Developmental Monitoring Research Articles

A Retrospective Study of Semi-Enclosed Bays Based on Short Core Samples in Surabaya and Bali, Indonesia

A retrospective study is one of the most critical aspects of paleoenvironmental studies on developmental planning and environmental monitoring from a geological perspective. The semi-enclosed bay of Lamong Bay, Surabaya, and Benoa Bay, Bali, was rapidly accelerated physics and ecological development on the national scope. The contrary semi-enclosed marine system is linked to large-scale anthropogenic disturbances. This study provides useful baseline information for stakeholders in preparing disaster mitigation plans. This study was aimed to determine past ecological changes based on the paleoenvironmental analysis in two bays with very different environmental development characteristics. i.e. Lamong Bay, Surabaya and Benoa Bay, Bali. Sampling was conducted in March 2017, including analysis of absolute age and sedimentation rate using the Pb210 isotope and foraminifera recent indexing from short core samples. The Ammonia-Elphidium index (A-E index) and the planktonic/benthic ratio (P/B) were used as a proxy of hypoxia and open ocean flow, respectively. Analysis of foraminifera characteristics showed that the study sites had experienced different ecological changes in the last few decades. Over the past 87 years, Lamong Bay has undergone ecological changes, from the aquatic environment strongly influenced by the open sea and supporting benthic life to shallow oligotrophic waters that cannot supports benthic life. In contrast, Benoa Bay has been shallow for the past 50 years and supports benthic life without the threat of hypoxia due to eutrophication.

\u201cI was Confused \u2026 and Still am\u201d Barriers Impacting the Help-Seeking Pathway for an Autism Diagnosis in Urban North India: A Mixed Methods Study

Timely recognition of autism in children is integral to improve developmental outcomes. This study used mixed-methods (84 case-registers and 20 in-depth interviews with caregivers of children with a diagnosis of autism) to explore the extent to which the nature of parental concerns and prior knowledge of developmental disorders impact the time between symptom recognition and autism diagnosis, and the contextual family, societal and health-system related factors that impede the autism help-seeking pathway. Lack of awareness of age-appropriate child developmental milestones, apparent amongst the community and health professionals, contributed to a 1.5-year delay between parental concerns and autism diagnosis. Recommendations to shorten this help-seeking pathway include harnessing the potential of non-specialist workers to increase awareness and enable developmental monitoring of young children through scalable tools.

Social attention as a cross‐cultural transdiagnostic neurodevelopmental risk marker

The primary objectives of this study were to evaluate the structure and age-related stability of social attention in English and Arabic-speaking youth and to compare social attention between children with autism spectrum disorder (ASD), other developmental disabilities (DD), and typically-developing controls. Eye-tracking data were collected from US (N=270) and Qatari (N=242) youth ages 1-17, including children evaluated for possible ASD. Participants viewed 44 stimuli from seven social paradigms. Fixation was computed for areas of interest within each stimulus. Latent variable models examined the structure of social attention. Generalized estimating equation models examined the effect of age, sex, culture, and diagnostic group on social attention. The best-fitting model included a general social attention factor and six specific factors. Cultural differences in social attention were minimal and social attention was stable across age (r=0.03), but females showed significantly greater social attention than males (d=0.28). Social attention was weaker in DD (d=-0.17) and lowest in ASD (d=-0.38) relative to controls. Differences were of sufficient magnitude across areas-of-interest to reliably differentiate DD from controls (AUC=0.80) and ASD-only from all other cases (AUC=0.76). A social attention dimension that represents an early-life preference for socially salient information was identified. This preference was cross-culturally consistent and stable across development but stronger in females and weaker in DD, especially ASD. Given rapid and easy-to-collect remote eye tracking administration, social attention measurement may be useful for developmental monitoring. Acquisition of population norms, analogous to height/weight/head circumference, might enhance early screening and tracking of neurodevelopment. LAY SUMMARY: This research found that social attention is a single dimension of behavior that represents a strong preference for social stimuli, is consistent across cultures, stable across age, and stronger in females. Children with developmental disabilities had lower levels of social attention than neurotypical children and children with autism spectrum disorder had the lowest levels of social attention.

