Ages And Stages Questionnaire Research Articles

Involving Mothers in Child Development Assessment in a Community-based Participatory Study Using Ages and Stages Questionnaires.

Background:Child-friendly environment project (MAZDAK) is a community-based project for monitoring the development of children in Iran that was implemented as a pilot study in one of the neighborhoods of Tehran (Eyvanak-e Gharb). This study attempted to engage mothers in monitoring of their children's development and assesses the status of children's development by a community-based participatory approach using the ages and stages questionnaires (ASQ).Methods:This study was a community-based participatory research. Two hundred households residing in Eyvanak-e Gharb with children under 5-year-old were selected as a convenient sample and completed the ASQ. Descriptive measures were used to describe the overall status of children, in each domain. Furthermore, we compared the current sample with other populations, using independent t-test.Results:This study engaged mothers, trained volunteers from the community, and some local institutions in screening and monitoring children development and addressing any poor developmental growth. The mean scores of the different domains (communication, gross motor, fine motor, problem solving, and social-personal) in sampled children in MAZDAK project were higher than corresponding mean scores of the children in a project conducted in Tehran in 2006.Conclusions:Involving mothers and community in monitoring children development based on ASQ was an effective strategy to monitor and foster children development.

Clinical Outcomes of High-Risk Infant Follow-Up Program in a Tertiary Care Centre.

Background:High-risk infant follow-up (HRIF) program is necessary for early detection, timely intervention, and promotion of health outcomes in vulnerable infants, ethically. The present study was carried out to assess the clinical outcomes of the HRIF Program in Alzahra hospital as a tertiary care centre, in Iran.Materials and Methods:In this cohort study, 5840 neonates were born at Alzahra hospital, from June 1, 2011 to 30th February 2012. Among those who were admitted to neonatal intensive care unit (NICU), 253 infants were recruited by census according to HRIs criteria. After doing necessary measurements and family education, information was recorded in HRI health certificate and then entered in the access database for analysis.Results:From 253 eligible HRIs registered, 241 (95%) infants attended the follow-up clinic after discharge. A total of180 cases were recalled for further visits, 110 of which attended the clinic. Anthropometric indices had an increasing trend in the first 6 months of life. There was no significant relation between ages and stages questionnaire (ASQ) results and infant birth weight, height, and head circumference. The ratios of intraventricular hemorrhage (IVH) and retinopathy of prematurity (ROP) were 8.7% and 3.1%, respectively. The incidence of congenital hypothyroidism was 2:341 in HRIs.Conclusions:Although some outcomes, such as ROP, improved in our study compared to similar studies, the findings indicate an impairment of the current follow-up processes and highlight the necessity to modify the current HRIF program. Ethically, we insist on integrating HRIF program in child health services to promote early childhood development.

Comparing the Results of Developmental Screening of 4 to 60-Month-Old Children in Tehran Using Parents Evaluation of Developmental Status and Ages and Stages Questionnaires

Objectives: This research was designed to evaluate the developmental status of children aged 4 to 60 months in Tehran city by two parent-based developmental screening questionnaires, parents evaluation of developmental status (PEDS) and ages and stages questionnaires (ASQ), and also to determine the consistency coefficient between these two tests. Methods: In this cross-sectional study, PEDS and ASQ were performed on 648 children (350 boys and 298 girls), aged 4 to 60 (mean, 23.5 ± 16.10) months at four health centers in Tehran city. Results: Developmental disorders were observed in 23.1% of children (4.6% delayed and 18.5% suspicious), who were examined by PEDS, and in 26.4% of children, who were examined by ASQ (14.7% delayed and 11.7% suspicious). The estimated values of kappa measure of agreement and Pearson Chi-Square for the results of the two screening tests were 0.30 (P < 0.001) and 115.98 (P < 0.001), respectively. The results of these tests were similar in 93.3%, 94% and 91% of cases in fine motor, gross motor and language domains of development, respectively. Due to the rather large sample size and similarity of the screening results by both questionnaires in 71.5% of cases, it is possible to conclude that this measure is an acceptable one. Conclusions: This study showed that PEDS and ASQ have acceptable agreement, thus it seems that PEDS can be used for children’s developmental screening especially in child care visits.

