Childhood Developmental Disorders Research Articles

НАРУШЕНИЯ НЕВРОЛОГИЧЕСКОГО РАЗВИТИЯ ДЕТЕЙ, РОЖДЕННЫХ НЕДОНОШЕННЫМИ

There has been a shift in the spectrum of diseases in preterm infants recorded recently: a significant improvement in survival rates has been achieved as well as a decrease in severe forms of cerebral palsy. However, many children born prematurely show manifestations of CNS developmental disorders, which include motor, cognitive and behavioral disorders. Premature birth leads to a slowdown and distortion of neuroontogenesis. The article deals with the morphophysiological prerequisites for neurological development disorders in children born prematurely. The bibliographical data and own studies of neurological disorders and deviations in neuropsychic development in 122 children aged 5 to 8 y/o born prematurely with Extremely low body weight (500 to 999 g, GA 25 to 30 weeks), VLBW (1000 to 1499 g, GA 28 to 33 weeks) and LBW (1500 to 2499 g, GA 31 to 36 weeks) were analyzed. The mechanisms and frequency of occurrence in prematurely born children of violations of general intellectual development, speech, schooling skills, attention deficit and hyperactivity disorder, autism, dyspraxia, tics, tension headache, anxiety and behavioral disorders are discussed. Under conditions of cerebral damage in the developing brain the neuroplasticity - a process of biological adaptation associated with the structure and functional reorganization of the CNS - acquires decisive importance. The developing brain has high neuroplasticity and significant reserve capabilities, which provide the ability of the elements of the nervous tissue for adaptive restructuring and compensatory (restorative) capabilities of the brain.

Measuring children's sustained selective attention and working memory: validity of new minimally linguistic tasks.

This study introduces visual tasks using nonlinguistic stimuli that measure sustained selective attention (SSA) and working memory (WM), two constructs foundational to learning and associated with developmental disorders in children. Using an argument-based approach to validation, we examine whether each task (a) measures distinct constructs, (b) shows internal consistency, (c) captures a range of performance, and (d) relates to development as indexed by age. Participants included 71 children, ages 4-10, of whom 12 had parental concern for language/learning. The SSA task presented spatial locations within a long and uninteresting task, following the continuous performance task paradigm. The WM task presented paired location sequences of increasing length, incorporating key elements of the n-back and complex span paradigms. Controlling for age, tasks were found to be minimally associated with each other (r = .26), suggesting related but distinct constructs. Internal consistency was high, with split-half reliability of .94 (SSA) and .92 (WM); the stability of these estimates was supported by bootstrapping simulations. Task performance was evenly distributed, with minimal floor or ceiling effects within this age range. Performance was positively related to age (SSA r = .49; WM r = .53). Exploratory correlations with a measure of parental concern were significant for SSA but not WM. The results show that these new tasks can be used to measure children's SSA and WM in a visual domain with minimal linguistic influence. These tasks capture developmental changes in the early school years. Further investigation can examine their utility for classifying children with developmental disorders.

Literature Review : Feeding Comfort With Stunting Problems in Toddlers

The poor practice of complementary feeding (MPASI) is one of the most common problems in developing countries. This can lead to poor absorption of nutrients, especially protein, which is associated with problems related to physical growth disorders such as stunting in children under the age of 5 years. This study used a cross-sectional design intending to clarify the relationship between complementary feeding practices and the risk of stunting in children aged 6 to 12 months from Central Lombok. It was an analytical observational study. A total of 206 children with an average age of 9.3 months were selected as the subjects of this study using cluster sampling. Most of them are women. This study analyzed four parameters of the practice of giving complementary foods, namely the age of the first time complementary foods, types of complementary foods, the frequency of complementary foods, and the frequency of complementary foods. This study found a significant relationship between the frequency of complementary feeding (p=0.047, 95%CI) and the number of complementary foods given (p = 0.020, 95% CI) with the risk of developmental disorders in children. On the other hand, other parameters such as age at initiation of complementary foods and solid food texture were not significantly associated with the risk of growth retardation. One of the factors that directly affect stunting in children under the age of 2 years is intake factors such as breast milk (ASI) and breast milk supplements (MPASI).

