Ages And Stages Questionnaire Research Articles

IJCM_26A: Validation of Rashtriya Bal Swasthya Karyakram (RBSK) screening tool in Screening of Developmental Delay (DD) among under 3-year children in Bengaluru.

Background: Most DD tools available are designed in western countries which are lengthy, time consuming and need expertise to administer. RBSK has a simple tool to screen children aged 0-6 for developmental delays and disabilities. However, the psychometric properties are not published in public domain to understand its validity Objective: To study psychometric properties of RBSK screening tool for Screening of Developmental Delay among under 3 year children in Bengaluru. Methodology: A cross-sectional study was conducted among 262 children were screened in area covering five PHCs in Bengaluru. The children, categorized into eight strata based on age and underwent evaluation for developmental delay using both by the RBSK screening tool and the Ages and Stages questionnaire (ASQ) which is considered as gold standard. sensitivity, specificity, positive and negative predictive value along with kappa statistics was calculated readings of both the study tools. Results: The study encompassed a near-equal proportion of male (145,55.3%) and female (117,44.7%) children. Notably, the RBSK screening tool detected developmental delays in 13% of cases, slightly higher than the 10.7% identified by the ASQ tool. The RBSK tool exhibited a sensitivity of 97.01%, specificity of 96.43%, positive predictive value of 99.56% and negative predictive value of 79.41%. The calculated Kappa value of 0.854 signifies substantial agreement with the gold standard ASQ tool, reaffirming the RBSK tool’s validity in identifying developmental delays. Good psychometric properties was observed across gross motor, fine motor, communication, psychosocial and problem solving domains. Conclusion: This study demonstrates good psychometric properties of the RBSK screening tool in terms of sensitivity, specificity, and positive predictive value. Its user-friendly administration enables screening a larger population, effectively identifying more children with developmental delays, thereby facilitating early interventions crucial for their well-being

Preschooler Screen Time During the Pandemic Is Prospectively Associated With Lower Achievement of Developmental Milestones.

The aim of this study was to assess the developmental risks associated with total screen time, and specifically newer mobile devices, in the context of the pandemic. This study uses parent-reported data from a prospective cohort of Canadian preschool-age children. The exposure variable is child daily screen time measured at the age of 3.5 years categorized as light (<1 hr/d), moderate (1-4 hr/d), or intensive (>4 hr/d) use (N = 315). Time spent on mobile devices was considered separately as a continuous variable. Our outcome is child global development scores, which combine assessments of communication, cognitive, personal-social, and motor skills measured at the age of 4.5 years using the Ages and Stages Questionnaire (ASQ) (N = 249, 79% retained). ASQ scores were dichotomized to distinguish children at risk of developmental delays (below the 15th percentile) from those not at risk. We estimate associations between child screen time and later global development using multiple regressions adjusted for child sex and temperament, and parent education. We also examine whether associations are moderated by child and parent characteristics. Logistic regressions revealed that intensive users were more at risk of global developmental delays compared with light users (OR = 4.29, p = 0.020). Mobile device use was also associated with lower global scores (β = -3.064; p = 0.028), but not with risk of delays. We found no evidence that associations were moderated by child sex and temperament, or parent education. The findings suggest that intensive screen time may be associated with delays in child global development. Early childhood professionals should encourage families with preschoolers to prioritize screen-free activities to promote optimal cognitive, language, social, and motor development.

Screening preterm-born infants for autistic traits may help to identify social communication difficulties at five years of age.

This study compared neurodevelopmental screening questionnaires completed when preterm-born children reached 2 years of corrected age with social communication skills at 5.5 years of age. Eligible subjects were born in 2011 at 24-34 weeks of gestation, participated in a French population-based epidemiological study and were free of motor and sensory impairment at 2 years of corrected age. The Ages and Stages Questionnaire (ASQ) and the Modified Checklist for Autism in Toddlers (M-CHAT) were used at 2 years and the Social Communication Questionnaire (SCQ) at 5.5 years of age. We focused on 2119 children. At 2 years of corrected age, the M-CHAT showed autistic traits in 20.7%, 18.5% and 18.2% of the children born at 24-26, 27-31 and 32-34 weeks of gestation, respectively (p = 0.7). At 5.5 years of age, 12.6%, 12.7% and 9.6% risked social communication difficulties, with an SCQ score ≥90th percentile (p = 0.2). A positive M-CHAT score at 2 years was associated with higher risks of social communication difficulties at 5.5 years of age (odds ratio 3.46, 95% confidence interval 2.04-5.86, p < 0.001). Stratifying ASQ scores produced similar results. Using parental neurodevelopmental screening questionnaires for preterm-born children helped to identify the risk of later social communication difficulties.

