Morbidity profile of children from birth to 18 years of age referred for intervention to the district early intervention centre in a District Hospital, Andhra Pradesh

Background: The 揅hild Health Screening and Early Intervention Services� program aims at early detection and management of the four dimensions prevalent in children-defects at birth, diseases in children, deficiency conditions, and developmental delays, including disabilities. Objective: The objective of the study was to assess the morbidity profile of children from birth to 18 years of age screened in the district early intervention center (DEIC). Methods: A record-based descriptive study was done in the DEIC in Chittoor, Andhra Pradesh. The data were retrieved for 1-year from April 2017 to March 2018 into the excel sheet, and the combined master sheet was prepared for analysis. The analysis was done with SPSS 21.0 Version. Results: A total of 10571 children were screened and referred to the DEIC during the period. Out of them, 5679 (53.7%) were male and 4892 (46.3%) were female. Among all the four types of morbidities screened, majority 4847 (45.9%) were having the childhood diseases, 4177 (39.5%) had developmental delays including disabilities, 1067 (10.1%) had different deficiencies, and 361 (3.4%) had birth defects. Among the adolescent health issues, 119 (1.1%) were screened and sent for the early intervention to the district hospital. Conclusions: A huge number of children were screened and referred to the DEIC every year for intervention. The health sector has to focus more on the resources like workforce, training of peripheral health workers at regular intervals about the different morbidities screened, that would help in identifying the morbidities at the earliest possible time and receive the intervention at the best center.

The importance of encouraging child development

@#Quality child growth and development are important tools in assisting today's children to become the adults of the future. Hence, developmental delays in young children have an impact not only on a child's abilities to learn new skills, but also in the opportunities of the greater community or society. In this regard, parents and caregivers are the most well-equipped to prevent the child from experiencing developmental delays. Children will learn to trust the person who sensitively interacts with them and this trust provides a foundation for future learning, growth, and development. This paper looks at the importance of encouraging child development through the parents or guardians of children, since they are inevitably linked to a child's learning, and they know their own children better than anyone else. Parents and guardians who do not have the skills required to monitor and encourage the development of young children can and should be trained by professionals. This research reveals that training parents and guardians to use the Developmental Surveillance and Promotion Manual in monitoring and encouraging development of young children is a very important way to prevent future developmental delays.

Família como promotora do desenvolvimento de crianças que apresentam atrasos / Family as a promoter of the development of children with delays

Este estudo faz uma revisão teórica para compreender a família como um ambiente promotor do desenvolvimento humano. A família corresponde ao principal contexto de inter-relações da criança. A qualidade do ambiente familiar e das relações neste contexto conduz a evolução do desenvolvimento infantil. O bebê, ao chegar ao ambiente familiar, exige mudanças estruturais, e, quando esta criança apresenta atrasos em seu desenvolvimento, o modo como a família enfrenta esta realidade pode propiciar risco à vida da criança. Programas de Intervenção Precoce buscam entender o desenvolvimento infantil a partir de uma visão multidimensional, ou seja, mudar o foco somente na criança e no seu déficit, passando a considerar: família, comunidade e trabalho em equipe interdisciplinar.(AU)

This paper makes a theoretical revision to understand the family as an environment that promotes human development. The family corresponds to the main context of a child's interrelationships. In this way, the quality of the family environment and the relationships established in this context directs the evolution of child's development. A baby, when arriving to a familiar environment, demands structural changes, and when this child presents delays in its development, the way the family faces this reality can propitiate risk to the development of the child and the whole family. Early Intervention Programs seek to understand child development from a multidimensional perspective, changing the focus to be only on the child and his / her deficit, to consider three main characteristics: family, community and interdisciplinary teamwork.(AU)

Analysis of Risk Factors for Developmental Delay in Preterm Infants Using Screening Test / 대한소아신경학회지

PURPOSE: The purpose of this study was to identify the risk factors for developmental delays in preterm infants. METHODS: We studied 151 preterm infants admitted to the neonatal intensive care unit (NICU) at the Hallym University Kangnam Sacred Heart Hospital from January 2013 to November 2016. After discharge, the infants were evaluated by a pediatric neurologist via the developmental screening test K-ASQ:SE II, which consists of five domains: communication (CC), gross motor (GM), fine motor (FM), problem solving (PS), and social-emotional (SE). The subjects were divided into a normal group and an abnormal group (abnormal results on at least one of the five domains). Several variables were compared between the two groups and risk factors for developmental delays were analyzed. RESULTS: Several factors, such as birth weight (BW), gestational age (GA), Apgar score at 1 and 5 min (AS1, AS5), hospital days (HDs), respiratory distress syndrome (RDS), chronic lung diseases, intraventricular hemorrhage (IVH), early sepsis, retinopathy of prematurity (ROP), and history of management of invasive ventilators, dexamethasone, anti-hypotensive, were significantly different between the normal and abnormal groups. BW was a risk factor for developmental delay according to the binary logistic regression analysis. On individual domain analysis, risk factors were lower GA for domains CC and FM, lower AS1 for GM domain, lower BW for PS domain, and longer HDs for SE domain. CONCLUSION: In preterm infants, regular developmental screening especially follow-up observation, is important for early detection of developmental delay, considering the risk factors, such as GA (≤30 weeks), BW (≤1,500 g), low AS1, and long HDs, which may be helpful in the early diagnosis of developmental delay.

