Test Performance Of Children Research Articles

Using reference equations to standardise incremental shuttle walk test performance in children and young people with chronic conditions and facilitate the evaluation of exercise capacity and disease severity

AimsThe aim was to evaluate whether standardised exercise performance during the incremental shuttle walk test (ISWT) can be used to assess disease severity in children and young people (CYP) with...

Theta/beta ratio in EEG correlated with attentional capacity assessed by Conners Continuous Performance Test in children with ADHD.

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder affecting children worldwide; however, diagnosing ADHD remains a complex task. Theta/beta ratio (TBR) derived from electroencephalography (EEG) recordings has been proposed as a potential biomarker for ADHD, but its effectiveness in children with ADHD remains controversial. Behavioral assessments, such as the Conners Continuous Performance Test-3rd edition (CPT-3), have been utilized to assess attentional capacity in individuals with ADHD. This study aims to investigate the correlation between TBR and CPT-3 scores in children and adolescents with ADHD. In a retrospective analysis, we examined patients regularly monitored for ADHD at Taipei Tzu Chi Hospital, who underwent both EEG and CPT-3 assessments. Severity of ADHD was evaluated using parent- and teacher-completed Swanson, Nolan, and Pelham (SNAP)-IV rating scales. The study encompassed 55 ADHD patients (41 with abnormal CPT-3 scores, 14 with normal CPT-3 scores) and 45 control subjects. TBR demonstrated elevation in ADHD patients with abnormal CPT-3 scores, indicating its potential to represent attentional capacity akin to behavioral assessments like CPT-3. However, significant correlations between TBR values and CPT-3 variables or SNAP-IV rating scales were not observed. Moreover, TBR values exhibited considerable overlap across the groups, leading to diminished sensitivity and negative predictive value as a potential neurophysiological ADHD biomarker. While our study underscores the utility of both TBR and CPT-3 in assessing attentional capacity, their sensitivity in diagnosing ADHD is limited. A comprehensive evaluation, integrating clinical expertise, parental input, and detailed neuropsychometric tests, remains pivotal for a thorough and precise diagnosis of ADHD.

Occupational Therapy Observation Tool-Adjustment Support Details for autistic children: Investigation of content validity and clinical utility.

Standardised testing is crucial for autistic children to receive appropriate interventions, necessary services, and funding. Behaviours associated with autism can hinder children's test performance and participation. The 18-item, two-page Occupational Therapy Observation Tool-Adjustment Support Details (OTOT-ASD) is used in conjunction with standardised assessments. The OTOT-ASD enables the recording of autism-related behaviours and the reasonable assessment accommodations made to support participation in testing. The current study aims to investigate the content validity and clinical utility of the OTOT-ASD from occupational therapists' perspectives. A specifically designed online questionnaire was distributed Victoria-wide to occupational therapists with clinical experience with autistic children. The questionnaire was designed in line with the COnsensus-based Standards for selection of health Measurement INstruments (COSMIN), including relevance, comprehensiveness, and comprehensibility of items evaluated for content validity. Applicability and clinical usefulness were also investigated. Quantitative data were analysed using descriptive statistics. Seventy-one occupational therapists responded to the questionnaire and 46 provided a full dataset. Over 96% of the respondents considered documenting behaviours and testing accommodations as important, yet less than 45% reported having resources to record this information. Ninety-five percent of the respondents perceived the OTOT-ASD to be useful in clinical practice. Over 70% agreed that OTOT-ASD items were significantly relevant to practice and comprehensive. To improve comprehensibility, identified items were altered following feedback. The findings suggest that the OTOT-ASD is clinically useful and content validity is sound. Further research on other psychometric properties of the OTOT-ASD and users' qualitative experiences in utilising the tool is recommended.

Reliability of spectral-temporal ripple tests in children

Spectral-temporal ripple tests in both adaptive and non-adaptive versions have been proposed for use in the audiology clinic. Though these methods have been found to yield repeatable results and to be correlated with each other in adults, similar information about test performance in children is lacking. In this preliminary study, children ages 6-12 years completed two repetitions of the adaptive spectral-temporally modulated ripple test (SMRT) and non-adaptive SMRT Lite for computeRless Measurement (SLRM) test. The first and second repetitions of the SLRM were correlated. Though mean performance on the SMRT was significantly correlated with the SLRM, the first and second repetitions of the SMRT were not significantly correlated.

