Follow up of growth, development and clinical outcome in neonates discharged from the NICU of tertiary care hospital in central India

Background: To assess the growth and neurodevelopmental outcome of all newborn discharged from the NICU of Netaji Subhash Chandra Bose Medical College, Jabalpur on follow up for 6 months.Methods: Prospective observational cohort study of 200 high risk newborn discharged from NICU. Babies were called for follow up at 1 month, 2 months, 4 month and 6 months of corrected age and detailed information was taken regarding NICU stay and morbidity with the help of data available from discharge card. Anthropometric parameters like weight, length, and head circumference were noted.' Suitable screening tests like denver's developmental screening test for Indian infants (DDSTII) for NDD (neurodevelopmental delay) and Amiel Tison scoring for tone assessment was done.Results: Among the 200 NICU graduates chosen, 40 lost during follow up. The neurodevelopmental delay in this study was 31.3%. Authors also analysed NDD according to gestational age wise groups. NDD in pre-terms was 39.6%. The developmental delay was more in babies with neonatal sepsis, perinatal asphyxia, prematurity, RDS, NEC etc.Conclusions: The morbidities like severe perinatal asphyxia, hypoglycaemia, seizures, shock, hypoxia, hypothermia, low gestational age have direct association with NDD.

Effects of anesthesia on neurodevelopment assessment in preschool children / 解放军医学杂志

Objective To investigate the effects of anesthesia on neurodevelopment of preschool children. Methods A total of 445 children, scheduled to undergo surgery in the Fourth Medical Center of Chinese PLA General Hospital from 1st May 2017 to 1st May 2018, were enrolled and, according to different test purpose, grouped as follows: (1) 120 children (GA group) who underwent surgery before Denver Developmental Screening Test (DDST) were matched to 325 unexposed children (Non-GA group). Meanwhile, 168 children (Naive group) were measured as blank control. (2) According to the number of anesthesia that children had undergone, those in GA group were assigned to three subgroups: single, twice and multiple groups. (3) Subgroup analyses was performed based on the time of cumulative duration of anesthesia exposures (less than 3 and greater than or equal to 3h). Data were collected with a questionnaire to evaluate the children's physical development, DDST results were recorded, and the effects were evaluated of the number of anesthesia and the time of cumulative duration of anesthesia exposures on the DDST results. Results For the children aged 0 to 6 yr, the DDST positive rates in Naive, Non-GA and GA groups were 6.0%, 6.5% and 12.5%, respectively. No significant difference existed in DDST positive rate between Naive group and Non-GA group (P=0.825). Compared with Non-GA group, the DDST positive rate increased in GA group (6.5% vs. 12.5%) with significant difference (P=0.038). Compared among the four domains of DDST separately, statistical difference was found only in terms of personal-social, those in GA group showed poor performance than in Non-GA group (P=0.025). For the children aged less than 3 yr, the DDST positive rates in GA group and Non-GA group were 18.6% and 3.9%, respectively, showing significant differences (P=0.019), but no statistical difference was found on DDST positive rate among the three groups of children aged 3 to 6 yr (P>0.05). In GA group, there was no increase in odds of early developmental vulnerability with increasing frequency of anesthesia exposure (P=0.784). However, the DDST positive rate was significantly higher with longer cumulative duration of anesthesia exposure (≥3h) than that of <3h (18.7% vs. 2.2%, P=0.008). Conclusions Exposure to anesthesia is an increased risk for the later neurodevelopment of preschool children, especially before 3 years old. The time of cumulative duration of anesthesia may be positively correlated to the children's neurodevelopment disabilities.

Validity of the Korean Developmental Screening Test for very-low-birth-weight infants / 소아과

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±2.8 weeks and 980.5±272.1 g, 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.

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.

