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Objective To evaluate the body mass index and neurologic development of 1-2 years offspring born to mothers with polycystic ovary syndrome. Study design A case-control study. Place and duration of study Dongyang Women and Children's Hospital, Zhejiang Province, China, between June 2018 and January 2019. Methodology A total of 145 children were included in the final analysis, including 16 daughters of mothers with PCOS, 13 sons of mothers with PCOS, 55 daughters of mothers without PCOS and 61 sons of mothers without PCOS. Developmental assessments for each child were conducted, including anthropometric measurements and ability developments using the Denver developmental screening test. Results The body mass index of children was significantly lower in polycystic ovary syndrome group than control group (p=0.022). Children of mothers with polycystic ovary syndrome and control group had no significant differences in the outcomes of the Denver developmental screening test (all p >0.05). Conclusion Maternal polycystic ovary syndrome may affect body mass index of offspring aged 1-2 years and had no negative effects on neurologic development. However, this conclusion may be limited due to the small sample size. Key Words: Neurologic development, Polycystic ovary syndrome, Offspring, Denver development screening test, Body mass index.

BACKGROUND The objective of this study was to determine the effect of febrile convulsion (FC) on neuromotor development. METHODS Data of 325 patients, who were followed up at our outpatient clinic and diagnosed with FC between January 2012 and December 2018, were retrospectively evaluated. Of these patients, 203 underwent the Denver Developmental Screening Test II (DDST II) and were included in the study as the patient group and 100 healthy children as the control group. RESULTS Of the study group, 84 (41.4%) were girls and 119 (58.6%) were boys (B/G: 1.4). Of all patients, 163 (80.3%) were diagnosed with simple FC, 22 (10.8%) with complicated FC, and 18 (8.9%) with FC+. There was no significant relationship found between FC subtypes and gender, family history of FC, family history of epilepsy, iron (Fe) deficiency, and Fe deficiency anemia. DDST II subtest points were significantly lower in all developmental areas in the patient group when compared to the controls (p < 0.001), while suspected and abnormal test results were higher in all developmental areas in the patient group compared to the controls (p=0.01). It was also determined that the language points were lower as the age of first seizure increased (r=- 0.319, p < 0.01). CONCLUSIONS Although FC is known to usually having a good prognosis, the low DDST II test results measured in this study indicated that the FC may pose a developmental risk and patients with FC should be followed up in terms of developmental features. Because of the retrospective nature of the study, there was no `preconvulsion` developmental evaluation. This is a major limitation of our study.

Background This study assessed the psychometric profile of 10 questionnaires (every 6 months, from 6 to 60 months) from the Japanese translation of the Ages and Stages Questionnaires, third edition (J‐ASQ‐3). Methods Data from 439 children in a birth cohort were used to identify the J‐ASQ‐3 score distribution, establish cut‐off scores, and calculate the instrument's internal consistency. Data were also collected from 491 outpatients to examine J‐ASQ‐3 test–retest reliability and concurrent validity, which was examined using the Kyoto Scale of Psychological Development (KSPD) and the Japanese version of the Denver Developmental Screening Test II (J‐Denver II). Both the original and the alternative screening criteria of the ASQ‐3 were used (failure in at least one and at least two domains, respectively). Results Cronbach's alpha for each J‐ASQ‐3 subscale on each questionnaire ranged from 0.45 to 0.89. Test–retest reliability was >0.75 for the subscales on almost all questionnaires. Concurrent validity was also adequate. In comparison with the screening results of the KSPD, the overall sensitivity and specificity were 96.0% and 48.8%, respectively, when the ASQ‐3 original criterion was used, and 92.1% and 74.9%, respectively, when the alternative criterion was used. In comparison with the screening results of the J‐Denver II, the overall sensitivity and specificity were 75.6% and 74.7%, respectively, when the ASQ‐3 original criterion was used, and 56.3% and 93.0%, respectively, when the alternative criterion was used. Conclusions This study quantified the psychometric profiles of the Japanese translations of 10 ASQ‐3 questionnaires. We demonstrated the validity of the J‐ASQ‐3 and determined new cut‐off scores. Further studies with larger samples from a greater range of locations are required to clarify the suitability of this tool for all Japanese children.

Introduction Children born with cleft lip and palate (CLP) are exposed to several risk factors for developmental delay. Methods This cross-sectional and descriptive study compared the performance of gross motor, adaptive fine motor, social-personal and language skills in children with non-syndromic cleft lip and palate (age = 36–47 months, n = 30) matched as to chronological age and gender. The evaluation instruments were Denver Developmental Screening Test II and MacArthur Communicative Development Inventory – part D, employed for the receptive and expressive vocabulary checklist. Intergroup comparisons were performed using t tests and Chi-square tests. The Pearson correlation coefficient was used to verify the inter-category correlation (p ≤ 0.05). Results There was statistically significant difference in gross motor, adaptive fine motor, and language skills, both in receptive and expressive aspects, in the comparison between groups. In the personal-social area, children with CLP presented performance below the expected, without statistically significant difference between groups. Conclusions Children with CLP are at risk for developmental disorders and should be monitored from early childhood to minimize the deleterious effects of this risk condition.

ObjectivesTo perform a multidimensional assessment of women who experienced severe maternal morbidity (SMM) and its short-term and medium-term impact on the lives and health of women and their children.DesignA retrospective cohort study.SettingA tertiary maternity hospital from the southeast region of Brazil.ParticipantsThe exposed population was selected from intensive care unit admissions if presenting any diagnostic criteria for SMM. Controls were randomly selected among women without SMM admitted to the same maternity and same time of childbirth.Primary and secondary outcome variablesValidated tools were applied, addressing post-traumatic stress disorder (PTSD) and quality of life (SF-36) by phone, and then general and reproductive health, functioning (WHO Disability Assessment Schedule), sexual function (Female Sexual Function Index (FSFI)), substance abuse (Alcohol, Smoking and Substance Involvement Screening Test 2.0) and growth/development (Denver Developmental Screening Test) of children born in the index pregnancy in a face-to-face interview.ResultsAll instruments were applied to 638 women (315 had SMM; 323 were controls, with the assessment of 264 and 307 children, respectively). SF-36 score was significantly lower in the SMM group, while PTSD score was similar between groups. Women who had SMM became more frequently sterile, had more abnormal clinical conditions after the index pregnancy and a higher score for altered functioning, while proportions of FSFI score or any drug use were similar between groups. Furthermore, children from the SMM group were more likely to have weight (threefold) and height (1.5 fold) for age deficits and also impaired development (1.5-fold).ConclusionSMM impairs some aspects of the lives of women and their children. The focus should be directed towards monitoring these women and their children after birth, ensuring accessibility to health services and reducing short-term and medium-term repercussions on physical, reproductive and psychosocial health.

IntroductionAn outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurred in Wuhan, China starting in December 2019. Yet the clinical features and long-term outcomes of neonates with SARS-CoV-2 exposure are lacking. The purpose of this study is to describe the clinical course and prognosis of the neonates exposed to SARS-CoV-2.Methods and analysisThis is a multicentre observational study conducted at the designated children and maternal and child hospitals in the mainland of China. Neonates exposed to SARS-CoV-2 infection will be recruited. The data to be collected via case report forms include demographic details, clinical features, laboratory and imaging results, as well as outcomes. Primary outcomes are the mortality of neonates with COVID-19 and SARS-CoV-2 infection of neonates born to mothers with COVID-19. Secondary outcomes are the birth weight, premature delivery and neurological development of neonates exposed to SARS-CoV-2. The neurological development is assessed by the Chinese standardised Denver Developmental Screening Test at the corrected age of 6 months.Ethics and disseminationThis study has been approved by the Children's Hospital of Fudan University ethics committee (No. (2020)31). The study findings will be disseminated in peer-reviewed journals and presented at national and international conferences in order to improve the understanding of the clinical course among neonates exposed to SARS-CoV-2 and to provide evidence-based treatment and prevention strategies for this group.Trial registration numberNCT04279899.

Background and objectives: The cochlear implant is not only meant to restore auditory function, but it also has a series of benefits on the psychomotor development and on the maturation of central auditory pathways. In this study, with the help of neuropsychological tests and cortical auditory potentials (CAEPs), we intend to identify a series of instruments that allow us to monitor children with a cochlear implant, and later on, to admit them into an individualized rehabilitation program. Materials and methods: This is a longitudinal study containing 17 subjects (6 boys and 11 girls) diagnosed with congenital sensorineural hearing loss. The average age for cochlear implantation in our cohort is 22 months old. Each child was tested before the cochlear implantation, tested again 3 months after the implant, and then 6 months after the implant. To test the general development, we used the Denver Developmental Screening Test (DDST II). CAEPs were recorded to assess the maturation of central auditory pathways. Results: The results showed there was progress in both general development and language development, with a significant statistical difference between the overall DQ (developmental quotient) and language DQ before the cochlear implantation and three and six months later, respectively. Similarly, CAEP measurements revealed a decrease of positive-going component (P1) latency after cochlear implantation. Conclusion: CAEPs and neuropsychological tests prove to be useful instruments for monitoring the progress in patients with cochlear implants during the rehabilitation process.