Prevalence and treatment of mental, behavioral, and developmental disorders in children with co-occurring autism spectrum disorder and attention-deficit/hyperactivity disorder: A population-based study.

There is a lack of nationally representative studies examining the co-occurrence of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) in children. This study examines comorbid mental, behavioral, and developmental disorders (MBDDs) and associated treatment modalities for children with co-occurring ASD and ADHD. Cross-sectional analyses were conducted using data from the pooled 2016-2018 National Survey of Children's Health (sample n=102,341). Nationally representative prevalences were estimated for sociodemographic variables, comorbidities, psychotropic medication, and behavioral treatment. We assessed multivariable associations between co-occurring ASD + ADHD and MBDDs, use of psychotropic medication, and receipt of behavioral treatment after adjustment for sociodemographic confounders. Compared to children with ASD without co-occurring ADHD, children with ASD + ADHD had higher prevalence of most MBDDs, including anxiety (AOR 4.03 [95% CI 2.77, 4.87]), depression (AOR 3.08 [95% CI 1.77, 5.36]), behavior or conduct problems (AOR 4.06 [95% CI 2.72, 6.06]), and other mental health conditions. Similarly, compared to children with ADHD without ASD, children with ASD + ADHD had higher odds of anxiety (AOR 3.49 [95% CI 2.65, 4.61]), depression (AOR 1.67 [95% CI 1.21, 2.29]), behavior or conduct problems (AOR 2.31 [95% CI 1.68, 3.17]), and other mental health conditions. Children with ASD + ADHD were significantly more likely to take psychotropic medication than children with ASD without ADHD. Among children with ASD + ADHD, males had higher odds of receiving behavioral treatment, whereas older children and adolescents were more likely to take psychotropic medication. A multidisciplinary approach is necessary to support the complex needs of these children.

An exposome connectivity paradigm for the mechanistic assessment of the effects of prenatal and early life exposure to metals on neurodevelopment.

The exposome paradigm through an integrated approach to investigating the impact of perinatal exposure to metals on child neurodevelopment in two cohorts carried out in Slovenia (PHIME cohort) and Greece (HERACLES cohort) respectively, is presented herein. Heavy metals are well-known neurotoxicants with well-established links to impaired neurodevelopment. The links between in utero and early-life exposure to metals, metabolic pathway dysregulation, and neurodevelopmental disorders were drawn through urinary and plasma untargeted metabolomics analysis, followed by the combined application of in silico and biostatistical methods. Heavy metal prenatal and postnatal exposure was evaluated, including parameters indirectly related to exposure and health adversities, such as sociodemographic and anthropometric parameters and dietary factors. The primary outcome of the study was that the identified perturbations related to the TCA cycle are mainly associated with impaired mitochondrial respiration, which is detrimental to cellular homeostasis and functionality; this is further potentiated by the capacity of heavy metals to induce oxidative stress. Insufficient production of energy from the mitochondria during the perinatal period is associated with developmental disorders in children. The HERACLES cohort included more detailed data regarding diet and sociodemographic status of the studied population, allowing the identification of a broader spectrum of effect modifiers, such as the beneficial role of a diet rich in antioxidants such as lycopene and ω-3 fatty acids, the negative effect the consumption of food items such as pork and chicken meat has or the multiple impacts of fish consumption. Beyond diet, several other factors have been proven influential for child neurodevelopment, such as the proximity to pollution sources (e.g., waste treatment site) and the broader living environment, including socioeconomic and demographic characteristics. Overall, our results demonstrate the utility of exposome-wide association studies (EWAS) toward understanding the relationships among the multiple factors that determine human exposure and the underlying biology, reflected as omics markers of effect on neurodevelopment during childhood.