The impact of anemia and body mass index (BMI) on neuromotor development of preschool children

Summary Objective: According to data from the World Health Organization (WHO), anemia is a prevalent health problem that leads to increased morbidity and mortality, especially in preschool children. Anemia is recognized as a major health problem due to its negative effects on the mental and physical development during childhood. The aim of our study was to determine the levels of anemia of children in a kindergarten affiliated to the Directorate of National Education using a non-invasive method, and to investigate the effects of anemia on the physical, mental and neuromotor development of children. Method: The levels of anemia was evaluated by using a non-invasive measurement device. Data collection was performed by means of a questionnaire to evaluate the children's physical development and set Denver Developmental Screening Test II scores. Results: Our findings show that 21% of non-anemic and 15% of anemic children are in the suspected abnormal group according to their DDST II total score. Furthermore, it has been identified that mild anemia has a positive effect on neuromotor development, while overweight and obesity affect neuromotor development in a negative way. Conclusion: According to the results obtained from the study, mild anemia may have a positive effect on the children's neuromotor development, while malnutrition could have a negative impact.

Survey on infants aged 12 months in Shanghai Jing'an District by Denver Development Screening Test and analysis of their intellectual development relevant risk factors / 上海交通大学学报（医学版）

Objective·To investigate the developmental state of infants in early childhood and identify risk factors for their early development in community. Methods·Cluster sampling was conducted to collect data of infants aged 12 months by Denver Developmental Screening Test (DDST) in Shanghai Jing'an District. Logistic analysis was employed to detect factors influencing the intellectual development of infants. Results·A total of 4102 infants were enrolled in the survey. The prevalence for abnormal screening result was 1.0%, while 4.3% for suspicious abnormal result. Logistic analysis revealed that low birth weight (OR=6.24, 95% CI 1.69-22.98, P=0.006), low head circumference (OR=5.22, 95% CI 1.20-22.84, P=0.031), mothers older than 35 years in pregnancy (OR=3.61, 95%CI 1.32-9.84, P=0.012) or history of brain impairment (OR=3.96, 95% CI 1.55-10.10, P=0.003) were the risk factors for abnormal screening result. Spearman rank correlation analysis showed a significant negative relationship between breastfeeding duration and suspicious abnormal screening result (ρ=-0.031, P=0.046). Conclusion·It is essential to draw attention to early developmental screening and interference, especially to infants with mothers older than 35 years in pregnancy, low birth weight, low head circumference or high-risk infants.Breastfeeding is helpful for decreasing detection rate of abnormal result.

Survey on infants aged 12 months in Shanghai Jing'an District by Denver Development Screening Test and analysis of their intellectual development relevant risk factors / 上海交通大学学报（医学版）

Objective·To investigate the developmental state of infants in early childhood and identify risk factors for their early development in community. Methods·Cluster sampling was conducted to collect data of infants aged 12 months by Denver Developmental Screening Test (DDST) in Shanghai Jing'an District. Logistic analysis was employed to detect factors influencing the intellectual development of infants. Results·A total of 4102 infants were enrolled in the survey. The prevalence for abnormal screening result was 1.0%, while 4.3% for suspicious abnormal result. Logistic analysis revealed that low birth weight (OR=6.24, 95% CI 1.69-22.98, P=0.006), low head circumference (OR=5.22, 95% CI 1.20-22.84, P=0.031), mothers older than 35 years in pregnancy (OR=3.61, 95%CI 1.32-9.84, P=0.012) or history of brain impairment (OR=3.96, 95% CI 1.55-10.10, P=0.003) were the risk factors for abnormal screening result. Spearman rank correlation analysis showed a significant negative relationship between breastfeeding duration and suspicious abnormal screening result (ρ=-0.031, P=0.046). Conclusion·It is essential to draw attention to early developmental screening and interference, especially to infants with mothers older than 35 years in pregnancy, low birth weight, low head circumference or high-risk infants.Breastfeeding is helpful for decreasing detection rate of abnormal result.