Association of Postpartum Depression with Maternal Serum Magnesium Levels, Infant Growth, and Neurodevelopmental Indices.

Postpartum depression (PPD) can exert both short-term and long-term effects on a child's health. Offspring born to mothers who suffer from PPD face an elevated susceptibility to encountering psychological disturbances and developmental delays. Moreover, there has been conjecture surrounding a plausible connection between maternal magnesium (Mg) levels and psychiatric manifestations. This study aims to investigate the relationship between maternal Mg levels and PPD and the correlation between PPD and an infant's growth and neurodevelopment at 6 and 12 months. This longitudinal study is a sub-study derived from the "PERSIAN Birth Cohort Study," encompassing 224 mother-infant pairs randomly enlisted during 2019-2020 in Isfahan. Maternal serum magnesium (Mg) levels were measured at 38 weeks of gestation. PPD was evaluated employing the Edinburgh Postpartum Depression Scale (EPDS) four weeks postpartum. Measurements of birth size were undertaken, adhering to standardized protocols at birth, 6 months, and 12 months. Anthropometric parameters and the Persian version of the validated Ages and Stages Questionnaires (ASQ) were employed to assess infant neurodevelopmental status at 6 and 12 months. Overall, 22.3% of mothers grappled with PPD. The mean (standard deviation) maternal magnesium levels (Mg) were 1.95 ± 0.23 mg/dL. No statistically significant association was detected between maternal serum magnesium (Mg) levels and the incidence of PPD. Correspondingly, no significant association emerged between PPD and indices of growth. However, a noteworthy distinction materialized in the communication scores of offspring born to depressed and non-depressed mothers following adjustments for confounding variables at 12 months (β = 1.81; 95% confidence interval: 0.32-3.30). Furthermore, a substantial regression in communication skills became apparent between 6 and 12 months. This study failed to establish a significant association between maternal serum magnesium (Mg) levels and PPD. Nevertheless, research lends credence to an inverse correlation between maternal depression and subsequent behavioral difficulties in offspring, such as communication skills. Thus, the imperative nature of screening for PPD should be underscored to facilitate its early detection and intervention, thereby enhancing infant well-being.

Neurodevelopmental evaluation of children who were operated due to congenital anomaly with the ‘Ages and Stages Questionnaire (ASQ)’ and ‘ASQ: Social–Emotional’

BackgroundThe purpose of surgeries performed for congenital anomalies in children is to increase the survival rates and provide a developmental comparison to that of their peers.AimThe objective of this study was to investigate the development of children following surgery for congenital anomalies and the risk factors affecting their development.MethodsOur study included 33 children who underwent surgery for gastrointestinal anomalies in our clinic between 2011 and 2016, and did not have any syndrome, chromosomal abnormality, or additional abnormality. Developmental levels were evaluated using the Ages and Stages Questionnaire (ASQ) and the ASQ: Social–Emotional (ASQ: SE) scales adapted for the use on Turkish children. Data on patient history were obtained retrospectively from patient files.ResultsThe study included 33 patients, including 11 with esophageal atresia, 6 with intestinal atresia, 11 with anorectal malformation, and 5 with Hirschsprung's disease. Developmental delay was found in the ASQ of 72.7% of the patients and the ASQ: SE tool was 27% of the patients. The rate of patients with scores below the threshold from each parameter of ASQ was higher than that of the normal population (p < 0.05). Development delay was detected using the ASQ scale in 100% of those with microcephaly at birth, in 91% of premature infants born between 1500 and 2500 g, and in 83.3% of those with low birth weight to gestational age.ConclusionsIn children who underwent surgery due to congenital anomalies, an evaluation through developmental tests, a post-surgical follow-up process, and a referral to the relevant disciplines when necessary may increase the success of surgery as well as increase the life quality of the patient.

