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Developmental Assessment (developmental + assessment)
Selected AbstractsDevelopmental assessment of preterm infants at 2 years: validity of parent reportsDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 1 2008Samantha Johnson PhD CPsychol Parental questionnaires are inexpensive alternatives to standardized testing for outcome measurement. The Parent Report of Children's Abilities has previously been revised (PARCA-R) and validated for use with very-preterm infants at 2 years of age. This study revalidated the PARCA-R for assessing cognition in a larger and more inclusive sample of preterm infants. One hundred and sixty-four children (82 males, 82 females) of <32 weeks' gestation (median 29wks, interquartile range [IQR] 28-30wks); and median birthweight 1200g (IQR 925-1463g) were evaluated using the Mental Development Index (MDI) of the Bayley Scales of Infant Development - 2nd edition (BSID-II) at 2 years' corrected age. Parents completed the PARCA-R questionnaire. Significant correlations between PARCA-R Parent Report Composite (PRC) scores and MDI scores (r=0.77, 95% confidence interval [CI] 0.69-0.82, p<0.01) demonstrated concurrent validity. A receiver operating characteristic-determined PRC cut-off of <44 had optimal discriminatory power (area under curve 0.92) for identifying MDI <70, with 85% sensitivity (95% CI 0.58-0.96), 87% specificity (95% CI 0.81-0.92), 98% negative predictive value (95% CI 0.95-1), and 37% positive predictive value (95% CI 0.22-0.54). The PARCA-R has good concurrent validity and diagnostic utility for identifying cognitive delay in very-preterm infants at 2 years of age. It is useful for outcome measurement, developmental screening, and facilitating parental involvement at folow-up. [source] Developmental assessment of children: A survey of Australian and New Zealand paediatriciansJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 8 2005Sean Beggs Objectives: To determine the current practice for developmental assessment of children by Australian and New Zealand paediatricians. To determine factors associated with higher levels of self-reported confidence and expertise in developmental paediatrics and factors associated with better practice. Methods: A cross-sectional postal survey of Australian and New Zealand paediatricians conducted in 2003, enquiring about their training in developmental paediatrics and their practice for evaluating development. Results: Of 811 questionnaires sent, 590 (73%) were returned. Ninety-one respondents indicated that they did not see children with developmental issues leaving 499 surveys for analysis. The overwhelming majority of paediatricians felt that more training was required in developmental paediatrics (88%) and that there was a need to be taught a formal developmental assessment tool (83%). Higher self-ratings of confidence and expertise in developmental paediatrics were associated with a period of formal developmental training (OR (95% CI) 2.7 (1.6,4.4), 3.4 (2.0,5.8), respectively), and being taught a formal developmental assessment tool (OR (95% CI) 2.0 (1.2,3.2), 2.2 (1.3,3.7), respectively). Predictors of paediatricians performing a formal developmental assessment included formal developmental training (OR (95% CI) 2.0 (1.1,3.8)) being taught an assessment tool (OR (95% CI) 2.8 (1.5,5.2)) and mandatory training (OR (95% CI) 2.4 (1.4,4.1)). Conclusions: Developmental paediatrics is a significant and important part of paediatric practice. This survey suggests, however, that paediatric training and continuing education should have not reflected this practice. The overall method and content of developmental training including whether formal assessment tools should be taught needs to be reviewed and revised. [source] How does early developmental assessment predict academic and attentional,behavioural skills at group and individual levels?DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 10 2009RIITTA VALTONEN LICPSYCH The main aim of the study was to explore the ability of a brief developmental assessment to predict teacher-rated learning and attentional and behavioural skills in the first grade of school at both the group and individual levels. A sample of 394 children (181 males, 213 females) aged 4 years were followed to the age of 6 years, and 283 of the children (145 males, 138 females; mean age 7y 11 mo) were followed further to the first grade (age 7y) at school. The children were administered a brief but comprehensive developmental assessment (Lene , a neurodevelopmental screening method) at their local child health-care centres at ages 4 and 6 years. In the first grade, teachers completed a detailed questionnaire (JLD Teacher Questionnaire) on the children's (mean age 7y 11mo, SD 3.1mo, range 7y 3mo,8y 4mo) performance and behaviour. Structural equation modelling showed that no single developmental area predicted development during the follow-up. Instead, a comprehensive developmental outcome at age 4 years significantly