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Cleveland Clinic Journal of Medicine Nov 2015Screening and surveillance are crucial components to the early detection of developmental disorders in children, which enables early interventions that provide the best... (Review)
Review
Screening and surveillance are crucial components to the early detection of developmental disorders in children, which enables early interventions that provide the best chances for improved outcomes. Identifying a developmental disorder is the initial step in evaluating the disorder. Surveillance is a flexible, continuous, longitudinal process aimed at identifying concerns, and it should be performed at every well-child visit. Screening involves administering a brief, standardized tool normalized for specific ages and stages of development to identify any developmental delays or specific concerns such as autism. Screening is recommended at every office visit and whenever a parent expresses a concern. Two general types of screening tests are available: problem-specific screening and broadband developmental screening. For each type, there are multiple different tests available that can be administered by a parent or a health care provider. Factors to consider in the test selection are the age range for which it is intended, time it takes to complete and score, cost, whether the test is paper-based or electronic, and the language availability.
Topics: Autistic Disorder; Child; Child, Preschool; Developmental Disabilities; Early Intervention, Educational; Humans; Infant; Mass Screening; Population Surveillance
PubMed: 26555812
DOI: 10.3949/ccjm.82.s1.06 -
Canadian Family Physician Medecin de... Aug 2018To provide a framework for primary care providers to approach developmental disabilities in both refugee and nonrefugee immigrant populations. (Review)
Review
OBJECTIVE
To provide a framework for primary care providers to approach developmental disabilities in both refugee and nonrefugee immigrant populations.
SOURCES OF INFORMATION
Ovid MEDLINE was searched from January 2005 to February 2017 using subject headings and for relevant English-language articles. Most of the content and recommendations in this review are derived from the Canadian Paediatric Society's Caring for Kids New to Canada website.
MAIN MESSAGE
As family physicians, it can be daunting to care for newcomer families who arrive without previous developmental disability or delay screening and diagnoses. Disruption to families and education, decreased health literacy, witnessed traumatic events, and culturally specific barriers can affect the presentation of developmental concerns among refugees and immigrants. Surveillance and screening for developmental concerns in a culturally sensitive manner using evidence-based tools are cornerstones of early intervention.
CONCLUSION
For refugees in particular, in light of the inequities they have faced before migration and during their migration trajectory, screening for developmental disabilities and intervening provides an opportunity to help achieve equitable outcomes for refugee children and optimize their health and well-being.
Topics: Canada; Cultural Competency; Developmental Disabilities; Emigrants and Immigrants; Health Services Accessibility; Humans; Refugees
PubMed: 30108071
DOI: No ID Found -
Pediatrics May 2020As the technical ability for genetic diagnosis continues to improve, an increasing number of diagnoses are made in infancy or as early as the neonatal period. Many of... (Review)
Review
As the technical ability for genetic diagnosis continues to improve, an increasing number of diagnoses are made in infancy or as early as the neonatal period. Many of these diagnoses are known to be associated with developmental delay and intellectual disability, features that would not be clinically detectable at the time of diagnosis. Others may be associated with cognitive impairment, but the incidence and severity are yet to be fully described. These neonates and infants with genetic diagnoses therefore represent an emerging group of patients who are at high risk for neurodevelopmental disabilities. Although there are well-established developmental supports for high-risk infants, particularly preterm infants, after discharge from the NICU, programs specifically for infants with genetic diagnoses are rare. And although previous research has demonstrated the positive effect of early developmental interventions on outcomes among preterm infants, the impact of such supports for infants with genetic disorders who may be born term, remains to be understood. We therefore review the literature regarding existing developmental assessment and intervention approaches for children with genetic disorders, evaluating these in the context of current developmental supports postdischarge for preterm infants. Further research into the role of developmental support programs for early assessment and intervention in high-risk neonates diagnosed with rare genetic disorders is needed.
Topics: Developmental Disabilities; Early Intervention, Educational; Genetic Diseases, Inborn; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases
PubMed: 32327449
DOI: 10.1542/peds.2019-0629 -
Journal of Mother and Child Apr 2021
Topics: Adult; Breast Feeding; Developmental Disabilities; Female; Genetic Predisposition to Disease; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Mother-Child Relations; Periodicals as Topic
PubMed: 33930263
DOI: 10.34763/jmotherandchild.20202403.edit.03_2020 -
Journal of Neurodevelopmental Disorders Sep 2021Transmission of SARS-CoV-2 in schools primarily for typically developing children is rare. However, less is known about transmission in schools for children with...