A Neonate with an Abnormally Shaped Head

A female newborn has an abnormally shaped head (Figs 1 and 2). Figure 1. Profile of infant. Figure 2. View of top of infant’s head. ### Prenatal and Birth Histories ### Presentation (Day 1) The infant’s respiratory distress resolved 2 hours after birth and she transitioned off CPAP. Dysmorphic features were noted on physical examination at 2 days of age and hence, further evaluation was undertaken. ### Vital Signs ### Physical Examination (Day 2)

Monitoring children’s development in early childhood education settings to promote early detection of autism

Autism is a developmental condition that can be detected in early childhood. Early intervention can improve outcomes, though many children are not identified until they reach primary school. Early childhood educators are well placed to monitor children’s development and identify those who may benefit from additional supports, though implementation of standardised tools and processes is limited. The National Disability Insurance Scheme in Australia has increased the onus on educators to support families to access funded services. A workshop on evidence-informed practice in early detection for autism was provided for early childhood professionals. The theory of practice architectures informed development and analysis of pre- and post-workshop surveys to explore changes in early childhood educators’ perspectives on factors influencing universal developmental monitoring and referrals to early intervention supports using an evidence-based tool, the Social Attention and Communication Surveillance-Revised (SACS-R). Post-workshop increases in early childhood educators’ perceived knowledge and confidence are evident, though recent policy reforms present challenges. Population surveillance using SACS-R in early childhood education is effective for identification and referral for children who have autism, and capacity building for professionals to use SACS-R is recommended.

Restorative Parenting: Delivering Trauma-Informed Residential Care for Children in Care

BackgroundThere are 78,150 children in care in England and 12% live in group residential settings. Little empirical research informs our understanding of how these vulnerable children heal from multi-type trauma in residential homes. Evidence-based multisystemic trauma-informed models of care are needed for good quality consistent care.ObjectiveUsing a novel multisystemic trauma-informed model of care with an embedded developmental monitoring index, the Restorative Parenting Recovery Programme, pilot data was collected from young people and care staff from four residential homes over a two-year period. Five key developmental areas of children’s recovery were investigated through monthly monitoring data. Staff were also interviewed to explore their experiences of delivering the intervention to contextualise the findings.MethodsData was gathered from 26 children, aged 6–14 years, over a two-year period. Their developmental wellbeing was measured using the Restorative Parenting Recovery Index and analysed through a comparison of means. To add further context to this preliminary analysis, qualitative interviews were undertaken with 12 Therapeutic Parents to explore their perceptions of how the Restorative Parenting Recovery Programme influenced the children’s development.ResultsYoung people showed significant improvements on indices relating to relationships (p = 0.002, d=0.844). Significant changes are observed during the first half of the programme in self-perception (p = 0.006, d = 0.871) and self-care (p = 0.018, d = 0.484), although limited progress around self-awareness and management of impulses and emotions.ConclusionsThis novel integrative approach to re-parenting and embedded measurement system to track the children’s progress is the first of its kind and has originated from extensive multisystemic clinical practice.

Developmental Screening and Monitoring are Associated with Increased Preschool Special Education Receipt

To appropriately route children with developmental disabilities to appropriate early interventions, those children must first be identified via developmental screening and/or developmental monitoring. Most early identification research emphasizes the relationship between developmental screening and Part C early intervention (EI) receipt for children birth to two. The relationship between developmental monitoring and service receipt is understudied, particularly for 3 to 5-year-old children are routed to Part B (619) early childhood special education services. Thus, this study used data from the National Surveys of Children’s Health (2007, 2012) to investigate the relationship between community-based health care providers (HCP) developmental screening and/or monitoring and the odds of early childhood special education receipt for preschool aged children (3 to 5). Across years, children whose HCP provided both developmental screening and monitoring, or developmental monitoring alone, had substantially greater odds of receiving special education compared to those who did not receive screening or monitoring. Receipt of developmental screening alone was associated with special education receipt in 2012, but not 2007. Developmental monitoring is understudied compared to developmental screening. Data presented here indicate that monitoring is associated with Part B 619 special education receipt and warrants further investigation to better understand how, with developmental screening, developmental monitoring might improve the identification of young children in need of 619 services. In particular, longitudinal analyses capturing data across systems, from screening and monitoring to assessment and service receipt, is needed to understand the effectiveness of monitoring for early identification and appropriate routing of children to relevant care systems.

