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Communicative Development Inventories (CDIs, parent-completed language development checklists) are a helpful tool to assess language in children who are unused to interaction with unfamiliar adults. Generally, CDIs are completed in written form, but in developing country settings parents may have insufficient literacy to complete them alone. We designed CDIs to assess language development in children aged 0;8 to 2;4 in two languages used in Coastal communities in Kenya. Measures of vocabulary, gestures, and grammatical constructions were developed using both interviews with parents from varying backgrounds, and vocabulary as well as grammatical constructions from recordings of children's spontaneous speech. The CDIs were then administered in interview format to over 300 families. Reliability and validity ranged from acceptable to excellent, supporting the use of CDIs when direct language testing is impractical, even when children have multiple caregivers and where respondents have low literacy levels.

Background: A strong link between phonological awareness (PA) and literacy exists, but the origins of this link are difficult to investigate, since PA skills are hard to test in young, pre-literate children, and many studies neither include such children nor report children's initial literacy levels. Aims: To examine PA and literacy in children who are attending or not attending school in rural East Africa. Sample: One hundred and eight children ages 7-10 years, with no education, or in grade 1 or 2, randomly selected from a community survey of all children in this age group. Methods: PA skill, reading, cognitive abilities, and socio-economic status were examined. Results: Implicit and explicit PA skill with small or large units is related to letter reading ability, and this effect is independent of age, schooling, and cognitive ability. Some PA tasks are performed above chance levels by children who cannot recognize single letters. Conclusions: Basic PA develops prior to the attainment of literacy, and learning to read improves PA both quantitatively and qualitatively.

Background: The majority of available psychometric tests originates from the Western World and was designed to suit the culture, language, and socio-economic status of the respective populations. Few tests have been validated in the developing world despite the growing interest in examining effects of biological and environmental factors on cognitive functioning of children in this setting. Aims: The present study aimed at translating and adapting Western measures of working memory, general cognitive ability, attention, executive function, and motor ability in order to obtain a cognitive instrument suitable for assessing 5-year-old semi-urban Ugandan children. This population represents a particular assessment challenge as school enrolment is highly variable at this age in this setting and many children are unused to a formal educational setting. Methods: Measures of the above domains were selected, translated, and modified to suit the local culture, education, and socio-economic background of the target population. The measures were piloted and then administered to semi-urban Ugandan children aged 4;6-5;6, who included children who had started and not yet started school. Results: Analysis of validity and reliability characteristics showed that 8 (at least one from each domain) out of the 11 measures were successfully adapted on the basis that they showed adequate task comprehension, optimum levels of difficulty to demonstrate individual and group differences in abilities, sensitivity to effects of age and education, and good internal as well as test-retest reliability. Conclusion: Translation and adaptation are realistic and worthwhile strategies for obtaining valid and reliable cognitive measures in a resource-limited setting.

Grammatical priming of picture naming was investigated in Kiswahili, which has a complex grammatical noun class system (a system like grammatical gender), with up to 15 noun classes that have obligatory agreements on adjectives, verbs, pronouns and other parts of speech. Participants heard a grammatically agreeing (concordant), nonagreeing (discordant) or neutral prime before seeing a picture of a common object and being asked to name the object. Priming was found, with naming following concordant primes being faster than naming following the neutral prime ("say"). However, more interestingly, effects were found such that where two noun classes share a prefix, the grammatical prime from each of these two noun classes also primed words that have the same prefix but are not in the same noun class, and hence for which the prime was not grammatical. It is concluded that the prime appears to be facilitating the phonological form of the prefix rather than the syntacto-semantic group of words that are known as a noun class, and that the phonological form associated with a grammatical entity may be more significant in its processing than has previously been supposed. (Contains 4 tables, 8 figures and 1 footnote.)