ОСОБЕННОСТИ ОРГАНИЗАЦИИ ОБУЧЕНИЯ АНГЛИЙСКОМУ ЯЗЫКУ ДЕТЕЙ СТАРШЕГО ДОШКОЛЬНОГО ВОЗРАСТА С ЗАДЕРЖКОЙ ПСИХИЧЕСКОГО РАЗВИТИЯ

Mental retardation is one of the most common mental development disorders in children. According to various data, about 3% of preschool children have developmental disorders of the delay type. In addition, it is difficult to establish the number of children with cognitive developmental features who do not have an established diagnosis. Such children enter the system of general education, including preschool, where they face the need to learn English. Some experts insist that due to the specifics of mental development, the study of foreign languages should be postponed until the time of normalization of higher mental functions. However, as demonstrated in the article, the study of a foreign language already at the senior preschool age can be quite successful. And not just to form a child’s skills in a new language, but also to say favorably on the development of cognitive skills in general. The paper shows that despite the low level of readiness to learn English, subject to certain rules and recommendations, taking into account the specifics of the structure of the mental retardation defect, creating special educational conditions, children with mental retardation can successfully learn English. It also presents the program for teaching English speaking skills (elementary skills of monologue and dialogic speech) for children of senior preschool age with developmental delay. The program was implemented by the group of children attending kindergarten; the results of the implementation are also presented in the article. The results were obtained that children of senior preschool age with mental retardation are able to successfully master elementary speaking skills (elementary skills of monologue and dialogical speech) in English with a special organization of the educational process within the framework of the preschool educational institution.

DETERMINAN FAKTOR RISIKO STUNTING PADA BALITA DETERMINANTS OF STUNTING RISK FACTORS IN TODDLERS

Stunting is a nutritional problem characterized by chronic growth and development disorders in children, has an impact on the physical (short/dwarf stature), and interferes with brain development, affecting children's abilities and achievements, productivity, and creativity. Based on SSGI data for 2021 in North Tapanuli Regency, the percentage of stunting is around 26.7% of the number of children under five. This figure is still below the national stunting rate target of below 24%. The purpose of this study was to determine the risk factors associated with stunting. This analytic cross-sectional study was conducted from February to April 2022. The sample in this study consisted of 96 toddlers divided into 2 groups, namely the toddler group with stunting of 48 people and the group of toddlers with normal nutritional status of 48 people. Sampling was taken by purposive sampling, namely those who came to be brought by their mothers to monitor growth and development at posyandu in the North Tapanuli Regency area. The inclusion criteria were toddlers aged 24-59 months, domiciled in North Tapanuli Regency, lived with their parents, and had a mother and child health record book (KIA). Data were obtained using questionnaires, and the MCH handbook and based on the results of anthropometric examinations. Based on the results of logistic regression, it showed that the most dominant risk factor was a history of chronic infection in toddlers with stunting (OR=24.8; 95% CI 4.43 - 140.11; p<0.000), mother's knowledge (OR=18.2; 95%CI 3.62 – 91.24;p<0.000), history of exclusive breastfeeding (OR=10.7; 95%CI 2.15 – 53.92;p<0.004) and maternal weight during pregnancy (OR = 8.1; 95% CI 1.62 – 40.36; p <0.01). It is hoped that the active participation of the family, especially mothers of toddlers, will prevent stunting by fulfilling nutrition during pregnancy and nutrition for toddlers, preventing chronic infections, and provide exclusive breastfeeding.

Bulan Imunisasi Anak Nasional: Imunisasi Penting Untuk Kekebalan dan Cegah Stunting

<span lang="EN-US">The problem of stunting in Indonesia is a serious threat that requires appropriate treatment to overcome developmental disorders in children caused by poor nutrition, repeated infections, and inadequate psychosocial simulation. The Stunting Reduction Program to 14% in 2024 is a program for the government and the people of Indonesia in the midst of this pandemic. Moreover, the activities at the Integrated Service Post (Posyandu) as the main milestone for monitoring the growth and development of toddlers in a smaller area are seen to be less than optimal. Economic conditions in Indonesia during the pandemic showed that poverty and unemployment rates were increasing, thus affecting the increase in the prevalence of stunting in Indonesia, this is because a person's economic condition affects the nutritional intake and nutrition he gets. The incidence of stunting in those who were not immunized was doubled compared to those who were fully immunized. In complete immunization about 10%, which is not immunized 21.1%. This shows that there is a relationship between immunization and stunting. The basic contribution of this program is the transfer of knowledge and the success of the National Child Immunization Month to reduce the number of stunting in Pandeglang Regency. The method of implementation is through three stages, namely the preparation stage and the implementation stage, as well as the evaluation stage. The preparation stage is the stage of preparing all data on children receiving immunizations and mothers as the main actors in preventing stunting. The implementation stage is in the form of immunization and health education regarding Stunting Prevention with the Success of National Child Immunization Month. Then, the evaluation stage becomes the final stage which examines deficiencies both in pre and post activities. The conclusion from community service is that the high stunting rate can be reduced by immunization.</span>

What Is the Evidence for Dietary-Induced DHA Deficiency in Human Brains?

