Comprehensive Developmental Inventory For Infants And Toddlers Research Articles

Maternal H. pylori seropositivity is associated with gestational hypertension but is irrelevant to fetal growth and development in early childhood

BackgroundHelicobacter pylori infection is known to alter growth-related hormones and affect growth in young children. However, it is still unknown whether maternal H. pylori infection has an impact on the levels of cord blood growth-related hormones and whether this can predict intrauterine growth restriction and poor physical and neurodevelopmental outcomes in children. This study aimed to examine associations between maternal H. pylori infection and pregnancy-related adverse events, fetal growth and early childhood development.MethodsIn this prospective cohort study, we recruited singleton pregnant women without major medical illnesses from January 2014 to January 2015. Seropositivity for H. pylori was defined as > 12 U/ml of anti-H. pylori IgG in maternal serum. Demographic data and pregnancy-related medical issues of the cohort were documented. Cord blood levels of insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), insulin, and ghrelin were determined using ELISA. The growth of the included neonates was monitored annually for up to 3 years, and cognitive development was assessed using the comprehensive developmental inventory for infants and toddlers (CDIIT) test 3 years after birth.ResultsOf the 106 enrolled women, 25 (23.6%) were H. pylori-seropositive. Maternal H. pylori seropositivity was correlated with a higher risk of developing gestational hypertension (GH) (12% vs. 1.2%, p = 0.04) and lower cord blood levels of IGF-1 (< 35 ng/ml, 70.0% vs. 40.7%, p = 0.02) and IGFBP-3 (< 1120 ng/ml, 100.0% vs. 76.3%, p = 0.02) compared with the seronegative women. No significant impacts on birth weight, childhood growth and cognitive development were found to be correlated with maternal H. pylori seropositivity during pregnancy.ConclusionsMaternal H. pylori infection during pregnancy was more likely to lead to the development of GH, but was not correlated with fetal and childhood growth and development. In addition to close monitoring of hypertension, H. pylori eradication can be considered for mothers with H. pylori infection.

IQ discrepancy differentiates levels of fine motor skills and their relationship in children with autism spectrum disorders.

PurposeWe investigated 1) the impact of differences in intelligence quotient discrepancy (IQD) on motor skills of preschool-aged children with autism spectrum disorders (ASD); 2) the relationships between IQD and motor skills in preschool-aged children with ASD.MethodsA total of 127 ASD preschool-aged children were divided into three groups according to the size of the IQD: IQD within 1 standard deviation (1SD; EVENIQ; n=81), discrepantly higher verbal intelligence quotient (VIQ; n=22; VIQ>performance intelligence quotient [PIQ] above 1SD [≥15 points]), and discrepantly higher PIQ (n=24; PIQ>VIQ above 1SD [≥15 points]). Children’s IQD and motor skills were determined with the Wechsler Preschool and Primary Scale of Intelligence™ – Fourth Edition and the motor subtests of the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT), respectively.ResultsOne-way analysis of variance revealed significant group differences for the fine motor domain of the CDIIT and the visual–motor coordination subtest (F=3.37–4.38, p<0.05). Children with discrepantly higher PIQ were associated with better fine motor skills than were children with even IQD and those with discrepantly higher VIQ, and vice versa. IQD (PIQ – VIQ) had significant positive correlations with the fine motor domain and fine motor subtests of the CDIIT (r=0.18–0.29, p<0.05).ConclusionThe IQD can identify different levels of fine motor skills in preschool-aged children with ASD. This study suggests important implications for clinicians, therapists, and researchers: discrepantly higher PIQ could be related to better visual–motor coordination, and discrepantly higher VIQ could be related to poor visual–motor coordination. Furthermore, the results support that when therapists are working with preschool-aged children with ASD who are developing fine motor skills or undertaking fine motor tasks related to visual–motor coordination, they may need to pay attention to the children’s IQD.