There is increasing global commitment to establish early childhood interventions that promote the development of the millions of disadvantaged children in low- and middle-income countries not reaching their developmental potential. However, progress is hindered by the lack of valid developmental tests feasible for use at large scale. Consequently, there is an urgent need for such tests. Whilst screeners and single-domain tests ('short tests') are used as alternatives, their predictive validity in these circumstances is unknown. A longitudinal study in Bogota, Colombia began in 2011 when 1,311 children ages 6-42 months were given the Bayley Scales of Infant and Toddler Development (Bayley-III) by psychologists and randomized to receive one of two batteries of short tests under survey conditions. Concurrent validity of the short tests with the Bayley-III ('gold standard') was reported. In 2016, at 6-8 years, 940 of these children were given tests of IQ (Wechsler Intelligence Scale for Children, WISC-V) and school achievement (arithmetic, reading, and vocabulary) by psychologists. We compared the ability of the short tests, the Family Care Indicators (FCI), height-for-age, stunting (median height-for-age

Early nutrition and growth have been found to be important early exposures for later development. Studies of crude growth in terms of weight and length/height, however, cannot elucidate how body composition (BC) might mediate associations between nutrition and later development. In this study, we aimed to examine the relation between fat mass (FM) or fat-free mass (FFM) tissues at birth and their accretion during early infancy, and later developmental progression. In a birth cohort from Ethiopia, 455 children who have BC measurement at birth and 416 who have standardised rate of BC growth during infancy were followed up for outcome variable, and were included in the statistical analysis. The study sample was restricted to mothers living in Jimma town who gave birth to a term baby with a birth weight ≥1500 g and no evident congenital anomalies. The relationship between the exposure and outcome variables was examined using linear-mixed regression model. The finding revealed that FFM at birth was positively associated with global developmental progression from 1 to 5 years (β=1·75; 95 % CI 0·11, 3·39) and from 4 to 5 years (β=1·34; 95 % CI 0·23, 2·44) in the adjusted model. Furthermore, the rate of postnatal FFM tissue accretion was positively associated with development at 1 year of age (β=0·50; 95 % CI 0·01, 0·99). Neither fetal nor postnatal FM showed a significant association. In conclusion, fetal, rather than postnatal, FFM tissue accretion was associated with developmental progression. Intervention studies are needed to assess whether nutrition interventions increasing FFM also increase cognitive development.

BackgroundThis study initiated the validation process of a translated and adapted version of the Malawi Developmental Assessment Tool (MDAT) for children in the Dominican Republic (DR). Like Malawi before the development of the MDAT, the DR did not have early childhood development (ECD) tools explicitly designed for low-resource areas that are also valid assessments of child development. We chose MDAT because it underwent a rigorous validation process and retained measurements of test items that were culturally adaptable from the Denver Developmental Screening Test II. We aimed to test the internal consistency and inter-rater reliability of the MDAT in children under the age of two years living in low-income neighborhoods in Santo Domingo in 2017.Methods and findingsForty-two children from 2 to 24 months of age (mean = 11.26, SD = 6.37, boys = 22, girls = 20) and their corresponding caregiver participated in the study. We conducted a cross-sectional, pre-experimental study. The primary outcome measure was an index of ECD, as assessed by the Dominican adaptation of the MDAT. The tool evaluates children in four domains: social, fine motor, language, and gross motor. To determine internal consistency, we obtained Spearman-Brown split-half reliability for each sub-scale. The results showed a good consistency (>.6) for social, fine motor, and gross motor, and an acceptable consistency (>.5) for language. Second, to test the inter-rater reliability, we conducted a Kendall's Taub test of independence for both the general scale and each sub-scale. Significant rτ scores ranged from .923 to .966, indicating appropriate inter-rater reliability. Third, we correlated the age variable with each subscale to determine if the development scale followed a progression of abilities that are expected to increase with maturation. The age variable correlated positively with all the subscales (social r = .887, p < .001; fine motor r = .799, p < .001; language r = .834, p < .001; gross motor r = .805, p < .001), indicating that the older the child, the better scores in the development measurements, as expected. There were no adverse events. This study, however, has multiple limitations. We did not gather information about socioeconomic position, which is an important variable when assessing child development; however, all participants lived in a low-income neighborhood. Given that this is the first ECD tool specific to the Dominican Republic, norm-referenced scores for the Dominican population do not yet exist. This study sample size is insufficient to make inferences about the national population.ConclusionsThis study represents the first attempt to obtain a valid tool to screen for development milestones in children living in poverty in the DR. More research is needed to refine the instrument. The availability of the tool will enable impact evaluations of ECD intervention programs and the development of evidence-based public policies in the DR.

This cross-sectional study analyzed mercury (Hg) levels in healthy Saudi mothers and their infants (age 3-12 months) and examined the influence of Hg on the infants' neurodevelopment using screening tools, such as the Denver Developmental Screening Test II (DDST-II) and Parents' Evaluation of Developmental Status (PEDS). A total of 944 mothers and their 944 infants were recruited from 57 Primary Health Care Centers (PHCCs) in Riyadh. The total Hg (THg) levels were measured in the mothers' and infants' urine (UTHg-M and UTHg-I) and hair (HTHg-M and HTHg-I) samples and in the breast milk and mothers' blood. Methylmercury (MeHg) levels were determined in hair samples from the mothers (MeHg-M) and infants (MeHg-I). Only 40.1% of the infants were breast-fed when enrolled, and 59.9% had stopped breastfeeding. Only 1.8% of the mothers and 0.3% of the infants had MeHg levels above the Environmental Proection Agency (EPA) reference dose (1 μg/g), with low medians of 0.132 and 0.091 μg/g dw, respectively, but the MeHg levels were significantly associated with infant DDST-II performance. The levels of corrected UTHg-M for creatinine (Cr), HTHg-M, HTHg-I, and HMeHg-M, however, displayed an association with infant PEDS performance. The medians and percentage of the tested population that exceeded the recommended limits for Hg in urine and hair set by the World Health Organization (5 μg/g Cr) and EPA (1 μg/g) were 0.695 μg/g Cr and 3% UTHg, 0.118 μg/g dw and 4.1% HTHg-M, 0.101 μg/g dw and 2.8% HTHg-I, and 0.132 μg/g dw and 1.8% HMeHg-M. Our study provides evidence of an association between some Hg measures and delays in infant neurodevelopment, despite their low levels and regardless of the infant's breastfeeding status. The results are of potential concern, because delayed psychomotor or mental performance in infants could be an indicator of later neurocognitive development in children, which may persist into adulthood, as shown in other studies. The absence of local standardization of the DDST-II and PEDS screening tools might raise some questions, although the DDST-II has been used in local institutions for a number of years. The development of effective standardized developmental screening tools is necessary to ensure that all children at risk of neurodevelopmental problems early in life are identified so that they can receive appropriate and timely intervention.

This paper assesses the initial psychometric properties of the Denver Developmental Screening Test (Denver II), a widely used child development measure in its first population-level administration in Brazil. The Portuguese version was administered to 2755 children under three years of age who were eligible for a home visiting program in Fortaleza, Northeast Brazil. We examine the measure's internal consistency and verify construct validity by testing the dimensionality through confirmatory factor analysis (CFA) and estimating associations with household socioeconomic variables (e.g., poverty, maternal education, stunting, and parenting practices). The test was found to be psychometrically robust and culturally relevant. Although we found a good fit with the structure proposed by the instrument's author, a structure of two latent variables (motor and cognitive) provided a better fit. This validity exercise provides useful information for policymakers and researchers interested in using this instrument in the Brazilian context or a similar one in the region.