Therapeutic hypothermia after perinatal asphyxia in Vietnam: medium-term outcomes at 18 months – a prospective cohort study

AimTo determine neurodevelopmental outcome at 18 months after therapeutic hypothermia for hypoxic-ischaemic encephalopathy (HIE) infants in Vietnam, a low-middle-income country.MethodProspective cohort study investigating outcomes at 18 months in severely asphyxiated...

Developmental delay in preterm infants during the first twelve months after birth and its risk factors.

Developmental delay in preterm infants in different geographical areas has different risk factors. The present research was a large study aiming to assess developmental delay in preterm infants during the first 12 months after birth and its risk factors in northwest Iran (with multiethnic texture). Eight hundred and seventy preterm infants (25 to 36 weeks; up to 12 months) were included in this descriptive-analytical study from the beginning of 2019 to the end of 2021 in northwest Iran by the convenient sampling method. Patients' basic and medical information was recorded in the data collection form, and the Ages and Stages Questionnaire (ASQ) was used to assess children's developmental status. The prevalence of developmental delay in this study was 26.4%. Regarding demographic characteristics such as age, height (at birth and one year of age), weight (at birth and one year of age), Apgar score (first and twentieth minutes), duration of ventilator connection, comorbidities and complications after birth, and breastfeeding during the first year of life, there was a statistically significant difference between the two groups of infants with and without developmental delay. Breastfeeding during the first 12 months after birth alone could have the power to predict developmental delay in preterm infants. Breastfeeding in the first year of life is considered one of the most important predictors of normal development in preterm infants. Therefore, encouraging the parents of these infants to breastfeed their infants at birth can be a positive step in improving the quality of life of these infants in the future.

Parental stress and child stimulation practices: examining associations with child developmental outcomes over time in Kenya and Zambia

BackgroundParental stress often arises when parenting demands exceed the expected and actual resources available for parents to succeed in the parenting role. Parental stress is an important contributor to parent-child relationships. This, in turn, affects opportunities to engage their children in stimulating activities which could improve their development outcomes. However, limited evidence exists from sub-Saharan Africa (SSA) on the association between parental stress, caregiving practices, and child developmental outcomes.MethodsThe findings reported in this paper were derived from data collected through previous longitudinal work on nurturing care evaluation studies in Kisumu and Nairobi Counties in Kenya, and Chisamba District in Zambia. A total of 341 caregivers and their children who participated in the three rounds of data collection were included in this study. The children’s mean age was 9.3 (SD = 8.2) months pre-intervention, 25.5 (SD = 8.6) months in mid-intervention, and 36 (SD = 10.0) months post-intervention. The Ages and Stages Questionnaire (ASQ), Parental Stress Scale (PSS), and caregiving tools were used to assess children’s developmental outcomes, parental stress, and stimulation practices, respectively. A Random Intercept Cross-Lagged Panel model (RI-CLPM) was used to determine the association between caregivers’ parenting stress, child stimulation practices, and child developmental outcomes.ResultsThe findings showed that caregiver stimulation practices were positively associated with developmental outcomes. Findings on the associations between parental stress and caregivers’ stimulation practices and children’s developmental outcomes were not universally supported.ConclusionThe findings show that improved caregiver stimulation practices are likely to improve children’s developmental outcomes. The policy implications of the findings from this study focus on improving parenting practices by addressing the predictors of parental stress. This includes subsidising childcare services to reduce costs.Trial registrationPan African Clinical Trials Registry (https://pactr.samrc.ac.za/) database (ID number: PACTR20180774832663 Date: 26/July/2018.

Do parent media habits contribute to child global development?

Parents of preschoolers' report using screen media frequently. More frequent screen use by parents may undermine child development by displacing time for foundational parent-child interactions. The objective of the present study is to examine the extent to which parent screen use contributes to child global development 1 year later. Data are from a cohort of 315 preschoolers from Nova Scotia, Canada and their parents during the COVID-19 pandemic. Parents reported the number of hours per day they spent using screens, as well as child screen time and sex, and parent educational attainment. Our outcome is child global development scores, which combine assessments of communication, cognitive, personal-social, and motor skills measured at 4.5 using the Ages and Stages Questionnaire (ASQ) (N = 249, 79% retained). Parents in our sample spent on average 6.35 h per day using screen media outside of work (SD = 3.07) and children spent on average 3.43 h per/day using screens. Multivariate linear regression indicated that each 1-h increase in parents daily screen media use, corresponded to a 1.25 decrease in child global development scores, B = -1.25 p < 0.05, 95% CI between -2.37 and -0.13. Our results indicate that parent screen use may represent a key component of children's media ecology. Given the importance of global development in early childhood for later health and achievement, the present results suggest that interventions should include parent screen use habits in media wellness interventions.

