Background:
Specific learning disorders (SLD) comprise varied conditions with ongoing problems in one of the three areas of educational skills–reading, writing, and arithmetic–which are essential for ...the learning process. There is a dearth of systematic reviews focused exclusively on the prevalence of SLD in India. Hence, this study was done to estimate the prevalence of SLD in Indian children.
Methods:
A systematic search of electronic databases of MEDLINE, Embase, PsycINFO, and CINAHL was conducted. Two authors independently assessed the eligibility of the full-text articles. The third author reassessed all selected studies. A standardized data extraction form was developed and piloted. The pooled prevalence of SLDs was estimated from the reported prevalence of eligible studies, using the random-effects model.
Results:
Six studies of the systematic review included the diagnostic screening of 8133 children. The random-effects meta-analysis showed that the overall pooled prevalence of SLD in India was 8% (95% CI = 4–11). The tools used to diagnose SLD in the studies were the National Institute of Mental Health and Neurosciences (NIMHANS)-SLD index and the Grade Level Assessment Device (GLAD).
Conclusions:
Nearly 8% of children up to 19 years have SLD. There are only a few high-quality, methodologically sound, population-based epidemiological studies on this topic. There is a pressing need to have large population-based surveys in India, using appropriate screening and diagnostic tools. Constructing standardized assessment tools, keeping in view the diversity of Indian culture, is also necessary.
To evaluate the effect of antiepileptic medications prescribed to mothers during pregnancy on the development and behavior of children.OBJECTIVESTo evaluate the effect of antiepileptic medications ...prescribed to mothers during pregnancy on the development and behavior of children.From the Kerala Registry of Epilepsy and Pregnancy, 98 children between the ages of 1½ to 2½ y were consecutively chosen. Children of mothers who did not have epilepsy during pregnancy and not exposed to antiseizure medications (ASMs) antenatally were selected as comparator group. Developmental assessment of the children was performed using Developmental Assessment Scale for Indian Infants (DASII) and Receptive-Expressive Emergent Language Scale (REELS). Behavior outcomes were assessed using Child Behavior Checklist.METHODSFrom the Kerala Registry of Epilepsy and Pregnancy, 98 children between the ages of 1½ to 2½ y were consecutively chosen. Children of mothers who did not have epilepsy during pregnancy and not exposed to antiseizure medications (ASMs) antenatally were selected as comparator group. Developmental assessment of the children was performed using Developmental Assessment Scale for Indian Infants (DASII) and Receptive-Expressive Emergent Language Scale (REELS). Behavior outcomes were assessed using Child Behavior Checklist.A significant delay in expressive language skills was seen in children exposed to antiseizure medication with an odds ratio of 2.539 (95% CI 1.10, 5.85, P = 0.026). A delay in expressive language skills was seen in polytherapy with clobazam (odds ratio 6.83; 95% CI 2.17, 21.56, P < 0.001). Also, delay was seen in receptive language skills in the same polytherapy group (odds ratio of 7.333; 95% CI 2.16, 24.92, P < 0.001). There were no statistically significant differences between study and comparative groups in motor and mental quotient domains and behavioral outcomes.RESULTSA significant delay in expressive language skills was seen in children exposed to antiseizure medication with an odds ratio of 2.539 (95% CI 1.10, 5.85, P = 0.026). A delay in expressive language skills was seen in polytherapy with clobazam (odds ratio 6.83; 95% CI 2.17, 21.56, P < 0.001). Also, delay was seen in receptive language skills in the same polytherapy group (odds ratio of 7.333; 95% CI 2.16, 24.92, P < 0.001). There were no statistically significant differences between study and comparative groups in motor and mental quotient domains and behavioral outcomes.The finding of speech delay in children exposed to ASMs is significant since individuals with a history of childhood speech or language disorders may experience long-term difficulties in mental health, social well-being, and academic outcomes.CONCLUSIONSThe finding of speech delay in children exposed to ASMs is significant since individuals with a history of childhood speech or language disorders may experience long-term difficulties in mental health, social well-being, and academic outcomes.