Docosahexaenoic acid (DHA) is a major constituent of neural and visual membranes and is required for optimal neural and visual function. DHA is derived from food or by endogenous synthesis from α-linolenic acid (ALA), an essential fatty acid. Low blood levels of DHA in some westernised populations have led to speculations that child development disorders and various neurological conditions are associated with sub-optimal neural DHA levels, a proposition which has been supported by the supplement industry. This review searched for evidence of deficiency of DHA in human populations, based on elevated levels of the biochemical marker of n-3 deficiency, docosapentaenoic acid (22:5n-6). Three scenarios/situations were identified for the insufficient supply of DHA, namely in the brain of new-born infants fed with high-linoleic acid (LA), low-ALA formulas, in cord blood of women at birth who were vegetarians and in the milk of women from North Sudan. Twenty post-mortem brain studies from the developed world from adults with various neurological disorders revealed no evidence of raised levels of 22:5n-6, even in the samples with reduced DHA levels compared with control subjects. Human populations most likely at risk of n-3 deficiency are new-born and weanling infants, children and adolescents in areas of dryland agriculture, in famines, or are refugees, however, these populations have rarely been studied. This is an important topic for future research.

DC:0-5™ Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood: Promotion in Russia.

The purpose of the report is to inform the community of Russian pediatric mental health professionals about the international DC:0-5™ Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood: its purpose, target age, structure and content of diagnostic axes, as well as about the steps already taken domestically to promote the Classification in Russia. We show that the diagnostic Classification is the brainchild of leading foreign experts in the mental health of children and that it is based on an analysis and extrapolation of a large body of clinical data from around the world and covers a wide range of mental disorders experienced by children during their first five years of life. The interdisciplinary focus of DC:0-5™ is emphasized, as well as the presence in it of a crosswalk to the DSM-5 and ICD-10 systems, and the possibility to supplement these classifications taking into account the age specificity of disorders. It was made note that this diagnostic classification is almost unknown among Russian specialists. The report briefly touches on the results of the research activities of the interdisciplinary research group of the Scientific Center for Mental Health (Moscow) carried out in the period between 2002 and 2017 and aimed at analyzing the diagnostic approaches proposed in the Classification and testing them on Russian sample populations. The release of the Russian version of DC:0-5™ in 2022 by the non-profit organization Caritas Social School (St. Petersburg), with the official consent of the DC:0-5™ developer and in cooperation with the Faculty of Psychology of St. Petersburg State University, and an accompanying DC:0-5™ introduction course developed by this team for Russian child mental health professionals were announced.

Educational Strategy for Speech Delay Therapy During The Covid-19 Pandemic

Background: Children might be affected by speech delay, which is a sort of developmental problem. The tiny one's speech is delayed in this situation. In a nutshell, speech delay occurs when a child's speech abilities do not develop in accordance with their age. Children with this condition require ongoing diagnosis and treatment. Due to limited access and limits on community activities, Covid-19, which affects the rhythm of human existence, also impacts the type, application, and approach of therapy.
 Methods: This research is a descriptive study. Following the objectives of the study, research subjects used secondary data from the Global Research on Developmental Disabilities Collaborators, who recognized developmental disabilities in 195 nations during the last 26 years, to meet the study's aims (1990-2016)
 Results: The number of developmental disorders in children under the age of five years in Indonesia declined between 1990 and 2016, with 1,710,437 cases in 1990 and 1,707. 335 cases in 2016. Indonesia has consistently been in the top ten countries in the world for developmental disability causes. Indonesia ranks fifth in the world in terms of congenital epilepsy, vision loss, and autism, ninth in terms of intellectual disability and ADHD, and seventh in terms of hearing loss. In Indonesia, efforts were made to put limits on communal activities, which are frequently abbreviated as PPKM. The number of incidents that occur in each location, which is classified using the risk zoning map, has an impact on the PPKM level
 Conclusions: The application of limits on community activities should not prevent children with developmental abnormalities (particularly speech delays) from getting motor development therapy. So that continuous treatment efforts are not inhibited, strategies and innovations must be introduced.

