includes ASD (autism spectrum disorder) and ADHD (attention deficit hyperactivity disorder). Parents often do not recognize the problem on time. Generally, their first concern is speech delay, leading to the suspicion of hearing problems. Therefore, it is very important to obtain objective anamnestic information and for the child to undergo a careful physical examination, a neurophysiological assessment, and metabolic and genetic testing. The etiology usually is multifactorial: genetic, epigenetic, and non-genetic factors act in combination through various paths. Most children seem to have typical neurodevelopment during first their year. It was found that approximately one-third of children with ASD lose some skills during the preschool period, usually speech related, but sometimes also non-verbal communication, social or play skills. In conclusion we must say that it is very important to recognize the early signs of ASD and any kind of other developmental delay and to start with early intervention. Clinical pediatricians tend to correlate clinical manifestations and biological underpinnings related to neurodevelopmental disorder, especially ASD. Therefore, better treatment possibilities are needed.

Prevalence of Phonological Articulation Disorders in Preschool Children in the City of Skopje

INTRODUCTION

Speech communication is a complex process based on the function of the central nervous system, and also on the speech mechanisms conditioned and controlled by auditory perception, verbal memory, intellectual activity and peripheral speech apparatus.The aim of this study was to determine the prevalence of the most common phonological articulation disorders in preschool children, from 4-6 years old.

MATERIALS AND METHODS

A cross-sectional study was conducted during 2018, on a representative sample of 550 preschool children aged 4 - 6 years, who attend preschool institutions-kindergartens in the city of Skopje. The study used standardized articulation tests: The Global Articulation Test (GAT) and the Triple Test (vocals, plasia, affricative, fricative, nasal, and lateral), and a questionnaire filled out by a social worker at the kindergarten about the socioeconomic status and the child's health condition.

RESULTS

Using GAT, we found that 260 (47.3%) children didn't manifest any phonological articulation disorders, but 290 (52.7%) had disorders. The analysis of gender-based data showed a higher percentage of speech disorders in 57% of boys and 46.9% of girls. The highest percentage of speech disorder is sigmatism with 24.5% in boys and 20.4% in girls, rhotacismus was found in 17.8% in boys and 16.5% in girls. Lambdacism with 8.3% was found in boys and 4.2% in girls. A mixed form (sigmatism, rotacism, and lambdacism) was also found in 2.4% of boys and 3.5% of girls.

CONCLUSIONS

The calculated prevalence of phonological articulation disorders in preschool children aged 4-6 years is 52.7%, (57.9% in boys and 46.9% in girls), or every second child in kindergarten has some form of speech disorder. These findings indicate that the treatment of speech disorders should begin in the appropriate services as soon as possible, because the early detection and treatment of speech disorders enable child's normal intellectual development. The treatment should be started in the preschool period, to allow the start of the educational process without any speech problems.