To assess the relationship between the use of psychoactive substances during pregnancy and the occurrence of severe maternal morbidity (SMM), perinatal outcomes and repercussions on the neuropsychomotor development of exposed children. A case-control study nested within a cohort of severe maternal morbidity (COMMAG) was performed. Women with SMM were considered cases. Controls were those with low-risk pregnancy, without SMM and admitted during the same time period as the cases. Cohort data were collected retrospectively in hospital records for childbirth. A face-to-face interview was also performed with 638 women (323 without SMM and 315 with SMM) and their children of the index pregnancy between 6 months and 5 years after childbirth. During the interview, substance abuse during pregnancy was assessed by a modified question from the Alcohol, Smoking and Substance Involvement Screening Test 2.0 (ASSIST) and the neuropsychomotor development in the children was assessed by the Denver Developmental Screening Test, 2 The prevalence of licit or illicit drug use during pregnancy was ∼ 17%. Among drug users, 63.9% used alcohol, 58.3% used tobacco, 9.2% used cocaine/crack and 4.6% used marijuana. There was no association between drug use during pregnancy and SMM, although tobacco use during pregnancy was associated with bleeding, presence of near-miss clinical criteria (NMCC) and alteration in infant development; alcohol use was associated with neonatal asphyxia; and cocaine/crack use was associated with the occurrence of some clinical complications during pregnancy. The use of psychoactive substances during pregnancy is frequent and associated with worse maternal, perinatal and child development outcomes. Avaliar a relação entre o uso de substâncias psicoativas na gestação e a ocorrência de morbidade materna grave (MMG), resultados perinatais e repercussões no desenvolvimento neuropsicomotor das crianças expostas. MéTODOS: Estudo de caso-controle a partir de uma coorte de morbidade materna grave (COMMAG). Mulheres com MMG foram consideradas casos. Controles foram mulheres com gestação de baixo risco, admitidas no mesmo período que os casos. Os dados da coorte foram coletados retrospectivamente em prontuários de internação para o parto e entrevistas presenciais conduzidas com 638 mulheres e seus filhos da gestação-índice, entre 6 meses e 5 anos após o parto. Na entrevista, o uso de substâncias na gestação foi avaliado com uma pergunta modificada introduzida no questionário para triagem do uso de álcool, tabaco e outras substâncias 2.0 (ASSIST, na sigla em inglês) e o desenvolvimento neuropsicomotor das crianças foi avaliado pelo teste de triagem do desenvolvimento Denver II. A prevalência do uso de drogas lícitas ou ilícitas na gestação foi de cerca de 17%. Das usuárias, 63,9% usaram álcool, 58,3% usaram tabaco, 9,2% usaram cocaína/crack e 4,6% usaram maconha. Não houve associação entre o uso de drogas na gestação e MMG. Contudo, o uso de tabaco foi associado a hemorragia, presença de critérios clínicos de

Purpose To verify indicators of cognitive development, receptive language skills and adaptive behavioral patterns in toddlers with Williams syndrome (WS). Methods The sample comprised 8 children of both sex, aged between 48 and 72 months with WS. Instruments of data collection were Denver Developmental Screening Test II; Peabody Picture Vocabulary Test; Vineland Adaptive Behavior Scale; Child Behavior Checklist for Ages 1½-5and 6 to 18; Columbia Mental Maturity Scale (CMMS), and Behavior Problems Inventory-01. Results The major developmental impairments were associated with fine motor skills and personal care abilities. Deficits in receptive language and communication skills were reported according to the PPVT and Denver II, respectively. The caregivers reported behavioral and emotional problems associated to anxiety and depression, and attention problems scales of CBCL. Conclusion The toddlers demonstrated deficits in adaptive functioning and behavioral, motor and cognitive difficulties such as inattention and hyperactivity, stereotypies and aggressive behavior. RESUMO Objetivo Verificar indicadores de desenvolvimento cognitivo, habilidades de linguagem receptiva e padrões comportamentais adaptativos em pré-escolares com Síndrome de Williams (SW). Método A amostra foi composta por 8 crianças de ambos os sexos, com idade entre 48 e 72 meses com SW. Os instrumentos de coleta de dados utilizados foram Denver Developmental Screening Test II; Peabody Picture Vocabulary Test; Escala de comportamento adaptativo Vineland; Child Behavior Checklist (CBCL) para as idades 1½-5 e 6 a 18; Inventário de Problemas de Comportamento (BPI-01) e Escala de Maturidade Mental Columbia. Resultados Os principais prejuízos de desenvolvimento foram associados a habilidades motoras finas e habilidades de cuidados pessoais. Os déficits em linguagem receptiva e habilidades de comunicação foram relatados de acordo com o PPVT e Denver II, respectivamente. Os cuidadores relataram problemas comportamentais e emocionais associados às escalas de ansiedade e depressão e de problemas de atenção do CBCL. Conclusão Os pré-escolares demonstraram déficits no funcionamento adaptativo e dificuldades comportamentais, motoras e cognitivas, como desatenção e hiperatividade, estereotipias e comportamento agressivo.

Summary Objective: According to data from the World Health Organization (WHO), anemia is a prevalent health problem that leads to increased morbidity and mortality, especially in preschool children. Anemia is recognized as a major health problem due to its negative effects on the mental and physical development during childhood. The aim of our study was to determine the levels of anemia of children in a kindergarten affiliated to the Directorate of National Education using a non-invasive method, and to investigate the effects of anemia on the physical, mental and neuromotor development of children. Method: The levels of anemia was evaluated by using a non-invasive measurement device. Data collection was performed by means of a questionnaire to evaluate the children’s physical development and set Denver Developmental Screening Test II scores. Results: Our findings show that 21% of non-anemic and 15% of anemic children are in the suspected abnormal group according to their DDST II total score. Furthermore, it has been identified that mild anemia has a positive effect on neuromotor development, while overweight and obesity affect neuromotor development in a negative way. Conclusion: According to the results obtained from the study, mild anemia may have a positive effect on the children’s neuromotor development, while malnutrition could have a negative impact.

The aim of the study was to describe the sociodemographic and clinical features of the mothers and their offspring staying with them in prison. The study was planned as a cross-sectional, single-center study of mothers residing in Tarsus Closed Women’s Prison of Turkish Ministry of Justice along with their 0 to 6 years old offspring. Mothers were evaluated via Structured Clinical Interview for DSM-IV Axis I Disorders. A psychologist blind to maternal evaluations applied the Denver Developmental Screening Test II (DII-DST). Children/mothers were also evaluated by a child and adolescent psychiatrist via K-SADS-PL. Twenty-four mothers with a mean age of 29.3 years were included. Most common diagnoses in mothers were nicotine abuse (n = 17, 70.8%), specific phobia (n = 8, 33.3%), alcohol abuse (n = 7, 29.2%) and substance abuse (n = 5, 20.8%). Twenty-six children (53.9% female) were living with their mothers in prison, and the mean age of those was 26.3 months. Results of the D-II-DST were abnormal in 33.3% of the children. Most common diagnoses in children were adjustment disorder (n = 7, 26.9%) separation anxiety disorder (n = 3, 11.5%) and conduct disorder (n = 2, 7.7%). A multi-center study is necessary to reach that neglected/under-served population and address the inter-generational transmission of abuse, neglect, and psychopathology.

A global developmental delay is expected from Down syndrome, affecting motor, cognitive, linguistic and personal-social skills. However, not always these delays are proportional; different conditions occur due to several intrinsic and extrinsic variables that must be controlled to form groups of greater homogeneity.Objective To enhance personal-social, fine motor-adaptive, gross motor and linguistic skills among children with Down syndrome and compare them with typically developing children, matched for gender, socioeconomic status and mental age, while controlling some variables that interfere with the global development.Methods The ethical aspects were fulfilled (Case No. 040/2009). The following inclusion criteria were considered: participants without a history of prematurity, very low birth weight, congenital hypothyroidism, significant hearing and vision problems, and signs of Autism Spectrum Disorder. After the inclusion criteria were considered, 40 children participated in the study, of which 20 had Down syndrome (experimental group - EG), these being of both genders and with chronological ages ranging from 38 to 63 months, and the other 20 being typically developing children (control group - CG), matching the EG in terms of gender, socioeconomic status and mental age, with this age ranging from 13 to 50 months. The evaluation consisted in applying the Denver Developmental Screening Test II, a test that assesses areas such as personal-social, fine motor-adaptive, linguistic and gross motor development. The results were subjected to statistical analysis using Student’s t-test.Results A statistically significant difference was verified between the groups for the language and fine motor-adaptive areas.Conclusion Children with Down syndrome showed lower performance in language and fine motor skills when compared with typically developing children. There was no statistically significant difference in gross motor and personal-social areas. It is worth mentioning the importance of controlling the variables to deal with more homogeneous groups.

Several outcomes of pregnancy after bariatric surgery are currently being studied. This cross-sectional, retrospective study evaluated the obstetric and perinatal outcomes of pregnancies in 19 women who underwent bariatric surgery, as well as the growth and development of their children, in the Southern Brazil. Among these women, 11 children were born prior to surgery and 32 were born post-surgery. The mean time between the surgery and the first pregnancy was 42.96 months. Preterm newborns were more common among the pre-surgery childbirths. Regarding growth, normal weights were observed in 27.3 % of the children in the pre-surgery births and obesity was observed in 54.5 %. In contrast, normal weights were observed in 59.4 % of the children born during the postoperative period and obesity was observed in 31.2 %. The average excess weight that the women lost prior to pregnancy was 64.88. Speech delays were found in three male children evaluated using the Denver Developmental Screening Test II. A statistical association was found between the interval from the surgery to the pregnancy and the outcome of the questionable Denver II test results (p = 0.011). Except for the large index of low birth weight, it can be concluded that pregnancy after bariatric surgery is safe. The growth rate was found to be adequate in the children born after the surgery, with reduced obesity. Although changes in speech development were detected, no factors were supported an association with pregnancy after bariatric surgery.