Constructing the ADHD Child in Historical Children’s Literature

In this article, debates around ideas of childhood and disability will be engaged through the close reading of the retrospective diagnosis of a child with ADHD in an early work of German children’s literature (also widely translated, including into English in 1848), Heinrich Hoffmann’s poem Struwwelpeter. ADHD is one of the most widely diagnosed and medicated childhood developmental disorders of the present day. At the same time, recent debates have raised questions about the diagnostic criteria, the potential side effects and efficacy of medication, and the impact of the current political context on the diagnosis and treatment of ADHD. Drawing on Michel Foucault’s classic arguments about bio-power (2008), as well as the most recent work of critical psychology on childhood developmental disorders, the article draws out both how retrospective diagnoses of ADHD and other disorders, including Autistic Spectrum Disorder (ASD), are defined by current criteria within the political context of the current psychological, cultural, and medical controversies.

KẾT QUẢ GIÁO DỤC HÀNH VI CHO MỘT TRƯỜNG HỢP HỌC SINH RỐI LOẠN TĂNG ĐỘNG GIẢM CHÚ Ý HỌC HÒA NHẬP Ở ĐẦU CẤP TIỂU HỌC

Attention Deficit Hyperactivity Disorder (AD\HD) is a common developmental disorder in children and significantly affects their development. The most commonly cited characteristics of students with AD\HD are hyperactivity, inattention, and difficulty in control. In inclusive primary class, students with AD\HD have such behaviors: Difficulty in complying with regulations, inattention when studying, and weak organizational skills,... These behaviors make it difficult for students with AD\HD to participate in playing and learning activities in inclusive class. This study’s results show that behavioral education is effective, helping to reduce inappropriate behaviors, enhance appropriate behaviors and improve learning outcomes of students with AD\HD at the first stage of inclusive primary education.

Evaluating the Safety and Efficacy of Transcranial Pulse Stimulation on Autism Spectrum Disorder: A Double-Blinded, Randomized, Sham-Controlled Trial Protocol

Autistic spectrum disorder (ASD) is a common developmental disorder in children. The latest non-intrusive brain stimulation (NIBS) technology-transcranial pulse stimulation (TPS)-has been proven effective in older adults with mild neurocognitive disorders and adults with major depressive disorder. Nonetheless, there is so far no robust randomized controlled trial (RCT) conducted on adolescents with ASD nationwide. This study proposes a two-armed (verum TPS group vs. sham TPS group), double-blinded, randomized, sham-controlled trial. Both groups will be measured at four timepoints, namely, baseline (T1), 2 weeks immediately after post-TPS intervention (T2), and at the 1-month (T3) and 3-month (T4) follow-ups. Thirty-four subjects, aged between 12 and 17, diagnosed with ASD will be recruited in this study. All subjects will be computerized randomised into the verum TPS group or the sham TPS group on a 1:1 ratio. All subjects will undertake functional MRI (fMRI) before and after the 2-weeks TPS interventions, which will be completed in 2 weeks' time. This will be the first RCT evaluating the efficacy of TPS adolescents with ASD in Hong Kong. Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT05408793.

T-BOT as an Effort to Overcome Speech Delay in Children

Speech is a developmental stage that begins in infancy. The speech stage must be considered as early as possible, because it can be used as a parameter or benchmark for the presence or absence of developmental disorders in children. Based on the results of the Observation and Research of Literature Studies conducted, speech delay or speech delay is a phenomenon that is often found in today's society, especially in the digital world as it is now. Based on the research obtained, parents (both father and mother) currently do not have quality time with their children because they are busy working and dominated by smartphones. Currently, there are many speech therapy practices, both opened independently by doctors and in hospitals. However, there are some parents who say that their children experience stress when they are brought to a therapy place because they feel threatened or afraid of the atmosphere in a therapy place that is foreign to them. There are studies that reveal that speech delay can also be done at home. The causes of speech delay are children who have too much screen time, are rarely invited to interact in two directions, and lack of stimulus from family or closest people.
 The purpose of making T-BOT or (Talking Robot) is as an effort to overcome and can be speech therapy for children from the age of 1.5 years by inputting various vocabulary, compound sentences consisting of 2 words, 3 words to 1 structured sentences. The existence of this T-BOT will be the first alternative for parents to help provide speech therapy for children at home and of course children do not feel pressured and feel more comfortable playing while practicing their speaking skills with the T-BOT. The output produced is in the form of a robot that provides information in the form of voice in Indonesian as the mother tongue of our country. The child's speech development will also be evaluated to see how effectively the T-BOT is working.