Association between maternal postnatal depressive symptoms and infants’ communication skills: A longitudinal study

Postnatal depression (PND) is associated with adverse effects on a broad range of child outcomes, including language problems. The current study aimed to investigate if the time of exposure to maternal PND symptoms measured with the Edinburgh Postnatal Depression Scale (EPDS) at 6 weeks, 4 months and 6 months postpartum were related to the infants’ communication skills measured with the Ages and Stages Questionnaires (ASQ) at 12 and 24 months. Secondly, to study to what extent the number of exposures to high level of PND symptoms (i.e., EPDS score≥10) might be associated with level of communication skills later (at 12 and 24 months), and last, to determine to what extent maternal PND symptoms at 6 weeks were related to changes in the developmental course of communication skills from 4 to 24 months. 1555 children and their mothers participate in the study. Regression analyses indicated that PND at 4 months were associated with lower levels of communicative skills at 12 (coefficient −0.37, 95% CI −0.63 to −0.12, p=0.004) and 24 months (coefficient −0.34, CI −0.56 to −0.13, p=0.002). Infants of mothers with an EPDS sum score≥10 obtained at a minimum of two time points, had significantly worse communicative skills at 12 months than infants of mothers with no indication of PND (difference −6.12, CI −11.14 to −1.09, p=0.017). No such significant relations were found at 24 months. However, linear mixed effects analysis showed that mothers’ depressive symptoms at 6 weeks were not significantly related to changes in infant communication scores from age 4 to 24 months. These findings suggest that symptoms of maternal PND symptoms should be taken into account for communication development in infancy.

Validez del Ages & Stages questionnaires para predecir el desempeño cognitivo en los primeros años de educación escolar

IntroductionThe Ages and Stages questionnaires (ASQ) has been recently validated in our country for developmental screening. The objective of this study is evaluate the validity of ASQ to predict low cognitive performance in the early years of schooling. Patients and methodDiagnostic test studies conducted on a sample of children of medium-high socioeconomic level were evaluated using ASQ at least once at 8, 18 and/or 30 months old, and later, between 6 and 9 years old, reevaluated using the Wechsler Intelligence Scale for Children-third edition (WISC-III). Each ASQ evaluation was recorded independently. WISC-III was standardized, considering underperformance when the total score were under -1 standard deviation Results123 children, corresponding to 174 ASQ assessments (42 of them were 8 months old, 55 were 18 months and 77 were 30 months of age) were included. An area under the ROC curve of 80.7% was obtained, showing higher values at 8 months (98.0%) compared to 18 and 30 months old (78.1 and 79.3%, respectively). Considering different ASQ scoring criteria, a low sensitivity (27.8 to 50.0%), but a high specificity (78.8 to 96.2%) were obtained; the positive predictive value ranged between 21 and 46%, while the negative value was 92.0-93.2%. ConclusionASQ has low sensitivity but excellent specificity to predict a low cognitive performance during the first years of schooling, being a good alternative to monitor psychomotor development in children who attend the private sector healthcare in our country.

Maternal depression and child development: Evidence from São Paulo's Western Region Cohort Study.

While a growing body of evidence has investigated the relationship between maternal mental health and child development, evidence on children's early life outcomes remains mixed. We analyze the empirical relationship between maternal depression and children's development at age one using data from the São Paulo Western Region Cohort project. Seven hundred and ninety-eight (798) mother-child dyads living in the Butantã-Jaguaré' region of São Paulo were assessed through a home visit between January and March 2015. Maternal mental health was assessed using the Edinburgh Postnatal Depression Scale (EPDS). Mothers were classified as "possibly depressed" if their EPDS score was between 10 and 13 and as "likely depressed" if their EPDS score was > 13. The child outcomes analyzed were height, weight, and overall development as assessed by the Ages and Stages Questionnaire (ASQ). Height and weight were age-normalized using WHO growth standards. Stunting was defined as height-for-age z-score (HAZ) < -2. Obesity was defined as body mass index z-score (BMIZ) > 2. Adjusted and unadjusted linear regression models were used to assess the associations between Edinburgh scores and child outcomes. No association was found between maternal depression variables and children's height, weight, stunting, and obesity. Positive associations were found between possible depression and ASQ (delta = 0.33; 95CI 0.11-0.54; p-value<0.01); no associations were found between likely depression and any of the outcomes analyzed. The results from this study suggest that symptoms of maternal depression are not associated with delays in child development in the study setting analyzed. Further research will be needed to understand this lack of association: while it is possible that caregivers' mental health did not affect caregiving behavior, it is possible that the effect of maternal depression can vary according to timing, persistence, and intensity. It is also possible that the EPDS instrument may fail to identify mothers with clinical depression, or that children with depressed mothers get increased support from other family members or public early childhood focused programs.