Adjustment to remote learning during the Covid-19 epidemic correlate with ADHD severity and test of variables of attention test performance in children with ADHD

Adjustment to remote learning during the Covid-19 epidemic correlate with ADHD severity and test of variables of attention test performance in children with ADHD

Hips Don't Lie: Hip Potentiation Predicts Jump in Children

<h3>Research Objectives</h3> To investigate the joint-specific biomechanical potentiation of the lower limb during jump test performance in children. Further, to examine the best predictor among variables of joint-specific biomechanical potentiation for the jump height enhancement in children. <h3>Design</h3> Cross sectional. <h3>Setting</h3> University Research laboratory. <h3>Participants</h3> Healthy children (N = 20; age = 8 - 14 years). <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Body weight normalized peak extensor joint moments, positive power, and work were calculated for the hip, knee, and ankle during countermovement (CMJ) and static jump (SJ). Joint-specific biomechanical potentiation was calculated as the ratio of CMJ/SJ for moment, power, and work values. Jump height (JHt) was calculated as the distance from the standing upright to the highest recorded point of the greater trochanter reflective marker using a motion capture system. Ratio of CMJ/SJ JHt was used to estimate JHt potentiation. <h3>Results</h3> CMJ/SJ ratios of the extensor moment (r = 0.548; p = 0.012), positive power (r = 0.547; p = 0.013), and positive work (r = 0.677; p = 0.001) at the hip were positively correlated with the CMJ/SJ ratio of JHt in children, even after adjusting for body height. CMJ/SJ ratio of the positive work at the hip was the only significant predictor of JHt, (rpartial = 0.471; p = 0.048) in children. <h3>Conclusions</h3> Results of our study provide novel data on the relationships of lower extremity joint-specific biomechanical potentiation variables with JHt enhancement in children. Specifically, our data suggests the importance of strength and power training of the hip for improving JHt in children. <h3>Author(s) Disclosures</h3> None.

Subclinical hypothyroidism and digit span test performance in children: a systematic review and meta-analysis

Background The digit span (DS) test is one of the most commonly used neuropsychological tests to assess certain cognitive domains, i.e., short-term verbal memory, working memory, and attention. Subclinical hypothyroidism (SH) may be associated with a risk of cognitive impairment in children and adolescents.&#x0D; Objective To evaluate the association between SH and DS test performance in children.&#x0D; Methods Eligible studies evaluating SH and DS test performance were included in this systematic review and further assessed for risk of bias using the Newcastle Ottawa Scale. We carried out a meta-analysis using the random effects model to determine mean difference with 95% confidence interval (95%CI) for continuous data. This systematic review was conducted according to the Preview Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement.&#x0D; Results Out of 1,511 participants in the five included studies, 129 had SH and 1,382 were euthyroid. The quality of all studies were fair to good. Three studies were extracted for meta-analysis, with results showing a trend toward a poorer DS test performance in the SH group compared to controls, although this difference was statistically insignificant (IV -0.57; 95%CI -1.61 to 0.46; P=0.28). There was no significant heterogeneity among the included studies (I2=0%; P=0.69).&#x0D; Conclusion No significant association was noted between SH and the domains of cognitive function assessed using the DS test. Several intrinsic and extrinsic factors and inability of the DS test to detect subtle impairment may limit its usefulness in children.

Lateral flow test performance in children for SARS-CoV-2 using anterior nasal and buccal swabbing: sensitivity, specificity, negative and positive predictive values

ObjectiveTo determine if the sensitivity of the lateral flow test is dependent on the viral load and on the location of swabbing in the respiratory tract in children.DesignPhase 1: Routinely...