BACKGROUND/OBJECTIVES: Birth weight (BW), independent of socioeconomic status, has been identified as a predictor for childhood cognitive development. However, it is not known whether this relation is related to low BW per se or particularly related to a deficit in fat mass (FM) or fat-free mass (FFM) at birth. This study therefore aimed at investigating the relation between body composition at birth and child development at 2 years of age.SUBJECTS/METHODS: An Ethiopian birth cohort was followed up at 2 years. Body composition was measured within 48 h of birth using infant air-displacement plethysmography. Child development was assessed at 2 years of age using Denver developmental screening test. Associations between body composition at birth and development at 2 years of age were tested using linear regression analysis.RESULTS: FFM but not FM at birth was positively associated with higher global developmental score at 2 years of age (β=2.48, 95% confidence interval (CI) 0.17; 4.79) adjusted for neonatal, postnatal and parental characteristics. This association was attributable to the association with the language developmental domain (β=1.61, 95 CI 0.33; 2.90).CONCLUSIONS: Among Ethiopian children, FFM at birth but not FM predicted better global and language development at 2 years of age. Higher FFM at birth might have exerted a positive effect on the growth and differentiation of the brain and neuronal circuits for better development. This study therefore highlights the need to improve mother's nutritional status during pregnancy in ways that stimulate fetal FFM growth.European Journal of Clinical Nutrition advance online publication, 27 September 2017; doi:10.1038/ejcn.2017.129.

The objective of this study was to examine the psychometric properties of the Spanish version of the Denver Developmental Screening Test II in a population of Spanish children. Two hundred children ranging from 9 month to 6 years were grouped into two samples (healthy/with psychomotor delay) and screened in order to check whether they suffered from psychomotor delay. Children from three Early Intervention Centres and three schools participated in this study. Criterion validity was calculated by the method of extreme groups, comparing healthy children to those with development delay. Interobserver and intraobserver reliability were calculated using Cohen Kappa coefficient, and internal consistency was calculated via the Kuder-Richardson coefficient. The scale demonstrated 89 % sensitivity, 92 % specificity, a positive predicted value of 91 % and a negative predicted value of 89 %, whereas the positive and negative likelihood ratio was 11.12 and 0.12, respectively. Intraobserver reliability ranged from 0.662 to 1, and interobserver reliability ranged from 0.886 to 1. The Kuder-Richardson coefficient values ranged from 87.5 to 97.6 %. Conclusion: The Spanish version of the Denver Developmental Screening Test II was found to have a good criterion validity, reliability and internal consistency and is a suitable screening test for use in a population of Spanish children.

Summary Telbivudine, an FDA pregnancy category B drug, has been found to reduce hepatitis B virus (HBV) perinatal transmission with no safety concerns in infants aged up to 1 year. This study evaluated the long-term efficacy and safety of telbivudine in 214 infants born to 210 pregnant women with chronic hepatitis B infection who were treated with telbivudine during pregnancy (weeks 20-32 of gestation). The infants were followed for up to 5 years after birth. The efficacy endpoint was the rate of perinatal transmission, which was established by HBsAg and HBV DNA levels at 7 and 12 months. Safety endpoints included head circumference, weight, height, and congenital abnormality and hospitalization rates. In addition, the Denver Developmental Screening Test was performed in 92 randomly selected infants. None of the 214 infants born to these women were infected with HBV, and all had effective serum hepatitis B surface antibody (HBsAb) levels. Compared with Chinese standard values, there were few differences in the infants’ mean head circumference, weight, and height values. No birth defects were diagnosed, and the congenital abnormality rate was 0.934%. Serious adverse events requiring hospitalization occurred in 20 infants (9.35%). The qualified Denver Developmental Screening Test rate in 92 infants was 97.82%, which was comparable to a rate of 92% in normal Chinese children. Thus, treatment with telbivudine during the second or third trimesters of pregnancy safely blocked perinatal transmission of HBV. Infants born to telbivudine-treated mothers showed normal growth and development during long-term follow-up of up to 5 years. This article is protected by copyright. All rights reserved.

Background:Thyroid hormones are essential for growth and brain development in childhood. Although congenital hypothyroidism (CH) is the most common reason for mental retardation, normal neurological development can be achieved through early and effective treatment. The aim of the present study was to evaluate the neurological development of CH patients aged 24–56 months.Methods:The study included a total of 116 healthy control subjects and 112 patients aged 24–56 months who were diagnosed with CH during the neonatal period and were being followed up at the Pediatric Endocrinology Department, Keçiören Training and Research Hospital, between 2012 and 2015. Demographics and clinical data of interventions and outcomes were retrieved for each patient. Statistical analysis was performed using an unpaired Student’s t-test to compare means and χResults:There were no significant differences between the CH and control groups with respect to gestational age, birth weight, height standard deviation scores (HSDS) and body weight standard deviation scores (BWSDS) (p>0.05). When the groups were compared according to the Denver Developmental Screening Test (DDST), no significant differences were found in terms of personal-social, fine motor skills, or language development (p=0.325, p=0.087 and p=0.636, respectively). However, a significant difference was found between the two groups with respect to gross motor development and the result of the DDST (p=0.001). No statistical difference was found between the control and patient groups on the day of starting treatment but the number of patients with an abnormal result in the DDST starting treatment at >15 days was found to be significantly higher than the number of patients starting treatment ≤15 days. No associations were found between the DDST results of the CH group and the following factors: initial L-thyroxine (LT4) level, initial LT4 dose and the onset of treatment.Conclusions:The findings of this study indicate that the DDST results in patients with CH are generally good. Initiating treatment immediately after diagnosis and during the first days of life is absolutely imperative. However, in contrast to timing, we could not find strong evidence for determining the precise optimal dosage of LT4 to initiate treatment in children diagnosed with CH. Both the American Academy of Pediatrics and the European Society for Pediatric Endocrinology recommend 10–15 μg/kg/day as the initial dose.

In low- and middle-income countries (LIMCs), measuring early childhood development (ECD) with standard tests in large scale surveys and evaluations of interventions is difficult and expensive. Multi-dimensional screeners and single-domain tests (‘short tests’) are frequently used as alternatives. However, their validity in these circumstances is unknown. We examined the feasibility, reliability, and concurrent validity of three multi-dimensional screeners (Ages and Stages Questionnaires (ASQ-3), Denver Developmental Screening Test (Denver-II), Battelle Developmental Inventory screener (BDI-2)) and two single-domain tests (MacArthur-Bates Short-Forms (SFI and SFII), WHO Motor Milestones (WHO-Motor)) in 1,311 children 6–42 months in Bogota, Colombia. The scores were compared with those on the Bayley Scales of Infant and Toddler Development (Bayley-III), taken as the ‘gold standard’. The Bayley-III was given at a center by psychologists; whereas the short tests were administered in the home by interviewers, as in a survey setting. Findings indicated good internal validity of all short tests except the ASQ-3. The BDI-2 took long to administer and was expensive, while the single-domain tests were quickest and cheapest and the Denver-II and ASQ-3 were intermediate. Concurrent validity of the multi-dimensional tests’ cognitive, language, and fine motor scales with the corresponding Bayley-III scale was low below 19 months. However, it increased with age, becoming moderate-to-high over 30 months. In contrast, gross motor scales’ concurrence was high under 19 months and then decreased. Of the single-domain tests, the WHO-Motor had high validity with gross motor under 16 months, and the SFI and SFII expressive scales showed moderate correlations with language under 30 months. Overall, the Denver-II was the most feasible and valid multi-dimensional test and the ASQ-3 performed poorly under 31 months. By domain, gross motor development had the highest concurrence below 19 months, and language above. Predictive validity investigation is needed to further guide the choice of instruments for large scale studies.

The Cri du Chat syndrome (CdC) is a rare genetic disorder caused by variable size deletions of the short arm of chromosome 5 (5p−). It is well known that home-reared patients show better performances as compared to institutionalised cases, and it was reported that continuous educational intervention can ameliorate their performances. To assess the efficacy of educational intervention and to develop new CdC oriented programs of rehabilitation, we compare the results obtained for many developmental skills in two groups of CdC patients undergoing two different rehabilitation programs. Using data on the development of a group of CdC patients obtained by validated Italian translation for the Denver Developmental Screening Test II, we compared a group of 13 patients undergoing an educational program developed for CdC patients, the Mayer Project (MP), with a second group of 15 cases in whom caring was not specifically oriented. A positive impact of the MP was reported by parents, observing an improvement in social skills obtained, even if no significant differences were observed when the items of the Denver Test are studied. The need for personalized care in CdC patients and the choice of different methods to compare the results are also discussed.

