Accuracy of parent-reported ages and stages questionnaire in assessing the motor and language skills of preterm infants

2020 ◽  
pp. 1-10
Author(s):  
G. Y. H. Hwarng ◽  
I. L Ereno ◽  
S. K. Ho ◽  
J. C. Allen ◽  
R. B. Moorakonda ◽  
...  

BACKGROUND: Parent-completed tools like the Ages and Stages Questionnaire Third Edition (ASQ-3) are important in developmental screening. As a screening tool, a high negative predictive value (NPV) is critical to avoid missing the diagnosis of developmental delay. This study evaluated the NPV and accuracy of the ASQ-3 in assessing the development of preterm infants. METHODS: Infants born at <32 weeks and/or <1250 grams, presented to the Neonatal Neurodevelopmental Clinic at the Singapore General Hospital for follow-up from January 2014 –June 2017, at 6, 12, and 18 months corrected age, were included. The ASQ-3 and standardized tests –Peabody Developmental Motor Scale –Second Edition (PDMS-2) and Preschool Language Scale, Fourth Edition UK (PLS-4 UK) –were administered. ASQ-3 gross motor and fine motor scores were compared to PDMS-2 at 6 and 12 months, and ASQ-3 communication scores to PLS-4 UK at 18 months. RESULTS: At 6 months (n = 145), NPV for gross motor and fine motor were 96.4% (accuracy 80.0%) and 95.4% (accuracy 77.2%) respectively. At 12 months (n = 127), NPV for gross motor and fine motor were 88.9% (accuracy 79.8%) and 82.8% (accuracy 74.0%) respectively. At 18 months (n = 113), NPV for language was 56.9% (accuracy 63.7%). CONCLUSIONS: The ASQ-3 showed high NPV and accuracy in screening gross motor and fine motor skills at 6 and 12 months, but not in screening language skills at 18 months. Judicious use of the ASQ-3 may allow for more effective utilization of resources.

Children ◽  
2019 ◽  
Vol 6 (8) ◽  
pp. 90
Author(s):  
Maeve Morgan-Feir ◽  
Andrea Abbott ◽  
Anne Synnes ◽  
Dianne Creighton ◽  
Thevanisha Pillay ◽  
...  

Extremely preterm infants are at increased risk of motor impairment. The Canadian Neonatal Follow-Up Network (CNFUN) afforded an opportunity to study the outcomes of extremely preterm children. The purpose of this study was to compare 18-month corrected age (CA) motor outcomes of extremely preterm infants with parent-reported functional outcomes at 3 years CA. CNFUN data of 1376 infants were used to conduct chi-square analyses to compare Bayley-III motor scores (composite, gross, and fine motor) at 18 months CA with parent-reported Ages and Stages Questionnaire motor scores (gross and fine motor) at 3 years CA. The correlation of motor scores at 18-months CA with parent-reported gross and fine motor scores at 3 years CA was also examined. We found that 1 in 5 infants scoring within or above the average range on the Bayley-III had parent-reported functional fine and gross motor difficulties at 3 years CA. Bayley-III scores were only moderately correlated with functional motor outcomes. Results of the study suggest that the Bayley-III at 18 months CA was able to detect the majority of infants with motor problems, but not all; therefore, ongoing follow-up of extremely preterm infants is required. The Bayley-III motor composite score has greater clinical utility compared to sub-scale scores.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Teklu Gemechu Abessa ◽  
Berhanu Nigussie Worku ◽  
Mekitie Wondafrash ◽  
Tsinuel Girma ◽  
Johan Valy ◽  
...  