Maternal dietary exposure to dioxins and PCBs and neurodevelopmental outcomes in 3 year old children in MoBa

Introduction: Exposure to dioxins and polychlorinated biphenyls (PCBs) during gestational life and breastfeeding may affect the developing brain. It is unclear whether maternal dietary exposure to dioxins and PCBs is associated with neurodevelopmental outcomes in children. Methods: We used the Norwegian Mother and Child Cohort Study (MoBa) to examine if early-life exposure to dioxins and PCBs was associated with externalizing and internalizing behavior as well as motor and language development at 3 years (n=44,092). Neurodevelopmental outcomes were assessed by parent-reports using shortened versions of The Child Behavior Checklist (CBCL), the Ages and Stages Questionnaire (ASQ), and a Dale-Bishop grammar rating. Maternal dietary exposure to dioxins and PCBs was assessed mid-pregnancy by an FFQ. Associations were investigated using logistic regression models, stratified by sex and adjusted for relevant covariates such as maternal education, BMI, parity, DHA/EPA and MeHg intake during pregnancy, and breastfeeding duration. Results: Maternal exposure to dioxins and PCBs in MoBa was generally low and median intake of dioxins and dioxin-like PCB (dl-compounds) was 3.6 times lower than the tolerable weekly intake (TWI) of 14 pg TEQ/kg bw. We found no statistically significant associations between exposure to dl-compounds or PCB-153 and internalizing or externalizing behavior, nor with motor development. However, high exposure to dl-compounds (TEQ&gt;TWI) or PCB-153 (&gt;P97.5) was associated with severe language delay in girls, adjusted ORs were 2.9 (95% CI 1.4, 5.9) for dl-compounds and 2.8 (95% CI 1.1, 7.1) for PCB-153. Conclusions: We found no associations between maternal dietary exposure to dioxins or PCBs and externalizing or internalizing behavior, nor with motor development. However, our findings indicated that high exposure to dioxins and PCBs early in life may be negatively associated with language development, and suggested a higher vulnerability in girls than boys.

Long-term effects of prenatal progesterone exposure: neurophysiological development and hospital admissions intwins up to 8 years of age.

To perform a neurophysiological follow-up at 48 or 60 months of age in children exposed prenatally to progesterone compared with a placebo and evaluate their medical histories up to 8 years of age. In this study, Danish participants of the PREDICT study, including 989 surviving children from 498 twin pregnancies, were followed-up. PREDICT was a placebo-controlled randomized clinical trial examining the effect of progesterone for prevention of preterm delivery in unselected twin pregnancies. Medical histories of the children were reviewed and neurophysiological development was evaluated by the parent-completed Ages and Stages Questionnaire (ASQ) at either 48 or 60 months after the estimated date of delivery. We used the method of generalized estimating equation to account for the correlation within twins. A total of 492 children had been exposed prenatally to progesterone and 497 to placebo. There was no difference in the number of admissions to or length of stay in hospital between the treatment groups, and we found no overall difference in the rates of diagnoses made. However, the odds ratios (ORs) for a diagnosis concerning the heart was 1.66 (95% CI, 0.81-3.37), favoring placebo, among all children, 2.38 (95% CI, 1.07-5.30) in dichorionic twins and 8.19 (95% CI, 1.02-65.6) in all children when excluding diagnoses made at outpatient clinic visits. ASQ scores were available for 437 children (progesterone, n = 225; placebo, n = 212). Mean ASQ score was slightly higher in the progesterone group compared with the placebo group (P = 0.03). In dichorionic twins, the risk of having a low ASQ score (< 10(th) centile) was decreased in the progesterone group (OR, 0.34 (95% CI, 0.14-0.86)). Second- and third-trimester exposure of the fetus to progesterone does not seem to have long-term harmful effects during childhood, but future studies should focus on cardiac disease in the child. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

Prospective assessment of neurodevelopment in children following a pregnancy complicated by severe pre-eclampsia

ObjectiveTo prospectively examine whether children of women with a pregnancy affected by severe pre-eclampsia (PE), compared to children of women without a PE-affected pregnancy, have differences in neurodevelopmental performance up...

