The prevalence of developmental disabilities is increasing worldwide over time. Developmental issues in infancy or early childhood may cause learning difficulties or behavioral problem in school age, further adversely affecting adolescent quality of life, which finally lead to low socioeconomic status in family, increase in medical expenses, and other relevant issues in various ways. Early childhood has brain plasticity, which means there is a high chance of recovering from developmental issues by early detection and timely intervention. Pediatricians are placed an ideal position to meet with young children till 6 years of age, of which age range is the time applicable to early intervention. Determining child's developmental status can be made by 2 pathways such as developmental surveillance and developmental screening tests. For better results, pediatricians should update their knowledge about developmental issues, risk factors, and screening techniques through varying educational program or other relevant educating materials. This paper will update reports on the prevalence of developmental disabilities and review the recent results of the Korean developmental screening test and discuss relevant issues. Finally, it will be addressed the pediatrician's role in early detecting developmental issues and timely intervention.
This descriptive exploratory study was conducted to analyze the results of developmental screening test using DDST and the follow-up diagnostic evaluation in one public health center, and to evaluate the feasibility of developmental screening in nursing. Samples were 373 children under 6 years who visited the public health center. Mothers' satisfaction on the developmental clinic was also determined. Summaries of the results were as follows:v 1. 0.5% of children in height and 1.9% of children in weight were included in below 3 percentile of Korean children's growth chart, but none of them showed developmental delay. 2. The results of DDST showed 92.1% of subjects were classified as normal, 3.7% as abnormal, and 4.2% as questionable among 354 children. 3. Most of children who showed the abnormal development at the first DDST were confirmed having the developmental delay at the follow-up diagnostic evaluation. On the other hand, most of children who showed the questionable development at the first DDST revealed having the normal development in follow-up screening test. 4. The result of the DDST was influenced by the birth order of the subject and delivery type. 5.The mean satisfaction score by mothers on developmental clinic was 4.35 in 5 Likert scale. In conclusion, we could certain the feasibility and usefulness of developmental screening in community and child care nursing. To fulfil the increasing needs of mothers with infants on the child development, nurses have to provide anticipatory guidance and parent education in addition to the developmental screening test. We hope to expand the developmental screening in nursing field not only of clinical setting but also of community.
This is an underlying study for expanding child growth and developmental screening program, which had been implemented as a part of maternal child health service in a certain public health center located in P City. This study attempted to develop system model to discover, consult and follow-up developmental disabilities in children in early stage. For the purpose of providing groundwork for further development of screening program, the system model was analyzed and evaluated. One of the focuses of this study was developing practical tool that can aid small number staffs of public health center to handle large number of patients. 9 types of developmental checklist by key month was developed to support understaffed public health center. These checklists were also supplied to other public health centers, greatly improving qualitative and quantitative development of screening project. Also, the 4-step program of operating and managing child growth and developmental screening was proved to be quite effective. Total 632 children were evaluated and 21 of them were suspected to have developmental problem. Among these children, 8 children were determined to receive regular supervision of public health center. Other 13 children were recommended to visit professional institution, but only 7 of them actually visited institution. Four of these children who visited professional institution are currently receiving treatment, while the other 3 children were determined to require close observation. Five times of screening education were provided to the staffs in public health center and personnel in charge of children in every district public center in P City. The purpose of this training was to improve individuals' capability to implement project and to establish basis for expanding child growth and developmental screening program. The participants were guided to have continuous attention for the project, and their knowledge, skill and recognition were greatly improved through educational training. Also, professional child consulting and education, including lecture for baby food and baby food menu exhibition, were given to parents. Through this opportunity, parents acquired higher understanding about baby food while the local residents' recognition for maternal child health service was greatly improved.
Purpose: This study was done to evaluate the validity of Korean Denver ll developmental screening test in screening children with developmental risk. Method: The participants in the study were 113 children referred for developmental assessment in the department of rehabilitation of D University hospital. They were examined with the BSID (Bayley Scales of Infant Development) II and Korean Denver II by one occupational therapist. The data was analyzed by $x^2$ test and discriminant analysis. Results: There was a significant relationship between the Mental Developmental Index (MDI) of the BSID II and the result of the Korean Denver II. The sensitivity and specificity of Korean Denver II were 0.87 and 0.62 when abnormal MDI was defined as lower than 85 was used as a diagnosis of developmental delay. There was a significant relationship between the Psychomotor Developmental Index (PDI) of the BSID ll and the result 0.7 Korean Denver ll. The sensitivity and specificity of Korean Denver II were 0.83 and 0.51 The over-all hit ratio was $79.6\%$. Conclusion: The result showed that the Korean Denver II was valid and has good sensitivity and moderate specificity in screening developmental delay.
Purpose: To investigate the rate of questionable development in infants born prematurely and explore factors affecting developmental delays. Method: The participants were 46 infants born prematurely being seen in one of two urban health centers. A questionnaire and the HOME checklist were used to collect data, and the Korean Denver II developmental screening test was administered. Results: Of the participants 21.7% were classified as having questionable development. The only variable with a significant difference between the two groups was acceptance in the HOME checklist. Psychosocial factors such as mothers' burden, depression, family functioning, and social support were not significantly different between the two groups. Conclusion: An early developmental screening test for prematurely born infants is needed. Also, the childrearing environment was identified as a significant factor in infants' development. These findings suggest that HOME score might be useful for identifying infants at risk for developmental delays and interventions for these infants will probably be more effective if their mothers can provide a more appropriate social environment. Further studies are suggested with larger samples.
