Developmental Assessment Scale For Indian Infants Research Articles

CDC Kerala 3: At-risk baby clinic service using different screening tools--outcome at 12 months using Developmental Assessment Scale for Indian Infants.

To describe CDC Kerala experience of establishing an at-risk baby clinic and the comparison of different developmental screening tools at 12 mo against the gold standard Developmental Assessment Scale for Indian Infants (DASII). At risk baby clinic of CDC, Kerala was established as a facility for follow up of NICU graduates from Sree Avittam Thirunal Hospital at 2, 4, 6, 8 and 12 mo corrected age and during each visit the mother is taught the CDC model early stimulation by developmental therapists and encouraged to continue to do the same at home. At 12 mo, assessment results of four simple developmental tools were compared with the gold standard DASII administered by a senior developmental therapist. Out of a total of 800 babies, outcome measurements at 12 mo were available for 604 infants. The prevalence of developmental delay using the screening tools, CDC grading for standing, Amiel Tison angles and DDST II (Denver II) gross motor were 24.8, 24 and 24.3% respectively and using DASII, a diagnostic tool (13.3%). Also the combination of Amiel Tison angles, CDC standing grading and DDST gross motor against DASII motor DQ had high specificity (94.15%) and negative predictive value (NPV) (70.18%) but with a very low sensitivity of 14.58% and low positive predictive value (PPV) of 53.85%. It was observed that a significant odds ratio for DASII mental deviation quotient (DQ) was seen for neonatal seizures (2.34) and low birth weight (1.49). The prevalence of developmental delay using the screening tools, CDC grading for standing, Amiel Tison angles and DDST II (Denver II) gross motor were 24.8, 24 and 24.3% respectively and together they had a high specificity, NPV and accuracy against DASII motor DQ as gold standard at one year assessment.

Effect of kangaroo mother care on growth and development of low birthweight babies up to 12 months of age: a controlled clinical trial

Kangaroo mother care (KMC) is a nonconventional low-cost method of newborn care. Our aim was to assess the effect of sustained KMC on the growth and development of low birthweight Indian babies up to the age of 12months. We enrolled 500 mother and baby pairs, in groups of five, in a parallel group controlled clinical trial. The three infants with the lowest birthweight in each group received KMC, while the other two received conventional care. All babies were exclusively breastfed for 6months. Babies in the intervention group were provided KMC until the infant was 40weeks of corrected gestation or weighed 2500g. Weight, length and head, chest and arm circumferences were evaluated at birth and at the corrected ages of 0, 3, 6, 9 and 12months. Development was assessed using the Developmental Assessment Scales for Indian Infants (DASII) at 12months. The KMC babies rapidly achieved physical growth parameters similar to the control babies at 40weeks of corrected age. But after that, they surpassed them, despite being smaller at birth. DASII motor and mental development quotients were also significantly better for KMC babies. The infants in the KMC group showed better physical growth and development than the conventional control group.

Ages and stages questionnaire as a screening tool for developmental delay in Indian children

To evaluate the ability of Ages and Stages Questionnaire, a parent completed developmental screening questionnaire to detect developmental delay in Indian children. Cross-sectional study. Child Development Clinic of a tertiary care center located in Northern India. 200 children, 50 each in the age groups of 4±1, 10±1, 18±1 and 24±1 months were recruited (20 high risks and 30 low risks in each age group). The Ages and Stages Questionnaire (ASQ) was translated into Hindi and administered to the parents, followed by standardized development assessment using Developmental Assessment Scale for Indian Infants (DASII). 102 (51%) children failed on ASQ and 90 (45%) children failed on DASII. The overall sensitivity of ASQ for detecting developmental delay was 83.3% and specificity was 75.4%. The sensitivity was best for the 24-months questionnaire (94.7%) and specificity was best for the 4-month questionnaire (86.4%). The sensitivity of ASQ was much higher in the high risk group (92.3%) as compared to the low risk group (60%). ASQ has strong test characteristics for detecting developmental delay in Indian children, especially in high risk cases. It may be easily converted into other Indian languages and used widely for developmental screening.

Neurodevelopmental and Behavioral Outcome of Very Low Birth Weight Babies at Corrected Age of 2 Years

Neurodevelopmental and behavioral assessment of very low birth weight babies (VLBW) at corrected age (CA) of 2years. 127, 110, 99 and 101 babies ≤34weeks and ≤1500g were followed at CA of 3, 6, 9, 12months respectively for developmental and neurological assessment. DASII (Developmental assessment scale for Indian infants) was used at CA of 18months and preschool behavioural checklist (PBCL) at CA 2years. Of 101 VLBW babies available for follow up at CA 1year, 3 (3%) babies had Cerebral Palsy (CP) and 3% (n = 3) had suspect abnormality (mild hypotonia), 11% (n = 11) had gross motor and 8% (n = 8) had language abnormality. Their mean mental (MeDQ) and motor (MoDQ) quotients were 80.4 ± 10.7 and 77.2 ± 13.3 and a score of < 70 was found in 17% (MeDQ) and 25.7% (MoDQ) VLBW babies. High PBCL score (mean 16.8 ± 5.4) was seen in 84%VLBW babies. On subgroup analysis, 2 babies (5%) in subgroup1 ( n = 54, ≤1200g,) and 1 (1.6%) in subgroup 2 (n = 78, 1201-1500g) had CP. Twelve (29%) in subgroup 1 had significant language delay (p = 0.004) as compared to 4 (15%) in subgroup 2 at 1year. BSID and PBCL scores were comparable. Amongst ELBW babies (<1000g), 6.6% (n = 1) had CP, 25% (n = 3) and 42% (n = 5) had low MeDQ and MoDQ respectively and all of them had high PBCL score. AGA and SGA had similar outcome. VLBW babies need close and longer follow up due to high risk of neurodevelopmental and behavioral abnormality.