Analysing four Norweigian population-based samples using the six-month version of the Ages and Stages Questionnaire showed few relevant clinical differences.

We investigated whether there were clinically relevant differences in the area mean scores of the six-month Ages and Stages Questionnaire (ASQ) between four Norwegian population-based samples. Area mean scores and standard deviations (SDs) were investigated for the five developmental areas of the ASQ: communication, gross motor, fine motor, problem solving and personal-social. Sample sizes varied from 166 to 1192 and the ASQ was completed on paper or by computer. ASQ scores in the four samples were compared using ANOVA and Tukey's procedure was used to adjust for multiple comparisons. The ASQ mean area scores were generally similar in the four data sets, with few clinically relevant differences, defined as a mean difference of greater than five points, which is the smallest increment in area score, or an effect size of >0.5 in absolute value. All the clinically relevant differences occurred when samples used a modified ASQ administration format. Several additional minor differences were statistically significant, which was expected due to the large samples. These results support the original Norwegian normative findings for the ASQ six-month form and the ASQ's use as a low-cost developmental screening tool in Norway, at least when the original format is administered.

Lack of a Negative Effect of BCG-Vaccination on Child Psychomotor Development: Results from the Danish Calmette Study - A Randomised Clinical Trial.

ObjectivesTo assess the non-specific effect of Bacillus Calmette-Guérin (BCG) vaccination at birth on psychomotor development.DesignThis is a pre-specified secondary outcome from a randomised, clinical trial.SettingMaternity units and paediatric wards at three university hospitals in Denmark.ParticipantsChildren born at gestational age (GA) 32 weeks and above. All women planning to give birth at the three sites were invited during the recruitment period. Out of 4262 randomised children, 144 were premature (GA < 37 weeks). There were 2129 children (71 premature) randomised to BCG and 2133 randomised (73 premature) to the control group.InterventionsBCG vaccination 0.05 ml was given intradermally in the upper left arm at the hospital within seven days of birth. Children in the control group did not receive any intervention. Parents were not blinded to allocation.Main outcome measuresPsychomotor development measured using Ages and Stages Questionnaire (ASQ) completed by the parents at 12 months. Additionally, parents of premature children (gestational age < 37 weeks) completed an ASQ at 6 and 22 months. Developmental assessment was available for 3453/4262 (81%).ResultsThe mean difference in ASQ score at 12 months adjusted for age and prematurity was -0.7 points (BCG vs. control, 95% confidence interval; -3.7 to 2.4), p = 0.67, corresponding to an effect size of Cohen’s d = -0.015 (-0.082 to 0.052). The mean difference in ASQ score for premature children at 22 months was -7.8 points (-20.6 to 5.0, p = 0.23), d = -0.23 (-0.62 to 0.15).ConclusionsA negative non-specific effect of BCG vaccination at birth on psychomotor development was excluded in term children.Trial RegistrationClinicalTrials.gov NCT01694108

Propranolol treatment of infantile hemangioma (IH) is not associated with developmental risk or growth impairment at age 4 years

Long-term adverse effects of propranolol treatment for infantile hemangioma (IH) in young children have been suggested. To compare growth and development in children treated with propranolol for IH with nontreated healthy controls. Eighty two (73%) children with IH aged 43 to 51months treated with propranolol for 6months or longer, and without other developmental risk factors, were recruited (cases) and matched with 4 twin counterparts and 78 children from a community-based cohort (control subjects). Parents completed the 48-months Ages and Stages Questionnaire (ASQ). Percentages of children with abnormal ASQ results were compared using χ(2) analyses. Mean ASQ scores and growth were compared using Mann-Whitney U tests. Six (7.3%) cases had abnormal ASQ results, compared with 10 (12.2%) controls (P=.292). Mean ASQ total score (25th-75th percentile) was 52.9 (50.8-57.0) for cases and 51.9 (49.0-56.0) for controls (P=.383). Height and weight of cases and controls were comparable. A parent-completed screening instrument was used. The exclusion of children born at gestational age less than 36weeks and/or children born small for gestational age partly limits generalizability. We found no increased developmental risk or growth impairment at age 4years in patients with IH treated with propranolol.