Funciones sensoriales en niños menores de 3 años diagnosticados con trastorno del espectro autista (TEA) / Sensory processing in toddlers diagnosed with autism spectrum disorder (ASD)

Las dificultades de procesamiento sensorial en niños con Trastorno del Espectro Autista (TEA) están ampliamente descritos en la literatura principalmente mediante el uso de encuestas a padres y observaciones. Con menor frecuencia se han descrito las dificultades de procesamiento sensorial en niños menores de 3 años de edad que han sido posteriormente diagnosticados con TEA. Este estudio retrospectivo está basado en 84 niños (28 diagnosticados con TEA, 28 con retraso en el desarrollo, y 28 niños con desarrollo típico) entre 18 y 36 meses de edad que asistieron a un programa de intervención temprana y cuyos padres completaron el cuestionario Infant Toddler Sensory Profile (Dunn & Daniels, 2002). Los resultados obtenidos en esta encuesta revelan que los niños menores de edad con TEA muestran un patrón específico de procesamiento sensorial en comparación con niños con otros retrasos en el desarrollo.

Sensory processing difficulties of children with Autism Spectrum Disorder (ASD) are extensively described in the literature using parent surveys and observations. The sensory processing difficulties of children under 3 years of age who are later diagnosed with ASD have seldom been described. This retrospective study is based on 84 children (28 diagnosed with ASD, 28 with developmental disabilities, and 28 typically developing children) between 18 and 36 months of age attending an early intervention program and whose parents completed the Infant Toddler Sensory Profile questionnaire (Dunn & Daniels, 2002). The results obtained in this survey reveals that toddlers with ASD exhibit a distinct pattern of sensory processing as compared to children with other developmental delays.

Family factors in developmental delays in children under six years old

Development delay in children under 6 years old is prevalent not only in both developed and developing countries. It is alarming that the number of delayed children is increasing. It is obliging to find out the family factors that possibly affect developmental delays in children six years old and younger. The objectives of the study were the following: (1) Describe the characteristics of families of children with developmental delays. (2) Determine the factors that significantly relate with developmental delays when comparing families of children, with delays and without delays. The sample was composed of 52 delayed children and their families, and 52 normal children and their families who were purposively chosen. The data was collected from March to May 2011 with the approval of the Saint Louis University Research Ethics Committee. The Metro Manila Developmental Screening Test was used  to test child development. The Parent Behavior Checklist was used to assess  parenting behavior of mothers. A questionnaire was used to collect family and child factors. The results of analysis revealed that higher frequencies of delays occurred in children one (23.08%) and three (23.08%) years of age; first born or only child (36.54%), and in households with three children or less (32.69%). Families of delayed children are of low socio-economic status, whose mother predominantly scored low in all categories of parenting. It was also found out that more frequencies  of delays occurred in the fine motor adaptive sector (86.54%), followed by the language (69.23%), gross motor (38.46%) and personal-social (32.69%) sectors respectively. Results of the chi square test revealed that expectation parenting behavior is significantly associated to developmental delay in the gross-motor sector (p 0.005) in children under six years of age. Developmental delays in the gross motor sector in the three to less than six-year-olds are significantly associated with father's occupation (p 0.009) and expectation parenting behavior (p 0.022). Analysis of factors associated with developmental delays when comparing delayed and normal children revealed that family factors are not significantly associated with developmental delays. A sub-analysis of age groups however revealed that mother's occupation and developmental delays are significantly associated in the three to less that six-year-old age group (p 0.026). It is concluded that children with developmental delays belong to families with disadvantaged socioeconomic status whose mothers scored low in all subscales of parenting behaviors; and family characteristics, parenting behaviors of the mother and child characteristics are not significantly related to developmental delays  in children under six years old. Therefore, health workers should be more vigilant in identifying children with developmental delays regardless of family characteristics.