BACKGROUND
Transmission of SARS-CoV-2 in schools primarily for typically developing children is rare. However, less is known about transmission in schools for children with intellectual and developmental disabilities (IDD), who are often unable to mask or maintain social distancing. The objectives of this study were to determine SARS-CoV-2 positivity and in-school transmission rates using weekly screening tests for school staff and students and describe the concurrent deployment of mitigation strategies in six schools for children with IDD.
METHODS
From November 23, 2020, to May, 28, 2021, weekly voluntary screening for SARS-CoV-2 with a high sensitivity molecular-based saliva test was offered to school staff and students. Weekly positivity rates were determined and compared to local healthcare system and undergraduate student screening data. School-based transmission was assessed among participants quarantined for in-school exposure. School administrators completed a standardized survey to assess school mitigation strategies.
RESULTS
A total of 59 students and 416 staff participated. An average of 304 school staff and students were tested per week. Of 7289 tests performed, 21 (0.29%) new SARS-CoV-2 positive cases were identified. The highest weekly positivity rate was 1.2% (n = 4) across all schools, which was less than community positivity rates. Two cases of in-school transmission were identified, each among staff, representing 2% (2/103) of participants quarantined for in-school exposure. Mitigation strategies included higher than expected student mask compliance, reduced room capacity, and phased reopening.
CONCLUSIONS
During 24 weeks that included the peak of the COVID-19 pandemic in winter 2020-21, we found lower rates of SARS-CoV-2 screening test positivity among staff and students of six schools for children with IDD compared to community rates. In-school transmission of SARS-CoV-2 was low among those quarantined for in-school exposure. However, the impact of the emerging SARS-CoV-2 Delta variant on the effectiveness of these proven mitigation strategies remains unknown.
TRIAL REGISTRATION
Prior to enrollment, this study was registered at ClinicalTrials.gov on September 25, 2020, identifier NCT04565509 , titled Supporting the Health and Well-being of Children with Intellectual and Developmental Disability During COVID-19 Pandemic.
Topics: COVID-19; Child; Developmental Disabilities; Humans; Pandemics; SARS-CoV-2; Schools
PubMed: 34465306
DOI: 10.1186/s11689-021-09376-z -
American Family Physician Sep 2011According to the literature, 12 to 16 percent of children in the United States have at least one developmental delay, yet as many as one-half of affected children will... (Review)
Review
According to the literature, 12 to 16 percent of children in the United States have at least one developmental delay, yet as many as one-half of affected children will not be identified by the time they enter kindergarten. If developmental delays are detected too late, opportunities for early intervention may be lost. Empirical literature on clinical recommendations for developmental delay screening in primary care is inconsistent and often insufficient to direct the family physician. In addition, multiple barriers exist, which often prevent physicians from performing initial screening and completing additional evaluation and referrals. Implementing office-based systems for screening and referrals may overcome these barriers and improve outcomes. Recent studies support the use of a validated screening tool at regular, repeated intervals, in addition to physician surveillance, at all well-child visits. The literature also supports screening for developmental delay with parent-completed tools rather than directly administered tools. The most extensively evaluated parent-completed tools are the Parents' Evaluation of Developmental Status and the Ages and Stages Questionnaire. Family physicians should be familiar with currently available screening tools, as well as their limitations and strengths. Additional evaluations and referrals are recommended if developmental delay is identified or suspected.
Topics: Child; Developmental Disabilities; Humans; Incidence; Mass Screening; Primary Health Care; United States
PubMed: 21888305
DOI: No ID Found -
Developmental Medicine and Child... May 2017
Topics: Developmental Disabilities; Humans; Mindfulness
PubMed: 28383120
DOI: 10.1111/dmcn.13401 -
BMC Pediatrics Mar 2022Early support for children with developmental disabilities is crucial but frequently unavailable in low-resource settings. We conducted a mixed-methods evaluation to...
BACKGROUND
Early support for children with developmental disabilities is crucial but frequently unavailable in low-resource settings. We conducted a mixed-methods evaluation to assess the feasibility, acceptability, and impact of a programme of early detection and intervention for young children with developmental disabilities in Western Uganda.