predicted skills in the first grade at the group level. Developmental status at age 4 and 6 years together explained 66% of the variance of academic skills and 40% of the variance of attentional and behavioural skills in the first grade. Age-specific logistic regression analyses were constructed to produce the risk indices. At the individual level it was possible to reach acceptable levels of sensitivity and specificity for academic skills at age 4 and age 6 years. Identification of attentional and behavioural problems at the individual level was possible at age 6 years, but the number of false positives was high. [source] Use of the Ages and Stages Questionnaire to predict outcome after hypoxic-ischaemic encephalopathy in the neonateJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 10 2008Natalie M Lindsay Background: Infants who suffer hypoxic-ischaemic encephalopathy (HIE) at birth are at increased risk of developmental disability. In this at-risk population, reliable, inexpensive and early identification of those children who are likely to require formal developmental assessment and intervention is needed. Aim: To evaluate the ability of the Ages and Stages Questionnaire (ASQ) to detect developmentally delayed children in an Australian population of infants who suffered HIE at birth. Methods: Fifty-five children who survived HIE were followed until 12,14 months of age. Test characteristics were calculated to examine the ability of the ASQ to appropriately identify developmentally delayed infants against this study's ,gold standard': the Bayley Scales of Infant Development II. Results: Comparing the ASQ with the Bayley Scales of Infant Development II, the questionnaire had the following test characteristics: sensitivity 92%, specificity 95%, positive predictive value 92%, negative predictive value 95% when used to detect severe developmental delay; and sensitivity 67%, specificity 93%, positive predictive value 92%, negative predictive value 68% when used to detect both severe and mild developmental delay. However, the ASQ used at standard cut-offs failed to detect any of the children with mild delay. Conclusions: The ASQ is extremely effective for the detection of severe developmental delay in children who have suffered HIE at birth. Its capacity to identify those with milder delay is limited. The ability of the test to detect only those with severe developmental delay means that the ASQ is of little value as a screening tool in this population. [source] Developmental assessment of children: A survey of Australian and New Zealand paediatriciansJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 8 2005Sean Beggs Objectives: To determine the current practice for developmental assessment of children by Australian and New Zealand paediatricians. To determine factors associated with higher levels of self-reported confidence and expertise in developmental paediatrics and factors associated with better practice. Methods: A cross-sectional postal survey of Australian and New Zealand paediatricians conducted in 2003, enquiring about their training in developmental paediatrics and their practice for evaluating development. Results: Of 811 questionnaires sent, 590 (73%) were returned. Ninety-one respondents indicated that they did not see children with developmental issues leaving 499 surveys for analysis. The overwhelming majority of paediatricians felt that more training was required in developmental paediatrics (88%) and that there was a need to be taught a formal developmental assessment tool (83%). Higher self-ratings of confidence and expertise in developmental paediatrics were associated with a period of formal developmental training (OR (95% CI) 2.7 (1.6,4.4), 3.4 (2.0,5.8), respectively), and being taught a formal developmental assessment tool (OR (95% CI) 2.0 (1.2,3.2), 2.2 (1.3,3.7), respectively). Predictors of paediatricians performing a formal developmental assessment included formal developmental training (OR (95% CI) 2.0 (1.1,3.8)) being taught an assessment tool (OR (95% CI) 2.8 (1.5,5.2)) and mandatory training (OR (95% CI) 2.4 (1.4,4.1)). Conclusions: Developmental paediatrics is a significant and important part of paediatric practice. This survey suggests, however, that paediatric training and continuing education should have not reflected this practice. The overall method and content of developmental training including whether formal assessment tools should be taught needs to be reviewed and revised. [source] The pharmacological and physiological profile of glutamate receptors at the Drosophila larval neuromuscular junctionPHYSIOLOGICAL ENTOMOLOGY, Issue 2 2005Deval Bhatt Abstract.,Drosophila larval muscles are commonly used for developmental assessment in regard to various mutations of synaptically relevant molecules. In addition, the molecular sequence of the glutamate receptors on the muscle fibre have been described; however, the pharmacological profiles to known agonists and antagonists have yet to be reported. Here, the responses of N -methyl- d -aspartic acid, ,-amino-3-hydroxy-5-methyl-4-isoxazole-propionate (AMPA), l -glutamate, kainate, quisqualic acid, NBQX, AP5 and DNQX are characterized with regard to synaptic transmission and direct effects on the muscle fibres. The muscle fibres depolarize to application of glutamate or quisqualate and the excitatory postsynaptic potential (EPSP) amplitudes are diminished. Kainate does not alter the muscle membrane potential but does reduce the EPSP amplitude. The known antagonists NBQX, AP5 and DNQX have no substantial effect on synaptic transmission at 1 mm, nor do they block the response of quisqualate. Kainate may be acting as a postsynaptic antagonist or via autoreceptors presynaptically to reduce evoked transmission. [source] Erythropoietin improves neurodevelopmental outcome of extremely preterm infantsANNALS OF NEUROLOGY, Issue 5 2010Achim-Peter Neubauer MD Objective Erythropoietin has been reported to possess neuroprotective properties in animal studies. No previous studies have investigated the neurodevelopmental outcome of extremely low birth weight (ELBW) infants treated with recombinant human erythropoietin (rEpo) and evaluated it at school age. Methods Of 200 ELBW infants treated from 1993 to 1998, 171 (86%) survived, and 148 (87%) were followed up to the age of 10 to 13 years. The neurodevelopmental and school outcome of the ELBW infants receiving rEpo treatment for stimulation of erythropoiesis in the first weeks of life (n = 89) was compared to that of untreated children (n = 57). To test for a neuroprotective effect of erythropoietin therapy, analyses of variance (ANOVAs) were conducted with erythropoietin treatment and intraventricular hemorrhage (IVH) as independent variables and Hamburg-Wechsler Intelligence Test for Children-III (HAWIK-III) intelligence quotient (IQ) scores as dependent variables. Results The rEpo group scored significantly better than untreated children in the overall developmental assessment (55% vs 39% normally developed, p < 0.05) as well as in the psychological examination (mean composite HAWIK-III IQ score, 90.8 vs 81.3, p < 0.005). The results of ANOVAs show that these differences were ascribable to children with IVH. Whereas those children with IVH treated with rEpo scored significantly better than untreated children (52% vs 6% normally developed, composite HAWIK-III IQ score, 90.3 vs 67.0), treated and untreated children without IVH did not differ in their outcome. The treatment and control groups were comparable in perinatal parameters relevant to prognosis. Interpretation The results of our observational study confirm the hypothesis of a neuroprotective effect of rEpo in ELBW infants with IVH. This offers a promising preventative therapeutic option for the treatment of these high-risk infants. ANN NEUROL 2010;67:657,666 [source] Survival and neurodevelopmental morbidity at 1 year of age following extremely preterm delivery over a 20-year period: a single centre cohort studyACTA PAEDIATRICA, Issue 2 2008K Riley Abstract Aim: To assess survival and neurodevelopmental outcome of extremely preterm infants over a 20-year period at a single tertiary neonatal centre. Methods: All infants between 22 and 25+6 weeks of gestation admitted to a single UK neonatal centre between 1981 and 2000 were enrolled prospectively. Infants in the same gestational age range who were born alive at the hospital but not admitted to the neonatal unit were also identified over the period 1991,2000. All surviving infants received neurological and developmental assessment at a corrected age of 1 year. Results: There was a progressive increase in survival at all gestational ages over the 20-year period. Overall survival rose from 32% to 71% as a proportion of all admissions. The proportion of survivors with adverse neurodevelopmental outcome at 1 year of age showed no consistent change over the same period. Conclusion: In this single centre cohort study, marked improvements in survival over a 20-year period were not accompanied by a significant increase in neurodevelopmental morbidity. [source] The role of epilepsy in early language development in a child with a congenital lesion in the right hemisphereDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 11 2008C Mayor-Dubois MA Early epilepsy is known to worsen the developmental prognosis of young children with a congenital focal brain lesion, but its direct role is often very difficult to delineate from the other variables. This requires prolonged periods of follow-up with simultaneous serial electrophysiological and developmental assessments which are rarely obtained. We studied a male infant with a right prenatal infarct in the territory of the right middle cerebral artery resulting in a left spastic hemiparesis, and an epileptic disorder (infantile spasms with transient right hemihypsarrhythmia and focal seizures) from the age of 7 months until the age of 4 years. Pregnancy and delivery were normal. A dissociated delay of early language acquisition affecting mainly comprehension