Abstract Background The World Health Organization (WHO) recommends incorporating psychosocial stimulation into the management of severe acute malnutrition (SAM). However, there is little evidence about the effectiveness of these interventions for SAM children, particularly when serious food shortages and lack of a balanced diet prevail. The objective of this study was to examine whether family-based psychomotor/psychosocial stimulation in a low-income setting improves the development, linear growth, and nutritional outcomes in children with SAM. Method Children with SAM (N = 339) admitted for treatment to the Jimma University Specialized Hospital, Ethiopia, were randomized to a control (n = 170) or intervention (n = 169) group. Both groups received routine medical care and nutritional treatment at the hospital. The intervention group additionally received play-based psychomotor/psychosocial stimulation during their hospital stay, and at home for 6 months after being discharged from hospital. The fine motor (FM) and gross motor (GM) functions, language (LA) and personal-social (PS) skills of the children were assessed using adapted Denver II, the social-emotional (SE) behavior was assessed using adapted Ages and Stages Questionnaires: Social-Emotional, and the linear growth and nutritional status were determined through anthropometric assessments. All outcomes were assessed before the intervention, upon discharge from hospital, and 6 months after discharge (as end-line). The overtime changes of these outcomes measured in both groups were compared using Generalized Estimating Equations. Results The intervention group improved significantly on GM during hospital follow-up by 0.88 points (p < 0.001, effect size = 0.26 SD), and on FM functions during the home follow-up by 1.09 points (p = 0.001, effect size = 0.22 SD). Both young and older children benefited similarly from the treatment. The intervention did not contribute significantly to linear growth and nutritional outcomes. Conclusion Psychomotor/psychosocial stimulation of SAM children enhances improvement in gross motor functions when combined with standard nutrient-rich diets, but it can enhance the fine motor functions even when such standard dietary care is not available. Trial registration The trial was retrospectively registered on 30 January 2017 at the US National Institute of Health (ClinicalTrials.gov) # NCT03036176.


PLoS Medicine ◽  
2020 ◽  
Vol 17 (12) ◽  
pp. e1003442
Author(s):  
Mette F. Olsen ◽  
Ann-Sophie Iuel-Brockdorff ◽  
Charles W. Yaméogo ◽  
Bernardette Cichon ◽  
Christian Fabiansen ◽  
...  

Background Lipid-based nutrient supplements (LNS) and corn–soy blends (CSBs) with varying soy and milk content are used in treatment of moderate acute malnutrition (MAM). We assessed the impact of these supplements on child development. Methods and findings We conducted a randomised 2 × 2 × 3 factorial trial to assess the effectiveness of 12 weeks’ supplementation with LNS or CSB, with either soy isolate or dehulled soy, and either 0%, 20%, or 50% of protein from milk, on child development among 6–23-month-old children with MAM. Recruitment took place at 5 health centres in Province du Passoré, Burkina Faso between September 2013 and August 2014. The study was fully blinded with respect to soy quality and milk content, while study participants were not blinded with respect to matrix. This analysis presents secondary trial outcomes: Gross motor, fine motor, and language development were assessed using the Malawi Development Assessment Tool (MDAT). Of 1,609 children enrolled, 54.7% were girls, and median age was 11.3 months (interquartile range [IQR] 8.2–16.0). Twelve weeks follow-up was completed by 1,548 (96.2%), and 24 weeks follow-up was completed by 1,503 (93.4%); follow-up was similar between randomised groups. During the study, 4 children died, and 102 children developed severe acute malnutrition (SAM). There was no difference in adverse events between randomised groups. At 12 weeks, the mean MDAT z-scores in the whole cohort had increased by 0.33 (95% CI: 0.28, 0.37), p < 0.001 for gross motor; 0.26 (0.20, 0.31), p < 0.001 for fine motor; and 0.14 (0.09, 0.20), p < 0.001 for language development. Children had larger improvement in language z-scores if receiving supplements with milk (20%: 0.09 [−0.01, 0.19], p = 0.08 and 50%: 0.11 [0.01, 0.21], p = 0.02), although the difference only reached statistical significance for 50% milk. Post hoc analyses suggested that this effect was specific to boys (interaction p = 0.02). The fine motor z-scores were also improved in children receiving milk, but only when 20% milk was added to CSB (0.18 [0.03, 0.33], p = 0.02). Soy isolate over dehulled soy increased language z-scores by 0.07 (−0.01, 0.15), p = 0.10, although not statistically significant. Post hoc analyses suggested that LNS benefited gross motor development among boys more than did CSB (interaction p = 0.04). Differences between supplement groups did not persist at 24 weeks, but MDAT z-scores continued to increase post-supplementation. The lack of an unsupplemented control group limits us from determining the overall effects of nutritional supplementation for children with MAM. Conclusions In this study, we found that child development improved during and after supplementation for treatment of MAM. Milk protein was beneficial for language and fine motor development, while suggested benefits related to soy quality and supplement matrix merit further investigation. Supplement-specific effects were not found post-intervention, but z-scores continued to improve, suggesting a sustained overall effect of supplementation. Trial registration ISRCTN42569496