METHODS
Early child development training for healthcare workers (HCWs) was implemented in three rural districts, and attendance was tracked. HCW knowledge and confidence were assessed pre-/post-intervention, and referral numbers tracked to evaluate impact. Facilitators were trained and mentored to deliver a participatory, group, early intervention programme (EIP) for young children with developmental disabilities and their families. Facilitators were tracked as they were identified, trained, and delivered the intervention, and attendance of families was tracked. Pre-/post-intervention assessments evaluated changes in family quality of life (PedsQL 2.0, Family Impact Module), and child nutritional outcomes. Focus group discussions with stakeholders also assessed feasibility, acceptability and impact.
RESULTS
Overall, 93 HCWs from 45 healthcare facilities received training. In the pre-/post-evaluation, median knowledge and confidence scores increased significantly (from 4.0 to 7.0 and from 2.7 to 4.7, respectively (p < 0.001)). HCWs reported feeling empowered to refer and offer care for families with a young child with disability. Referral rates increased significantly from 148 to 251 per annum (70%; p = 0.03). Eleven EIP facilitators were trained, and all delivered the intervention; 84 families were enrolled, of which 78% attended at least 6 out of 10 modules. Amongst those with paired pre-/post-intervention data (n = 48), total family quality of life scores increased significantly (21%, p < 0.001). Improvements were seen across all domains of quality of life, with the largest impacts on emotional functioning and social functioning (p < 0.001). The programme was acceptable to caregivers and facilitators. Caregivers reported improved knowledge, family relationships, hope, emotional wellbeing, and reduced self-stigma.
CONCLUSIONS
A programme of early detection and intervention for children with early developmental disabilities and their families was feasible and acceptable in a rural community-based Ugandan setting. HCW training positively impacted knowledge, confidence, attitudes, and referral rates. Families enrolled to the EIP reported significant improvements in quality of life. Important programmatic barriers identified included geographical spread, poverty, gender inequality, and stigma.
Topics: Caregivers; Child; Child, Preschool; Developmental Disabilities; Family; Humans; Quality of Life; Uganda
PubMed: 35346133
DOI: 10.1186/s12887-022-03184-7 -
Journal of Neurodevelopmental Disorders Dec 2018Until recently, most behavioral studies of children with intellectual and developmental disabilities (IDD) have used standardized assessments as a means to probe... (Review)
Review
Until recently, most behavioral studies of children with intellectual and developmental disabilities (IDD) have used standardized assessments as a means to probe etiology and to characterize phenotypes. Over the past decade, however, tasks originally developed to investigate learning processes in typical development have been brought to bear on developmental processes in children with IDD.This brief review will focus on one learning process in particular-statistical learning-and will provide an overview of what has been learned thus far from studies using statistical learning tasks with different groups of children with IDD conditions. While a full picture is not yet available, results to date suggest that studies of learning are both feasible and informative about learning processes that may differ across diagnostic groups, particularly as they relate to language acquisition.More generally, studies focused on learning processes may be highly informative about different developmental trajectories both across groups and within groups of children.
Topics: Developmental Disabilities; Humans; Intellectual Disability; Language Development; Language Development Disorders; Learning; Statistics as Topic
PubMed: 30541453
DOI: 10.1186/s11689-018-9252-y -
Community Mental Health Journal Aug 2023People with intellectual and developmental disabilities (IDD) have higher incidences of mental health conditions and behavioral support needs than people without IDD but...
People with intellectual and developmental disabilities (IDD) have higher incidences of mental health conditions and behavioral support needs than people without IDD but may not receive needed care from community providers. We examined rates of co-occurring conditions in a representative sample of adults with IDD who use state funded services in Virginia. Using data from two datasets, we identified four categories of mental health and behavioral conditions. We used these categories to examine differences in individual- and system-level factors in people with and without co-occurring conditions. We found high rates of co-occurring conditions in our sample. We found important disability factors and system-level characteristics that were associated with having a diagnosed mental health condition or behavioral support needs. Differing patterns of diagnosis and treatment for co-occurring conditions suggests more work needs to be done to support people with IDD and co-occurring mental health conditions living in the community.
Topics: Adult; Humans; Child; Developmental Disabilities; Intellectual Disability; Mental Health; Virginia
PubMed: 36739327
DOI: 10.1007/s10597-023-01091-4