Developmental Risk for Infants with Cleft Lip with or Without Cleft Palate Based on Caregiver-Proxy Reports.

(1) Assess caregiver-reported development in infants born with cleft lip ± alveolus (CL ± A) and cleft lip and palate (CLP); (2) determine factors associated with increased developmental risk; and (3) determine consistency of developmental risk before and after surgery for cleft lip. Prospective, longitudinal assessment of development. Time (T) 1, prior to lip closure; T2, 2 months post lip closure. Three US craniofacial teams and online parent support groups. 123 total caregivers (96% mothers); 100 at T1, 92 at T2, and 69 at both T1 and T2. Ages and Stages Questionnaire-3 (ASQ-3): Communication, Gross Motor, Fine Motor, Problem Solving, Personal Social Domains. At T1 47%; at T2 42% passed all 5 Domains; 36% of infants pass all 5 Domains at both T1 and T2. Infants with CLP were at greatest risk on Communication [B = 1.449 (CI = .149-20.079), p = .038; Odds Ratio (OR) = 4.3 (CI = .923-19.650)] and Gross Motor Domains [B = 1.753 (CI = .316-20.605), p = .034; OR = 5.8 (CI = 1.162-28.671)]. Male infants were at greatest risk on Fine Motor [B = 1.542 (CI = .495-20.005), p = .009; OR = 4.7 (CI = 1.278-17.101)] and Problem Solving Domains [B = 1.200 (CI = .118-19.708), p = .044; OR = 3.3 (CI = .896-12.285)]. Based on caregiver report, infants with CL ± A and CLP meet referral criteria at a high rate. Infants with CLP and male infants were at greatest risk. Regular developmental screening is recommended.

Evaluation of Developmental Delay in Term Babies on Ventilator Support: A Cross-sectional Study

Introduction: Developmental limitation in two or more developmental domains that affects children under the age of five is termed as developmental delay. Due to various reasons such as drug-induced toxicity and maternal variables like a history of drinking, smoking, or infections during pregnancy (e.g., rubella), neonates may require admission to the Neonatal Intensive Care Unit (NICU). Although NICU admission improves survival rates, the extended stay and the use of different types of equipment in the NICU may lead to developmental delay. Aim: To identify the developmental delays in critically ill fullterm babies on ventilator support, using the Ages and Stages Questionnaire-3 (ASQ-3) scale. Materials and Methods: A cross-sectional study was designed to evaluate developmental delays in term babies receiving ventilator support. A total of 35 babies who met the inclusion criteria were included in the study. Once the babies reached 17 to 18 months of age, parents were given ASQ-3 to complete. The data were analysed and expressed as mean, standard deviation, frequency, and percentage. Results: Out of the 35 full-term babies on ventilator support, 22 babies (62.9%) showed lower values in gross motor function, 12 (34.3%) in fine motor function, and 12 (34.3%) in problem-solving skills compared to communication and other components, according to ASQ-3. Conclusion: The findings of this research suggest that critically ill full-term infants on ventilator support exhibit significant developmental delays, particularly in gross motor, fine motor, and problem-solving skills.

The association between maternal social support levels during pregnancy and child development at three years of age: the Japan Environment and Children's Study.

Social relationships are essential in maintaining the physical and mental health of mothers and their children. However, there is limited evidence on how social support provided to the mother during pregnancy could impact child development. Herein, we examined whether maternal social support levels during pregnancy was associated with the risk of developmental delay in 3-year-old children. Overall, 68,442 mother-child pairs completed questionnaires on maternal social support during pregnancy and development delay in 3-year-old children. The maternal social support level was evaluated using four items. The risk of development delay was evaluated using the Japanese version of the Ages and Stages Questionnaire-3 (ASQ-3) with five domains of communication, gross motor, fine motor, problem-solving, and personal-social. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression according to the quintiles of maternal social support levels after adjusting for potential confounding factors. Social support during pregnancy was associated with a lower risk of development delay at 3 years of age. Beneficial effects were detected in all domains of the ASQ-3 (p for trend <0.001). Multivariable ORs (95% CIs) for the highest versus lowest quartiles of maternal social support level were 0.57 (0.50-0.65) for communication, 0.49 (0.43-0.55) for gross motor delay, 0.58 (0.53-0.64) for fine motor delay, 0.56 (0.51-0.62) for problem-solving delay, and 0.52 (0.45-0.60) for personal social delay. The associations remained unchanged when stratified by maternal education level, paternal education level, living with children, household income, and postpartum depression. Maternal social support during pregnancy was inversely associated with the risk of developmental delay at 3 years of age.

