scholarly journals Assessment of a neuro-developmental screening tool in children in Bhutan

2019 ◽  
Vol 3 ◽  
pp. 1496
Author(s):  
Brian Wong ◽  
Sara Grundy ◽  
Lhab Tshering ◽  
Kinley Tshering ◽  
Farrah J. Mateen
Keyword(s):  
Cultural Context ◽  
Growth Parameters ◽  
The United States ◽  
Receptive Language ◽  
Community Dwelling ◽  
Screening Tools ◽  
Developmental Screening ◽  
Fine Motor ◽  
Self Help ◽  
The Mean

Background: Developmental screening tools are designed to fit the cultural context in which they are utilized, yet often find a wider international audience. This study evaluates the efficacy of one such tool, the Parental Evaluation of Developmental Status: Developmental Milestones (PEDS:DM), developed in the United States and tested in the lower income Asian country of Bhutan. We aimed to test the PEDS:DM instrument to measure neurodevelopmental delay in children in Bhutan. Methods: In total, 96 community-dwelling Bhutanese children (3-7 years old) without diagnosed neurocognitive conditions were recruited from ambulatory clinics in urban Bhutan in 2016 as part of a larger study on retinal imaging and cognitive and growth parameters. Scoring was based on neurocognitive domains (gross and fine motor, receptive and expressive speech, self-help, social-emotional). Rates of failure (meant to indicate delay) within domains were calculated. Results: Modifications of some standard questions were deemed necessary by the study staff to suit the cultural context, such as replacing kickball with football in a question regarding games played with rules to maintain local relevance. In a modified PEDS:DM test with these improvised modifications, the mean percentage of age-appropriate domains failed was 58.8% and the mean percent delay was 12.3% (range 0-41.4%, available in n=83). The highest prevalence of failures was 59.4% for receptive language and 76.3% for expressive language, much higher than the lowest rate of failure seen in self-help (5.4%).  Conclusions: The PEDS:DM requires further modifications and validation studies before it can be reliably implemented to assess developmental delay in children in Bhutan. In this pilot study, the rate of delay as reported by the PEDS:DM would be scored as markedly elevated, especially when compared to available epidemiologic studies in the region.

scholarly journals Assessment of a neuro-developmental screening tool in children in Bhutan

2019 ◽  
Vol 3 ◽  
pp. 1496
Author(s):  
Brian Wong ◽  
Sara Grundy ◽  
Lhab Tshering ◽  
Kinley Tshering ◽  
Farrah J. Mateen
Keyword(s):  
Cultural Context ◽  
Growth Parameters ◽  
The United States ◽  
Receptive Language ◽  
Community Dwelling ◽  
Screening Tools ◽  
Developmental Screening ◽  
Fine Motor ◽  
Self Help ◽  
The Mean

Background: Developmental screening tools are designed to fit the cultural context in which they are utilized, yet often find a wider international audience. This study evaluates the efficacy of one such tool, the Parental Evaluation of Developmental Status: Developmental Milestones (PEDS:DM), developed in the United States and tested in the lower income Asian country of Bhutan. We aimed to test the PEDS:DM instrument to measure neurodevelopmental delay in children in Bhutan. Methods: In total, 96 community-dwelling Bhutanese children (3-7 years old) without diagnosed neurocognitive conditions were recruited from ambulatory clinics in urban Bhutan in 2016 as part of a larger study on retinal imaging and cognitive and growth parameters. Scoring was based on neurocognitive domains (gross and fine motor, receptive and expressive speech, self-help, social-emotional). Rates of failure (meant to indicate delay) within domains were calculated. Results: Modifications of some standard questions was deemed necessary by the study staff to suit the cultural context, such as replacing kickball with football in a question regarding games played with rules to maintain local relevance. In a modified PEDS:DM test with these improvised modifications, the mean percentage of age-appropriate domains failed was 58.8% and the mean percent delay was 12.3% (range 0-41.4%, available in n=83). The highest prevalence of failures was 59.4% for receptive language and 76.3% for expressive language, much higher than the lowest rate of failure seen in self-help (5.4%).  Conclusions: The PEDS:DM requires further modifications and validation studies before it can be reliably implemented to assess developmental delay in children in Bhutan. In this pilot study, the rate of delay as reported by the PEDS:DM would be scored as markedly elevated, especially when compared to available epidemiologic studies in the region.

scholarly journals Screening Community-Living Older Adults for Protein Energy Malnutrition and Frailty: Update and Next Steps