Objective: Vitamin B12 deficiency is frequently observed in developing countries. Herein we report the long-term clinical and laboratory outcomes in 45 children presented with various symptoms of vitamin B12 deficiency. Materials and Methods: Symptoms and physical findings, and percentiles for weight, height, and head circumference at presentation were recorded. The educational level of the patients' mothers, vitamin B12 deficiency-related diseases and family income data were collected. Complete blood count, serum vitamin B12, folate, iron, iron binding capacity and ferritin, and plasma homocysteine levels were recorded measured at presentation. The patients were treated with vitamin B12, as follows: 1 mg/d IM for 1 week, followed by 1 mg IM QWK for 2 weeks, and then monthly 1mg injections. Patients were neurologically and hematologically re-evaluated after treatment. The visual evoked potential (VEP) test was used to examine the integrity and function of the visual pathway. Brainstem evoked potential (BAEP) responses were used to analyze auditory function. Neuromotor development was assessed using Denver II Development Screening Test. Results: The mean age of 20 male and 25 female patients was 5.6 +/- 5.9 years (range: 1.4 months-17 years). The most common symptoms at presentation were weakness, failure to thrive, and hematologic manifestations (pallor, petechiae, ecchymosis). Abnormal neurologic findings at presentation were observed in 20% of the patients, and were more commonly observed in those

Homelessness and poverty can present serious health issues for children, including those associated with developmental delays. Early identification and intervention may decrease risk associated with delayed development. Parent-completed measures have been used to help screen for children's development, but little is known about how they may enhance early detection with homeless children. The primary aims of this pilot study were to describe growth and developmental characteristics of homeless children and to compare a parent-completed measure with professionally-conducted developmental screening results. A prospective, comparative study was conducted with 20 homeless mothers and their 21 children. Health professionals used the Denver Developmental Screening Test II, identifying nine children with possible language delay. Mothers completed the Ages and Stages Questionnaires and identified three areas of concern: fine motor (n = 9), communication/language (n = 4), and problem solving (n = 4). The percentage agreement between these two tools was strongest in gross motor (95%) and personal social development (95%) but weakest in language development (67%). While it is essential for all children, developmental screening is particularly crucial for homeless children because of increased risks related to poverty and homelessness. Nurses and nurse practitioners are in a unique position to assess applicability of such instruments and to provide critically needed interventions for these children.

Gumus E, Aras BD, Cilingir O, Yarar C, Carman KB, Laciner-Gurlevik S, Kocak O, Artan S. Apolipoprotein E allelic variants and cerebral palsy. Turk J Pediatr 2018; 60: 361-371. Cerebral palsy (CP) is the most frequent cause of mobility restriction and posture disturbance in childhood. Against the complexity in disease etiology, genetic factors, including Apolipoprotein E allelic distribution in this patient population, are worthy targets for investigation. ApoE is a lipoprotein of central nervous system encoded by ApoE gene with its 3 main co-dominant alleles, 2, 3 and 4. We aimed to evaluate the allelic frequencies of ApoE gene and its association with coexisting clinical entities such as vision and hearing impairment, cognitive problems, seizures and MRI findings in a pediatric patient population native to middle Anatolian region. Seventy-eight children with CP and 60 healthy controls were genotyped. Genotypic variations along with coexisting clinical conditions and CP-related medical findings were compared between the patient and control groups. The Denver Developmental Screening Test for all, the Wechsler Intelligence Scale for Children-IV (short form WISC-IV; Turkish version) for the patients > 6y and the Stanford-Binet Intelligence Scale (SB-5) for those who aged 2-6 years old were employed to evaluate cognitive and mental abilities of the patients. ApoE 2 and 4 alleles were more frequent in the patient group (p < 0.05), whereas ApoE 3 allele was more frequent in the healthy controls. ApoE 2/4 genotype has been determined 29% in the case group, but none in healthy control group. In the patient group with apolipoprotein 4 or 2 alleles, the rate of emergency cesarean section was found being significantly higher than the group with 3 allele. Brain MRI findings were not significantly different among ApoE allelic variants within the patient group. Our data show that the ApoE alleles may be effective in the development of cerebral palsy and may be associated with some clinical manifestations in those patients.

The Neonatal Screening for Inborn Errors of Metabolism of the Association of Parents and Friends of Special Needs Individuals (APAE) - Bauru, Brazil, was implanted and accredited by the Brazilian Ministry of Health in 1998. It covers about 286 cities of the Bauru region and 420 collection spots. Their activities include screening, diagnosis, treatment and assistance to congenital hypothyroidism (CH) and phenylketonuria (PKU), among others. In 2005, a partnership was established with the Department of Speech-Language Pathology and Audiology, Bauru School of Dentistry, University of São Paulo, Bauru, seeking to characterize and to follow, by means of research studies, the development of the communicative abilities of children with CH and PKU. Objective: The aim of this study was to describe communicative and psycholinguistic abilities in children with CH and PKU. Materials and Methods: Sixty-eight children (25 children aged 1 to 120 months with PKU and 43 children aged 1 to 60 months with CH) participated in the study. The handbooks were analyzed and different instruments were applied (Observation of Communication Behavior, Early Language Milestone Scale, Peabody Picture Vocabulary Test, Gesell & Amatruda's Behavioral Development Scale, Portage Operation Inventory, Language Development Evaluation Scale, Denver Developmental Screening Test, ABFW Child Language Test-phonology and Illinois Test of Psycholinguistic Abilities), according to the children's age group and developmental level. Results: It was observed that the children with PKU and CH at risk for alterations in their developmental abilities (motor, cognitive, linguistic, adaptive and personal-social), mainly in the first years of life. Alterations in the psycholinguistic abilities were also found, mainly after the preschool age. Attention deficits, language and cognitive alterations were more often observed in children with CH, while attention deficits with hyperactivity and alterations in the personal-social, language and motor adaptive abilities were more frequent in children with PKU. Conclusion: CH and PKU can cause communicative and psycholinguistic alterations that compromise the communication and affect the social integration and learning of these individuals, proving the need of having these abilities assisted by a speech and language pathologist.

SUMMARY Developmental differences in the Denver Developmental Screening Test items were demonstrated between Okinawa and Tokyo samples of children. The Tokyo children were generally more advanced than Okinawa children after one year of age, while the Okinawa children showed earlier development in the middle and late periods of the first year. There were also interesting differences between Okinawa and Denver. Okinawa children were initially slow in gross motor development, whereas Denver children were markedly advanced in some of the language items. Ecological and socio-cultural factors, which may contribute to these differences, are discussed, as are the implications of the results for developmental screening. RESUME Caracteristiques du developpement infantile en Okinawa: comparaison avec Tokyo et Denver Des differences de developpement aux items du Denver Developmental Screening Test ont ete observees entre echantillons d'Okinawa et de Tokyo. Les enfants de Tokyo etaient generalement plus avances que ceux d'Okinawa apres l'âge d'un an, tandis que les enfants d'Okinawa revelaient un developpement plus precoce pour les periodes moyenne et tardive de la premiere annee. Des differences egalement interessantes ont ete observees entre Okinawa et Denver. Les enfants d'Okinawa sont initialement lents dans le developpement moteur general. Les enfants de Denver sont avances de facon marquee dans certains des items de langage. Les facteurs ecologiques et socio-culturels qui peuvent contribuer a ces differences sont discutes comme le sont les implications du Denver Developmental Screening Test. ZUSAMMENFASSUNG Charakteristika der Entwicklung von Kindern in Okinawa: Vergleich mit Tokio und Denver Anhand des Denver Entwicklungs-Screening-Tests wurden Unterschiede in der Entwicklung zwischen Kindern in Okinawa und Kindern in Tokio gefunden. Nach dem ersten Lebensjahr waren die Kinder in Tokio in der Regel weiter entwickelt als die in Okinawa, wahrend diese in der Mitte und der spateren Phase des ersten Lebensjahres eine fruhere Entwicklung aufwiesen. Man fand ebenfalls interessante Unterschiede zwischen Okinawa und Denver. Die Kinder in Okinawa waren anfanglich in ihrer grob-motorischen Entwicklung verlangsamt. Die Kinder in Denver waren in einigen Sprachuntersuchungen deutlich fortgeschritten. Die okologischen und sozio-kulturellen Faktoren, die mit zu diesen Unterschieden fuhren konnen, werden diskutiert, sowie die Bedeutung dieser Ergebnisse fur den Denver Entwicklungs-Screening-Test. RESUMEN Caracteristicas del Desarrollo Infantil en Okinawa: comparacion con Tokio y Denver Se demostraron diferencias significativas en el desarrollo de los items del test de Screening de Desarrollo de Denver entre muestras de Okinawa y Tokyo. Los ninos de Tokyo eran por lo general mas avanzados que los de Okinawa a partir del ano de edad, mientras que los ninos de Okinawa mostraban un desarrollo anterior en los periodos medio y final del primer ano de vida. Habian tambien diferencias interesantes entre Okinawa y Tokyo. Los ninos de Okinawa eran inicialmente lentos en el desarrollo motor grosero. Los ninos de Denver eran marcadamente avanzados en algunos de los items del lenguaje. Se discuten los factores ecologicos y socioculturales que pueden contribuir a estas diferencias, como son las implicaciones de los resultados del Screening test de Desarrol o de Denver.