Health Disparities in Developmental Status of One-year-old Neonates With Low and Normal Birth Weight: A Comparative Study

Background and Purpose: Low birth weight (LBW) neonates usually experience delays in developing gross and fine motor skills. Studies in Iran reveal a prevalence of growth retardation ranging from 7% to 26.3% among Iranian children. Recognizing the significance of complications associated with LBW, this study aims to scrutinize the developmental status of LBW infants at one year of age and juxtapose it with that of normal birth weight (NBW) neonates. Materials and Methods: This retrospective cohort study involved 105 one-year-old children in Shirvan City, Iran. Participants were selected through a census, and their information was extracted from the SIB system (the integrated health record system). Data collection utilized the 12-month version of the ages and stages questionnaire (ASQ) and a demographic questionnaire. Statistical analyses, including the t-test, Pearson correlation coefficient, and linear regression, were performed using SPSS software, version 26. Results: The ASQ questionnaire revealed that the dimensions of problem-solving and individual-social skills had the lowest and highest mean scores, respectively. A comparison of developmental domains between the two groups did not yield any significant differences. However, when considering gender, a noteworthy relationship emerged in both groups, particularly in communication and gross motor skills, as well as individual-social development and problem-solving. Conclusion: Noteworthy disparities were identified between LBW and NBW infants at birth, encompassing factors such as breastfeeding and maternal educational levels. Consequently, public health policies should prioritize initiatives to enhance mothers’ and infants’ health and nutritional well-being before and during pregnancy and early childhood.

The reliability and validity of the isixhosa version of the euroqol toddler and infant populations (EQ-TIPS) health related quality of life instrument

Background: Considering the high burden of disease in young children measurement of Health-Related Quality of Life is needed to evaluate the burden of morbidity. This study aims to report on the validity and reliability of the isiXhosa EuroQol Toddler and Infant Populations (EQ-TIPS) measure for South Africa.Methods: A sample of 181 caregivers of children 0-36 months were recruited from a hospital in-patient (inpt) and outpatient (outpt) facility and crèches. The EQ-TIPS, Ages and Stages Questionnaire (ASQ), Faces, Leg, Activity, Cry, Consolability (FLACC) and dietary information were administered at baseline. EQ-TIPS was administered one week later in crèche children for test-retest reliability.Results: Known groups showed significant differences for pain (X2=37.21, p&lt;0.001), and EQ-TIPS level sum score (KWH=25.9, p&lt;0.001) between health groups. The Visual Analogue Scale was unable to discriminate general health between groups (KW-H=3.92, p=0.141). Concurrent validity was weak to moderate and significant for all dimensions hypothesised to correlate. There was significant fair to moderate test-retest reliability for EQ-TIPS dimensions of movement, play, pain and eating.Conclusion: The isiXhosa EQ-TIPS is valid and reliable for very young children in South Africa and we suggest that it be included in the assessment of children with health conditions within this context.

Prenatal exposures to organophosphate ester metabolites and early motor development in the MADRES cohort