Usefulness of the Korean Developmental Screening Test for infants and children for the evaluation of developmental delay in Korean infants and children: a single-center study / 소아과

PURPOSE: To evaluate the usefulness of the Korean Developmental Screening Test (K-DST) for infants and children for developmental delay assessment. METHODS: This study was based on retrospective studies of the results of the K-DST, Preschool Receptive-Expressive Language Scale (PRES), Sequenced Language Scale for Infants (SELSI), Childhood Autism Rating Scale (CARS), Modified Checklist for Autism in Toddlers (M-CHAT), electroencephalography, magnetic resonance imaging, and extensive tests conducted in 209 of 1,403 patients, of whom 758 underwent the K-DST at the Korea University Guro Hospital between January 2015 and December 2016 and 645 were referred from local clinics between January 2015 and June 2016. RESULTS: Based on the K-DST results, the male children significantly more frequently required further or follow-up examination than the female children in most test sections, except for gross motor. The male children had notably lower mean scores than the female children. The PRES/SELSI results showed that when more further or follow-up evaluations were required in the K-DST communication section, significantly more problems in language delay or disorder emerged. When further or follow-up evaluation was required in the cognitive section in the CARS/M-CHAT, the possibility of autism increased significantly. A child tended to score low in the CARS test and show autism when further or follow-up evaluation was recommended in the K-DST. CONCLUSION: This study demonstrated the usefulness of the K-DST as a screening test early in the development of infants and children in Korea. Data of normal control groups should be examined to determine the accuracy of this investigation.

The Validity of Korean Ages and Stages Questionnaires (K-ASQ) in Korean Infants and Children / 대한소아신경학회지

PURPOSE: As a preliminary study on the development of a new developmental screening tool, this study examined the validity of the Korean Ages and Stages Questionnaires (K-ASQ). METHODS: The clinical sample included a total of 218 Infants and children at 30, 36, 60 months of age, who were diagnosed with developmental disorders. Age- and sex-matched normal controls were selected from a national large-scale K-ASQ database. Sensitivity, specificity, and accuracy were calculated in different age and diagnosis groups, and receiver operating characteristic (ROC) curve analysis was performed as well. In addition, concurrent validity was analyzed for the clinical sample by comparing the K-ASQ with other reference scales. RESULTS: The sensitivity, specificity, and accuracy of the K-ASQ were above fair (0.82-0.96) overall, however they varied depending on age and diagnosis groups. Specifically, the sensitivity at 60 months was relatively low (0.65). Especially, the discrimination sensitivity for the language delay group was poor at 60 months (0.42). ROC analysis showed that the overall discrimination capacity was above fair in all 5 domains [area under the curve (AUC): 0.74-0.98]. However, there were some domains and age groups with relatively poor discrimination capacity. In terms of concurrent validity, the correlations between the K-ASQ domains and reference scale subscales were statistically significant overall, but weak in some domains. CONCLUSION: The overall discrimination capacity and concurrent validity of the K-ASQ were above fair, but there were some domains, age, and diagnosis groups in which the K-ASQ was not successful in identifying potentially developmentally challenged children. These findings suggested the need for the development of a new developmental screening test tool, which is suitable for Korean infants & children.

The Appropriateness of the Items of Korean Ages and Stages Questionnaires (K-ASQ) Developmental Screening Test in Korean Infants and Children / 대한소아신경학회지