Normative data for 1176 healthy, urban Turkish children were analysed for sex and social-class differences in performance of the Denver Developmental Screening Test (DDST). Sex differences were minor, and were similar to those found in other countries. Social-class differences, however, in contrast to findings in other DDST studies, were consistently in favour of the more advantaged children in all areas of functioning from about the age of 10 months. These differences became more marked with age, particularly in language and fine-motor skills. These findings indicate considerable cultural differences within urban Turkey and suggest that the use of only one set of norms may lead to misdiagnosis. Further, they question the predictive validity of this test for lower-class urban Turkish children, particularly for language and fine-motor tasks.

SUMMARY The items in the Denver Developmental Screening Test used in the first year of life have been standardised on a random sample of 668 infants in Cardiff. Differences were found between the ages at which the Cardiff and Denver populations achieved the items. Cardiff infants being in general slightly more advanced on language and personal-social items and slower on motor items. The implications of these findings are discussed. Standardisation on older age-groups is continuing. RESUME Les differents items du Denver Developmental Screening Test utilises au cours de la premiere annee ont eteetalonnes sur un echantillon tire au hasard de 668 nourrissons de Cardiff. Des differences ont ete notees entre les âges auxquels les populations de Cardiff et de Denver reussissent les items. Les enfants de Cardiff etant legerement plus en avance aux items de langage et de relation sociale et plus en retard aux items moteurs. Les consequences de ce fait pour l'usage du test sont discutees. L'etalonnage pour des groupes d'enfants plus âges est en cours. ZUSAMMENFASSUNG Die Aufgaben, die im Denver Test fur das erste Lebensjahr benutzt werden, wurden an einer Zufallsstichprobe von 668 Kindern in Cardiff standardisiert. Es ergaben sich Unterschiede bezuglich des Alters, in dem die Denver und die Cardiff Kinder die erwarteten Testleistungen erbrachten, wobei die Cardiff Kinder im Allgemeinen im Sprachlichen Bereich und im Bereich ihrer personlichen und sozialen Entwicklung weiter waren als bei den Aufgaben, die die motorische Entwicklung erfasten. Die Bedeutung dieser Ergebnisse fur die Anwendung des Testes werden diskutiert. Eine Standardisierung fur altere Kinder wird fortgesetzt. RESUMEN Los items del test del desarrollo de Denver utilizado en al primer ano de vida han sido estandardizados en una muestra al azar de 668 ninos de Cardiff. Se encontraron diferencias entre las edades a las que alcanzaron los items entre las poblaciones de Cardiff y de Denver, siendo los ninos de Cardiff en general ligeramente mas adelantados en los items del lenguaje y personal-social y mas lentos en los items motores. Se discuten las implicaciones de este hallazgo. Esta en curso la estandardizacion de otros grupos de mayor edad.

SUMMARY During standardisation of the Denver Developmental Screening Test on 668 Cardiff children in their first year, the effect of sex, social class and position in family on the age of achievement of the test item was studied. No conclusive differences were seen, and the implications of this are discussed. RESUME Au cours de l'etalonnage du Denver Developmental Screening Test sur 668 nourrissons de Cardiff, durant leur premiere annee, une etude a recherche les effets du sexe, de la classe sociale et de la position dans la famille sur l'âge auquel les items sont reussis. Aucune difference significative n'a ete trouvee et les consequences de ce fait sont discutees. ZUSAMMENFASSUNG Im Rahmen der Standardisierung des Denver Entwicklungstestes an 668 Sauglingen wurde eine Untersuchung gemacht uber den Einflus von Geschlecht, sozialer Klassenzugehorigkeit und Stellung in der Familie auf das Alter, in dem die Testaufgaben gelost wurden. Es ergaben sich keine entscheidenden Unterschiede. Die entsprechenden Schlusfolgerungen werden diskutiert. RESUMEN Durante la estandardizacion del test del desarrollo de Denver, realizada en 668 nnos de Cardiff en su primer ano de vida, se realizo un estudio sobre los efectos del sexo, clase social y posicion en la familia, sobre la edad en que se alcanzo cada item del test. No se encontro ninguna diferencia concluyente y se discuten las implicaciones de ello.

Objective Postpartum depression in mothers is associated with developmental problems in their children. Many women who are depressed following childbirth are also depressed during pregnancy. The aim of this study was to examine the associations between maternal depressive symptoms during pregnancy and child development at 18 months of age. Design A prospective cohort study, Avon Longitudinal Study of Parents and Children. Setting The former county of Avon, southwest England. Population All pregnant women in the defined area with delivery dates between April 1991 and December 1992, 9244 women and their children. Methods Data were collected antenatally, at 18 and 32 weeks of gestation and at 8 weeks and 8 months postnatally, through postal questionnaires, including a self-report measure of depression (Edinburgh Postnatal Depression Scale [EPDS]). By the time their child was 18 months old, women completed five further questionnaires about their children’s health and development. Main outcome measure Child development at 18 months using a modified Denver Developmental Screening Test (modified DDST). Results Applying the standard 12/13 cutoff, 1565 (14%) women were depressed antenatally but not at either time-points postnatally. Employing the modified DDST, 893 (9%) children were developmentally delayed at 18 months of age. Persistent depression (EPDS ≥ 10 at both time-points) is associated with developmental delay (adjusted OR 1.34, 95% CI 1.11–1.62). Applying the 12/13 and 14/15 cutoffs gave similar results. After further adjustment for postnatal depression, the effect sizes were slightly attenuated. Conclusions These findings highlight the importance of depression in pregnancy. Some effects on child development attributed to postpartum depression are caused in part by depressive symptoms during pregnancy.

Hypoxic-ischemic encephalopathy (HIE) is a major cause of neonatal morbidity and mortality. Electroencephalography (EEG) and brain magnetic resonance imaging (MRI) are frequently performed in these infants, but the prognostic value of the combined use of EEG and MRI needs additional exploration. The purpose of this study was to investigate, in neonates with HIE, the role of early EEG and conventional MRI in the prediction of infants at risk for persistent encephalopathy at 18 months of age. Thirty-four term infants with HIE were enrolled in this prospective study. EEG was recorded within the first 72 hours after birth and a brain MRI scan was done between 1 and 4 weeks of age. Denver Developmental Screening Test II was performed at 6, 12, and 18 months of age. Three infants (9%) had mild HIE, 21 infants (62%) had moderate HIE, and 10 infants (29%) had severe HIE. The EEG background was normal, moderately, severely, and extremely discontinuous in eight (24%), three (9%), sixteen (47%), and seven (20%) neonates, respectively. EEG background activities correlated significantly with HIE severity ( P = 0.0001). MRI findings significantly correlated with EEG background ( P = 0.001). Normal MRI scans and minimal basal ganglia lesions were always associated with normal EEG background. Patients with severe basal ganglia and thalamic lesions in MRI (n = 2) had extreme discontinuous EEG background. For the prediction of poor outcomes, abnormal EEG background activity had a sensitivity (Sn) = 100%, a specificity (Sp) = 100%, positive predictive value (PPV) = 100%, and negative predictive value (NPV) = 100%, whereas values of abnormal MRI scans were Sn of 100%, Sp = 43%, PPV = 82%, and NPV=100%. EEG background activity is the best element to predict abnormal outcomes. Severe basal ganglia and thalamic injuries on MRI scans are associated with poor outcomes. Otherwise, MRI does not contribute to the prediction of outcomes at 18 months of age.

Developmental status of young infants with congenital heart disease (CHD) is associated with physical and psychosocial factors. With the aim of obtaining basic data to perform developmental support, the study was conducted to examine the development and associated factors among these infants.The Japanese Denver Developmental Screening Test was performed in 75 infants at 3-5 months of age, and a questionnaire was sent to their mothers about recognition of their child's development. Infants with and without developmental delay were compared using the characteristics of diagnosis of heart disease, symptoms and surgery, the state of growth of infants, and recognition of a child's development by its mother. To specify more adequate factors, a multiple logistic regression analysis was conducted.Of 75 infants, 14 (18.7%) had developmental delay. Weight gain of standard weight-2SD, Kaup index, and recognition of a child's development by mothers were associated with delayed development. In particular, infants gaining weight at10 g/day were significantly more delayed than those gaining weight at20 g/day. In addition, infants whose mothers recognized developmental delay were significantly delayed compared to those not recognized.Developmental status of young infants with CHD was found to be strongly associated with growth. In particular, weight gain10 g/day appeared to be the critical point for delayed development, as well as mothers' recognition of their child's development.