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1238-1238
Author(s):  
Meta Van den Heuvel ◽  
Harriet Babikako ◽  
Emmie Mbale ◽  
John Mukisa ◽  
Margaret Nampijja ◽  
...  

Abstract Objectives To assess the association between play and interaction, and developmental outcomes in children with moderate acute malnutrition (MAM) in a prospective cohort of hospitalized children in Malawi and Uganda (http://www.chainnetwork.org). Methods Children (age 2– 23 months) requiring hospitalization for acute illness were enrolled from January 2017 till December 2018. Children meeting WHO criteria for MAM by mean upper arm circumference (MUAC) were included in this sub-analysis. Child development was assessed using the Malawi Developmental Assessment Tool at discharge and 180-day follow-up. The Family Care Indicator (FCI) evaluated the number of play items and interactions in the home. Developmental outcomes at discharge and follow-up were assessed using paired t-test. Linear regression analysis examined associations between FCI score and developmental outcomes at follow-up, with adjustment for sex, prematurity, height-for-age z-score and HIV status, parental education, household assets, and maternal mental health. Results 128 children with MAM (52.3% male, mean age 11.3 months (±4.5) were included (mean MUAC 120 mm ± 3.2). Children were excluded for: pre-existing neurodisability (n = 5), death during follow-up (n = 4), and loss to follow-up (n = 22). At discharge 24.4% of the children had delays in the gross motor domain, 18.7% in the fine motor domain, 4.1% in the language domain and 7.3% in the social domain. Over the 6-month study period, significant improvements (P &lt; 0.001) in the mean difference of gross motor (1.3), fine motor (0.83) and social domain (0.59) Z-scores were observed. No significant change was identified in the language domain Z-score. Adjusted linear regression revealed that a one-point increase in the number of play items was associated with an increase in gross motor z-score of 0.16 (95% CI 0.01–0.32, P = 0.04) and a one point increase in interaction activities was associated with an increase in language z-score of 0.27 (95% CI 0.03–0.51, P = 0.03) at follow-up. Conclusions Children with MAM admitted for an acute illness showed significant improvements in developmental outcomes at 180-day follow-up. The role of play and interaction activities at home should be further investigated for their potential to promote developmental outcomes in children with MAM. Funding Sources Bill and Melinda Gates Foundation.


Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 833
Author(s):  
Seung-Han Shin ◽  
Ee-Kyung Kim ◽  
Seh-Hyun Kim ◽  
Hyun-Young Kim ◽  
Han-Suk Kim

Spontaneous intestinal perforation (SIP) and surgical necrotizing enterocolitis (NEC) are intestinal conditions requiring surgical intervention in preterm infants. We aimed to compare the head growth and neurodevelopment of preterm infants with SIP and surgical NEC. A retrospective single-center study was performed in preterm infants born at less than 32 weeks of gestation and who had undergone surgery for NEC or SIP. Data from the Bayley Scales of Infant and Toddler Development 3rd Edition (Bayley-III) at 24 months of corrected age (CA) and the Korean Ages and Stages Questionnaire (K-ASQ) or Korean Developmental Screening Test (K-DST) at 36 months were collected. Among 82 eligible infants, 60 infants had surgical NEC, and 22 infants were diagnosed with SIP. Head growth was faster until CA 4 months in preterm infants with SIP than in those with surgical NEC. At 36 months, abnormal findings in the K-ASQ or K-DST were more prevalent in the NEC group than in the SIP group in the gross motor (48.2% vs. 0%, p = 0.015), fine motor (40.7% vs. 0%, p = 0.037), cognitive (55.6% vs. 12.5%, p = 0.047), and social domains (44.4% vs. 0%, p = 0.032). More studies evaluating the neurodevelopmental outcomes of preterm infants with surgical NEC and SIP are required.