Physical features of newborns exposed during pregnancy to anticonvulsant medication and developmental monitoring

Antiepileptic drug (AED) use during pregnancy can affect the physical features, intelligence, and behavior in the exposed infants and children. Identifying these AED-related effects early makes intervention in childhood possible. To examine the accuracy of the identification of AED effects on the physical features of newborn infants, the written findings in routine physical examinations in medical records can be evaluated. Documentation of AED exposure and the physical findings recorded was obtained from the hospital medical records of 207 infants at a large birthing hospital. Comparison was made of the findings in these infants by private pediatricians and two study pediatricians who were unaware of infant exposure status. The comparisons of the findings were analyzed using the Kappa statistic. The level of agreement in the assessment of the presence of facial features characteristic of midface hypoplasia by private pediatricians and the study pediatricians was poor (Kappa=0.04; 95 CI-0.07 to 0.01); for microcephaly was fair (Kappa=0.39; CI-0.14 to 0.93); and for growth restriction was fair (Kappa-0.22; CI-0.18 to 0.63). Findings recorded by hospital pediatricians in medical records during routine medical care showed that most (74%) of the pediatricians were aware of the infant's exposure to AED during pregnancy. Pediatricians did not do well in identifying the physical signs of midface or digit hypoplasia or microcephaly or growth restriction. Better early identification of the physical effects from AED exposure would make it possible for infants to benefit from developmental monitoring.

Are Developmental Monitoring and Screening Better Together for Early Autism Identification Across Race and Ethnic Groups?

National Surveys of Children's Health (NSCH, 2016-2018) data were analyzed to determine if conjoint monitoring and screening showed stronger associations with children under 5 identified with ASD compared to monitoring alone, screening alone or no monitoring or screening; and investigate relationships between monitoring and screening across racial/ethnic subgroups. 86 of 332 children with ASD received their diagnosis in a timeframe suggesting potential monitoring and screening for identification purposes. Analyses showed that conjoint monitoring and screening and monitoring alone, but not screening alone, was associated with early identified ASD cases across race groups. Caution is warranted as interpreting NSCH monitoring and screening items solely for identification purposes is inaccurate in many cases. More research on monitoring with screening is needed.

Childhood Outcomes Following Parechovirus Infections in a US Young Infant Cohort.

Parechovirus A type 3 (PeV-A3) is associated with central nervous system infection in young infants. There are limited data regarding long-term outcomes, mostly reported from Australia and European populations. The objective of this study was to assess frequency of neurodevelopmental impairment (NDI) following PeV-A3 infection in our US cohort. Infants hospitalized during the 2014 outbreak with laboratory-confirmed PeV-A3 infection were evaluated with medical history, neurologic examination, parental completion of Ages and Stages Questionnaire and developmental assessment using Bayley Scales of Infant and Toddler Development, Third Edition cognitive, motor and language quotients. Determination of NDI was based on published criteria. Relationship of severity of PeV disease to outcome measures was determined using Fisher exact, χ2 and Mann-Whitney U test as appropriate. Nineteen children, term gestation, were evaluated at ~3 years of age; PeV-A3 illness was uncomplicated for 6 (32%), complex, non-neurologic for 9 (47%) and encephalitis/seizures for 4 (21%). No differences were noted in mean Bayley Scales of Infant and Toddler Development, Third Edition quotients between infants by clinical presentation. Quotients for all were within 1 SD of population norms. Two (11%) children had mild NDI; 1 with mild cerebral palsy. Ages and Stages Questionnaire results included 11% at referral level and 37% suspect concern. Parents of 6 (32%) noted behavior concerns. These findings were unrelated to severity of the PeV-A3 illness. Parent concerns were identified frequently following infant PeV-A3 disease. Eleven percent had neurodevelopmental impairment at 3 years of age. Severity at presentation did not correlate with adverse childhood outcomes. Longitudinal developmental monitoring following infantile PeV-A3 disease is warranted.

Child Development Monitoring in Well-baby Clinics in Kenya.