A method for translating research data from the Denver Test into individual scores of developmental status measured in a continuous scale is presented. It was devised using the Denver Developmental Screening Test (DDST) but can be used for Denver II. The DDST was applied in a community-based survey of 3389 under-5-year-olds in Porto Alegre, Brazil. The items of success were standardised by logistic regression on log chronological age. Each child's ability age was then estimated by maximum likelihood as the age in this reference population corresponding to the child's success and failures in the test. The score of developmental status is the natural logarithm of this ability age divided by chronological age and thus measures the delay or advance in the child's ability age compared with chronological age. This method estimates development status using both difficulty and discriminating power of each item in the reference population, an advantage over scores based on total number of items correctly performed or failed, which depend on difficulty only. The score corresponds with maternal opinion of child developmental status and with the 3-category scale of the DDST. It shows good construct validity, indicated by symmetrical and homogeneous variability from 3 months upwards, and reasonable results in describing gender differences in development by age, the mean score increasing with socio-economic conditions and diminishing among low-birthweight children. If a standardised measure of development status (z-scores) is required, this can be obtained by dividing the score by its standard deviation. Concurrent and discriminant validity of the score must be examined in further studies.

Objective Developmental disabilities are lifelong conditions with considerable public health impact, incurring substantial financial and societal costs. Data on prevalence and associated factors can provide the basis for setting priorities and designing interventions. Methods A representative random sample of 694 United Arab Emirates national children aged 3 years were evaluated in a two-stage epidemiological study. Results Stage 1 screening using the Denver Developmental Screening Test found that 8.4% [confidence interval (CI): 6.4–10.7] had global developmental delay (GDD). Using clinical diagnostic interview in Stage 2, the weighted prevalence for clinically significant developmental disability was estimated to be 2.44% (CI: 1.28–3.56). GDD was associated with pregnancy and birth complications, poor maternal education, family history of developmental problems, and major traumatic life events, as well as behavioral problems in children. Conclusion Our findings suggest the need for comprehensive and early screening programs for developmental problems, and the importance of training medical and child care professionals accordingly.

This study assessed the development of 4-5-year-old children in an urban low-income community in Sri Lanka, with the aim of investigating their readiness for formal education. A modified Denver developmental screening test was used to determine the presence of age-appropriate motor, cognitive (including language) and social skills in 295 children. Of these children, 17.8% were unable to perform more than 50% of the tasks correctly. Children with motor problems were more likely to have difficulties with cognitive tasks than children without motor problems. Children who attended preschool did significantly better in most tasks compared with those who did not. The level of maternal education did not show a direct association with the competencies of the children. This assessment schedule can be used as a quick screening method in the community for early recognition of children with the potential for learning problems in school.

A descriptive correlational study that used the Denver Developmental Screening Test (DDST)-Chinese version (the testing items and norms were translated from DDST) was conducted to evaluate the child developmental status in three kindergartens in Peitou District of Taipei City. Seventy-one children between 3 and 5 years of age were included. The DDST has four developmental dimensions: gross motor, fine motor-adaptive, language, and personal-social. The tests yielded 7 (9.9 %) subjects with questionable and 1 (1.4 %) subject with abnormal developmental results. The subjects' gender, parental educational level, parental occupation, sibling number, and day-care provider before age 3 did not relate to the test results. The percentage of children passing each item decreased as the task became harder in terms of the developmental order in the gross motor, fine motor-adaptive, language and personal-social dimensions of the DDST. These indicated that the DDST-Chinese version is valid in capturing the maturing status of the children in this study. Of items intersecting the subject's age-line, the gross motor dimension had the lowest mean percentage of pass and all-pass rate, which indicated a lag in gross motor development compared to the other three dimensions. Conversely, the fine-motor adaptive dimension had the highest mean percentage of pass and all-pass rate, and more than 60 % of the study subjects could pass items that were ahead of their age-line. This suggested that development in the fine-motor adaptive dimension was more advanced than the norms of the DDST. There were no distinct differences between the study subjects and the norms in the language and person-social dimensions. The differences between the study subjects and the norms in the fine motor-adaptive dimension suggest that the DDST-Chinese version norms need to be standardized in order to account for cultural differences. To be a valid tool, the norms of the DDST-Chinese version should be standardized to be concordant with current development among Taiwanese children.

BACKGROUND: Scald burn injuries are the leading cause of burn-related emergency room visits and hospitalizations for young children. A portion of these injuries occur when children are removing items from microwave ovens. This study assessed the ability of typically developing children aged 15 months to 5 years to operate, open, and remove the contents from a microwave oven. METHODS: The Denver Developmental Screening Test II was administered to confirm typical development of the 40 subjects recruited. All children recruited and enrolled in this study showed no developmental delays in any domain in the Denver Developmental Screening Test II. Children were observed for the ability to open both a push and pull microwave oven door, to start the microwave oven, and to remove a cup from the microwave oven. RESULTS: All children aged 4 years were able to open the microwaves, turn on the microwave, and remove the contents. Of the children aged 3 years, 87.5% were able to perform all study tasks. For children aged 2 years, 90% were able to open both microwaves, turn on the microwave, and remove the contents. In this study, children as young as 17 months could start a microwave oven, open the door, and remove the contents putting them at significant risk for scald burn injury. CONCLUSIONS: Prevention efforts to improve supervision and caregiver education have not lead to a significant reduction in scald injuries in young children. A redesign of microwave ovens might prevent young children from being able to open them thereby reducing risk of scald injury by this mechanism. Language: en

The outcome of children with self-limited infantile epilepsy was reported to be normal psychosocial and cognitive development as a characteristic criterion. We aimed to investigate the clinical course and neurocognitive outcome in children with self-limited infantile epilepsy in a Turkish cohort. The clinical course, electroencephalographic (EEG) characteristics, neuroimaging, treatment, and outcome of children with self-limited infantile epilepsy were retrospectively analyzed. All infants were reevaluated with the Denver Developmental Screening Test in addition to neurologic examination. Of 44 patients, self-limited familial infantile epilepsy was diagnosed in 8 infants (18.2%) and self-limited nonfamilial infantile epilepsy in 28 (63.6%). Interictal EEGs and neurologic examinations were normal in all cases. Fine motor and gross motor skills, language, adaptive personal/social skills were near-normal in all patients with self-limited familial infantile epilepsy. Delay in language parameters was observed in 2 infants with self-limited nonfamilial infantile epilepsy. Language skills should be thoroughly evaluated with detailed neurocognitive screening tests in patients with self-limited infantile epilepsy.

To describe the last 5 years' experience of Child Development Centre (CDC), Kerala Developmental Evaluation Clinic II for children between 2 and 10 y, referred for suspicion of developmental lag in the preschool years and scholastic difficulty in the primary classes with specific focus on developmental profile and the experience of the home based intervention package taught to the mothers. A team of evaluators including developmental therapist, preschool teacher with special training in clinical child development, speech therapist, special educator, clinical psychologist and developmental pediatrician assessed all the children referred to CDC Kerala. Denver Developmental Screening Test (DDST-II), Vineland Social Maturity Scale (VSMS) and Intelligent Quotient (IQ) tests were administered to all children below 6 y and those above 6 with apparent developmental delay. Speech/delay (35.9 %), behavior problem (15.4 %), global delay/ intellectual disability (15.4 %), learning problem (10.9 %), pervasive developmental disorders (7.7 %), seizure disorder (1.7 %), hearing impairment (0.7 %), and visual impairment (0.7 %) were the clinical diagnosis by a developmental pediatrician. Each child with developmental problem was offered a home based intervention package consisting of developmental therapy and special education items, appropriate to the clinical diagnosis of the individual child and the same was taught to the mother. The experience of conducting the developmental evaluation clinic for children between 2 and 10 y has shown that a team consisting of developmental therapist, speech therapist, preschool teacher, special educator, clinical child psychologist and developmental pediatrician, using appropriate test results of the child could make a clinical diagnosis good enough for providing early intervention therapy using a home based intervention package.