Organophosphate esters (OPEs) are increasingly considered neurotoxicants which may impact gross and fine motor development. We evaluated associations between prenatal OPE exposures and infant motor development. Third trimester urinary concentrations of nine OPE metabolites were measured in 329 mother-infant dyads participating in the Maternal And Developmental Risks from Environmental and Social Stressors (MADRES) cohort. Child gross and fine motor development at 6, 9, 12, and 18-months were assessed with the Ages and Stages Questionnaire-3 (ASQ-3) and operationalized in models using dichotomous instrument-specific cutoffs for typical motor development. Five OPE metabolites with >60% detection were specific-gravity-adjusted, natural log-transformed, and modeled continuously, while four metabolites with <60% detection were modeled dichotomously (detected/not-detected). We fit mixed effects logistic regression between OPE metabolites and fine/gross motor development and assessed sex-specific effects using a statistical interaction term and sex-stratified models. Among children, 31% and 23% had gross and fine motor scores, respectively, below the ASQ-3 at-risk cutoffs at least once across infancy. A doubling in prenatal diphenyl phosphate (DPHP) exposure was associated with 26% increased odds of potential fine motor delays (ORfine = 1.26, 95% CI: 1.02, 1.57, p = 0.04). We also observed significant interactions by infant sex for associations of detected dipropyl phosphate (DPRP) with gross motor development (pinteraction = 0.048) and detected bis(1-chloro-2-propyl) phosphate (BCIPP) with fine motor development (pinteraction = 0.02). Females had greater odds of potential motor delays for both detected DPRP (females vs males ORgross (95% CI) = 1.48 (0.71, 3.09), p = 0.30 vs 0.27 (0.06, 1.29), p = 0.10) and detected BCIPP (females vs males ORfine (95% CI) = 2.72 (1.27, 5.85), p = 0.01 vs 0.76 (0.31, 1.90), p = 0.56). There were no other significant associations between other metabolites and motor development, despite similar patterns. We found evidence of adverse effects of prenatal OPE exposures on infant motor development with greater adverse effects among female infants with some OPE metabolites.

Use of non-invasive transcutaneous auricular vagus nerve stimulation: neurodevelopmental and sensory follow-up.

To assess the impact of non-invasive transcutaneous auricular vagal nerve stimulation (taVNS) paired with oral feeding on long-term neurodevelopmental and sensory outcomes. We tested 21 of 35 children who as infants were gastrostomy tube (G-tube) candidates and participated in the novel, open-label trial of taVNS paired with oral feeding. To evaluate possible effects on development at 18-months after infant taVNS, we performed the Bayley-III (n = 10) and Sensory Profile (SP-2, n = 12) assessments before the COVID pandemic, and Cognitive Adaptive Test (CAT), Clinical Linguistics and Auditory Milestone (CLAMS), Ages and Stages Questionnaire (ASQ), and Peabody Developmental Motor Scales-2 gross motor tests as possible during and after the pandemic. We compared outcomes for infants who attained full oral feeds during taVNS ('responders') or received G-tubes ('non-responders'). At a mean of 19-months, taVNS 'responders' showed significantly better general sensory processing on the SP-2 than 'non-responders'. There were no differences in other test scores, which were similar to published outcomes for infants who required G-tubes. This is the first report of neurodevelopmental follow-up in infants who received taVNS-paired feeding. They had similar developmental outcomes as historical control infants failing oral feeds who received G-tubes. Our data suggests that infants who attained full oral feeds had better sensory processing.

O064 Screen Time, Sleep, and Behavioural Development in Preschool Children: Relationships Caregiver Rules and Perceptions of Screen Time

Abstract Sleep is highly important for children’s behaviour (Touchette et al., 2007). However, screen time is associated with poorer sleep (Janssen et al., 2020), and greater behavioural difficulties (Hinkley et al., 2018), but they are rarely investigated together. Caregivers’ rules and perceptions about screen time are also associated with children’s engagement with screens. Caregivers of preschoolers completed online questionnaires about children’s screen time, sleep-related behaviours (Child Sleep-Wake Scale), behaviour (Child Behavior Checklist (CBCL, 1.5-5)), person-social development (Ages and Stages Questionnaire-3 (ASQ-3)), and questions about their rules and perceptions of screen time. Greater screen times predicted lower personal-social scores, and better sleep-related behaviours predicted lower internalising scores. Greater screen times were predicted by caregivers’ tendency to disagree about limits on screen time and a greater inclination to think limits cause conflict. Lower child personal-social scores predicted caregivers’ tendency to disagree about screen time limits. Greater child externalising behaviours predicted caregivers’ belief that screen time helps calm their child and that time limits cause conflicts. Poorer child sleep also predicted caregivers’ tendency to think screen time limits cause conflict. Therefore, caregivers’ rules and perceptions are associated with children’s screen times, but also children’s behaviours are associated with caregivers’ rules and perceptions about screen time. This is concerning as screen time predicted poorer personal-social behaviours in children. Providing caregivers with alternative ways to manage behaviours and conflicts surrounding time limits could also help in managing children’s screen times. This could have long-term implications for healthy sleep, social, and behavioural development in children.