Improving the utility of the fine motor skills subscale of the comprehensive developmental inventory for infants and toddlers: a computerized adaptive test

Aim: This study aimed at improving the utility of the fine motor subscale of the comprehensive developmental inventory for infants and toddlers (CDIIT) by developing a computerized adaptive test of fine motor skills.Methods: We built an item bank for the computerized adaptive test of fine motor skills using the fine motor subscale of the CDIIT items fitting the Rasch model. We also examined the psychometric properties and efficiency of the computerized adaptive test of fine motor skills with simulated computerized adaptive tests.Results and conclusions: Data from 1742 children with suspected developmental delays were retrieved. The mean scores of the fine motor subscale of the CDIIT increased along with age groups (mean scores = 1.36–36.97). The computerized adaptive test of fine motor skills contains 31 items meeting the Rasch model’s assumptions (infit mean square = 0.57–1.21, outfit mean square = 0.11–1.17). For children of 6–71 months, the computerized adaptive test of fine motor skills had high Rasch person reliability (average reliability >0.90), high concurrent validity (rs = 0.67–0.99), adequate to excellent diagnostic accuracy (area under receiver operating characteristic = 0.71–1.00), and large responsiveness (effect size = 1.05–3.93). The computerized adaptive test of fine motor skills used 48–84% fewer items than the fine motor subscale of the CDIIT. The computerized adaptive test of fine motor skills used fewer items for assessment but was as reliable and valid as the fine motor subscale of the CDIIT.Implications for RehabilitationWe developed a computerized adaptive test based on the comprehensive developmental inventory for infants and toddlers (CDIIT) for assessing fine motor skills.The computerized adaptive test has been shown to be efficient because it uses fewer items than the original measure and automatically presents the results right after the test is completed.The computerized adaptive test is as reliable and valid as the CDIIT.

Prenatal phenolic compounds exposure and neurobehavioral development at 2 and 7 years of age

BackgroundPhenolic compounds such as bisphenol A (BPA), nonylphenol (NP), and octylphenol (OP) are known as endocrine-disrupting compounds and are commonly used. Their impacts on the neurodevelopment of children are inconclusive. The current study aims to investigate the association between umbilical cord blood levels of BPA, NP, OP and neurodevelopmental outcomes at 2 and 7years of age. MethodsThe study was based on the Taiwan Birth Panel Study, a prospective birth cohort. We collected cord blood plasma to measure phenolic compound levels using ultra-performance liquid chromatography-tandem mass spectrometry. In the follow-up, 208 mother-child pairs with 2-year-old children and 148 mother-child pairs with 7-year-old children were recruited in this study. We used the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) and the Wechsler Intelligence Scale for Children (WISC-IV) for neurodevelopmental assessments at 2 and 7years of age, respectively. Multiple linear regressions were used for statistical analysis. ResultsThe detection rates of BPA, NP, and OP were 55.9%, 77.6%, and 68.3%, respectively. In this study, the median BPA, NP, and OP levels in 2-year-olds were 3.3, 72.6, and 3.3 (ng/ml), respectively. However, the median levels of BPA, NP, and OP were 3.2, 49.3, and 6.6 (ng/ml), respectively. The levels of phenolic compounds were log10-transformed for statistical analysis. Gender stratification was performed. In the WISC-IV neurocognitive assessment, we found both a significant negative association and a trend between cord blood plasma BPA levels and full-scale IQ (p for trend<0.01), the verbal comprehension index (p for trend<0.01), and the perceptual reasoning index (p for trend<0.01) in the study population. After stratification by sex, significant associations were found in full-scale IQ (p for trend=0.03) and the verbal comprehension (p for trend<0.01) index in boys. In girls, prenatal BPA exposure had adverse effects on full-scale IQ (p for trend=0.02), perceptual reasoning index (p for trend<0.01), and working memory index (p for trend=0.02). None of the developmental quotients (DQs) of the CDIIT analysis were significantly associated with phenolic compound levels in cord blood based on continuous or categorical measures. ConclusionPrenatal exposure to BPA affects neurocognitive development, and this effect differs between 7-year-old boys and girls. More studies are needed to elucidate the relationship between phenolic compound exposure in utero and children's neurobehavioral development.