Many in vitro developmental toxicity assays have been proposed over several decades. Since the late 1980s, we have made intermittent attempts to introduce in vitro assays as screening tests for developmental toxicity of inhouse candidate products. Two cell-based assays which were developed two decades apart were intensively studied. One was an assay of inhibitory effects on mouse ascites tumor cell attachment to a concanavalin A-coated plastic sheet surface (MOT assay), which we studied in the early days of assay development. The other was an assay of inhibitory effects on the differentiation of mouse embryonic stem cell to beating heart cells (EST assay), which we assessed more recently. We evaluated the suitability of the assays for screening in-house candidates. The concordance rates with in vivo developmental toxicity were at the 60% level. The EST assay classified chemicals that inhibited cell proliferation as embryo-toxic. Both assays had a significant false positive rate. The assays were generally considered unsuitable for screening the developmental toxicity of our candidate compounds. Recent test systems adopt advanced technologies. Despite such evolution of materials and methods, the concordance rates of the EST and MOT systems were similar. This may suggest that the fundamental predictivity of in vitro developmental toxicity assays has remained basically unchanged for decades. To improve their predictivity, in vitro developmental toxicity assays should be strictly based on elucidated pathogenetic mechanisms of developmental toxicity.
Kim, Chae Young;Jung, Euiseok;Lee, Byong Sop;Kim, Ki-Soo;Kim, Ellen Ai-Rhan
Clinical and Experimental Pediatrics
/
제62권5호
/
pp.187-192
/
2019
Purpose: The importance of the neurodevelopmental outcomes of very-low-birth-weight (VLBW) infants has been emphasized as their mortality rate has markedly improved. This study aimed to assess the validity of the Korean Developmental Screening Test (K-DST), a developmental screening tool approved by the Korean Society of Pediatrics, for the timely diagnosis of neurodevelopmental delay in VLBW infants. Methods: Subjects included VLBW infants enrolled in the Korean Neonatal Network database between January 2012 and December 2014. The collected data were analyzed for sensitivity, specificity, positive predictive value, and negative predictive value (NPV) in the K-DST compared to those in the Bayley Scales of Infant Development-II for VLBW infants. Results: A total of 173 patients were enrolled. Their mean gestational age and mean birth weight were $27.5{\pm}2.8weeks$ and $980.5{\pm}272.1g$, respectively. The frequency of failed psychomotor developmental index (PDI) <85 was similar to that in at least one domain of K-DST <1 standard deviation. Failure in more than one K-DST domain compared with a mental developmental index (MDI) <85 showed a sensitivity and NPV of 73.2% and 75.0%, respectively. Failure in more than one K-DST domain compared with PDI <85 showed a sensitivity and NPV of 60.3% and 71.6%, respectively. Each K-DST domain had a stronger correlation with predicting a failing MDI <85 than a failing PDI <85 (P<0.05). Conclusion: K-DST could be a useful screening tool for predicting mental developmental delay in VLBW infants and referring them for neurodevelopmental assessments.
Purpose: This study was intended to develop the framework of public health center based 'Child growth and developmental clinic' and analyze the efficiency of services. This was the part of Mother-Child Health Guidance Project by the Public Health Center in Seoul. The purposes of this project were to improve children's health and development with early detection of developmental delay by screening test, and to assist and guide the parent for child care and rearing, so that children can reach their maximum potential. Method: Framework and standards for operation of 'Child growth and development clinic' were developed. We selected screening tool. developed parent education materials, and educated the personnel of public health center. Result: 243 children were enrolled for developmental screening, and we detect the children with developmental delay and referred them for further evaluation. The proportion of developmental delayed children was approximately 2% of the enrolled children. Also, we analyzed the characteristics of enrolled children, and their parental needs and attitude on child rearing. Some problems in operation of developmental clinic were discussed. Conclusion: Though we can found some limitations, we are confident that pubic health center can be charge of important role for improving child development for the majority. This study will be the basis of children's developmental clinic running by public health center.
Purpose: This study was done to evaluate the validity of the Korean - Child Development Review in screening children with developmental risks. Method: The participants in the study were 172 children aged 6-75 months old and their parents. Data were collected by questionnaire or interview. Korean Denver II and Bayley test were administered with K-CDR for validation of children who were referred for developmental assessment at D University Hospital or public health center. The data were analyzed using correlation, $X^2$ test, and cross tab analysis. Results: There was a significant relationship between the K-CDR and Korean Denver II. The correlation coefficients were .42 to .61 by developmental sector. The sensitivity and specificity of K- CDR were .84 and .66 respectively when "abnormal" with MDI of Bayley test defined as lower than 85 the score which was used as a diagnosis of developmental delay. The responses to 6 questions for parents showed significant differences according to 3 groups by developmental state. Parents of children in the developmental disability group more frequently checked problems from the 26 problem checklist about their children's development and behavior. Conclusion: The results show that K-CDR is valid and has good sensitivity and moderate specificity in screening developmental delay.
Purpose: This study was conducted to estimate the prevalence of questionable development according to developmental screening testing for children, and to explore biological and environmental risk factors of developmental delays. Method: The study participants were 153 children under two years of age. A questionnaire and Home Observation for measurement of the Environment (HOME) inventory were used to collect data, and Korean Denver II was administered. Results: The overall prevalence of questionable development was 11.1%. Significant differences in biological factors between the normal development group and questionable development group were the rate of prematurity, twins, the educational level of mother and father's and the presence of an illness in the mother (p<.10). Maternal acceptance in HOME was significantly different between the two groups. The factors related to questionable development that were significant in the logistic regression analysis were prematurity (OR=3.56, p=.026), and maternal acceptance in HOME score (OR=.629, p=.028). Conclusion: Early developmental screening tests seem necessary for all children, especially for prematurely born children. Also, child rearing environments were identified as significant factors in the development of all children. These findings suggest that the HOME scores might be useful in identifying children at risk for developmental delays, and that interventions for these children will probably be more effective if their mothers are helped to provide a more appropriate social environment.
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