2014 ◽  
Vol 31 (1) ◽  
pp. 32-46
Author(s):  
Rebecca J. Sargisson ◽  
Cheniel Powell ◽  
Peter Stanley ◽  
Rosalind de Candole

The motor and language skills, emotional and behavioural problems of 245 children were measured at school entry. Fine motor scores were significantly predicted by hyperactivity, phonetic awareness, prosocial behaviour, and the presence of medical problems. Gross motor scores were significantly predicted by the presence of medical problems. The fine motor scores of Māori children were poorer than those of Pākekā or children of other ethnicities, and right-handed children had better fine motor scores than left-handed children. There was some evidence that left-handed boys performed particularly poorly on tasks requiring fine motor skills. Children with medical problems had poorer gross motor scores than children without medical problems. Implications for the identification of problems at school entry are discussed.


2019 ◽  
Vol 43 (1-2) ◽  
pp. 41-76
Author(s):  
Irma Arteaga ◽  
Kathy Thornburg ◽  
Rajeev Darolia ◽  
Jacqueline Hawks

Background: The literature on the effects of teacher coaching in early childhood (EC) education programs is underdeveloped but emerging. Using the theory of action in professional development as our theoretical framework, we hypothesize that active coaching improves teaching methods and creates a more effective classroom environment for enhancing children’s learning and skills. Objectives: This study evaluates the effects of the Mississippi Building Blocks (MBB) program, an EC intervention with a strong emphasis on supervisor and coaching training. Research design: We conduct a randomized controlled experiment in which data were collected at baseline, midpoint (Month 3), and postintervention (Month 6) in 24 preschool classrooms in Mississippi. Subjects: The experiment included 195 preschoolers, of which 95 were in classrooms led by teachers who received coaching (treatment) and 100 were in classrooms without coaching (control). Measures: We measured child’s emergent language and literacy, fine motor skills, gross motor skills, print language skills, problem-solving, math skills, and socioemotional development. Results: We find that MBB coaching led to substantial improvements in child outcomes relative to the control group, particularly in gross motor skills, print language skills, and socioemotional development. We also find some evidence that MBB coaching improved math skills, though these estimates are on the margin of statistical significance. Finally, a mediator analysis indicates that improvements in the classroom learning environment brought about by MBB coaching improved child outcomes. Conclusions: Our findings suggest that an intensive form of classroom coaching for teachers leads to significant gains in child outcomes.


2017 ◽  
Vol 40 (1) ◽  
pp. 5-11
Author(s):  
Mirza Md Ziaul Islam ◽  
M Monir Hossain ◽  
Sheikh Anisul Haque ◽  
Naila Zaman Khan

Background: Preterm infants are at risk for long term neurodevelopmental impairements. Neurodevelopmental assessment at early months of infancy has been proposed as a valuable tool for prediction of neurodevelopmental outcomes in this population.Objective: The present study attempted to find the neurodevelopmental impairments in preterm infants and thus to identify the at risk infants for follow up and subsequent therapeutic intervention.Methodology: This prospective cross-sectional observational study was conducted in Dhaka Shishu (Children) Hospital from October 2011 to March, 2012. A total 103 preterm neonates who met the inclusion criteria underwent rapid neurodevelopmental assessment (RNDA) at neonatal period and again at their 3 months of age to find the at risk infants for long term neurodevelopmental impairments.Results: Among the enrolled 103 preterm infants during RNDA at neonatal period, abnormal domains found in primitive reflexes 41(39.7%), gross motor 42(40.7%), fine motor 32(31%), vision 40(38.7%), hearing 32 (31%), speech 40(38.7%), cognition 3(2.8%), behavior 3 (2.8%) and 3(2.8%) had seizure. Again in RNDA at 3 months of age, the no. of preterm infants having abnormal developmental domains are: gross motor 49(47.5%), fine motor 19(18.3), vision 9(8.6%), hearing 16(15.4%), speech 15 (14.5%), cognition 6(5.7%), speech 15 (14.5%), cognition 6(5.7%), behavior 11(10.6%) and 3 (2.9%) had seizure.Conclusion: The identification of neurodevelopmental impairments in early months of preterm infants should offer a valuable complement to tools for identification of at risk infants for long term sequlae (in neurodevelopmental impairment).Bangladesh J Child Health 2016; VOL 40 (1) :5-11