PURPOSE: Since National Health Screening Program for Infants and Children in Korea started from November, 2007, the need to design a new tool that can timely identify infants and chlildren with possible delayed development has been emphasized. The developmental screening devices currently used in Korea are mostly adapted from foreign tests and could be considered inappropriate for children growing in a different cultural background. Therefore, we assessed the appropriateness of Korean-Ages and Stages Questionnaires (K-ASQ) items in Korean infants and children, as a preliminary study to develop a new developmental screening test tool. METHODS: Data on K-ASQ tests that were performed in multicenters as a National Health Screening Program in Korea were analyzed to measure (1) the item difficulty and norm relevance (2) the goodness of fit for factor structure (3) the sensitivity of item for developmental evaluation. A total of 1,696 subjects, 877 boys (51.7%) and 819 girls (48.3%) were studied and with about 50 boys and 50 girls for each age of months, the sample was relatively evenly distributed. RESULTS: Analysis of K-ASQ data showed that (1) The subjects scored higher when compared to the K-ASQ's original criteria. (2) The suitability of confirmative factor structure was insufficient, especially problem solving [x2=41.063, P<0.01, CFI (Comparative Fit Index)=0.929, TLI (Turker-Lewis index)=0.834, RMSEA (Root Mean Square Error Approximation)=0.152] and personal-social domains (x2=55.208, P<0.01, CFI=0.817, TLI=0.573, RMSEA=0.182). (3) Some questions did not show significant difference in the sensitivity of item for developmental evaluation among monthly age groups. CONCLUSION: According to the analysis of previous K-ASQ data, the appropriateness of the questionnaires is good in general, but some questions of problem-solving and personal social domains are not appropriate. We suggested the development of a new developmental screening test tool, which is suitable for Korean infants and children.

A study on Developmental delay among children less than 2 year attending Well Baby Clinic - Prevalence and antecedents factors.

Background: Early detection of neurodevelopmental abnormalities is important because of possibility of instituting early intervention program for that child. Trivandrum developmental screening test (TDSC) has sensitivity of 66.7% and specificity of 78.8%. This makes it a reasonably good test to screen children. Aims & Objective: To study the prevalence of developmental delay among children less than 2 years attending well baby clinic using TDSC and antecedents factors of developmental delay. Material and Methods: This cross sectional study was conducted on 200 patients visiting well baby clinic starting from age of 1 month till 2 years. Study was conducted for a period of 3 months from February 2013 to May 2013. Details pertaining to exact age, term or preterm status, maternal and paternal h/o was taken. Developmental screening was done using TDSC chart. Bell, pen, keys were used for assessment along with chart. Results were analyzed using SPSS 16.0. Results: Total of 200 patients was screened.181 children were found to be normal with 85.6%- 94.2 % CI. In 19 children, delay was found with 5.8%-14.4 % CI. Preterm, IUGR, respiratory distress, sepsis, seizures in neonatal period showed significant p value for developmental delay. Microcephaly patients when screened for TDSC showed developmental delay with p value less than 0.05.All growth parameters (head, weight and length) when less than third centile showed significant association to developmental delay. The study also showed linear regression curve significant for awareness of developmental as maternal education improves. Conclusion: Developmental screening with TDSC showed developmental delay prevalence 9.5%. All children should be screened in well baby clinic for developmental delay. In India, sources have found prevalence of 1.5-2.5% of developmental delay in children less than 2 years of age. High incidence of our study can be due to study done at tertiary care centre. Preterm and IUGR were found to have developmental delay with significant p value. Various antecedents’ factors responsible for early brain injury showed significant p value. Hence every child attending well baby clinic should be screened for developmental delay with effective screening method such as TDSC.

Analysis of results in 1 064 cases of Denver developmental screening test on children between 0 to 18 months / 中国基层医药

Objective To analyze the situation of the intellectual development of children between 0 to 18months.Methods Using Denver Developmental Screening Test(DDST),1 064 children aged between 0 to 18 months in four items:their indicidual and social reaction ability,subject-touching reaction ability of fingers,and speaking ability as well as movement ability were tested,each itern had 2 kinds of tests and here only need to test one kind which is shown on the left part of DDST.Every example need to understand the pregnancy history,family history,birth of children,past history,parents'jobs and education level.The measured results were calculmed,about the ages of which 50%examlnation could pass in each test itern and 90%could pass,and compared with tested children in Denver.Results The passing rate of same item would be increased as age increases.the passing rate would be different between different test items in the sslne age,and the more difficult the item,the lower the passing rate.The common trend of children's intellectual development Was in accordance with that of Denver children,whereas there were age differences that pass certain items.Conclusion As a screening way of infants'intellectual tests,DDST had universal significance.Lacking scientific education was an important cause of mental retardation in children.