Data are presented on the development of tests of reading skill for primary school pupils in rural Tanzania. Instruction in these schools is in Kiswahili, a regularly spelled language. Three graded tests were developed to test children who had only some letter knowledge, could read single words, or were proficient readers. The tests correlated well with scores on other educational achievement tests and showed age and school grade differences. (Author/VWL)

Communicative Development Inventories (CDIs, parent-completed language development checklists) are a helpful tool to assess language in children who are unused to interaction with unfamiliar adults. Generally, CDIs are completed in written form, but in developing country settings parents may have insufficient literacy to complete them alone. We designed CDIs to assess language development in children aged 0;8 to 2;4 in two languages used in Coastal communities in Kenya. Measures of vocabulary, gestures, and grammatical constructions were developed using both interviews with parents from varying backgrounds, and vocabulary as well as grammatical constructions from recordings of children's spontaneous speech. The CDIs were then administered in interview format to over 300 families. Reliability and validity ranged from acceptable to excellent, supporting the use of CDIs when direct language testing is impractical, even when children have multiple caregivers and where respondents have low literacy levels. [ABSTRACT FROM PUBLISHER]

It is frequently necessary to assess children with little or no schooling to determine their level of cognitive functioning, especially in developing countries. It is not possible, however, to assume that assessments will hold equal validity for children with and without the experience of schooling. The authors, therefore, set out to create a battery of tests suitable for both schooled and unschooled children. They assessed 973 schooled and 645 unschooled children in rural coastal Kenya using culturally adapted cognitive tests. Significant effects of age and schooling were found on all tests. On some tests (verbal knowledge, speeded figure matching, and pattern copying), unschooled children did not improve as much with age as schooled children. The effects of length of exposure to schooling and of age were greater than that of initial enrollment in school. The authors conclude that it is possible to assess unschooled children, but test batteries must be carefully constructed and standardized. [ABSTRACT FROM AUTHOR]

Cross-sectional studies of the relationship between helminth infection and cognitive function can be informative in ways that treatment studies cannot. However, interpretation of results of many previous studies has been complicated by the failure to control for many potentially confounding variables. We gave Tanzanian schoolchildren aged 9-14 a battery of 11 cognitive and three educational tests and assessed their level of helminth infection. We also took measurements of an extensive range of potentially confounding or mediating factors such as socioeconomic and educational factors, anthropometric and other biomedical measures. A total of 272 children were moderately or heavily infected with Schistosoma haematobium, hookworm or both helminth species and 117 were uninfected with either species. Multiple regression analyses, controlling for all confounding and mediating variables, revealed that children with a heavy S. haematobium infection had significantly lower scores than uninfected children on two tests of verbal short-term memory and two reaction time tasks. In one of these tests the effect was greatest for children with poor nutritional status. There was no association between infection and educational achievement, nor between moderate infection with either species of helminth and performance on the cognitive tests. We conclude that children with heavy worm burdens and poor nutritional status are most likely to suffer cognitive impairment, and the domains of verbal short-term memory and speed of information processing are those most likely to be affected. [ABSTRACT FROM AUTHOR]

The ninhydrin reaction is commonly used for the detection of amino acids. However, in the literature, different conditions with respect to the buffer system, its pH and concentration, type of organic solvent, incubation time, and temperature, as well as the concentrations of the reagents, are described. To identify the most suitable conditions, colour development with reagents of varying compositions and different reaction temperatures and times were investigated using asparagine as a model amino acid. Asparagine was selected since it is one of the most abundant free amino acids in many types of samples. The optimal reaction mixture consisted of 0.8 mol L -1 potassium acetate, 1.6 mol L -1 acetic acid, 20 mg mL -1 ninhydrin and 0.8 mg mL -1 hydrindantin in DMSO/acetate buffer 40/60 ( v / v ) (final concentrations). The best reaction condition was heating the samples in 1.5 mL reaction tubes to 90 °C for 45 min. Afterwards, the samples were diluted with 2-propanol/water 50/50 ( v / v ) and the absorbance was measured at 570 nm. The proteinogenic amino acids showed a similar response except for cysteine and proline. The method was highly sensitive and showed excellent linearity as well as intra-day and inter-day reproducibility.