New Electrographic Marker? Evaluation of Sleep Spindles in Children with Attention Deficit Hyperactivity Disorder.

Introduction: Attention deficit and hyperactivity disorder (ADHD) is one of the most common developmental disorders in childhood which lasts lifelong. Sleep structure and sleep spindle features are disorganized in ADHD. In this study, we aimed to look for a new, simple, inexpensive, and an easily detectable electrographic marker in the diagnosis of ADHD by using electroencephalography (EEG). Method: We included treatment free 35 patients with ADHD and 32 healthy children (HC) who were examined by polysomnography (PSG) and EEG for sleep disorders. The ADHD group were separated into three groups according to predominant presentations of ADHD. We determined the sleep staging and slow and fast sleep spindles, calculated each spindle's amplitude, frequency, activity, duration and density at non rapid eye movement (REM) sleep stage 2. Results: Slow sleep spindle's amplitude, duration, density and activity are significantly higher in ADHD group (most significant in ADHD-I) than the HC group (p < 0,05). Sleep spindle's features are not statistically significant between in ADHD subgroups. Conclusions: In children with ADHD, slow sleep spindles showed higher amplitude, activity, density and duration in the frontal regions. These results indicate that slow sleep spindles in children with ADHD may reflect executive dysfunction and slow frontal spindles may be useful as a new electrographic marker in children with ADHD. This is the first study of its kind evaluating all aspects of sleep spindles in ADHD patients.

Description of Total Vitamin D25-Oh in Toddlers and Children With Developmental Disorders

The age of children is a period in which the process of growth and development takes place. The existence of growth and development disorders in children is a serious problem for both developed and developing countries worldwide. The importance of monitoring growth and development requires adequate nutrition and nutrition, one of which is vitamin D. Vitamin D is a prohormone that plays an important role in the absorption of calcium in the intestine and helps harden bones by regulating the availability of calcium in the blood. This study aims to describe Total Vitamin D 25-OH in toddlers and children with growth and developmental disorders. The research sample was determined by purposive sampling technique based on inclusion and exclusion criteria. The research was conducted at Prodia Kramat Clinical Laboratory in March-April 2021. The D 25-OH level was checked from the patient's serum using the DiaSorin Liaison XL tool. Other variables measured to determine vitamin D status are appetite, eating frequency, nutritional adequacy, consumption of vitamin D supplements, outdoor activity, sunbathing, and genetic and environmental risk factors. Data from the examination of total vitamin D 25-OH levels and vitamin D status of the respondents were analyzed descriptively, then displayed in a table and described. The results showed that most respondents who were examined experienced stunting expected growth and development disorders by 76%, with total vitamin D 25-OH status experiencing insufficiency of 53% .

Technology-assisted task-sharing to bridge the treatment gap for childhood developmental disorders in rural Pakistan: an implementation science case study