Utility of continuous performance test (MOXO-CPT) in children with pre-dialysis chronic kidney disease, dialysis and kidney transplantation

Children with chronic kidney disease and on kidney replacement therapy may have neurocognitive and psychosocial disorders. Although kidney transplantation improves quality of life, psychological problems may exist in children who undergo kidney transplantation. Herein, we aimed to investigate attention-deficit hyperactivity disorder-like symptoms with MOXO-continuous performance test in children with pre-dialysis chronic kidney disease, dialysis and kidney transplantation. The MOXO-continuous performance test measures four domains of attention-deficit hyperactivity disorder-like symptoms, including attention, timeliness, hyperactivity and impulsivity. Patients with at least three scores < -1.5 standard deviations were considered aspositive to MOXO-continuous performance test. Test scores of the pre-dialysis chronic kidney disease, dialysis (divided intoperitoneal dialysis and hemodialysis subgroups) and kidney transplantation groups were compared. Correlations of test scores with the patient's clinical and laboratorycharacteristics and effects of hospitalizations and schooling were assessed. Seventy-two patients aged 13.3 ± 3.4years (23 withkidney transplantation, 23 ondialysis and 26 withpre-dialysis chronic kidney disease) were evaluated. Overall MOXO-continuous performance test positivity was 29%. No differences were detected between the three groups concerning total or z scores. Attention and timeliness z scores were significantly higher in females (p = 0.004 and p = 0.008, respectively). Age was positively correlated to attention and timeliness total scores (p = 0.000, r = 0.445 and p = 0.004, r = 0.243, respectively), and inversely correlated to hyperactivity total scores (p = 0.000, r = -0.415). Prevalence of attention-deficit hyperactivity disorder-like symptoms in the study population was much higher than that of pediatric attention-deficit hyperactivity disorder. We believe that the MOXO-continuous performance test is a valid supportive measure for evaluationof attention-deficit hyperactivity disorder diagnosisin children with various stages of chronic kidney disease or on kidney replacement therapy.

The Influence of State and Trait Anxiety on the Achievement of a Virtual Reality Continuous Performance Test in Children and Adolescents with ADHD Symptoms.

The three types of presentations of ADHD often co-occur with other disorders, anxiety being one of the most prevalent. For this reason and because there are few studies that have examined the influence of anxiety on attentional activities, this study aims to determine how internalizing difficulties (anxiety levels) can influence performance in a virtual reality continuous performance test. The study used a non-probabilistic clinical sample comprising 68 boys (66%) and 35 girls (34%) aged between 6 and 16 (M = 12.24; SD = 2.45) who had been referred to clinical services for the evaluation of ADHD symptoms. Once informed consent was given, the children were administered the STAI-C scale and a virtual reality continuous performance test by expert researchers. Hierarchical regression models showed that only state anxiety demonstrated significant explanatory power over attentional variables. These findings confirm how important it is for children to feel relaxed when they undergo psychological evaluation tests, as otherwise the individual’s intervention design would be based on biased data. Similarly, the findings also suggested an effect of IQ in the interpretation of continuous performance scores.

Reference values and validation of the 1-minute sit-to-stand test in healthy 5–16-year-old youth: a cross-sectional study

ObjectivesIt is essential to have simple, reliable and valid tests to measure children’s functional capacity in schools or medical practice. The 1-minute sit-to-stand (STS) test is a quick fitness test...

Speech Recognition in Noise Using Binaural Diotic and Antiphasic Digits-in-Noise in Children: Maturation and Self-Test Validity.

