ABSTRACT
Medical practitioners are, like the other health, education and childhood professionals, important actors of the language and learning disorders' screening. Six years old--the age at which children start the elementary school--is a key age for this screening. At the request of practitioners, a multidisciplinary staff had developed a screening tool: ERTLA6 (Epreuves de repérage des troubles du langage et des apprentissages de l'enfant de 6 ans). The objective was to validate the capacity of ERTLA6 to predict the school performance. A sample of 187 children was randomly constituted among the whole population of last year nursery school children in an area of France (the Académie de Nancy-Metz). Those children, aged from 5 to 6, were screened with ERTLA6 by the school practitioner during a medical visit (score from 0 [the best] to 18 [the worse]). The School outcomes (considered as judgment criteria) were assessed 2 or 3 years later, after two years of elementary school. 148 children had completed their follow-up (the others: 27 moving house, 6 absents the day of evaluation, 2 missing data). Mean age was 5; 10 years. With a threshold > or = 7, ERTLA6 sensibility and specificity were respectively 79% [63-94] and 87% [81-93]; the positive predictive value was 58% [42-74], the negative predictive value was 95% [90-99]. The percentage of well classified children was 84% [69-99]. To our knowledge, ERTLA6 is the first validated tool in France for screening language and learning disorders which can be used by practitioners for the prediction of school outcomes.
Subject(s)
Language Disorders/diagnosis , Learning Disabilities/diagnosis , Surveys and Questionnaires , Child , Female , France , Humans , Male , Mass Screening , Predictive Value of Tests , PsychometricsABSTRACT
BACKGROUND: School accidents are frequent but little epidemiological information is available to guide prevention. In this study we examined the incidence, causes, and consequences of school accidents as a function of the pupil's characteristics. METHODS: An epidemiological study was conducted in all 2 396 adolescents attending two secondary school groups. Sociodemographic characteristics of the pupils and data on school accidents during a one-year period were collected using a questionnaire filled out by the school nurse in the presence of the victims. The chi-square independence test, Fisher's exact test and the logistic regression method were used for the statistical analysis. RESULTS: Sports and physical training (SPT) accidents accounted for 52.8% of the accidents, recreation accidents for 12.7% and other accidents for 33.6%. The annual incidence of one accident or more, for all types of accidents combined, was 12.9%, that for two or more accidents 2.3%. The rate of SPT and recreation accidents decreased strongly with age. SPT accidents were more frequent in girls, the other accidents more frequent in boys. Among the SPT accidents, 69.2% occurred under training conditions and 33.7% were caused by another person. Causes mentioned by the victims were: carelessness (26.0%), clumsiness (17.5%), misappreciation of risk (13.8%), tiredness (9.5%), nervous irritation (8.6%), rowdyism (6.0%), disrespect of the teacher's instructions (6.0%). The lesions were: contusions (50.7%), wounds (18.7%), tendinitis (11.7%), wrenches (9.2%), others (7.3%). They differed between age groups, sex, and category of sports. Localizations were mainly: fingers (27.4%), other localizations of the upper limb (20.1%), head (20.6%). A physician was consulted for 19.5% of the accidents and hospitalization followed 2.7%. Absence from school and exemption from SPT were frequent (11.4% and 16.3% respectively). CONCLUSION: The results could be used to inform adolescents so they and their families could become more aware of the risk of school accidents. Prevention should mainly focus on the younger children. An effort must be made regarding risk assessment in order to help the pupils become more careful and responsible during their sports activities. The choice of these activities and the materials used should be made more suitable for adolescents.
Subject(s)
Accidents/statistics & numerical data , Wounds and Injuries/epidemiology , Adolescent , Child , Female , Humans , Incidence , Male , Surveys and Questionnaires , Wounds and Injuries/etiologyABSTRACT
BACKGROUND: School accidents in adolescents in professional and technological secondary schools are relatively frequent. This work investigates these accidents in Lorraine (a French region) to identify preventive measures. METHODS: A cross-sectional study was carried out in 4,751 adolescents from five volunteering schools. Only accidents occurring during one school-year and declared to the Social Security Services as work accidents were studied. RESULTS: Incidence of accidents per 1,000 subjects was 52.0: 21.3 for accidents during sports and physical training (SPT), 7.8 for those occurring during school training (except SPT), and 22.9 for spare time accidents. The incidence increased strongly with age and differed greatly between the type of schools. Girls had more accidents during SPT than boys. Injuries during school training were wounds and contusions of upper limb while the injuries during SPT and spare time were mainly articular disorders, contusions, and wounds of the upper limb, the lower limb, and the head and neck. A physician was consulted in almost 100% of the injuries, a radiological examination was performed for 75%, and a surgical intervention for 14% of the injuries. Absence from school, exemption from workshops and from SPT were frequent. The predominant risk factors were the type of activities, especially activities the adolescents were not accustomed to, personal behavior and risks taken by adolescents. CONCLUSION: Accidents are frequent, in particular among older adolescents. It is important to identify activities at risk, and to target prevention and awareness campaigns, assessment training to evaluate risks of each activity, and promoting safe behavior, although environmental factors cannot be excluded.