To document the effectiveness of low intensity, clinic based intervention models for Autism Spectrum Disorders (ASD) in countries with low disability resources. Thirty-nine participants with a mean (SD) of 36.03(11.15) mo were assessed before and after intervention with Childhood Autism rating scale (CARS), and at baseline with the Denver Developmental Screening Test for quantifying the effectiveness of the clinic-based intervention in ameliorating autism symptoms and studying the effect of developmental disability respectively. Developmental therapists in the clinic gave low-intensity group intervention for 45–60 min to the child through mother and encouraged to continue the training, for 3–4 h, at home to address the specific goals in the three ASD symptom clusters. Most of the children were also placed in play-schools. Follow-up support was given either on a weekly, fortnightly or monthly basis. Data was analyzed using appropriate bivariate and multivariate techniques. There was amelioration in the severity of autism after intervention, which was statistically and clinically significant. Intervention was useful to help children with mild to severe autism. Low-intensity, clinic-based intervention can be effectively used in situation where there is paucity of disability resources.

Background: The primary aim of this study was to find widely available, inexpensive, and non-invasive parameters for early identification or prediction of the infants with hypoxic-ischemic encephalopathy (HIE) who will have a severe adverse outcome (classified as death or a major neurological deficit). Methods: Fifty-seven full-term or near-term newborn infants with a diagnosis of HIE were consecutively admitted to the neonatal intensive care unit and studied. Occurrence of seizures during the first 24 h, cranial ultrasonography (US) findings within the first 5 days of life, and Denver developmental screening test II (DDST II) at 6 months of age, were analyzed in relation to mortality and neurological status at 2 years of age. Results: Of the 57 infants, 10 were lost to follow-up. Twenty of the remaining 47 infants had a severe adverse outcome. Among the predictors of severe adverse outcome, occurrence of seizures was found to have a poor predictive accuracy. Cranial US had 100% sensitivity, however with a rather low specificity (55%). However, DDST II at 6 months of age, yielded a very high predictive accuracy (sensitivity=100%, specificity=95%). Conclusion: We conclude that DDST II at 6 months of age could be used in predicting severe neurological outcome in infants with HIE.

Aims and methods: Concurrent validity of maternal opinion of child development was estimated in a cross-sectional, population-based survey of 6–59-mo children (n=3025), using a standard measure devised from the Denver Developmental Screening Test. Results: Sensitivity, specificity and negative predictive value increased with maternal education and family income. Positive predictive value was higher in low-income families and children with impairments, low birthweight and long hospital stays. Conclusion: Children at social and clinical risk should be assessed more carefully, even if maternal report is normal or advanced.

To develop and validate a simple screening tool for identifying developmental delay among children of 0–6 y of age in the community. The 51-items of Trivandrum Development Screening Chart for children of 0–6 y [TDSC (0–6 y)], were carefully prepared from the norms in various existing developmental charts/scales, by experts keeping in mind the face validity and content validity. The criterion validity was assessed in a community sample of 1,183 children of 0–6 y with a mean age of 35.38 mo (SD of 19.25) including 597 (50.46 %) boys and 586 (49.54 %) girls. TDSC (0–6 y) was validated against Denver Developmental Screening Test (DDST) as the ‘Reference Standard’. When one item delay in TDSC (0–6 y) was considered as ‘TDSC delay’ (test positive), the sensitivity and specificity of TDSC (0–6 y) was found to be 84.62 % (95 % CI: 71.92–93.12) and 90.8 % (95 % CI: 88.97–92.43) respectively with a Negative Predictive Value of 99.23 % (95 % CI: 98.48–99.67) and LR (negative) of 0.17(95 % CI: 0.09–0.32). The test-retest and inter-rater reliability [an interclass correlation (ICC) of 0.77 for test-retest and ICC of 0.97 for inter-rater] were good and acceptable. TDSC (0–6 y) is a simple, reliable and valid screening tool for use in the community to identify children between 0 and 6 y with developmental delay, enabling early intervention practices.

Families represent the fastest-growing subgroup of the homeless population. Most of the research has focused on urban homeless families and not on rural homeless families. The purpose of this study was to describe the characteristics and health of rural homeless families in Ohio. A descriptive cross-sectional design was used to study 76 families who had 125 children under 12 years of age. An interview schedule, the Denver Developmental Screening Test (DDST), the Child Behavior Checklist (CBCL), and the SCL-90-R were used to collect data. The majority of the mothers perceived themselves and their children as having no physical health problems. Twenty-four of the children were behind on their immunizations. Forty-four (52%) of the children under 6 years of age had DDST scores that indicated they might have developmental lags and 15 of the children over 4 years of age had CBCL scores that indicated they might have behavioral problems. The reported use of illegal drugs, alcohol, and cigarettes was high for this group of mothers. Strategies are included that nurses can use in working with rural homeless families.

We prospectively acquired clinical data regarding the presentation, evaluation, and developmental progress of all patients identified with dissociated motor maturation to define their clinical outcomes. Children ( N = 8) referred for evaluation of suspected cerebral palsy because of delayed sitting or walking and identified to have dissociated motor maturation were followed with serial clinical examination. All displayed the characteristic “sitting on air” posture while held in vertical suspension and had otherwise normal developmental assessments. This posture is composed of the hips held in flexion and abduction with the knees extended and feet plantar or dorsiflexed. Three children were initially evaluated at 10 months of age owing to absence of sitting and five other children were evaluated at a mean of 14 months (range 12—19 months) owing to inability to stand. Follow-up evaluations were conducted over a mean of 10.5 months (range 5—34 months). Five children were born prematurely at 34 to 36 weeks gestation. Denver Developmental Screening Test and general and neurologic examinations were normal except to note hypotonia in six children and the “sitting on air” posture in all of the children. Four children have older siblings or parents who “walked late” (after 15 months). On average, the children attained sitting by 8 months (range 7—10 months). One child did not crawl prior to independent walking, two children scooted rather than crawled, and five children crawled at an average of 13.5 months (range 10—16 months). All children cruised by a mean of 18 months (range 16—21.5 months) and attained independent walking by 20.1 months (range 18—23.5 months). Neuroimaging and serum creatine kinase enzyme testing were normal in two children who were tested. These eight children conform to the syndrome of dissociated motor maturation. The “sitting on air” posture serves as a diagnostic sign and anticipated excellent prognosis, but follow-up is required to ensure a normal outcome. ( J Child Neurol 2003;18:391—393).

Objective To investigate the 6-month neurodevelopmental outcomes of prematurely born neonates and find the determining neonatal factors of minor neurological dysfunctions (MNDs). Study design We examined data collected prospectively on 151 infants born before 37th week of gestation in 2009–2010 who were assessed at 6months corrected age with the Bayley Scales of Infant Development—2nd Edition (BSID-II) and the Denver Developmental Screening Test (DDST). Results Of 151 neonates born before 37weeks, 20 (13.2%) had MNDs at 6months corrected age. These proportions were 21.6%, 13.2%, and 8.2% for neonates born before 28weeks, 29weeks to 32weeks, and 33weeks to 36weeks, respectively. Half of neonates with MNDs have a birth body weight of less than 1000g. BSID-II and DDST are highly correlated in assessing the MNDs of premature neonates at 6months corrected age. MND was independently associated with postnatal corticosteroid use (odds ratio [OR], 11.2; 95% confidence interval [CI], 1.9–66.0, P =0.008) and cholestasis (OR, 6.2; 95% CI, 1.16–33.1, P =0.033). Conclusions Premature neonates, even those born at 33 to 36weeks, are found to have MNDs as early as 6months corrected age by BSID-II and DDST, with risk increasing as gestation decreases.

Objective To chart the emergence of precursors and early signs of autism spectrum disorder (ASD) and autistic traits in the Avon Longitudinal Study of Parents and Children, a prospective longitudinal cohort study of the surviving offspring of 14,541 pregnant women from southwestern England with an expected delivery date between April 1991 and December 1992. Method Parents' contemporaneous reports of their infant's development (241 questionnaire responses collected up to 30 months of age) were examined in relation to the diagnosis of autism spectrum disorder by age 11 years (n = 86) and a measure of autistic traits, derived by factor analysis. Results Among the children later diagnosed with ASD, concerns about vision and hearing were more often reported in the first year, and differences in social, communication, and fine motor skills were evident from 6 months of age. Repetitive behaviors and differences in play, imitation, and feeding habits were reported in the second year. Differences in temperament emerged at 24 months of age and bowel habit by 30 months. All of these early signs were strongly associated with the presence of autistic traits in the rest of the population and these differences were often evident in the first year of development. Over the first 30 months of development, the best predictors of both later ASD and autistic traits included the Social Achievement and Communication scores from the Denver Developmental Screening Test, measures of communicative skills (Vocabulary and Combines Words) from the MacArthur Infant Communicative Development Inventories, and a repetitive behavior score. Conclusions Precursors, early signs, and other developmental differences were reported in the first year of development among children from the general population who later developed autism spectrum disorder and subtler autistic traits. Other differences emerged and unfolded as development progressed. The findings confirm the long-held suspicion that early differences underscore the multifaceted nature of autism spectrum disorder and the broader autism phenotype, and highlight the centrality of impairments in social communication skills.