In many cognitive developmental studies, young children ( < 6 years) fail to understand that changing the appearance of a person, object, or animal does not change its underlying reality. They appear to believe that a cat wearing a dog mask is genuinely a dog (appearance/reality distinction) and that a boy wearing a dress is genuinely a girl (sex/gender constancy). These skills may be affected by various influences: testing methods, training on the constancy of biological traits, child's or sibling's diagnosis of gender dysphoria, and child's diagnosis of autism. This study aimed to partially replicate the study of Arthur et al. (Journal of Experimental Child Psychology, 2009, Vol. 104, pp. 427-446) showing that experimental lessons emphasizing the constancy or otherwise of biological traits affected appearance/reality and sex/gender constancy performance. The study examined the influence of school lessons with content on sex/gender stereotyping and pro/anti constancy on the performance of young English children (mean age = 5;6 [years;months]; N = 58) on appearance/reality and sex/gender constancy tasks. Children performed above chance on sex/gender stability (change over time) but performed below chance on sex/gender constancy and appearance/reality tasks (change due to superficial alterations). These scores are comparable to those in nearly all previous studies. Children's scores were not influenced by school lesson content, although not all schools provided content. Conclusions are drawn about the effect of lesson content, which may be too diffuse and long term to affect performance. The level of children's performance and what this means in absolute terms about children's understanding of sex/gender stereotypes and the possibility of a child changing sex/gender is also discussed., (Copyright © 2024 The Author. Published by Elsevier Inc. All rights reserved.)

We investigated whether learning an artificial language at 17 months was predictive of children's natural language vocabulary and grammar skills at 54 months. Children at 17 months listened to an artificial language containing non-adjacent dependencies, and were then tested on their learning to segment and to generalise the structure of the language. At 54 months, children were then tested on a range of standardised natural language tasks that assessed receptive and expressive vocabulary and grammar. A structural equation model demonstrated that learning the artificial language generalisation at 17 months predicted language abilities - a composite of vocabulary and grammar skills - at 54 months, whereas artificial language segmentation at 17 months did not predict language abilities at this age. Artificial language learning tasks - especially those that probe grammar learning - provide a valuable tool for uncovering the mechanisms driving children's early language development., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Advancements in paediatric oncology have made quality of life after cancer increasingly clinically important. Little is currently known about children's experiences of treatment completion and its management., Aim: The current study explores children's experience of ending treatment for Acute Lymphoblastic Leukaemia (ALL), and the meaning it is given, particularly how endings are signified and marked., Method: Semi-structured interviews were conducted with seven children who had completed cancer treatment for ALL with good prognoses. Interviews were analysed using Interpretative Phenomenological Analysis., Results: Five superordinate themes were generated: 'the end is always there', 'the punctuation of endings', 'that which is remembered, that which is forgotten', 'the voiced and the unvoiced', and 'freedom from cancer.', Conclusion: Children highlighted the importance of punctuating and celebrating the end of their treatment, and the need for doing this in ways that helped them process the complexity of ending active treatment and provides space for their voices., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)

At the group level, children exposed to certain health and demographic risk factors, and who have delayed language in early childhood are, more likely to have language problems later in childhood. However, it is unclear whether we can use these risk factors to predict whether an individual child is likely to develop problems with language (e.g., be diagnosed with a developmental language disorder). We tested this in a sample of 146 children who took part in the UK-CDI norming project. When the children were 15-18 months old, 1,210 British parents completed: (a) the UK-CDI (a detailed assessment of vocabulary and gesture use) and (b) the Family Questionnaire (questions about health and demographic risk factors). When the children were between 4 and 6  years, 146 of the same parents completed a short questionnaire that assessed (a) whether children had been diagnosed with a disability that was likely to affect language proficiency (e.g., developmental disability, language disorder, hearing impairment), but (b) also yielded a broader measure: whether the child's language had raised any concern, either by a parent or professional. Discriminant function analyses were used to assess whether we could use different combinations of 10 risk factors, together with early vocabulary and gesture scores, to identify children (a) who had developed a language-related disability by the age of 4-6 years (20 children, 13.70% of the sample) or (b) for whom concern about language had been expressed (49 children; 33.56%). The overall accuracy of the models, and the specificity scores were high, indicating that the measures correctly identified those children without a language-related disability and whose language was not of concern. However, sensitivity scores were low, indicating that the models could not identify those children who were diagnosed with a language-related disability or whose language was of concern. Several exploratory analyses were carried out to analyse these results further. Overall, the results suggest that it is difficult to use parent reports of early risk factors and language in the first 2 years of life to predict which children are likely to be diagnosed with a language-related disability. Possible reasons for this are discussed., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Jago, Alcock, Meints, Pine and Rowland.)