Digits-in-noise (DIN) tests have become popular for hearing screening over the past 15 years. Several recent studies have highlighted the potential utility of DIN as a school-aged hearing test. However, age may influence test performance in children due to maturation. In addition, a new antiphasic stimulus paradigm has been introduced, allowing binaural intelligibility level difference (BILD) to be measured by using a combination of conventional diotic and antiphasic DIN. This study determined age-specific normative data for diotic and antiphasic DIN, and a derived measure, BILD, in children. A secondary aim evaluated the validity of DIN as a smartphone self-test in a subgroup of young children. A cross-sectional, quantitative design was used. Participants with confirmed normal audiometric hearing were tested with a diotic and antiphasic DIN. During the test, arrangements of three spoken digits were presented in noise via headphones at varying signal-to-noise ratio (SNR). Researchers entered each three-digit spoken sequence repeated by the participant on a smartphone keypad. Overall, 621 (428 male and 193 female) normal hearing children (bilateral pure tone threshold of ≤ 20 dB hearing level at 1, 2, and 4 kHz) ranging between the ages of 6 and 13 years were recruited. A subgroup of 7-year-olds (n = 30), complying with the same selection criteria, was selected to determine the validity of self-testing. DIN testing was completed via headphones coupled to a smartphone. Diotic and antiphasic DIN speech recognition thresholds (SRTs) were analyzed and compared for each age group. BILD was calculated through subtraction of antiphasic from diotic SRTs. Multiple linear regressions were run to determine the effect of age on SRT and BILD. In addition, piecewise linear regressions were fit across different age groups. Wilcoxon signed-rank tests were used to determine differences between self- and facilitated tests. Age was a significant predictor, of both diotic and antiphasic DIN SRTs (p < 0.05). SRTs improved by 0.15 dB and 0.35 dB SNR per year for diotic and antiphasic SRTs, respectively. However, age effects were only significant up to 10 and 12 years for antiphasic and diotic SRTs, respectively. Age significantly (p < 0.001) predicted BILD, which increased by 0.18 dB per year. A small SRT advantage for facilitated over self-testing was seen but was not significant (p > 0.05). Increasing age was significantly associated with improved SRT and BILD using diotic and antiphasic DINs. DIN could be used as a smartphone self-test in young children from 7 years of age with appropriate quality control measures to avoid potential false positives.

Gaps-In-Noise Test Performance in Children with Speech Sound Disorder and Cognitive Difficulty.

Background and ObjectivesThe Gaps-In-Noise (GIN) test is a clinically effective measure of the integrity of the central auditory nervous system. The GIN procedure can be applied to a pediatric population above 7 years of age. The present study conducted the GIN test to compare the abilities of auditory temporal resolution among typically developing children, children with speech sound disorder (SSD), and children with cognitive difficulty (CD).Subjects and MethodsChildren aged 8 to 11 years-(total n=30) participated in this study. There were 10 children in each of the following three groups: typically developing children, children with SSD, and children with CD. The Urimal Test of Articulation and Phonology was conducted as a clinical assessment of the children’s articulation and phonology. The Korean version of the Wechsler Intelligence Scale for Children-III (K-WISC-III) was administered as a screening test for general cognitive function. According to the procedure of Musiek, the pre-recorded stimuli of the GIN test were presented at 50 dB SL. The results were scored by the approximated threshold and the overall percent correct score (%).ResultsAll the typically developing children had normal auditory temporal resolution based on the clinical cutoff criteria of the GIN test. The children with SSD or CD had significantly reduced gap detection performance compared to age-matched typically developing children. The children’s intelligence score measured by the K-WISC-III test explained 37% of the variance in the percent-correct score.ConclusionsChildren with SSD or CD exhibited poorer ability to resolve rapid temporal acoustic cues over time compared to the age-matched typically developing children. The ability to detect a brief temporal gap embedded in a stimulus may be related to the general cognitive ability or phonological processing.

Effects of posture regulation on mood states, heart rate and test performance in children

This experiment aimed to investigate the effects of seated posture regulation on children’s psychological and physiological state and test performance. Thirty-eight boys (mean age: 12.3 ± 0.53 years) participated in both upright and normal posture conditions in a within-participants design. Participants completed a two-dimensional mood scale to measure psychological mood states and performed three tests (calculation, listening comprehension and word memory). Heart rate, as an index of physiological arousal state, was measured. Upright posture resulted in greater vitality and pleasure, as well as increased heart rate, compared with normal posture. Upright posture also led to significantly higher scores for calculation and listening comprehension tests. Moreover, increases in vitality level positively influenced increases in calculation and listening comprehension test scores. This study suggests that adopting an upright posture results in maintaining a positive psychological state and improving test performance of children.

Low Indeterminate Rates Associated With Use of the QuantiFERON-TB Gold In-Tube Test in Children With Inflammatory Bowel Disease on Long-term Infliximab.