2019 ◽  
Vol 45 (3) ◽  
pp. 640-660 ◽  
Author(s):  
Johanna T. Dwyer ◽  
Jaime J. Gahche ◽  
Mary Weiler ◽  
Mary Beth Arensberg
Keyword(s):  
Older Adults ◽  
Predictive Validity ◽  
Screening Tool ◽  
Protein Energy Malnutrition ◽  
The United States ◽  
Community Dwelling ◽  
Screening Tools ◽  
World Health ◽  
Community Settings ◽  
Protein Energy

Abstract Protein-energy malnutrition (PEM)/undernutrition and frailty are prevalent, overlapping conditions impacting on functional and health outcomes of older adults, but are frequently unidentified and untreated in community settings in the United States. Using the World Health Organization criteria for effective screening programs, we reviewed validity, reliability, and feasibility of data-driven screening tools for identifying PEM and frailty risk among community-dwelling older adults. The SCREEN II is recommended for PEM screening and the FRAIL scale is recommended as the most promising frailty screening tool, based on test characteristics, cost, and ease of use, but more research on both tools is needed, particularly on predictive validity of favorable outcomes after nutritional/physical activity interventions. The Malnutrition Screening Tool (MST) has been recommended by one expert group as a screening tool for all adults, regardless of age/care setting. However, it has not been tested in US community settings, likely yields large numbers of false positives (particularly in community settings), and its predictive validity of favorable outcomes after nutritional interventions is unknown. Community subgroups at highest priority for screening are those at increased risk due to prior illness, certain demographics and/or domiciliary characteristics, and those with BMI < 20 kg/m2 or < 22 if > 70 years or recent unintentional weight loss > 10% (who are likely already malnourished). Community-based health professionals can better support healthy aging by increasing their awareness/use of PEM and frailty screening tools, prioritizing high-risk populations for systematic screening, following screening with more definitive diagnoses and appropriate interventions, and re-evaluating and revising screening protocols and measures as more data become available.

scholarly journals A Mobile App Directory of Occupational Therapists Who Provide Home Modifications: Development and Preliminary Usability Evaluation

10.2196/14465 ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. e14465
Author(s):  
An Thi Nguyen ◽  
Emily Kling Somerville ◽  
Sandra Martina Espín-Tello ◽  
Marian Keglovits ◽  
Susan Lynn Stark
Keyword(s):  
Older Adults ◽  
Phase 1 ◽  
Occupational Therapists ◽  
The United States ◽  
Mobile App ◽  
Community Dwelling ◽  
Phase 2 ◽  
Home Modifications ◽  
The Mean ◽  
Community Dwelling Older Adults

Background Home modifications provided by occupational therapists (OTs) are effective in improving daily activity performance and reducing fall risk among community-dwelling older adults. However, the prevalence of home modification is low. One reason is the lack of a centralized database of OTs who provide home modifications. Objective This study aimed to develop and test the usability of a mobile app directory of OTs who provide home modifications in the United States. Methods In phase 1, a prototype was developed by identifying OTs who provide home modifications through keyword Web searches. Referral information was confirmed by phone or email. In phase 2, community-dwelling older adults aged older than 65 years and OTs currently working in the United States were purposefully recruited to participate in a single usability test of the mobile app, Home Modifications for Aging and Disability Directory of Referrals (Home Maddirs). Participants completed the System Usability Scale (SUS) and semistructured interview questions. Interview data were coded, and themes were derived using a grounded theory approach. Results In phase 1, referral information for 101 OTs across 49 states was confirmed. In phase 2, 6 OTs (mean clinical experience 4.3 years, SD 1.6 years) and 6 older adults (mean age 72.8 years, SD 5.0 years) participated. The mean SUS score for OTs was 91.7 (SD 8.0; out of 100), indicating good usability. The mean SUS score for older adults was 71.7 (SD 27.1), indicating considerable variability in usability. In addition, the SUS scores indicated that the app is acceptable to OTs and may be acceptable to some older adults. For OTs, self-reported barriers to acceptability and usability included the need for more information on the scope of referral services. For older adults, barriers included high cognitive load, lack of operational skills, and the need to accommodate sensory changes. For both groups, facilitators of acceptability and usability included perceived usefulness, social support, and multiple options to access information. Conclusions Home Maddirs demonstrates good preliminary acceptability and usability to OTs. Older adults’ perceptions regarding acceptability and usability varied considerably, partly based on prior experience using mobile apps. Results will be used to make improvements to this promising new tool for increasing older adults’ access to home modifications.