without any autistic features was documented. This delay was much more severe than usually expected in children with early focal lesions, and its evolution, with catch-up to normal, was correlated with the active phase of the epilepsy. We postulate that the epilepsy specifically amplified a pattern of delayed language emergence, mainly affecting lexical comprehension, reported in children with early right hemisphere damage. [source] Neurodevelopmental outcomes in children with HIV infection under 3 years of ageDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 8 2006C J Foster BA MBBS MRCPCH Following the introduction of combination antiretroviral therapy, children vertically infected with the human immunodeficiency virus (HIV-1) living in the developed world are surviving into adult life. This paper reviews the neurodevelopmental outcomes of 62 consecutively-presenting children with HIV-1 infection diagnosed before 3 years of age (32 males, 30 females; median age at presentation 6mo). Neurological and developmental data are presented with immunological and virological responses to antiretroviral therapy. Fourteen children (22%) had abnormal neurological signs and 25 (40%) demonstrated significant developmental delay on standardized developmental assessments. Children presenting with more severe HIV-1 disease and immune compromise had significantly more abnormal neurological signs and developmental delays than children presenting with milder HIV-1 symptomatology. Immune function, control of HIV-1 viral replication, and growth parameters improved with antiretroviral therapy (median age at last follow-up 7y 3mo); however, abnormal neurological signs and significant gross motor difficulties persisted. [source] Applying the Infant-Toddler Social & Emotional Assessment (ITSEA) and Brief-ITSEA in early interventionINFANT MENTAL HEALTH JOURNAL, Issue 6 2007Margaret J. Briggs-Gowan To examine the internal consistency and validity of the Infant-Toddler Social and Emotional Assessment (ITSEA) and Brief-ITSEA (BITSEA) parent-report questionnaires in an early intervention sample. A sociodemographically diverse sample of 192 parents of 11- to 36-month-old children referred to early intervention programs completed surveys containing the ITSEA, BITSEA, and Child Behavior Checklist (CBCL). Parents were interviewed with the Vineland Adaptive Behavior Scales. Evaluators blind to children's status on the ITSEA and BITSEA rated child behavior during developmental assessments. Finally, a subsample of 71 children was administered the Mullen Scales of Early Learning. Findings support the internal consistency of the ITSEA and BITSEA, with the majority of Cronbach's alphas above .70. Supporting validity, ITSEA and BITSEA problem scores correlated significantly with CBCL Internalizing and Externalizing scores (rs=.28 to .78), as well as with observational ratings of problem behaviors on constructs paralleling the ITSEA domains (rs=.21 to .45). In contrast, ITSEA Competence and BITSEA Competence demonstrated moderate negative associations with CBCL scores (rs=,.39 to ,.43). Finally, ITSEA Competence and BITSEA Competence correlated significantly with developmental level on the Mullen, Vineland Socialization, and observational ratings of competence (rs=.25 to .43). Emphasizing the importance of addressing social-emotional issues in early intervention settings, 58.6% of children had high social-emotional/behavioral problems and/or low competence on the ITSEA; 39.8% had high ITSEA Problems and 38.5% had low ITSEA Competence. Results indicate the need to assess social-emotional adjustment in early intervention settings and support the use of the ITSEA and BITSEA for this purpose. [source] Neurodevelopmental outcomes and surgery in neonatesJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 12 2006Karen Walker Abstract: A neonate requiring major surgery in 2006 has a greater prospect of survival than ever before. Increasingly, however, there is awareness that critical illness may affect later neurodevelopment. Pre-existing conditions in addition to the physiologic stresses associated with cardiac and general surgery are implicated but remain unavoidable in the case of significant structural abnormalities such as transposition of the great arteries or congenital diaphragmatic hernia. For those affected by neurodevelopmental impairment, there is a significant cost to the child, family and society. Current research focuses on the preventable causes of brain injury, before, during and after the intervention, and the rate of impairment in apparently uncomplicated procedures. In contrast to the quantity of neurodevelopmental outcome data following cardiac surgery, there remain few outcome studies dealing with non-cardiac surgery despite such intervention being two to three times more common. There appear to be compelling clinical and economic arguments for the instigation of formalised population-based developmental assessments for all infants undergoing major surgery. [source] | |||||||||||||||||||