Improving Child Development Screening: Implications for Professional Practice and Patient Equity

Introduction and Objectives: A pediatric group with 25 clinics and 150 providers used multifaceted approaches to implement workflow processes and an electronic health record (EHR) flowsheet to improve child developmental screening. The key outcome was developmental screening done for every patient during 3 periods between ages 8 and 36 months. Identification of developmental concerns was the secondary study outcome. Screening rates and referrals were hypothesized to be optimized for children regardless of demographic backgrounds. Methods: During preventive visits, developmental screens targeted patients in age groups 8 to 12, 13 to 24, and 25 to 36 months. EHRs were analyzed for screening documentation, results, and referrals by patient demographics. Fifteen pediatric professionals were interviewed about their qualitative experiences. Quality improvement interventions included appointing clinic champions, training staff about the screening process and responsibilities, using a standardized tool, employing plan-do-study-act cycles, posting EHR prompts, providing financial incentives, and monitoring screening rates using control charts. Results: Within 25 months, screening rates improved from 60% to >95% within the 3 preventive visit age groups for a total of more than 30 000 children. Professionals valued the team process improvements. Children enrolled in Medicaid, black children, and those living in lower income zip codes had lower screening rates than privately insured, white children, and those living in higher income areas. Ages and Stages Questionnaire 3rd edition results were significantly different by gender, race/ethnicity, insurance, and income categories across all groups. Referral rates varied by race/ethnicity and zip code of residence. Conclusions: This project resulted in an effective and efficient process to improve child developmental screening that was valued by pediatric professionals. Analyses of patient demographics revealed disparities in services for the most vulnerable families. Ongoing quality improvement, health services research, and advocacy offer hope to improve health equity.

The Effectiveness of Comparison of the Use of the Kuesioner Pra Skrining Perkembangan (KPSP) with Denver II on Development Children aged 0 – 72 months in the Dadok Primary Health Center Work Padang

Background: The issues of toddler boom and improvement that want for use as a reference withinside the detection encompass 10% of youngsters reaching early age abilities, 50% of youngsters will attain their abilities, 75% of youngsters will gain extra abilities, 90% of youngsters could have on the way to attain the age restriction on the present-day still. However, some time ago, they encountered several growth and development problems which were quite worrying for preschool children. Objectives: This study was to determine the accuracy of developmental outcomes for children aged 0 – 72 months between the Guide to the Kuesioner Pra Skrining Perkembangan (KPSP) and the Denver Developmental Screening Test II (Denver II). Questioner Pra Skrining Perkembangan (KPSP) and the Denver Developmental Screening Test II (Denver II) have a good result, valid and reliable to view developmental outcomes for children aged 0 – 72 months in Dadok Primary Health Center. Methods: The research method used is analytic with the design used being cross-sectional, then the Cohen's Kappa coefficient statistical test is carried out. The research sampling technique used purposive sampling as many as 56 children aged 0-72 months with exclusion criteria, namely children who were sick, had physical disabilities, and experienced other developmental disorders that could not be measured with the KPSP and Denver II instruments. The research into finished from December 2020 to December 2021. Results: The effects of this examination discovered that the improvement of youngsters elderly 0-72 months turned into nevertheless in the precise or everyday category. This may be visible from the effects of developmental tests on the usage of the KPSP and Denver II instruments, each of that has equal effectiveness for use in assessing improvement in youngsters. This is evidenced by the results of the Cohen's Kappa coefficient statistical test with a Kappa value of 0.638 which means it is good (0.61-0.80). Conclusion: It is expected for parents to implement an early detection program for child development by the child's ability at home. Parents are expected to attend seminars or training on growth and development according to the child's age level. invite the child to be more diligent in moving, provide stimulation to the leg muscles, or take the child to therapy so that it can be handled properly.

