69.1 COGNITION AND THE PEDIATRIC BRAIN: EVALUATING DEVELOPMENTALLY DELAYED CHILDREN AND TRANSLATING A LINGUISTIC AND CULTURALLY BOUND TOOL FOR A DIVERSE WORLD

Abstract

This presentation aims to: 1) understand how to improve specificity of the Cornell Assessment of Pediatric Delirium (CAPD) for children with atypical brains; 2) consider how to approach tool translation through studies of the CAPD. Notably, translation to Japanese used the backtranslation method to ensure that cultural and linguistic equivalence was maintained. 1) Children and adolescents with moderate to severe disability were included, and standard-of-care twice-daily screening using the Richmond Agitation and Sedation Scale (RASS) and CAPD were conducted, along with a once-daily mental health evaluation. 2) CAPD and anchor points chart were translated in consultation with the original author, and backtranslation to preserve content and meaning was used. Finally, this translation was studied for reliability and validity. 1) CAPD scoring used in combination with RASS ≥3 fluctuation allowed for specificity of 97%. 2) Japanese physicians were comfortable with the translation and the original author with the backtranslation. Ultimately, the Japanese CAPD (JCAPD) was found to be reliable and valid in a Japanese pediatric intensive care unit (PICU). Using our knowledge of variations in cognition, or in linguistic and cultural impacts on evaluating cognitive functioning, is central to developing widely useful pediatric delirium tools and should be considered regarding all neuropsychiatric evaluations of children.