Predictive validity of the Standardized Infant NeuroDevelopmental Assessment (SINDA) to identify 4-5 year-old children at risk of developmental delay in a low-risk sample.

BACKGROUND: Early detection of developmental problems is important as it allows for early intervention. Previous studies, in high-risk infants, found high predictive values of atypical scores on the Standardized Infant NeuroDevelopmental Assessment (SINDA) for later neurodevelopmental disorders (i.e., cerebral palsy, intellectual disability). AIMS: The present study explored SINDA's predictive values to identify risk of developmental delay at 4-5 years. STUDY DESIGN: Cohort study. SUBJECTS: 786 low-risk Dutch children (367 boys; median gestational age: 40 (27-42) weeks; mean birth weight: 3455 (SD 577) grams). OUTCOME MEASURES: The SINDA was assessed at 2-12 months and risk of developmental delay was assessed using the Ages and Stages Questionnaire (ASQ) at 4-5 years. SINDA's predictive values were determined for five ASQ domains and the total ASQ score for children at risk of marked (all ASQ domains deviant) and any (one or more ASQ domains deviant) developmental delay. RESULTS: Presence of one atypical SINDA scale score showed low to moderate sensitivities (12-88 %, depending on the SINDA scale and ASQ domain involved), moderate to high specificities (66-94 %), low positive predictive values (PPVs; 3-16 %), and high negative predictive values (NPVs; 95-100 %) for children at risk of marked and any developmental. Presence of multiple atypical SINDA scale scores predicted deviant ASQ domains slightly better (sensitivities = 11-62 %, specificities = 90-98 %, PPVs = 6-30 %, and NPVs = 95-100 %). CONCLUSIONS: In low-risk infants, SINDA's predictive value is low for detecting children at risk of marked and any developmental delay at 4-5 years, as reflected by the low sensitivities. One of the explanations is the relatively low prevalence of developmental delay in low-risk populations. This might have consequences for the application of the SINDA in general healthcare settings (e.g. child health clinics), but further studies are needed to draw this conclusion.

Long-term effects of experiencing childhood parental death on mental and physical health: A NESDA study.

Experiencing parental death during childhood is an adverse, potentially traumatic experience that may have substantial long-term effects on mental and physical well-being. The current study was based on data of the Netherlands Study of Depression and Anxiety to investigate mental health (i.e., depressive symptoms, anxiety symptoms, and suicidal ideation) and physical health outcomes (i.e., metabolic syndrome, telomere length, and perceived physical health) as well as health behaviour (i.e., smoking status, alcohol use, and physical activity) to provide more insight into the long-term outcomes after experiencing childhood parental death (CPD). For individuals who experienced CPD, we also investigated the role of loss-related factors in these associations, namely the age of the child when their parent passed away and gender of the deceased parent. Interviews and questionnaires were completed by adults between 18 and 65 years; 177 participants experienced CPD (mean age = 45.19, 61.6% female) and 2463 did not (mean age = 41.38, 66.6% female). Results showed no overall association between the experience of CPD and mental and physical health indices and health behaviour. Within the CPD group, experiencing CPD at a younger age was related to a higher likelihood of suicidal ideation. These findings seem to illustrate a general positive adjustment with regard to long-term health functioning after experiencing such an impactful life event. Future research should focus on individual differences in terms of adaptation, especially elucidating on contextual factors after the loss, such as the kind of support that is or is not provided by the surviving parent and/or other important individuals.