Background:Maternal and child health (MCH) clinics represent an integrated approach for providing healthcare to pregnant women and children 0-59 months of age. Although MCH clinics are also charged with monitoring child development, which involves tracking developmental milestones, it is unclear how these services are provided or perceived within the clinic. This study aimed to describe self-reported knowledge, perceptions, and practice of developmental monitoring in selected MCH clinics in western Kenya.Methods:This cross-sectional descriptive study was conducted within six clinics. We administered a descriptive survey to measure caregiver and healthcare staff attitudes towards and awareness of developmental monitoring; we also reviewed MCH booklets to identify services received at the clinic. Data collection occurred over a period of one day at each of the six clinic sites. The data were analyzed using descriptive statistics.Results:During the study period, 78 caregiver-child pairs presented to the clinics and had their MCH booklets reviewed. The median child age was three months (interquartile range [IQR]: 1-8 months). Most caregivers were aware of weight monitoring and immunization services; however, when asked specifically about developmental monitoring, only 2.6% of caregivers were aware this service was available at the clinics. Nearly 80% of caregivers reported that they would be very interested in developmental monitoring services. Thirty-three MCH healthcare staff were interviewed about services provided and goals of clinical care. Fewer healthcare staff (60.6%) identified their roles in developmental monitoring compared to their roles in growth (90.9%) and nutritional monitoring (84.8%). Developmental milestones had not been recorded in any of the 78 MCH booklets. However, 78.1% of healthcare staff indicated support for developmental screening.Conclusion and Global Health Implications:While developmental monitoring was valued by healthcare providers, it was not consistently performed at the six clinics in our study. We recommend further work to raise awareness about developmental monitoring and to measure the implications of increased caregiver knowledge and perceptions on developmental monitoring practice.

"Watch Me!" Training Increases Knowledge and Impacts Attitudes Related to Developmental Monitoring and Referral Among Childcare Providers.

To evaluate the impact of "Watch Me!" developmental monitoring training on childcare providers' knowledge and attitudes related to monitoring developmental milestones and making recommended referrals when there is a concern about a child's development. A pretest-posttest design using web-based surveys was used to assess the impact of "Watch Me!" training on knowledge and attitudes related to conducting five key components of developmental monitoring (tracking development, recognizing delays, talking to parents about development, talking to parents about concerns, and making referrals). Variables included belief that developmental monitoring is important and is part of childcare provider role; perceived knowledge of, access to tools for, and prioritization of developmental monitoring; and ability to list recommended referrals when there is a concern. Childcare providers demonstrated a significant pre-post increase in perceived knowledge and access to the tools to engage in five core components of developmental monitoring after completing "Watch Me!" training. There was also a significant pre-post increase in childcare providers' ability to list the child's doctor as an appropriate referral (39 pre-63% post), but not in the ability to list Part C/Part B programs as an appropriate referral (56 pre-58% post). CONCLUSIONS FOR PRACTICE: "Watch Me!" training may be effective at impacting targeted areas of knowledge and attitude about developmental monitoring among childcare providers in the short term.

Neurodevelopmental evaluation strategies for children with congenital heart disease aged birth through 5 years: recommendations from the cardiac neurodevelopmental outcome collaborative.

This paper provides specific guidelines for the neurodevelopmental evaluation of children aged birth through 5 years with complex congenital heart disease. There is wide recognition that children with congenital heart disease are at high risk for neurodevelopmental impairments that are first apparent in infancy and often persist as children mature. Impairments among children with complex congenital heart disease cross developmental domains and affect multiple functional abilities. The guidelines provided are derived from the substantial body of research generated over the past 30 years describing the characteristic developmental profiles and the long-term trajectories of children surviving with complex congenital heart conditions. The content and the timing of the guidelines are consistent with the 2012 American Heart Association and the American Academy of Pediatrics scientific statement documenting the need for ongoing developmental monitoring and assessment from infancy through adolescence. The specific guidelines offered in this article were developed by a multidisciplinary clinical research team affiliated with the Cardiac Neurodevelopmental Outcome Collaborative, a not-for-profit organisation established to determine and implement best neurodevelopmental practices for children with congenital heart disease. The guidelines are designed for use in clinical and research applications and offer an abbreviated core protocol and an extended version that expands the scope of the evaluation. The guidelines emphasise the value of early risk identification, use of evidence-based assessment instruments, consideration of family and cultural preferences, and the importance of providing multidimensional community-based services to remediate risk.