Maternal dietary exposure to dioxins and polychlorinated biphenyls (PCBs) is associated with language delay in 3 year old Norwegian children

BackgroundPrenatal exposure to dioxins and PCBs is potentially harmful to the developing fetus and may increase the risk of delayed or impaired neurodevelopment. Several studies have reported negative associations between prenatal exposure to these compounds and aspects of cognition related to language in early childhood. ObjectivesThe aim was to examine the association between maternal low level dietary exposure to dioxins and PCB during pregnancy and language development in 3year old children in a large group of mother-child pairs participating in the Norwegian Mother and Child Cohort Study (MoBa). MethodsThis study includes 44,092 children of women who were recruited to the Norwegian Mother and Child Cohort Study (MoBa) during the years 2002–2009. Maternal dietary exposure to dioxins and PCBs was estimated based on a validated food frequency questionnaire (FFQ) answered mid-pregnancy and a database of dioxin and PCB concentrations in Norwegian foods. Exposure to dioxins and dioxin-like PCBs (dl-compounds) was expressed in total toxic equivalents (TEQ), and PCB-153 was used as marker for non-dioxin-like PCBs (ndlPCBs). Children's language skills at age 3 were assessed by parental report including a Dale and Bishop grammar rating and questions about communication skills from the Ages and Stages Questionnaire (ASQ). Logistic regression models adjusted for confounders were used to examine the association between maternal dietary exposure to dl-compounds or PCB-153 and language development in children. ResultsThe maternal dietary exposure to dl-compounds and PCB-153 was generally low, and 98% of women had intakes of dl-compounds ≤14pg TEQ/kg bw/week, which is the tolerable weekly intake set by EU's Scientific Committee for Food (SCF). High maternal exposure (>14pg TEQ/kg bw/week of dl-compounds (median 2.6pg/kg bw/day, range 2–16) or >97.5-percentile intake of PCB-153 (median 11ng/kg bw/day, range 5–28) was associated with higher odds of incomplete grammar (in boys and girls, adjusted ORs 1.1 to 1.3) and severe language delay in girls, adjusted ORs 2.8 [95% CI 1.1, 7.1] for PCB-153 and 2.9 [95% CI 1.4, 5.9] for dl-compounds. Furthermore, high exposure to dl-compounds was associated with moderate language delay 1.4 [95% CI 1.0, 2.0] and lower communication score (ASQ), adjusted OR 1.4 [95% CI 1.1, 1.9] in girls. ConclusionsThe main findings of this study were: 1) Girls born to mothers who exceeded the tolerable weekly intake for dl-compounds or had a PCB-153 intake above the 97.5 percentile in early pregnancy may have increased risk of language delay at age 3years. 2) Negative associations with maternal exposure to dl-compounds or PCB-153 were observed for both boys and girls having incomplete grammar, which is a subtle reduction in language skills. This interesting finding should not be considered as deviant at this age.

Developmental Disorders in Preterm Neonates during the First Two Years of Life Using the Ages and Stages Questionnaire

BACKGROUND AND OBJECTIVE: With the advancement of medical care procedures, survival rate of preterm neonates has increased remarkably. In Iran, few studies have assessed the extent and severity of developmental disorders in these infants. This study aimed to evaluate developmental disorders in premature neonates. METHODS: This cohort study was conducted on 270 premature infants born in Ghaem Hospital in Mashhad, Iran with mean birth weight of 1460±40 grams. Data on pregnancy, parturition and complications during hospitalization were recorded. Moreover, preterm neonates were evaluated in terms of developmental delay at 6, 12, 18 and 24 months of age based on the Ages and Stages questionnaire (ASQ). FINDINGS: In this study, symptoms of developmental delay were observed in 152 neonates (56%) at six months, 115 neonates (42.7%) at 12 months, 101 infants (37.5%) at 18 months, and 49 neonates (18%) at 24 months. In addition, abnormal development was detected in different areas, including communication (n=21, 7.8%), major movements (n=53, 19.6%), minor movements (n=74, 27.5%), social interactions (n=89, 33%), and problem solving (n=153, 57%). After a two-year follow-up, 27 infants (60%) had asphyxia, 29 (28%) had respiratory distress syndrome, and 20 infants (15%) had developmental disorders. CONCLUSION: According to the results of this study, about one-sixth of preterm neonates had developmental delay at two years of age. The highest rate of developmental disorders was observed in the area of problem solving, which should be taken into account in neonatal rehabilitation services. On the other hand, appropriate monitoring of neonatal asphyxia and jaundice is likely to reduce the risk of other complications during infancy.