Selecting score types for longitudinal evaluations: the responsiveness of the Comprehensive Developmental Inventory for Infants and Toddlers in children with developmental disabilities.

ObjectiveThe objective of this study was to examine the responsiveness of the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) in children with developmental disabilities (DD).MethodsThe responsiveness of a measure is its ability to detect change over time, and it is fundamental to an outcome measure for detecting changes over time. We compared the responsiveness of four types of scores (ie, raw scores, developmental ages [DAs], percentile ranks [PRs], and developmental quotients [DQs]) in the five subtests of the CDIIT. The CDIIT was administrated three times at intervals of 3 months on 32 children with DD aged between 5 months and 64 months (mean =30.6, standard deviation [SD] =17.8). The CDIIT is a pediatric norm-referenced assessment commonly used for clinical diagnosis of developmental delays in five developmental areas: cognition, language, motor, social, and self-care skills. The responsiveness was analyzed using three methods: effect size, standardized response mean, and paired t-test.ResultsThe effect size results showed that at the 3-month and 6-month follow-ups, responsiveness was small or moderate in the raw scores and DAs of most of the subtest scores of the CDIIT, but the level of responsiveness varied in the PRs and DQs. The standardized response mean results of the 3-month and 6-month follow-ups showed that most of the subtest scores of the CDIIT had respectively moderate and large responsiveness in raw scores and DAs, but the responsiveness varied (from no to large) in PRs and DQs.ConclusionThe findings generally support the use of the CDIIT as an outcome measure. We also suggest using the raw scores and DAs when using a norm-referenced pediatric developmental assessment to evaluate developmental changes and program effectiveness in children with DD.

Reliability and Validity of the Revised Individualized Structured Mastery Tasks in Children with Developmental Delay

Objective: Mastery motivation is an under-assessed resiliency factor that helps all children achieves their potential; it impels children to strive to master skills and to solve challenging problems. Because children with developmental delay (DD) are perceived to have lower motivation than children with typical development, it is important to have good behavioural measures of mastery motivation. This research describes psychometric properties of the revised individualized structured mastery tasks (ISMT-R), a behavioral assessment, which was updated based on empirical and theoretical feedback. The purposes of this study were: to examine the test-retest, inter-rater and inter-coding reliabilities of the ISMT-R and the relationships between the ISMT-R and both the Dimensions of Mastery Questionnaire (DMQ 18) and developmental ability measured by a standardized developmental test. Method: The design produced a cross-sectional study. Sixty-two mother-child dyads of children with DD aged 23-43 months were recruited. Children were tested with the ISMT-R (puzzles and cause-effect tasks) and the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT). DMQ 18 was filled out by mothers and produced scores for four persistence scales and mastery pleasure scale. Intraclass Correlation coefficient was used to examine reliabilities, and correlation analysis was used to estimate the validities (α=0.05; two-tailed). Results: The ISMT-R had well to excellent test-retest, inter-rater and inter-coding reliabilities. Children’s persistence at moderately difficult tasks positively correlated with the predicted dimensions of the maternal ratings of the child’s persistence on the DMQ 18 and the child’s development based on the CDIIT. Conclusion: The ISMT-R has acceptable reliability and convergent validity, and can be a useful tool for assessing mastery motivation of children with DD. It also can be used in clinical settings to help clinicians distinguish between motivation and developmental ability for each child with DD.