Efektifitas Finger Painting Terhadap Perkembangan Motorik Halus Pada Anak Prasekolah : Literature Review

Preschool children are they who aged 3-6 years, and at that age they have enormous potential to optimize aspects of their development, including the development of fine motor skills. children need to be trained for fine motor skills from an early age because children's hand skills are a window of knowledge, one way to improve fine motor development in preschool children is by finger painting. The purpose of this study was to determine the effectiveness of finger painting activities to improve fine motor development in preschool children based on a literature review. The design of this study was a literature review of three articles from Google Scholar with keywords including finger painting, fine motor development, preschoolers, Denver II (Developmental Screening Test) and full text articles published at least in the last 5 years. The sample in this study is children aged 3-6 years. The results of the analysis of the characteristics of the respondents in the three articles were a total of 70 respondents. The average value of the increase in fine motor development before the intervention was 2.89 and after it were 4.39. The conclusion from this literature review is that finger painting activities are effective in increasing fine motor development in preschool children. It is suggested for the nurse to be able to implement and provide education especially for parents to do finger painting activities as an intervention to improve fine motor development in preschool children.Keywords: Preschool children; denver II; Finger Painting; Fine motor development AbstrakAnak prasekolah adalah anak yang berusia 3-6 tahun, anak yang sudah memasuki usia tersebut mempunyai potensi yang sangat besar untuk mengoptimalkan aspek perkembangannya, termasuk perkembangan ketrampilan motorik halus. Sejak dini anak perlu dilatih untuk motorik halusnya karena ketrampilan tangan anak adalah jendela pengetahuan, salah satu cara untuk meningkatkan perkembangan motorik halus pada anak prasekolah yaitu dengan finger painting. Tujuan dari penulisan ini adalah untuk mengetahui efektifitas pemberian kegiatan finger painting untuk meningkatkan perkembangan motorik halus pada anak prasekolah berdasarkan literature review. Desain karya tulis ilmiah berupa literature review dari tiga artikel penelitian yang di dapat dari laman google scholar dengan kata kunci finger painting, perkembangan motorik halus, anak prasekolah, Denver II, berupa artikel fulltex dan minimal terbit 5 tahun terakhir. Sampel dalam penelitian ini yaitu anak yang berusia 3-6 tahun. Hasil analisa karakteristik responden dari tiga artikel berjumlah 70 responden. Nilai rata-rata peningkatan perkembangan motorik halus sebelum intervensi 2,89, setelah intervensi 4,39. Simpulan dari hasil literature review ini yaitu kegiatan finger painting terbukti efektif untuk meningkatkan perkembangan motorik halus pada anak usia prasekolah. Saran bagi perawat dapat menerapkan dan memberikan edukasi kepada orangtua untuk melakukan kegiatan finger painting sebagai salah satu intervensi untuk meningkatkan perkembangan motorik halus pada anak usia prasekolah. Kata kunci: Anak Prasekolah; Denver II; Finger Painting; Perkembangan Motorik Halus

Implementation of Developmental Screening in Early Childhood Education: An Investigation of Process Variables and Acceptability

Many children with developmental delays need early intervention services but do not receive them. Developmental screening provides the impetus for identification of delays and service referrals but is not used consistently across all early childhood education settings. We used an implementation science framework to examine attitudes and engagement in a developmental screening program across three early childcare centers. Teachers demonstrated adequate knowledge of screening following training in the screener and were highly engaged in the screening process. Teachers’ positive attitudes toward screening increased yet perceived barriers to regular use of screening in their practice remained unchanged. Family participation in the screening process varied across centers and suggested a trend between family income and participation. Future research is needed to target pervasive barriers to teachers’ use of screening, such as perceived difficulties in engaging parents in the screening process.

Predictive Validity of Developmental Screening Questionnaires for Identifying Children With Later Cognitive or Educational Difficulties: A Systematic Review

Context: Parent/caregiver completing developmental screening questionnaires (DSQs) for children before 5 years of age is currently recommended. The DSQs recommended by the American Academy of Pediatrics (AAP) are the Ages and Stages Questionnaires (ASQ), Parents' Evaluation of Developmental Status (PEDS), and the Survey of Well-being of Young Children (SWYC). Nevertheless, their predictive validity has not been well-established.Objective: To assess in the current literature, the value of AAP-recommended DSQs (ASQ, PEDS, SWYC) administered between 0 and 5 years of age, for predicting long-term cognitive achievement and/or school performance (CA/SP), after 1 year or more of evaluation and at/or after age 5 years, in the general population.Data Sources: Cochrane, MEDLINE PubMed, CINAHL, EMBASE, Web of Science, Scielo, and Scopus databases (until March 2021).Study Selection: Two authors selected the studies. Forward and backward citation follow-up was done; authors of DSQ were contacted to identify additional studies.Data Extraction: Cohorts were identified, and authors of selected studies were contacted to corroborate and complete extracted data.Results: Thirty-two publications, corresponding to 10 cohorts, were included. All cohorts used ASQ. Only cohort using PEDS was identified but did not meet the inclusion criteria. No cohorts conducted with SWYC were identified. Associations between ASQ and CA/SP were extracted for eight cohorts. The odds ratios were >3, and the area under the curve was 0.66–0.87. A trade-off between sensitivity and specificity was observed.Limitations: Heterogeneity in population characteristics and in DSQ adaptations.Conclusions: A positive association between ASQ and later CA/SP was found in different social, cultural, and economic settings. Additional studies are necessary to determine the impact factors in the predictive capacity of DSQs.Systematic Review Registration: PROSPERO, identifier: CRD42020183883.