Social sciences researchers emphasize that new technologies can overcome the limitations of small and homogenous samples. In research on early language development, which often uses parental reports, taking the testing online might be particularly compelling. Due to logistical limitations, previous studies on bilingual children have explored the language development trajectories in general (e.g., by including few and largely set apart timepoints), or focused on small, homogeneous samples. The present study protocol presents a new, on-going study which uses new technologies to collect longitudinal data continuously from parents of multilingual, bilingual, and monolingual children. Our primary aim is to establish the developmental trajectories in Polish-British English and Polish-Norwegian bilingual children and Polish monolingual children aged 0-3 years with the use of mobile and web-based applications. These tools allow parents to report their children's language development as it progresses, and allow us to characterize children's performance in each language (the age of reaching particular language milestones). The project's novelty rests on its use of mobile technologies to characterize the bilingual and monolingual developmental trajectory from the very first words to broader vocabulary and multiword combinations.

Background: Within the current context of a global pandemic, the value of the Internet has been greatly elevated for many people. This study is an investigation into a 30-day online intervention called Creativity in Mind (CIM)., Aims: To provide a preliminary indication of the relationship between participation in CIM and change in mood symptoms and wellbeing., Methods: A co-produced mixed methods design was used to evaluate CIM. Data was obtained from 55 participants. Each day for 30 days participants received a predetermined creative challenge that they were encouraged to complete and share within the group. Measures of mood and wellbeing were collected at three time points, including a 3-month follow-up. Qualitative interviews were undertaken with 18 participants and analysed using framework analysis., Results: Scores on mood and wellbeing measures showed an overall significant improvement following completion of the programme. However, only a small number of participants demonstrated clinically significant improvement (14%) or deterioration (5%). The qualitative data indicated that CIM was experienced positively, with some negative emotions arising from the volume of interactions and negative comparisons made between participants., Conclusions: Preliminary results demonstrate that the pattern of clinically significant change across individual participants was comparable to other psychological therapy.

Purpose Early motor abilities (gesture, oral motor, and gross/fine skills) are related to language abilities, and this is not due to an association with cognitive or symbolic abilities: Oral motor skills are uniquely associated with language abilities at 21 months of age. It is important to determine whether this motor-language relationship continues beyond the earliest stage of language development to understand language acquisition better and better predict which children may have lasting language difficulties. Method In this longitudinal study, we assessed language comprehension and production, oral motor skill, gross/fine motor skill, and meaningless manual gesture at ages 3 years ( N = 89) and 4 years ( N = 71), comparing the contribution of motor skill and earlier (at 21 months of age) language ability. We also examined covariates: nonverbal cognitive ability, socioeconomic status, and stimulation in the home as measured on the Home Screening Questionnaire. Results Motor abilities continue to have a significant relationship with language abilities independent of other factors in the preschool years. Meaningless manual gesture ability, gross/fine motor skill, and oral motor skill were still associated with language skill at 3 years of age; these relationships are not explained by the contribution of cognitive abilities or earlier language abilities. Conclusions Relationships between early motor skill and language development persist into preschool years and are not explained by other cognitive or home factors, nor by a relationship with earlier language ability. This finding should lead to a better understanding of the origins of language abilities.

Sociocultural influences on the development of child language skills have been widely studied, but the majority of the research findings were generated in Northern contexts. The current crosslinguistic, multisite study is the first of its kind in South Africa, considering the influence of a range of individual and sociocultural factors on expressive vocabulary size of young children. Caregivers of toddlers aged 16 to 32 months acquiring Afrikaans ( n = 110), isiXhosa ( n = 115), South African English ( n = 105), or Xitsonga ( n = 98) as home language completed a family background questionnaire and the MacArthur-Bates Communicative Development Inventory (CDI) about their children. Based on a revised version of Bronfenbrenner's (1977) ecological systems theory, information was obtained from the family background questionnaire on individual factors (the child's age and sex), microsystem-related factors (the number of other children and number of adults in the child's household, maternal level of education, and SES), and exosystem-related factors (home language and geographic area, namely rural or urban). All sociocultural and individual factors combined explained 25% of the variance in expressive vocabulary size. Partial correlations between these sociocultural factors and the toddlers' expressive vocabulary scores on 10 semantic domains yielded important insights into the impact of geographic area on the nature and size of children's expressive vocabulary. Unlike in previous studies, maternal level of education and SES did not play a significant role in predicting children's expressive vocabulary scores. These results indicate that there exists an interplay of sociocultural and individual influences on vocabulary development that requires a more complex ecological model of language development to understand the interaction between various sociocultural factors in diverse contexts., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Southwood, White, Brookes, Pascoe, Ndhambi, Yalala, Mahura, Mössmer, Oosthuizen, Brink and Alcock.)