Mercury, APOE, and children's neurodevelopment

The benefit of the nutritious elements in fish is insufficient for explaining the controversial finding regarding prenatal mercury (Hg) exposure and neurodevelopment; the varying frequency of susceptible genes among these populations may shed light on these observations. However, limited studies have been reported on the association between genetic susceptibility of prenatal Hg exposure and child development. Apolipoprotein E (APOE, protein; Apoe, gene) is a major protein transporter expressed in the brain. The Apoe epsilon 4 (ɛ4) allele is associated with poor neural repair function and is a risk factor associated with Alzheimer disease. We conducted a prospective cohort study in 2004 and 2005. In this study, 168 subjects were recruited at delivery and followed up at two years of age, and genetic polymorphisms of Apoe were included to assess genetic susceptibility and to determine the relationship between Hg concentrations in cord blood and neurodevelopment. The results showed that adverse effects on neurodevelopment were consistently associated with prenatal Hg exposure in all subtests of Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) among ɛ4 carriers as assessed by both simple linear and multiple linear regression models. After controlling for confounding factors, statistical significance was found in the subtests of cognition tests (β=−8.47, 95% confidence interval (CI)=−16.10 to −0.84), social tests (β=−11.02, 95% CI=−20.85 to −1.19) and the whole test of CDIIT (β=−10.45, 95% CI=−17.36 to −3.54) in a multiple linear regression model. Additionally, the interaction effect between gene polymorphisms of Apoe and Hg levels was significant in the whole test CDIIT and subtests of cognition, language and fine motor tests. In conclusion, Apoe modifies the adverse effects of cord blood Hg on neurodevelopment at the age of two years.

In utero exposure to environmental lead and manganese and neurodevelopment at 2 years of age

Background and objectiveManganese, lead, arsenic and mercury are common neurotoxic metals in the environment. Nonetheless, the relationship between prenatal exposure to low doses of neurotoxic metals and neurodevelopment in children is not clear. The objective of this study was to explore the relationship between in utero exposure to environmental neurotoxic metals and neurodevelopment at 2 years of age. MethodsThe population of this study came from the Taiwan Birth Panel Study. We included 230 pairs of non-smoking mothers without any occupational exposure and their singleton full-term children. The information about exposure during pregnancy was obtained using a structured questionnaire, and the manganese, lead, arsenic and mercury levels in umbilical cord blood samples were analyzed using inductively coupled plasma mass spectrometry. We used the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) to evaluate the developmental status of each child at 2 years of age, and we examined the association of in utero exposure to environmental metals and neurodevelopment using linear regression models. ResultsThe median concentrations of manganese, lead, arsenic and mercury in the cord blood samples in this study were 47.90µg/L (range, 17.88–106.85µg/L), 11.41µg/L (range 0.16–43.22µg/L), 4.05µg/L (range, 1.50–12.88µg/L) and 12.17µg/L (range, 1.53–64.87µg/L), respectively. After adjusting for maternal age, infant gender, environmental tobacco smoke during pregnancy and after delivery, Home Observation for Measurement of the Environment Inventory results, and arsenic and mercury levels in cord blood, we found that manganese and lead levels above the 75th percentile had a significant adverse association with the overall (β=−7.03, SE=2.65, P=0.0085), cognitive (β=−8.19, SE=3.17, P=0.0105), and language quotients (β=−6.81, SE=2.73, P=0.0133) of the CDIIT. ConclusionsIn utero exposure to environmental manganese and lead may have an adverse association with neurodevelopment at 2 years of age, and there is an interaction effect between the manganese and lead levels in the cord blood that could aggravate the effect.

Maternal Mobile Phone Use and Children's Neurocognitive Development

Objectives: Today, mobile phone use is common and has increased rapidly in many countries. The health effects of exposure to mobile phone use on children are controversial. We described maternal mobile phone use from pregnancy until the 12 months post-birth and examined the association between exposure to mobile phone use and the children's neurocognitive development in the general population in Taipei, Taiwan. Methods: The study was a part of the Taiwan Birth Panel Study. A total of 133 pairs of parents and their singleton child were recruited into this study. We used the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) and Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) to assess child neurocognitive development. We also assessed the intelligence of the mothers using the Standard Progressive Matrices Plus (SPM+). Mothers completed questionnaires to report their mobile phone use. Regression modeling was used to estimate the association between mobile phone exposure and children's neurocognitive development. Results: Most of the mothers answered less than 3 phone calls per day, and the call duration was less than 3 minutes for each phone call from pregnancy until 12 months post-birth. We found no significant association between maternal mobile phone use and neurocognitive development in young children. Conclusions: There is no convincing evidence that maternal mobile phone use has an adverse effect on the neurocognitive development of young children. Prospective research using a personal exposure assessment is needed to elucidate a causal relationship.