scholarly journals PREMIGRATION, DISPLACEMENT, AND POSTMIGRATION EXPERIENCES OF LONELINESS AMONG HMONG OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S901-S901
Author(s):  
Cindy Vang ◽  
Michael Sieng
Keyword(s):  
Older Adults ◽  
Influencing Factors ◽  
Cultural Context ◽  
Minority Group ◽  
The United States ◽  
Community Dwelling ◽  
Constructivist Grounded Theory ◽  
The Social ◽  
Refugee Experience ◽  
Community Access

Abstract Available evidence highlights the detrimental impact of loneliness on the mental and physiological health of older adults. While immigrant older adults report higher prevalence for experiencing loneliness compared to native born older adults, minimal research has simultaneously explored the premigration, displacement, and postmigration experiences of loneliness among older adults with a refugee history. This study aimed to explore loneliness in these three phases among Hmong older adults, an ethnic minority group resettled in the United States as refugees over 40 years ago. Drawing on data from a constructivist grounded theory study guided by an intersectionality framework, the first author interviewed 17 community-dwelling Hmong older adults age 65 and older residing in Fresno and Sacramento, California. Two coders coded and analyzed the transcribed interviews. Findings revealed negative, disruptive, and discriminatory experiences underscored by systems of oppression grounded on the social, political, psychological, and cultural context of each phase. Influencing factors that contributed to loneliness were identified as: trust, loss, aging-related issues, isolation, sense of community, access to cultural community, instability, violence, and cultural adjustments. In specific phases, particular influencing factors were more evident and persistent in producing loneliness. Some influencing factors remained a problem for participants across all phases. With the unprecedented growth of refugees all over the world, this study highlights the need for more research, practice, and policy focused on the context of the refugee experience to gain greater insight into their loneliness experiences and expand the notion of loneliness as an individual experience.

scholarly journals A Mobile App Directory of Occupational Therapists Who Provide Home Modifications: Development and Preliminary Usability Evaluation (Preprint)

2019 ◽  
Author(s):  
An Thi Nguyen ◽  
Emily Kling Somerville ◽  
Sandra Martina Espín-Tello ◽  
Marian Keglovits ◽  
Susan Lynn Stark
Keyword(s):  
Older Adults ◽  
Phase 1 ◽  
Occupational Therapists ◽  
The United States ◽  
Mobile App ◽  
Community Dwelling ◽  
Phase 2 ◽  
Home Modifications ◽  
The Mean ◽  
Community Dwelling Older Adults

BACKGROUND Home modifications provided by occupational therapists (OTs) are effective in improving daily activity performance and reducing fall risk among community-dwelling older adults. However, the prevalence of home modification is low. One reason is the lack of a centralized database of OTs who provide home modifications. OBJECTIVE This study aimed to develop and test the usability of a mobile app directory of OTs who provide home modifications in the United States. METHODS In phase 1, a prototype was developed by identifying OTs who provide home modifications through keyword Web searches. Referral information was confirmed by phone or email. In phase 2, community-dwelling older adults aged older than 65 years and OTs currently working in the United States were purposefully recruited to participate in a single usability test of the mobile app, Home Modifications for Aging and Disability Directory of Referrals (Home Maddirs). Participants completed the System Usability Scale (SUS) and semistructured interview questions. Interview data were coded, and themes were derived using a grounded theory approach. RESULTS In phase 1, referral information for 101 OTs across 49 states was confirmed. In phase 2, 6 OTs (mean clinical experience 4.3 years, SD 1.6 years) and 6 older adults (mean age 72.8 years, SD 5.0 years) participated. The mean SUS score for OTs was 91.7 (SD 8.0; out of 100), indicating good usability. The mean SUS score for older adults was 71.7 (SD 27.1), indicating considerable variability in usability. In addition, the SUS scores indicated that the app is acceptable to OTs and may be acceptable to some older adults. For OTs, self-reported barriers to acceptability and usability included the need for more information on the scope of referral services. For older adults, barriers included high cognitive load, lack of operational skills, and the need to accommodate sensory changes. For both groups, facilitators of acceptability and usability included perceived usefulness, social support, and multiple options to access information. CONCLUSIONS Home Maddirs demonstrates good preliminary acceptability and usability to OTs. Older adults’ perceptions regarding acceptability and usability varied considerably, partly based on prior experience using mobile apps. Results will be used to make improvements to this promising new tool for increasing older adults’ access to home modifications.