Intermodal preferential looking (IMPL) is widely used in experimental studies of infant development, especially language development. Control measures vary, and it is not clear how these affect findings. We examined effects of parental awareness of stimuli. Infants (17-19 months) looked at paired pictures, one name-known and one name-unknown, each assigned target status in 50 % of trials. Infants looked longer at a name-known than a name-unknown target, regardless of parents' awareness. When parents were aware, looking to a name-unknown target increased over a paired name-known non-target. There is evidence that infants' looking at pictures in this paradigm is not due to direct matching of targets to novel names, but is influenced by additional cues present, in a way that could alter the conclusions of studies of infant word learning and other aspects of infant learning. Implications of these findings are discussed, emphasising replicability and theoretical conclusions drawn from studies using this method., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: The home environment is reported to contribute significantly to children's developing cognitive skills. However, it is not yet evident whether this role prevails in the context of extreme poverty and frequent ill-health. We therefore investigated the role of the home environment in Ugandan children taking into account the frequent infections and extreme poverty in which they lived. Methods: Cognitive abilities of 163 5-year-old children were assessed. Home environments of these children, their health status and family socioeconomic status (SES) were assessed respectively using the EC-HOME, anthropometry and illnesses, and traditional SES measures. Structural equation analyses compared five models on the influence of the home environment, SES, and child health on the cognitive scores. Results: The model in which the home environment mediates the combined influence of SES and child health on cognitive performance showed a particularly good fit to the data compared with the four alternative models, i.e. those in which the HOME, SES and health independently influence cognitive performance. Conclusions: Home environments providing cognitive stimulation can enable children to overcome effects of major adverse life experiences on cognitive development., Competing Interests: No competing interests were disclosed.

Objectives: This study investigated the incidence of lived experience of mental health problems amongst UK-based trainee clinical psychologists and factors associated with anticipated disclosure for trainees both with and without lived experience., Methods: A web-based survey comprising the Multidimensional Perfectionism Scale, an adapted version of the Perceived Devaluation and Discrimination Scale, and questions about lived experience and anticipated likelihood of disclosure., Results: The survey was completed by 348 trainees across 19 UK training institutions. Sixty-seven percent reported lived experience of a mental health problem. For these trainees, there was no difference in anticipated likelihood of disclosing to different recipient types after controlling for maladaptive perfectionism. However, across all participants, anticipated disclosure was associated with maladaptive perfectionism, temporal proximity, anticipated stigma (past), and recipient type. Anticipated stigma (present) was not associated with anticipated disclosure., Conclusions: Results support an approach to communicating about mental health disclosure that incorporates responsibility, interdependency, and transparency. Suggestions for further research are discussed., (© 2018 John Wiley & Sons, Ltd.)

Objective(s): To assess the prevalence of personal experiences of mental health problems among clinical psychologists, external, perceived, and self-stigma among them, and stigma-related concerns relating to disclosure and help-seeking., Method: Responses were collected from 678 UK-based clinical psychologists through an anonymous web survey consisting of the Social Distance Scale, Stig-9, Military Stigma Scale, Secrecy Scale, Attitudes towards Seeking Professional Psychological Help Scale-Short Form, alongside personal experience and socio-demographic questions., Results: Two-thirds of participants had experienced mental health problems themselves. Perceived mental health stigma was higher than external and self-stigma. Participants were more likely to have disclosed in their social than work circles. Concerns about negative consequences for self and career, and shame prevented some from disclosing and help-seeking., Conclusions: Personal experiences of mental health problems among clinical psychologists may be fairly common. Stigma, concerns about negative consequences of disclosure and shame as barriers to disclosure and help-seeking merit further consideration., (© 2018 Wiley Periodicals, Inc.)