Effectiveness of Queen’s Parenting Program on Psychological Well-Being of Pre-School Children with Neuropsychological/Developmental Learning Disabilities

The present study aimed to examine the effectiveness of the Queen’s Parenting Program on psychological well-being of pre-school children with neuropsychological/developmental learning disability (NDLD). The population included all pre-school children with (NDLD). To conduct the research, using the stratified random sampling, 40 children with inclusion criteria were selected and then randomly put in the experimental and control groups. To collect data, the Wechsler Pre-school and primary Scale Intelligence (WPPSI) and Behavior Rating Inventory for Executive Function-Pre-school (BREIEF-P) for determining the inclusion criteria and the Ages and Stages Questionnaire (ASQ) for measuring psychological well-being were used. The results of analyzing data using ANCOVA and MANOVA indicated that psychological wellbeing and its dimensions improved significantly in children of the experimental group in comparison with the control group (p&amp;lt;0.05). Therefore, Queen’s program is effective on the psychological wellbeing of children with pre-school children with neuropsychological/developmental learning disability.

Parechovirus Encephalitis and Neurodevelopmental Outcomes.

We aimed to describe the clinical features and outcome of human parechovirus (HPeV) encephalitis cases identified by the Australian Childhood Encephalitis (ACE) study. Infants with suspected encephalitis were prospectively identified in 5 hospitals through the (ACE) study. Cases of confirmed HPeV infection had comprehensive demographic, clinical, laboratory, imaging, and outcome at discharge data reviewed by an expert panel and were categorized by using predetermined case definitions. Twelve months after discharge, neurodevelopment was assessed by using the Ages and Stages Questionnaire (ASQ). We identified thirteen cases of suspected encephalitis with HPeV infection between May 2013 and December 2014. Nine infants had confirmed encephalitis; median age was 13 days, including a twin pair. All had HPeV detected in cerebrospinal fluid with absent pleocytosis. Most were girls (7), admitted to ICU (8), and had seizures (8). Many were born preterm (5). Seven patients had white matter diffusion restriction on MRI; 3 with normal cranial ultrasounds. At discharge, 3 of 9 were assessed to have sequelae; however, at 12 months' follow-up, by using the ASQ, 5 of 8 infants showed neurodevelopmental sequelae: 3 severe (2 cerebral palsy, 1 central visual impairment). A further 2 showed concern in gross motor development. Children with HPeV encephalitis were predominantly young, female infants with seizures and diffusion restriction on MRI. Cranial ultrasound is inadequately sensitive. HPeV encephalitis is associated with neurodevelopmental sequelae despite reassuring short-term outcomes. Given the absent cerebrospinal fluid pleocytosis and need for specific testing, HPeV could be missed as a cause of neonatal encephalopathy and subsequent cerebral palsy.

Pediatric sleep problems and social-emotional problems. A population-based study

ObjectiveTo examine the association between sleep and social-emotional development in two-year-old toddlers. MethodsThe study is part of a longitudinal cohort study, the Akershus Birth Cohort Study, which targeted all women giving birth at Akershus University Hospital in Norway. The current study is from the fourth round of the study, including 2014 women two years after delivery. The Brief Infant Sleep Questionnaire (BISQ) and the Ages and Stages Questionnaire: Social Emotional (ASQ:SE) were filled out by the mothers and were used to assess toddler sleep, and social-emotional development, respectively. Other domains of development (communication problems, gross motor problems, and fine motor problems) were assessed with the Ages and Stages Questionnaire (ASQ). Confirmatory factor analysis was conducted on the ASQ:SE, and logistic regression analyses were used to examine both crude associations between sleep variables and social-emotional problems, and adjusting for potential confounders. ResultsThe mean sleep duration of the toddlers was 12h and 27min; the majority of the children (54%) had 1–2 awakenings per night, while 10% of the children had a sleep onset latency of more than 30min. All sleep parameters, including short sleep duration, nocturnal awakenings and sleep onset problems, were significantly associated with social-emotional problems in a dose-response manner. For example, sleeping less than 11h per night was associated with a five-fold increase in the odds of social-emotional problems, compared to sleeping 13–14h per night. Adjusting for potential confounders, including maternal age, maternal education, marital status, parity, gestational age, child birth-weight and other developmental problems, did not, or only slightly, attenuate the associations between any of the sleep variables and social-emotional problems. ConclusionsShort sleep duration, nocturnal awakenings and sleep onset problems were all associated with higher odds of social-emotional problems, even after accounting for developmental problems and demographic factors. Thus, a broad assessment of sleep and social-emotional problems when toddlers present with either can be useful.