The Usefulness of the Battelle Developmental Inventory Screening Test

1993 ◽  
Vol 32 (5) ◽  
pp. 273-280 ◽  
Author(s):  
Frances Page Glascoe ◽  
Karen E. Byrne
Keyword(s):  
Screening Test ◽  
Cognitive Skills ◽  
Receptive Language ◽  
Developmental Screening ◽  
Screening Tests ◽  
Pediatric Practice ◽  
Developmental Problems ◽  
The Mean ◽  
Borderline Intelligence ◽  
Battelle Developmental Inventory

Recent research supporting the effectiveness of early intervention and laws expanding services have increased the demand for accurate developmental screening tests. The Battelle Developmental Inventory Screening Test (BDIST), for children 6 months to 8 years old, has a number of desirable features, including subtests for fine and gross motor, adaptive, personal-social, receptive and expressive language, and cognitive skills; a range cutoff and age-equivalent scores; and national standardization. To assess its accuracy, the BDIST was administered to 104 children 7 to 83 months old, along with several other screening tests and a battery of criterion measures. Tied to 1.5 standard deviations below the mean, BDIST failing scores were moderately sensitive, detecting 75% of the children with developmental problems, such as mental retardation, borderline intelligence, language delays, and learning disabilities. Since 73% of the nonhandicapped children passed the BDIST, the test showed moderate specificity. Children within one month of their birthdays were likely to be over- or underreferred. Although the BDIST needs further research, it is a promising developmental screening instrument. The Receptive Language (RL) subtest, slightly more sensitive than the total BDIST but less specific, takes only a few minutes and thus is useful for prescreening in time-limited settings, such as pediatric practice.

Developmental Screening for Young Children

2012 ◽  
Vol 5 (10) ◽  
pp. 579-586
Author(s):  
Jacqueline Le Geyt
Keyword(s):  
Early Intervention ◽  
Developmental Delay ◽  
Normal Population ◽  
Childhood Development ◽  
Developmental Screening ◽  
Fine Motor ◽  
Common Condition ◽  
Stage Of Development ◽  
Self Help ◽  
Developmental Progress

Childhood development is the gaining of skills in various aspects of the child's life. It can be monitored using “developmental milestones”; objective targets reached at various stages, generally classified in to four main areas: gross motor, fine motor and vision, speech and hearing, and social and self-help skills. Although each stage of development will be reached at slightly different ages within the normal population, the order that the various skills are obtained by each child remains fairly consistent. Universally agreed ages that a child “should” have reached each skill are well documented, after which the attained skill is classified as being delayed. These milestone ages are important to allow the practitioner to assess if a child has a delay in any or all of the areas of development, and therefore highlight those children needing further assessment. Early intervention is essential for optimising developmental progress in the delayed child. Developmental delay (DD) is a common condition seen regularly by GPs.

DOZ047.20: Growth, feeding difficulties, and developmental scores in children born with esophageal atresia: a single-center study

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
A Grech ◽  
M Kwan ◽  
L Hatton ◽  
P Robinson ◽  
J Karpelowsky ◽  
...  
Keyword(s):  
Respiratory Infections ◽  
Oesophageal Atresia ◽  
Receptive Language ◽  
Fine Motor ◽  
Poor Growth ◽  
Feeding Difficulties ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
The Mean ◽  
The Impact

Abstract Background Children with repaired tracheoesophageal fistula/oesophageal atresia (TOF/OA) often have ongoing feeding difficulties and poor growth related to esophageal dysmotility, strictures, gastroesophageal reflux, aspiration, and respiratory infections. The impact of neurocognitive development on feeding in this cohort is less well studied. Objective The objective of this study was to investigate the growth, parent-reported feeding difficulties, and developmental scores of children with TOF/OA at The Children's Hospital at Westmead in Sydney, Australia. Methods The validated Montreal Children's Hospital Feeding Scale (MCH-FS) was completed by parents of patients aged 6 months to 6 years at a multidisciplinary aerodigestive clinic between February 2016 and October 2018. Growth, developmental outcomes (using the Bayley Scales of Infant and Toddler Development [BAYLEY-III]), demographic information, OA subtype, and associated comorbidities were reviewed. Results Forty-three caregivers completed the MCH-FS at least once, with questionnaires returned up to five times, totaling 101 reviews. The mean age was 4 years (± 1.9) and 53% were female. Thirty percent of patients were born prematurely and 30% had VACTERL association. Mean [± SD] growth z-scores were below WHO/CDC means for weight (−0.86 ± 1.37), length/height (−0.70 ± 1.2), and weight-for-length/BMI (−0.35 ± 1.15). BAYLEY-III scores were available for 27 children at 13 (± 1) months. Mean scores for four domains were within ‘average’ range (8–12): cognition (11 ± 2), receptive language (8 ± 3), expressive language (8 ± 2), and fine motor skills (9 ± 2). The mean gross motor score was below average (7 ± 3). Parent-reported feeding difficulties were moderate. When first completed, cumulative MCH-FS scores indicated 44% of patients had severe feeding difficulties, 40% moderate, and 14% mild. Sixty percent of patients required referral to a speech pathologist. However, most parents did not feel that these feeding difficulties influenced the relationship with their child or their family (88% and 84%, respectively). Conclusions The majority of patients in the cohort experienced significant feeding difficulties and some below average developmental scores, underscoring the need for multidiscplinary support for children born with TOF/OA. Further work in correlating growth, developmental, and feeding outcomes within subjects will assist in identifying early risk factors that may highlight infants most predisposed to these challenges, and who may benefit from early intervention.