Autism Spectrum Disorder detection framework for children based on federated learning integrated CNN-LSTM

The incidence of Autism Spectrum Disorder (ASD) among children, attributed to genetics and environmental factors, has been increasing daily. ASD is a non-curable neurodevelopmental disorder that affects children’s communication, behavior, social interaction, and learning skills. While machine learning has been employed for ASD detection in children, existing ASD frameworks offer limited services to monitor and improve the health of ASD patients. This paper presents a complex and efficient ASD framework with comprehensive services to enhance the results of existing ASD frameworks. Our proposed approach is the Federated Learning-enabled CNN-LSTM (FCNN-LSTM) scheme, designed for ASD detection in children using multimodal datasets. The ASD framework is built in a distributed computing environment where different ASD laboratories are connected to the central hospital. The FCNN-LSTM scheme enables local laboratories to train and validate different datasets, including Ages and Stages Questionnaires (ASQ), Facial Communication and Symbolic Behavior Scales (CSBS) Dataset, Parents Evaluate Developmental Status (PEDS), Modified Checklist for Autism in Toddlers (M-CHAT), and Screening Tool for Autism in Toddlers and Children (STAT) datasets, on different computing laboratories. To ensure the security of patient data, we have implemented a security mechanism based on advanced standard encryption (AES) within the federated learning environment. This mechanism allows all laboratories to offload and download data securely. We integrate all trained datasets into the aggregated nodes and make the final decision for ASD patients based on the decision process tree. Additionally, we have designed various Internet of Things (IoT) applications to improve the efficiency of ASD patients and achieve more optimal learning results. Simulation results demonstrate that our proposed framework achieves an ASD detection accuracy of approximately 99% compared to all existing ASD frameworks.

Neurodevelopmental Outcome of Infants with Transient Hypothyroxinemia of Prematurity in a Newborn Intensive Care Unit

The aim of this study was to evaluate neurological development of infants with transient premature hypothyroxinemia (THOP). This prospective study included newborns who were born between 28-36 weeks of gestation (GW) and were admitted to the neonatal intensive care unit. Newborns exposed to maternal thyroid disease, or with severe intracranial problems, and congenital anomalies were excluded. Infants with THOP were the study group and those without THOP formed the control group. The study group was subdivided into those receiving levothyroxine replacement (5 μg/kg/day) and those who were untreated. Neonatal demographics, and morbidities, including respiratory distress syndrome, bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) were evaluated. The Ages and Stages Questionnaire (ASQ) and ASQ:Social-Emotional (ASQ:SE) developmental screening tests were administered to the entire study population at the corrected age of two years. Seventy infants were included in this study, 40 of whom had THOP. The mean GW was 34.4±3.8 weeks in the study group and 37.2±2.3 weeks in controls (p=0.69). Mean overall birth weight was 1640±428 g. Levothyroxine replacement was started in 12/40 infants (30%). The groups were similar in terms of demographic characteristics. Rates of BPD and ROP were higher in the treated group (p=0.01). ASQ and ASQ:SE results did not differ between groups (p=0.75), nor did these scores differ between infants with THOP who did or did not receive levothyroxine (p=0.14). Although levothyroxine replacement therapy was associated with increased rates of BPD and ROP, this treatment did not appear to improve long-term neurological outcomes in this small group of infants with THOP. Prospective controlled studies with much larger sample sizes are needed to clarify the role of levothyroxine replacement in THOP.

Group well child care and risk for developmental delay: Preliminary findings among Asian immigrants

Group well-child care (GWCC) may promote interactive caregiving and prevent developmental delay. Method: This cross-sectional study explored the association between GWCC attendance and odds for suspected developmental delay among low-income Asian immigrants as measured by the Ages and Stages Questionnaire (ASQ)-III at age 18 months. Results: Odds for suspected developmental delay (OR=0.81, 95 % CI 0.40–1.62) were not significantly lower for GWCC infants. However, odds for developmental risk were significantly lower for GWCC infants in the ASQ’s problem-solving domain (OR= 0.40, 95 % CI 0.17–0.92). Conclusion: Among low-income Asian immigrants, GWCC participation may be associated with lower odds for cognitive developmental delay.