A Comparison of the Korean-Ages and Stages Questionnaires and Denver Developmental Delay Screening Test

OBJECTIVE: To evaluate concurrent validity between the Korean-Ages and Stages Questionnaires (K-ASQ) and the Denver Developmental Screening Test II (DDST II), and to evaluate the validity of the K-ASQ as a screening tool for detecting developmental delay of Korean children. METHOD: A retrospective chart review was done to examine concurrent validity of the screening potentials for developmental delay between the K-ASQ and the DDST II (n=226). We examined validity of the K-ASQ compared with Capute scale (n=141) and Alberta Infant Motor Scale (AIMS) (n=69) as a gold standard of developmental delay. Correlation analysis was used to determine the strength of the associations between tests. RESULTS: A fair to good strength relationship (k=0.442, p<0.05) was found between the K-ASQ and the DDST II. The test characteristics of the K-ASQ were sensitivity 76.3-90.2%, specificity 62.5-76.5%, positive likelihood ratio (PLR) 2.41-3.40, and negative likelihood ratio (NLR) 0.16-0.32. CONCLUSION: Evidence of concurrent validity of the K-ASQ with DDST II was found. K-ASQ can be used for screening of developmental delay.

Diagnosis of Speech Disorder and Language Developmental Delay in Korean Preschoolers

OBJECTIVE: This study was designed for evaluating the clinical usefulness of the Korean Denver Developmental Screening Test II (KDDST II) for screening of speech-language delays, for evaluating the co-morbidity of psychiatric disorders and examining the prevalence of hearing impairment in speech-language delays. METHOD: Fifty eight preschoolers whose chief complaints fell into 'late talker', 'dysarticulation' or 'stuttering' performed KDDST II, speech-language evaluation and hearing screening. Psychiatric consultation was performed if the child had any behavioral or emotional red flags. RESULTS: More than 50% were classified as 'language delay only', 25.9% as 'language delay with speech disorder', 22.4% as 'phonological disorder only'. Eleven children (34.4%) with language delay were classified as 'global developmental delay'. Sensitivity of KDDST II as a screening tool of language delay was only 84.4%. Two cases of hearing impairment and 3 cases of complicated otitis media were detected by hearing screening. Seventeen children (29.3%) also had psychiatric disorders such as attention deficit hyperactive disorder, anxiety disorder, and autism spectrum disorder. CONCLUSION: Evaluation of whole spectrums of development and hearing screening were recommended in the children with speech-language delays. Psychiatric consultation should be also considered in a case of any behavioral or emotional concerns.

Usefulness of Korean Infant Developmental Screening Test in Premature Infants / 소아과

PURPOSE: This study aimed to evaluate the usefulness of Korean Infant Development Screening Test in predicting delayed development in premature infants. METHODS: A total of 74 children with histories of prematurity, who visited the pediatric neurology clinic of Korean University Ansan Hospital from August, 2002 to July, 2004, were examined, using the Korean Infant Development Screening Test. They were divided into two groups; a normal group and a patient (neurologically compromised) group. RESULTS: At 7 months of conceptional age, the normal and patient groups differed significantly in the fine motor, cognitive-adaptive sections. At 12 months of conceptional age both group, differed significantly in the gross motor, fine motor, personal-social, language and cognitive-adaptive sections. At 18-24 months, the group, differed significantly in gross motor, fine motor, personal-social, language and cognitive-adaptive sections. CONCLUSION: The Korean Developmental Screening Test was useful in predicting developmental delay in premature infants.

Neonatal behavioral neurological assessment and developmental screening test for newborns with hypoxic ischemic encephalopathy / 中国康复理论与实践

@#ObjectiveTo discuss the effect of neonatal behavioral neurological assessment (NBNA) and developmental screening test (DST) on newborns with hypoxic ischemic encephalopathy (HIE). MethodsNBNA was performed for 60 newborns with HIE within 12-14 days and DST was also performed at 6th month after birth.ResultsMild and severe degree HIE newborns with low NBNA scores had unfavorable prognosis. Conclusions NBNA and DST can provide evidence for early interference for newborn's HIE.