Mobile phone use and early-childhood neurodevelopment at 2 years of age

Background and aims: This study was to examine the association between prenatal and postnatal mobile phone use exposure and early-childhood neurodevelopment in two-year-old children from the general population in Taipei, Taiwan. Methods: The study was a part of the Taiwan Birth Panel Study. A total of 150 pairs of parents and their singleton child were selected into this study. We used the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) to assess child neurodevelopment at two years of age. The CDIIT was used to assess development in the areas of cognition, language, motor (including gross motor and fine motor), social, and self-help of children. Exposure to mobile phone was reported on a questionnaire. Regression model was used to estimate the association between mobile phone exposure and children’s neurodevelopment. Results: In logistic regression models, there aren’t any significant associations in all the eight domains of the CDIIT. The adjusted OR was 1.1 (95% CI: 0.3-3.5) for motor during 7 months of gestation to birth, and the adjusted OR for gross motor and fine motor were 1.2 (95%CI: 0.4-3.6) and 0.7 (95%CI: 0.1-3.6), respectively in the early-childhood neurodevelopment at 2 years. Conclusions: In this study, we didn’t find any significant association between prenatal and postnatal mobile phone use exposure and early-childhood neurodevelopment in two-year-old children. However, research on the negative effect of mobile phone use and neurodevelopment is still scanty. Therefore, the further association of mobile phone use and neurodevelopment is needed to explore.

Construct validity of the Comprehensive Developmental Inventory for Infants and Toddlers

The aim of this study was to investigate the construct validity of the diagnostic test, the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT). A total of 1085 children in four age groups (infant, 1-year-old, 2-year-old, preschool age) were enrolled. The Developmental Quotient of each subdomain of the five CDIIT subtests (Cognition, Language, Motor, Social, and Self-help) was used as the basic unit for factor analysis with the iterative principle factor method and promax rotation. The two-factor solution in two younger age groups and 2- or 3-factor solutions in the 2-year-old and preschool groups provided superior factor structure in terms of interpretability and compatibility with existing child development theories. Although five constructs were proposed in the original manual of CDIIT, two to three constructs were revealed in this empirical study.

Applying data mining to explore the risk factors of parenting stress

High parenting stress has been shown to be associated with illness, poor marital relationships, and child abuse. It is thus important to detect and reduce the stress early. Numerous situational, socioeconomic, child, and parent factors contribute to parenting stress. However, regression analysis, the traditional method of exploring risk factors in medicine and social science, has the limitation of not showing the classification, nor exploring unknown potentional factors. Hence, the goal of this study is to explore the risk factors of parenting stress using data mining with decision tree C5.0, to obtain more information. The data are from a professional research group, TBPS, in the National Taiwan University. A total of 206 mother-term born child dyads were recruited to complete the measures of the Parenting Stress Index (PSI), the Child Behaviour Checklist (CBCL), the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT), and the Chinese Toddler Temperament Scale (CTTS), and so this database includes thousands of variables. The study results indicate that a child development problem, CDIIT, is the major contributing factor to parents with the highest stress, the 90% parenting stress group. For the 80%, 70%, and 60% parenting stress groups, the behavioural problem of children, CBCL, is the major factor causing parenting stress. The data mining decision tree showing the classification route of risk factors is better than the regression model at detecting the significant factors. The findings in this work are considered helpful references for medical staff and social workers to help parents prevent and reduce their parenting stress and thus promote health.

Concurrent Validity in Taiwan of the Comprehensive Developmental Inventory for Infants and Toddlers Who Were Full-Term Infants

This study investigated the concurrent validity of the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) with the Bayley Scales of Infant Development-II (BSID-II) in full-term infants. 106 full-term infants ages 6 to 18 months (63 boys, 43 girls) were recruited as a convenience sample. One tester administered the CDIIT and BSID-II to all children. The Developmental Ages and Developmental Quotients of the motor and the mental scales from both tests were analyzed with Pearson correlations and quadratic weighted kappa tests. The results showed that correlation coefficients for Developmental Ages between both tests on cognitive and motor subtests were high (r = .91-.95) and for Developmental Quotients were moderate (r = .57-.67). Moderate classification agreement was found in the two scales (quadratic weighted kappa = .50-.53). Developmental Quotients classification for the CDIIT tended to be a little higher than for the BSID-II. It was concluded that although acceptable concurrent validity was found for the Motor and Cognitive subtests of the CDIIT, the tester should be cautious to compare Developmental Quotients obtained from the above two tests in clinical or in research settings.