Tumor necrosis factor alpha (TNF-α) inhibitors are linked with increased risk of reactivation of active tuberculosis. The QuantiFERON-TB Gold In-Tube test is approved for screening latent tuberculosis infection in children and adults. There are limited data on the test performance in children on long-term treatment with TNF-α inhibitors. The objective of this study was to assess the proportion of indeterminate results for the QuantiFERON-TB Gold In-Tube in children with inflammatory bowel disease (IBD) on long-term infliximab treatment and to evaluate the range of interferon-γ responses to mitogen. A single-center prospective study of children 5 to 19 years of age with IBD on long-term infliximab treatment (>3 months). Each child was assessed for tuberculosis exposure risk and had blood drawn for the QuantiFERON-TB Gold In-Tube. Data on the range of interferon-γ responses and final QuantiFERON-TB Gold In-Tube test results were collected. Ninety-three children were included, with a median age of 16 years. The median total duration of infliximab therapy was 34 months (range, 3-119 months). The QuantiFERON-TB Gold In-Tube was indeterminate in 1 patient (1.1%), positive in 2 patients, and negative in 90 patients. The maximum interferon-γ response to mitogen (10 IU/mL) was observed in 82 patients (88%), with only 1 patient having an inadequate response. The proportion of indeterminate results was significantly lower than the prospectively hypothesized rate of 8%, based on prior studies in nonimmunosuppressed patients (P = 0.004). Pediatric patients with IBD on long-term treatment with infliximab had an adequate interferon-γ response to mitogen and a low indeterminate rate when assessed with the QuantiFERON-TB Gold In-Tube test. This study demonstrates a robust interferon gamma response to phytohemagglutinin stimulation in a pediatric population on long-term therapy with infliximab. The QuantiFERON-TB Gold In-Tube test may therefore be useful as a periodic screening tactic for latent TB in children on long-term infliximab therapy.

Continuous performance test in children with intellectual disability and attention deficit hyperactivity disorder

ABSTRACTData regarding clinical and neuropsychological features of attention deficit in children with lower cognitive ability is still scarce. The objective was to analyze the response patterns on the Continuous Performance Test II in children with Intellectual Disability and Attention Defficit Hyperactivity Disorder (ADHD). This is a cross-sectional study, in which patients were divided into 2 groups: one group with ADHD and Full IQ > 80 and another group with ADHD + Full IQ score < 80. They were afterwards administered the CPT II (Continuous Performance Test). A total of 215 children were included in the study, 57% of them with ADHD IQ > 80 and 43% with ADHD + Lower Intellectual Performance (LIP). Patients with ADHD and Lower Intellectual Performance presented more omissions error, slower reaction time and greater variability in the performance as the tests progresses, as well as worse stimulus detection and discrimination capacity. The results observed supply new information for the proper understanding of the functioning of attention processes in a poorly studied population.

Neurocognitive Function in Children with Primary Hypertension after Initiation of Antihypertensive Therapy

To determine the change in neurocognitive test performance in children with primary hypertension after initiation of antihypertensive therapy. Subjects with hypertension and normotensive control subjects had neurocognitive testing at baseline and again after 1 year, during which time the subjects with hypertension received antihypertensive therapy. Subjects completed tests of general intelligence, attention, memory, executive function, and processing speed, and parents completed rating scales of executive function. Fifty-five subjects with hypertension and 66 normotensive control subjects underwent both baseline and 1-year assessments. Overall, the blood pressure (BP) of subjects with hypertension improved (24-hour systolic BP load: mean baseline vs 1 year, 58% vs 38%, P < .001). Primary multivariable analyses showed that the hypertension group improved in scores of subtests of the Rey Auditory Verbal Learning Test, Grooved Pegboard, and Delis-Kaplan Executive Function System Tower Test (P < .05). However, the control group also improved in the same measures with similar effects sizes. Secondary analyses by effectiveness of antihypertensive therapy showed that subjects with persistent ambulatory hypertension at 1 year (n = 17) did not improve in subtests of Rey Auditory Verbal Learning Test and had limited improvement in Grooved Pegboard. Overall, children with hypertension did not improve in neurocognitive test performance after 1 year of antihypertensive therapy, beyond that also seen in normotensive controls, suggesting improvements with age or practice effects because of repeated neurocognitive testing. However, the degree to which antihypertensive therapy improves BP may affect its impact upon neurocognitive function.