Background: Specific language impairment (SLI) is diagnosed when language is significantly below chronological age expectations in the absence of other developmental disorders, sensory impairments or global developmental delays. It has been suggested that gesture may enhance communication in children with SLI by providing an alternative means to convey words or extend utterances. However, gesture is a complex task that requires the integration of social, cognitive and motor skills, skills that some children with SLI may find challenging. In addition, there is reason to believe that language and gesture form an integrated system leading to the prediction that children with a SLI may also have difficulties with gestural communication., Aims: To explore the link between language and gesture in children with poor language skills., Methods & Procedure: Fifteen children with SLI and 14 age-matched typically developing children (TD) participated in this study. The children completed measures of expressive and receptive vocabulary, non-verbal cognition, motor control, gesture comprehension and gesture production., Outcomes & Results: TD children achieved significantly higher scores on measures of gesture production and gesture comprehension relative to children with SLI. Significant correlations between both measures of vocabulary and both measures of gesture suggest a tight link between language and gesture., Conclusions & Implications: The findings support the idea that gesture and language form one integrated communication system, rather than two separate communication modalities. This implies that children with SLI may have underlying deficits that impact not only on language but also on gesture production and comprehension., (© 2015 Royal College of Speech and Language Therapists.)

Motor control has long been associated with language skill, in deficits, both acquired and developmental, and in typical development. Most evidence comes from limb praxis however; the link between oral motor control and speech and language has been neglected, despite the fact that most language users talk with their mouths. Oral motor control is affected in a variety of developmental disorders, including Down syndrome. However, its development is poorly understood. We investigated oral motor control in three groups: adults with acquired aphasia, individuals with developmental dysphasia, and typically developing children. In individuals with speech and language difficulties, oral motor control was impaired. More complex movements and sets of movements were even harder for individuals with language impairments. In typically developing children (21-24 months), oral motor control was found to be related to language skills. In both studies, a closer relationship was found between language and complex oral movements than simple oral movements. This relationship remained when the effect of overall cognitive ability was removed. Children who were poor at oral movements were not good at language, although children who were good at oral movements could fall anywhere on the distribution of language abilities. Oral motor skills may be a necessary precursor for language skills.

Background: There is little data on the burden of neurological impairment (NI) in developing countries, particularly in children of Africa., Methods: We conducted a survey of NI in children aged 6-9 years in a rural district of Kenya. First, we screened for neurological disability by administering the Ten Questions Questionnaire (TQQ) to parents/guardians of children in a defined population. In phase two, we performed a comprehensive clinical and psychological assessment on children who tested positive on TQQ and on a similar number of children who tested negative., Results: A total of 10 218 children were screened, of whom 955 (9.3%) were positive on TQQ. Of these, 810 (84.8%) were assessed, and of those who tested negative 766 (8.3%) were assessed. The prevalence for moderate/severe NI was 61/1000 [95% confidence interval (95% CI) 48-74]. The most common domains affected were epilepsy (41/1000), cognition (31/1000), and hearing (14/1000). Motor (5/1000) and vision (2/1000) impairments were less common. Of the neurologically impaired children (n = 251), 56 (22%) had more than one impairment. Neonatal insults were found to have a significant association with moderate/severe NI in both the univariate [odds ratio (OR) = 1.70; 95% CI 1.12-2.47] and multivariate analyses (OR = 1.30; 95% CI 1.09-1.65)., Conclusions: There is a considerable burden of moderate/severe NI in this area of rural Kenya, with epilepsy, cognition, and hearing being the most common domains affected. Neonatal insults were identified as an important risk factor.

Background: The 'Ten Questions' Questionnaire (TQQ) is used to detect severe neurological impairment in children living in resource-poor countries. Its usefulness has been established in Asia and the Caribbean, but there are a few published studies from Africa. We evaluated the TQQ as part of a larger study of neurological impairment in a rural community, on the coast of Kenya., Methods: The study was conducted in two phases from June 2001 to May 2002; in phase one, a community household screening of 10,218 children aged 6-9 years using the TQQ was performed. Phase two involved a comprehensive clinical and psychological assessment of all children testing positive on the TQQ (n = 810) and an equivalent number of those testing negative (n = 766). Data were interpreted using the impairment-specific approach., Results: Overall, the sensitivity rates for screening the different impairments were: cognitive (70.0%), motor (71.4%), epilepsy (100%), hearing (87.4%) and visual (77.8%). All the specificity rates were greater than 96%. However, the positive predictive values were low, and ranged from 11 to 33%., Conclusions: These results are similar to those from other continents and provide evidence that the TQQ can be used to compare the epidemiology of moderate/severe impairment in different parts of the world. Furthermore, the TQQ can be used to screen for moderately/severely impaired children in resource-poor countries; however, the low positive predictive values mean that other assessments are required for confirmation., (Copyright 2004 S. Karger AG, Basel)