Analysis on the Results of Developmental Screening Test in One Public Health Center / 아동간호학회지

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: 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.

Correlation of Periventricular Leukomalacia on the Brain MRI and the Denver II and Capute Developmental Test

OBJECTIVE: This study was designed to evaluate the correlation of periventricular leukomalacia (PVL) on brain MRI and Denver II and Capute developmental test. METHOD: Thirty children with PVL on brain MRI showing delayed development were included. The severity of PVL was graded as localized/generalized lesion in three fields; periventricular hyperintensity in T2 weighted image (PVHI in T2WI), reduced volume of cerebral white matter (RV of CWM), ventriculomegaly with periventricular wall irregula rity (VM with PVWI). Development quotients were obtained by Denver II and Capute test, and assessed according to the severity of PVL. RESULTS: Although language, fine motor-adaptive, personal- social scale of Denver II and cognitive-adaptive and clinical linguistic and auditory milestone of Capute test had little correlation with severity of PVL, gross motor developmental scale assessed by Denver II had a certain degree of correlation with severity of PVL which was not significant statistically. The gross motor developmental scale of the nineteen preterm births had a significant correlation with VM with PVWI, but the other developmental scales still had no significant correlation with PVL. CONCLUSION: As for the children with delayed development the degree of motor development was a significant predictor of the PVL on brain MRI, but those of language and cognitive development were not.

The Seoul Infant Developmental Screening Test

PURPOSE: The importance of early detection of developmental delays during infancy and preschool years has been repeatedly stressed, as early diagnosis of retardation increases the opportunities for effective therapy. Several screening tests developed in other countries are inappropriate for Korean children. The purpose of this study was to standardize a developmental screening method for Korean children. MEHTODS: One hundred and forty-four test items were selected and tested on 1,021 children in Seoul, aged 2 weeks to 4 years. Ages at which 25, 50, 75% and 90% of children pass each test were calculated, and using these data, the Seoul Infant Developmental Screening Test was constructed. RESULTS: Among 144 tests, 141 were selected for the test. There was little difference between boys and girls until the age of 1 year. After 1 year, boys advanced in motor development, while girls exceeded boys in language and social-adaptive sector of development. There was no difference according to fathers' occupations or mothers' educational levels. CONCLUSION: The Seoul Infant Developmental Screening Test was standardized on Korean children and can be used as a screening tool. The reliability and validity of the test should be further tested on normal children as well as children with developmental delays in the future.

Comparison of the Findings of DDST (II), Brain SPECT and Brain MRI in Cerebral Palsy Children

OBJECTIVE: To evaluate the clinical values of the DDST II (Denver Developmental Screening Test, 2nd revision), 99mTc HMPAO brain single photon emission computed tomography (SPECT) findings and brain magnetic resonance imaging (MRI) in the assessment of cerebral palsy children. METHOD: Twenty-two children with cerebral palsy were investigated. Four profiles of DDST (II) were summated to a monthly age according to each developmental status. 99mTc HMPAO brain SPECT imagings were analyzed for the calculation of the perfusion defect indices. The clinical severities were scored as mild to severe, and were compared to a motor age of Maryland criteria. The presence of abnormal findings of brain MRI was also checked. RESULTS: (1) The gross and fine motor profiles of DDST (II) were significantly different between normal and abnormal findings of the brain SPECT in cerebral palsy children. (2) The region of interests ROIs in brain SPECT correlated with many profiles of DDST (II), 1) prefrontal area of the brain SPECT and language profile of DDST (II), 2) premotor area and gross motor/language profile, 3) thalamic area and social-personal profile, 4) basal ganglia area and gross motor/language proflie. respectively. (3) There was no relationship between each profile of DDST (II) and brain MRI findings. CONCLUSION: The DDST (II) and Brain SPECT seemes to be more useful than the brain MRI for the functional assessment of cerebral palsy children.