A “handy” reminder

Because of the long-term risk of neurodevelopmental impairments, many neonatal intensive care unit (NICU) graduates receive developmental surveillance in high risk infant follow up programs. There are no national recommendations for the duration of follow up but a survey published in 2014 (J Perinatol 2014;34:71-74) showed that programs rarely extend through 5 years of age. A longitudinal study of extremely preterm children published this month in The Journal of Pediatrics reminds us that longer follow up may be necessary for many children. Duncan et al showed that toddlers who had difficulties with bimanual hand function at 18-22 months of corrected age continued to have both fine and gross motor difficulties at 6-7 years of age, independent of whether they had participated in occupational or physical therapy at 18-22 months. Duncan et al did not study whether the children in their study were monitored between study timepoints or if therapy services were continued between 18-22 months and 6-7 years. However, 35% of the cohort had fine motor impairments at 6-7 years suggesting they may have benefited from ongoing developmental monitoring and timely therapy services. We need more studies that help us understand the path between early impairments and school function and studies that help us to prepare high risk infants for school and ameliorate the impact of preschool impairments. Although this study focused on motor difficulties, we know that NICU graduates also are at risk for cognitive, social, and behavioral difficulties. This study therefore serves as a “handy” reminder to maintain developmental vigilance during the toddler years. Article page 51 ▸ Hand Function at 18-22 Months Is Associated with School-Age Manual Dexterity and Motor Performance in Children Born Extremely PretermThe Journal of PediatricsVol. 225PreviewTo determine associations between hand function at age 18-22 months (early) and scores on the Movement Assessment Battery for Children, 2nd edition (MABC) at 6-7 years of age (school age) in extremely preterm children. Full-Text PDF

Dyadic Synchrony and Responsiveness in the First Year: Associations with Autism Risk.

In the first year of life, the ability to engage in sustained synchronous interactions develops as infants learn to match social partner behaviors and sequentially regulate their behaviors in response to others. Difficulties developing competence in these early social building blocks can impact later language skills, joint attention, and emotion regulation. For children at elevated risk for autism spectrum disorder (ASD), early dyadic synchrony and responsiveness difficulties may be indicative of emerging ASD and/or developmental concerns. As part of a prospective developmental monitoring study, infant siblings of children with ASD (high-risk group n = 104) or typical development (low-risk group n = 71), and their mothers completed a standardized play task when infants were 6, 9, and/or 12 months of age. These interactions were coded for the frequency and duration of infant and mother gaze, positive affect, and vocalizations, respectively. Using these codes, theory-driven composites were created to index dyadic synchrony and infant/maternal responsiveness. Multilevel models revealed significant risk group differences in dyadic synchrony and infant responsiveness by 12 months of age. In addition, high-risk infants with higher dyadic synchrony and infant responsiveness at 12 months received significantly higher receptive and expressive language scores at 36 months. The findings of the present study highlight that promoting dyadic synchrony and responsiveness may aid in advancing optimal development in children at elevated risk for autism. LAY SUMMARY: In families raising children with an autism spectrum disorder (ASD), younger siblings are at elevated risks for social communication difficulties. The present study explored whether social-communication differences were evident during a parent-child play task at 6, 9, and 12 months of age. For infant siblings of children with ASD, social differences during play were observed by 12 months of age and may inform ongoing monitoring and intervention efforts.

History Information’s are Indispensable in Developmental Assessment of Children

For achieving the good health and wellbeing for all children, the main role of pediatrician and other health care professionals is to follow their development. We implemented developmental monitoring for 465 children at the age of 12 - 60 months, in the period of 4 years (2016 - 2019), using standard algorithm in which start is always with child history. It should be comprehensive, and must include a detailed prenatal, perinatal, and postnatal history. Obtained results showed that 16.13% of participants have some serious illness in family history, and the same percentage (16.13%) manifested serious perinatal problems which imposed the support in intensive care unit. Breastfeed are 49,46 % of children. Only 7,53 % are not completely vaccinated. About the parameters for the development, we obtained that 11,83 % were not walking at the time of the assessment, and 65,81 % were not speaking. Toilet control was negative, and in 75,27 % they still were wearing diapers. Allergic manifestations at the time when the assessment was done is present in 8,60%. Finally, serious illness in child past history was positive in 19.35 % of evaluated sample. We concluded that a good history is needed and indispensable in the assessment process, particularly when exogenous causes are identified as the risk for the developmental delay. Obtained positive answers are directory for further investigation as well to correlate risk-consequences relationship.