BackgroundAs in many low-income countries, the treatment gap for developmental disorders in Pakistan is nearly 100%. The World Health Organization (WHO) has developed the mental Health Gap Intervention guide (mhGAP-IG) to train non-specialists in the delivery of evidence-based mental health interventions in low-resource settings. However, a key challenge to scale-up of non-specialist-delivered interventions is designing training programs that promote fidelity at scale in low-resource settings. In this case study, we report the experience of using a tablet device-based application to train non-specialist, female family volunteers in leading a group parent skills training program, culturally adapted from the mhGAP-IG, with fidelity at scale in rural community settings of Pakistan.MethodsThe implementation evaluation was conducted as a part of the mhGAP-IG implementation in the pilot sub-district of Gujar Khan. Family volunteers used a technology-assisted approach to deliver the parent skills training in 15 rural Union Councils (UCs). We used the Proctor and RE-AIM frameworks in a mixed-methods design to evaluate the volunteers’ competency and fidelity to the intervention. The outcome was measured with the ENhancing Assessment of Common Therapeutic factors (ENACT), during training and program implementation. Data on other implementation outcomes including intervention dosage, acceptability, feasibility, appropriateness, and reach was collected from program trainers, family volunteers, and caregivers of children 6 months post-program implementation. Qualitative and quantitative data were analyzed using the framework and descriptive analysis, respectively.ResultsWe trained 36 volunteers in delivering the program using technology. All volunteers were female with a mean age of 39 (± 4.38) years. The volunteers delivered the program to 270 caregivers in group sessions with good fidelity (scored 2.5 out of 4 on each domain of the fidelity measure). More than 85% of the caregivers attended 6 or more of 9 sessions. Quantitative analysis showed high levels of acceptability, feasibility, appropriateness, and reach of the program. Qualitative results indicated that the use of tablet device-based applications, and the cultural appropriateness of the adapted intervention content, contributed to the successful implementation of the program. However, barriers faced by family volunteers like community norms and family commitments potentially limited their mobility to deliver the program and impacted the program’ reach.ConclusionsTechnology can be used to train non-specialist family volunteers in delivering evidence-based intervention at scale with fidelity in low-resource settings of Pakistan. However, cultural and gender norms should be considered while involving females as volunteer lay health workers for the implementation of mental health programs in low-resource settings.

INCREASING EARLY DETECTION OF CHILDHOOD GROWTH DISORDERS WITH CHRONIC DISEASES IN COVID-19 ERA

Impaired growth is still a problem that needs attention in Indonesia. There are still many incidents of children with short stature due to lack of nutrition, undernourished toddlers, and even malnutrition. Therefore, the detection of child growth still needs to be improved. The Covid-19 pandemic has made parents of patients afraid and anxious to take their children to health facilities, so that monitoring of their growth is neglected, especially in pediatric patients with chronic diseases. This community service activity is intended to provide training to parents of patients on how to measure anthropometric status in pediatric patients with chronic diseases so that parents are expected to be able to screen or detect growth disorders early and independently. Therefore, education and training are held with the aim of increasing the knowledge and skills of parents in examining the anthropometric status of children. Evaluation is done by asking questions and practicing anthropometric status checks at the beginning and end of the activity and good numbers of material uptake by participants are obtained so that participants can independently assess the child's anthropometric status and get an increase in skills. The knowledge of the patient's parents about awareness of growth and development screening is still lacking so that it can affect the detection of developmental disorders in children. With this activity, it can provide the ability of the patient's parents to equip themselves to monitor the growth of their child.

HIGH-INTENSITY OF GADGET USE INCREASES “CAUTIONS” TOWARD PRESCHOOL CHILDREN DEVELOPMENT

Development is an ongoing process and related to functional matters. One of the factors influencing development is the environment. Excessive and uncontrolled use of gadgets can adversely affect children's motor development, social abilities and communication. This study aims to analyze the relationship between the intensity of gadget use to social personal development, fine motor, gross motor and language in preschool age children (3-6 years). The study subjects were 135 children aged 36 to 72 months. Sampling is done by Purposive Sampling technique. Data retrieval using Denver II Sheet (which has been adapted for use in Indonesia) for early detection examination of child developmental disorders. The results of the study obtained the type of gadgets used by children: 82.5% smartphones, 4.4% tablets, 5.2% smartphones and tablets, 5.2% smartphones and laptops. Based on the type of application used: 8.1% learn (reading, writing, etc.), 35.6% video, 45.9% games and 10.9% puzzles. Meanwhile the intensity of gadget use in preschoolers was obtained 27.4% low intensity, 32.6% medium intensity and 40.0% children using gadgets with high intensity. Chi-square test results showed social personal development p 0.000; fine motor p 0.001; gross motor p 0.069 and language p 0.000.The conclusion of this study is the intensity of gadget use related to the development of social personal, fine motor and language in preschool children (36-72 months).