CYP1A1 Ile462Val and GSTT1 modify the effect of cord blood cotinine on neurodevelopment at 2 years of age

Maternal exposure to environmental tobacco smoke (ETS) has been reported to be associated with children's neurobehavioral development but there was no studies investigating the genetic susceptibilities to maternal ETS exposure on children's neurodevelopment. The aim of the study was to explore the modification effect of metabolic gene polymorphisms to cord blood cotinine on children's neurodevelopment at the 2 years of age. This study is one investigation of the Taiwan Birth Panel Study and a total of 145 pregnant women and their neonates were recruited between April 2004 and January 2005. We interviewed them by a structured questionnaire after delivery and collected umbilical cord blood at birth. Cotinine in umbilical cord blood as an indicator of environmental tobacco smoke was analyzed by using HPLC–MS/MS and the detection limited of this method was 0.05 ng/mL. Four metabolic genes, CYP1A1 MspI, CYP1A1 Ile462Val, GSTT1 and GSTM1 were identified. The Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) was used for assessing children's neurodevelopment at the 2 years of age accompanying with the measurement of Home Observation for Measurement of the Environment scale. We used multiple linear regression models to estimate the effects of cord blood cotinine and gene modification. Cotinine levels were significantly negatively associated with developmental quotients (DQs) of the whole test, and cognitive, language, fine-motor and social subtests of the CDIIT. Lower cognitive and language DQs were found in exposed group with absent type of GSTT1. In addition, the lowest scores in fine-motor and whole test DQs were detected in exposed group with CYP1A1 Ile462Val variant type and GSTT1 absent type. It can be concluded that CYP1A1 Ile462Val and GSTT1 metabolic genes can modify the effect of cord blood cotinine on early child neurodevelopment especially for language and fine motor development.

P1-120 Influential factors of the development in infants and toddlers application of the “International Classification of Functioning, Disability and Health” framework

Objective: The Structural Equation Modeling (SEM) analysis was conducted based on “International Classification of Functioning, Disability and Health”(ICF) framework to examine the multiple factors relating to general development of infants and toddlers. Methods: The health condition at birth and family characteristics of 122 infants born at National Taiwan University Hospital were collected during the period between May and October in 2004. Scores of the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) at 6 months and toddler stage served as the outcomes and represented the domain of activities and participation in the ICF

Concurrent validity of the Comprehensive Developmental Inventory for Infants and Toddlers with the Bayley Scales of Infant Development-II in preterm infants.

The Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) is a new developmental test designed in Taiwan and lacks concurrent validity information. This study investigated the concurrent validity of the CDIIT with the Bayley Scales of Infant Development-II (BSID-II) in preterm infants aged 6-18 and 21-40 months, respectively. We recruited 160 preterm infants (84 boys, 76 girls) with a corrected age of 6-18 months and followed them up until 21-40 months of age. One tester administered the CDIIT and BSID-II to all infants. Developmental ages (DAs) and developmental quotients (DQs) from both tests were analyzed with Pearson correlation and kappa tests. Correlation coefficients for DAs and DQs between the 2 cognitive and motor subtests and classification agreements were high at 6-18 months (r = 0.80-0.97; kappa = 0.80, 0.85) and moderate to high at 21-40 months (r = 0.60-0.77; kappa = 0.44, 0.57). DQ classification for the CDIIT motor subtests tended to be higher than for the BSID-II motor scales at 21-40 months. In preterm infants, concurrent validity between the motor and cognitive subtests of the CDIIT and the BSID-II was acceptable. The CDIIT can be thus used in clinics for the early identification of developmental delay in infants and toddlers.