WHAT ROLES DO INDONESIAN NURSES PLAY IN THE EARLY IDENTIFICATION AND INTERVENTION OF CHILDREN WITH DEVELOPMENTAL DISABILITIES? A QUALITATIVE STUDY

Background: Developmental delays can be a basis for identifying children who may experience a disability. Accordingly, developmental screenings and monitoring are implemented to facilitate early identification of developmental disabilities Objective: To explore Indonesian’s community nurses’ perceptions regarding their roles in the early identification and intervention of developmental disabilities Method: This was a descriptive phenomenological study. Eleven community health nurses participated in a multiple semi-structured interview. Thematic analysis was used to analyse data. Findings: Four themes of nursing roles emerged, these include parents’ expression of need, a focus on curative management, provision of nursing care and being alert to discuss a possible developmental delay. Indonesian nurses describe their roles as focusing on curative management and include monitoring child growth and nutritional status because they perceive these roles as the main program of the centres and as to fulfilling parents’ expressions of needs, however they will raise concern when it is suspected or observed, that the child has delayed development. Conclusion: Child’s developmental surveillance has been implemented in developed countries as the basis to identify developmental disabilities earlier in children, however Indonesian nurses focus more on nutrition and eradicating communicable diseases rather than child’s developmental monitoring. More investigation is needed to find barriers of implementation of developmental screenings.

Motor Function in School-Aged Children With Positional Plagiocephaly or Brachycephaly.

To determine whether children with a history of positional plagiocephaly/brachycephaly (PPB) show persistent deficits in motor development. In a longitudinal cohort study, we completed follow-up assessments with 187 school-aged children with PPB and 149 participants without PPB who were originally enrolled in infancy. Primary outcomes were the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition (BOT-2) composite scores. Children with PPB scored lower than controls on the BOT-2. Stratified analyses indicated that differences were restricted to children who had moderate-severe PPB. No consistent differences were observed in children who had mild PPB. Children who had moderate-severe PPB in infancy show persistent differences in motor function. We suggest close developmental monitoring and early intervention to address motor deficits.

Quality of life and comprehensive health supervision for children with Down syndrome in Thailand.

Children with Down syndrome often require several specialty doctors and multidisciplinary teams for their associated anomalies. This may impact their quality of life and creates gaps in treatment monitoring. No studies have yet been conducted in Thailand to measure their quality of life and level of comprehensive health supervision. Therefore, we aimed to study the quality of life among children with Down syndrome and determine if they receive comprehensive health supervision for their condition. In this descriptive research, data were collected from a medical record review of children with Down syndrome during a 1-year period in our Pediatric Outpatient Clinic; 50 children and 39 caregivers participated. Mean total quality of life score of the children was 67.9/100 points. The children had the highest scores (73.6 ± 12.8) in emotional functioning and the lowest (57.2 ± 25.6) in cognitive functioning. It appears that the quality of life may be lower in Down syndrome patients than in Thai children without it. Regarding health supervision, all 50 were screened for thyroid function, and 48 received cardiac evaluations. However, only 17 (34%) received "complete basic assessment" of 5 screening combinations with developmental evaluations and growth monitoring. Furthermore, none received "comprehensive" evaluations for all recommended conditions. While these findings show a need for health supervision improvement for children with Down syndrome within our hospital, they may also be indicative for most care facilities throughout Thailand.

Interdisciplinary Identification of Preschooler Developmental Status, Interventions and Monitoring in the Preschool System in Israel

A unique program was designed for interdisciplinary interventions in regular daycare settings in Israel in order to identify and treat, in their natural environments, preschoolers aged 3-6 with developmental delays. Evaluations determine developmental status in speech, motor skills, emotional health, sleep hygiene, nutritional status, and more. Progress is monitored over two years. Educational staff and parents are an integral part of the program; the former acquire skills that promote sustainability of the project, and parents learn skills that benefit all their children. The background and development of the program, the rationale for its various elements and its implementation are discussed. This program may be of particular significance where there is a high concentration of immigrant or refugee populations.