Avaliação do comportamento pessoal e social de pré-escolares/Evaluation of personal-social behavior of pre-schoolers

Introdução: o comportamento pessoal-social consiste no modo como a criança interage com outras pessoas e como se engaja nas atividades de autocuidado. A educação infantil é um importante espaço para a criança desenvolver este comportamento. Objetivos: verificar a prevalência de alteração no comportamento pessoal-social entre pré-escolares, e analisar a associação com variáveis biopsicossociais. Métodos: estudo seccional, exploratório e descritivo, com crianças de 2 a 6 anos de idade de uma escola pública em (informação suprimida). O desfecho foi avaliado através da escala do comportamento pessoal social do Teste de Triagem do Desenvolvimento de Denver II, e variáveis biopsicossociais através de questionário. Os dados foram analisados por estatística descritiva e inferencial. Resultados: dentre 60 crianças participantes do estudo, 15,0% apresentou alteração no comportamento pessoal social. Apesar de não detectar associações entre o desfecho e as variáveis biopsicossociais, identificou-se que muitas crianças não tiveram oportunidade de executar tarefas comuns do cotidiano. Conclusão: o estudo aponta para a importância da família e da escola possibilitarem o engajamento em atividades de autocuidado a fim de que as crianças desenvolvam autonomia para o ingresso no ensino fundamental.AbstractIntroduction: Personal-social behavior consists of the way the child interacts with other people and how he engages in self-care activities. Early childhood education is an important space for children to develop this behavior. Objectives: to verify the prevalence of changes in personal-social behavior among preschoolers, and to analyze the association with biopsychosocial variables. Methods: sectional, exploratory and descriptive study was carried out with children aged 2 to 6 years old from a public school in João Pessoa. The outcome was assessed using the personal social behavior scale of the Denver II Developmental Screening Test, and biopsychosocial variables using a questionnaire. The data were analyzed using descriptive and inferential statistics. Results: among 60 children participating in the study, 15.0% showed changes in personal social behavior. Despite not detecting associations between the outcome and the biopsychosocial variables, it was found that many children did not have the opportunity to perform common everyday tasks. Conclusion: The study points to the importance of the family and the school to make it possible to engage in self-care activities so that children develop autonomy for entering elementary school.Keywords: Child Development. Preschool. Activities of Daily Living. Risk Factors ResumenIntroducción: el comportamiento personal-social consiste en la forma en que el niño interactúa con otras personas y cómo se involucra en actividades de autocuidado. La educación infantil es un espacio importante para que los niños desarrollen este comportamiento. Objetivos: verificar la prevalencia de cambios en la conducta personal-social entre preescolares y analizar la asociación con variables biopsicosociales. Métodos: se realizó un estudio seccional, exploratorio y descriptivo con niños de 2 a 6 años de una escuela pública de João Pessoa. El resultado se evaluó mediante la Escala de comportamiento social personal de la Prueba de detección del desarrollo de Denver II y las variables biopsicosociales mediante un cuestionario. Los datos se analizaron mediante estadística descriptiva e inferencial. Resultados: entre los 60 niños que participaron en el estudio, el 15,0% mostró cambios en el comportamiento social personal. A pesar de no detectar asociaciones entre el resultado y las variables biopsicosociales, se encontró que muchos niños no tenían la oportunidad de realizar tareas cotidianas comunes. Conclusión: el estudio señala la importancia de la familia y la escuela para posibilitar la realización de actividades de autocuidado para que los niños desarrollen autonomía para ingresar a la escuela primaria.Palabras clave: Desarrollo Infantil. Preescolar. Actividades Cotidianas. Factores de Riesgo