2021 ◽  
Vol 40 (1) ◽  
Author(s):  
Gary L. Darmstadt ◽  
Naila Z. Khan ◽  
Summer Rosenstock ◽  
Humaira Muslima ◽  
Monowara Parveen ◽  
...  

Abstract Background Topical treatment with sunflower seed oil (SSO) or Aquaphor® reduced sepsis and neonatal mortality in hospitalized preterm infants <33 weeks’ gestational age in Bangladesh. We sought to determine whether the emollient treatments improved neurodevelopmental outcomes during early childhood. Methods 497 infants were randomized to receive SSO, Aquaphor®, or neither through the neonatal period or hospital discharge. 159 infant survivors were enrolled in the longitudinal follow-up study using a validated Rapid Neurodevelopmental Assessment tool and the Bayley Scales of Infant Development II (BSID II) administered at three-monthly intervals for the first year and thereafter at six-monthly intervals. Lowess smoothing was used to display neurodevelopmental status across multiple domains by age and treatment group, and Generalized Estimating Equations (GEE) were used to compare treatment groups across age points. Results 123 children completed at least one follow-up visit. Lowess graphs suggest that lower proportions of children who received massage with either SSO or Aquaphor® had neurodevelopmental delays than control infants in a composite outcome of disabilities. In GEE analysis, infants receiving SSO showed a significant protective effect on the development of fine motor skills [odds ratio (OR) 0.92, 95% confidence interval (CI) 0.86–0.98, p=0.006]. The Psychomotor Development Index (PDI) in the BSID II showed significantly lower disability rates in the Aquaphor group (23.6%) compared to the control (55.2%) (OR 0.21, 95% CI 0.06–0.72, p=0.004). Conclusions Emollient massage of very preterm, hospitalized newborn infants improved some child neurodevelopmental outcomes over the first 2 years of follow-up. Findings warrant further confirmatory research. Trial registration ClinicalTrials.gov (98-04-21-03-2) under weblink https://clinicaltrials.gov/ct2/show/NCT00162747


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mehreen Zaigham ◽  
Lena Hellström-Westas ◽  
Magnus Domellöf ◽  
Ola Andersson

Abstract Background With prelabour caesarean section rates growing globally, there is direct and indirect evidence of negative cognitive outcomes in childhood. The objective of this study was to assess the short-term neurodevelopmental outcomes after prelabour caesarean section as compared to vaginally born infants. Methods We conducted a prospective, observational study of infants delivered by prelabour caesarean section at the Hospital of Halland, Halmstad, Sweden and compared their development with an historical group of infants born by non-instrumental vaginal delivery. Results Infants born by prelabour caesarean section were compared with a group of vaginally born infants. Follow-up assessments were performed at 4 and 12 months. Prelabour caesarean infants (n = 66) had significantly lower Ages and Stages Questionnaire, second edition (ASQ-II) scores in all domains (communication, gross motor, fine motor, problem solving and personal-social) at 4 months of age with an adjusted mean difference (95% CI) of − 20.7 (− 28.7 to − 12.6) in ASQ-II total score as compared to vaginally born infants (n = 352). These differences remained for gross-motor skills at the 12 month assessment, adjusted mean difference (95% CI) -4.7 (− 8.8 to − 0.7), n = 62 and 336. Conclusions Adverse neurodevelopmental outcomes in infants born by prelabour caesarean section may be apparent already a few months after birth. Additional studies are warranted to explore this relationship further.


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