scholarly journals Characteristics of toddlers with early versus later diagnosis of autism spectrum disorder

Autism ◽  
2020 ◽  
pp. 136236132095950 ◽  
Author(s):  
Lauren E Miller ◽  
Yael G Dai ◽  
Deborah A Fein ◽  
Diana L Robins
Keyword(s):  
Autism Spectrum Disorder ◽  
Young Children ◽  
The United States ◽  
Receptive Language ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Fine Motor ◽  
Similar Degree ◽  
Autism Symptoms ◽  
Linear Pattern

Autism spectrum disorder symptom emergence is heterogeneous, yet literature comparing young children diagnosed early versus later is relatively scant. Toddlers diagnosed with autism spectrum disorder between 12 and 18 months ( n = 20), 19 and 24 months ( n = 65), or 25 and 41 months ( n = 27) were compared on demographics, developmental functioning, and symptoms. Later diagnosed children were more impaired than both younger groups on nonverbal reasoning, adaptive behavior, and autism spectrum disorder severity. Fine motor, receptive language, and social skills followed a linear pattern, with 25- to 41-month children more delayed than 19- to 24-month participants, who were more delayed than 12- to 18-month toddlers. Communication skills were similarly impaired across groups. Universal autism spectrum disorder screening before 18 months may detect toddlers when symptoms are milder and more amenable to intervention. Lay abstract The emergence of autism symptoms in childhood is variable, with some children showing signs of autism spectrum disorder very early, and others not being identified until much later. Although most children in the United States are not diagnosed with autism spectrum disorder until preschool, at ages 3–4 years, symptoms can be reliably detected at 14 months. It is less certain how those toddlers diagnosed with autism spectrum disorder earlier versus later differ from each other clinically. This study revealed that young children diagnosed later in development, between ages 25 and 41 months, are more impaired on measures of cognitive, adaptive, and social functioning than their counterparts who are diagnosed with autism spectrum disorder earlier. All young children with autism spectrum disorder are impaired in communication to a similar degree, however. Universal autism screening at 18 months may identify toddlers with autism spectrum disorder when their symptoms are milder and more readily amenable to intervention. Repeated screening at 24 months is supported to detect those children missed by an earlier screening, who may be more severely affected. Caregivers should be encouraged to pursue diagnostic evaluation at an initial positive screening result to ensure timely diagnosis and treatment.

Brief Report: Performance of Australian Children at One Year of Age on the Bayley Scales of Infant and Toddler Development (Version III)

2010 ◽  
Vol 27 (1) ◽  
pp. 54-58 ◽  
Author(s):  
Karen Walker ◽  
Nadia Badawi ◽  
Robert Halliday ◽  
Sharon Laing
Keyword(s):  
Cultural Context ◽  
Expressive Language ◽  
Receptive Language ◽  
Fine Motor ◽  
Australian Population ◽  
Gross Motor ◽  
Toddler Development ◽  
One Year ◽  
Bayley Scales

AbstractThis article reports mean scores on the Bayley Scales of Infant and Toddler Development (Version III) for 211 randomly selected healthy term (≥ 37 weeks gestation) Australian infants at one year of age. Mean scores were significantly different from standardised norms in all subscales except fine motor. Australian infants scored higher on cognitive and receptive language (p < .01) and lower on expressive language and gross motor (ps < .01) subscales. These findings raise questions regarding the validity of this test in the Australian population and suggest that the test be re-normed on Australian children for valid interpretation of scores in this cultural context.

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