Validity and reliability of the developmental assessment screening scale.

Objectives:To develop and validate the 6-year Ages and Stages Questionnaire (ASQ) for school-age children.Methods:Parents/caregivers of children 66–78 months were recruited from 6 countries and 15 states in the United States. Similar to other ASQ intervals, the 6-year ASQ has five developmental domains targeted for children from 66 months to 78 months of age. We assessed internal consistency reliability, test-retest reliability, the scale structure, validity (correlation coefficients), and utility of the 6-year ASQ. The 6-year ASQ screens development in five domains using 30 items.Results:Coefficient alpha measuring internal consistency was 0.97. Test-retest reliability was estimated by having parents complete two ASQ's on the same child within a week interval. Correlations between scores of the two ASQ's reflected stability of scores. Test-retest reliability results were robust with an intraclass correlation coefficient of 0.94. Factor analysis results resulted in a five factors structure. The Pearson correlations coefficients between the latent variables were moderate to large and statistically significant, P < 0.0001. The 6-year ASQ screens development in five domains using 30 items. The administration time varied from 10 to 60 min with a mean of 15.17 min. General utility result shows that the 6-year ASQ can be used with satisfaction by caregivers, pediatricians, professionals, and parents.Conclusions:Preliminary data on the 6-year ASQ reflected promising results. An easy-to-administer, accurate caregiver-completed screening tool may increase the frequency of screening for school-age children.

Associations of vitamin D status, bone health and anthropometry, with gross motor development and performance of school-aged Indian children who were born at term with low birth weight

ObjectivesThere is little information regarding motor development of children born at term with low birth weight (LBW), a group that constitutes a large proportion of children in South Asia. We...

Nutritional and developmental status among 6- to 8-month-old children in southwestern Uganda: a cross-sectional study

BackgroundUndernutrition continues to pose challenges to Uganda's children, but there is limited knowledge on its association with physical and intellectual development.ObjectiveIn this cross-sectional study, we assessed the nutritional status and milestone development of 6- to 8-month-old children and associated factors in two districts of southwestern Uganda.DesignFive hundred and twelve households with mother–infant (6–8 months) pairs were randomly sampled. Data about background variables (e.g. household characteristics, poverty likelihood, and child dietary diversity scores (CDDS)) were collected using questionnaires. Bayley Scales of Infant and Toddler Development (BSID III) and Ages and Stages questionnaires (ASQ) were used to collect data on child development. Anthropometric measures were used to determine z-scores for weight-for-age (WAZ), length-for-age (LAZ), weight-for-length (WLZ), head circumference (HCZ), and mid-upper arm circumference. Chi-square tests, correlation coefficients, and linear regression analyses were used to relate background variables, nutritional status indicators, and infant development.ResultsThe prevalence of underweight, stunting, and wasting was 12.1, 24.6, and 4.7%, respectively. Household head education, gender, sanitation, household size, maternal age and education, birth order, poverty likelihood, and CDDS were associated (p<0.05) with WAZ, LAZ, and WLZ. Regression analysis showed that gender, sanitation, CDDS, and likelihood to be below the poverty line were predictors (p<0.05) of undernutrition. BSID III indicated development delay of 1.3% in cognitive and language, and 1.6% in motor development. The ASQ indicated delayed development of 24, 9.1, 25.2, 12.2, and 15.1% in communication, fine motor, gross motor, problem solving, and personal social ability, respectively. All nutritional status indicators except HCZ were positively and significantly associated with development domains. WAZ was the main predictor for all development domains.ConclusionUndernutrition among infants living in impoverished rural Uganda was associated with household sanitation, poverty, and low dietary diversity. Development domains were positively and significantly associated with nutritional status. Nutritional interventions might add value to improvement of child growth and development.