The Andersen aerobic fitness test: New peak oxygen consumption prediction equations in 10 and 16-year olds.

Measurement of aerobic fitness by determining peak oxygen consumption (VO2peak ) is often not feasible in children and adolescents, thus field tests such as the Andersen test are required in many settings, for example in most school-based studies. This study provides cross-validated prediction equations for VO2peak based on the Andersen test in 10 and 16-year-old children. We included 235 children (n=113 10-year olds and 122 16-year olds) who performed the Andersen test and a progressive treadmill test to exhaustion to determine VO2peak . Joint and sex-specific prediction equations were derived and tested in 20 random samples. Performance in terms of systematic (bias) and random error (limits of agreement) was evaluated by means of Bland-Altman plots. Bias varied from -4.28 to 5.25mL/kg/min across testing datasets, sex, and the 2 age groups. Sex-specific equations (mean bias -0.42 to 0.16mL/kg/min) performed somewhat better than joint equations (-1.07 to 0.84mL/kg/min). Limits of agreement were substantial across all datasets, sex, and both age groups, but were slightly lower in 16-year olds (5.84-13.29mL/kg/min) compared to 10-year olds (9.60-15.15mL/kg/min). We suggest the presented equations can be used to predict VO2peak from the Andersen test performance in children and adolescents on a group level. Although the Andersen test appears to be a good measure of aerobic fitness, researchers should interpret cross-sectional individual-level predictions of VO2peak with caution due to large random measurement errors.

EFFECT OF EXTENDING THE RESPONSE WINDOWAND OF SUBJECT PRACTICE ON MEASURES OFAUDITORY PROCESSING IN CHILDREN WITHLEARNING OR READING DISABILITY

Background This study studied the effect of extending the response window on the auditory processing (AP) test performance of children with a learning disability or reading disability (LD/RD). The study also investigated whether subject practice affected test performance. Material and Methods Twenty-four children with an LD and 12 typically developing (TD) age-matched peers between 9 and 13 years of age participated in the study. The participants were administered three AP tests – the dichotic digit (DD), duration pattern sequence (DPS), and random gap detection (RGD) test – under two conditions: standard response window and extended response window. Results The performance of the LD group on the DD and DPS tests significantly improved using an extended time window whereas the performance of the TD group did not change. Conclusions The findings suggest that some children with an LD achieve higher scores on auditory processing tasks if given a longer response window. This has implications for diagnosis and for providing a potential differential diagnosis tool.

Altered Cervical Vestibular-Evoked Myogenic Potential in Children with Attention Deficit and Hyperactivity Disorder

Emerging evidence suggests that children with attention deficit and hyperactivity disorder (ADHD) present more difficulties in standing and walking balance than typically developing children. Most of previous studies have assessed these functions using postural and sensory organization tests showing differences in balance performance between control and ADHD children. However, to date, it is unknown whether these balance alterations are accompanied with vestibular dysfunction. The principal aim of this study is to evaluate vestibular otolith function in ADHD and matched control children. We assessed vestibular otolith function in children with ADHD and controls using the subjective visual vertical (SVV) bucket test and cervical vestibular-evoked myogenic potentials (cVEMPs). In addition, gait and balance were evaluated using the dynamic gait index (DGI) and computerized posturography. Non-significant differences between groups were obtained in SVV evaluation. DGI results show lower scores for overall test performance in children with ADHD (p < 0.001), while computerized postural recordings showed significant differences for the limit of stability between groups (p = 0.02). cVEMPs in response to 500 Hz tone bursts presented at 100 dB were absent or reduced in children with ADHD, as revealed by differences in P1 and N1 peak-to-peak amplitudes between groups (p < 0.01). These findings suggest that vestibular brainstem reflexes are altered in a subset of children with ADHD. We propose to include cVEMP reflexes in the clinical evaluation of ADHD patients.