There is a dearth of validated red flags measures for early identification of autism spectrum disorder (ASD) among toddlers. Hence, a new screening measure was developed. Item generation was done ...through literature search. Content validity (CVI) assessment was done. Criterion validity was done using Diagnostic and Statistical Manual 5 (DSM-5) as reference standard, data were collected from the case records of children with ASD diagnosis at 2 y, and evaluated for developmental milestones between 12 and 18 mo in a tertiary care setting. Item reduction of the measure from 18 to 9 was done. The area under the curve in the receiver operating characteristic (ROC) curve for new measure was 0.81 (95% CI = 0.73, 0.87);
z
= 7.874;
p
< 0.001 against DSM-5 score of ≥ 2 in the new measure; achieved sensitivity of 93.42% (95% CI = 85.3, 97.8) and specificity of 60% (95% CI = 45.9, 73.0). Thus, new validated red flag sign card (Concern-9) can be used effectively for early screening and identification of ASD among children aged 12–18 mo.
OBJECTIVESTo develop a tool to assess pre-writing skills of 2-5 y old children in India. METHODSThe tool development process followed the recommendations by Fitzpatrick et al. and the Consensus based ...Standards for the selection of health Measurement Instruments (COSMIN), and included 4 phases. In Phase I, an initial 35-item draft tool was developed by an expert panel for the tool-development. In Phase II, the 35-item draft tool was prevalidated through peer and expert reviews, pilot-study to assess the tool-comprehensibility, and assessment of test-retest and inter-rater reliability. In Phase III, the 35-item draft tool was administered on the 575 typically developing children aged 2-5 y, recruited from rural, urban, slum, and coastal areas through stratified random sampling. In Phase IV, the normative age-range for development of each item was generated by calculating the age-percentiles (10th, 25th, 50th, 75th, 90th). Factor analysis and item reduction was done for items in 2-3, 3-4, and 4-5 y age-groups. The final tool was converted to graphic format with 10th-90th age-percentile bars. RESULTSThe final tool had 26 items with a three-factor structure. Cronbach's alpha was within acceptable limits for all three age-groups (0.723, 0.778, and 0.823 in 2-3 y, 3-4 y, and 4-5 y respectively). Kappa coefficients of the items ranged from 0.6-1 in interrater reliability and 0.64-1 test-retest reliability analysis reflecting substantial agreement between ratings. CONCLUSIONSA 26-item screening tool "Prewriting skills Assessment Tool" (PAT) to assess writing readiness of 2-5 y old children was developed. Tool reliability and construct validity have been established.
Background: Overweight and obesity among adolescents and children are associated with early onset of non-communicable diseases and greater risk of complications in adulthood. The study was conceived ...in the background of the high burden on adult non-communicable diseases in the state, to assess the prevalence and determinants of overweight and obesity among higher secondary students in one of its fourteen districts, with a view to explore the areas to be focused in preventive activities.Methods: Anthropometric, blood pressure, and physical examination of 1846 class plus one students were conducted in Thiruvananthapuram. Lifestyle assessment of the children was also conducted using a self-administered prevalidated questionnaire. Prevalence of overweight and obesity was calculated based on Indian academy of pediatrics body mass index cut-offs. Logistic regression analysis was done to discover factors associated with overweight conditions.Results: Among the students, 14.19% were overweight; 6.45% were obese. Boys, rural residents, and those from low socioeconomic background had lower odds of being overweight. Students who had main meal (s) from outside on three or more days a week (adjusted odds ratio 1.99; CI: 1.17-3.386), and with history of hypercholesterolemia (adjusted odds ratios (aOR) 1.8; CI: 1.19-2.63), obesity (aOR 1.6; CI: 1.11-2.23), or diabetes (aOR 1.5; CI: 1.17-1.95) in the immediate-family had higher odds of being overweight. Hypertension and acanthosis were significantly higher among overweight students (p=0.001).Conclusions: The results warrant the adoption of screening and timely intervention for non-communicable disease risk factors from school level itself to reduce future morbidity and the risk of complications.
Objective
To validate effectiveness of low intensity, home based early intervention (EI) models in autism for countries with low disability resources.
Methods
Fifty-two toddlers and young children ...were assessed before and after intervention with Childhood Autism Rating Scale, Vineland Social Maturity Scale, and Receptive-Expressive Emergent Language Scale. Developmental and speech therapists helped mothers assemble low-cost training kits based on the developmental age of the child, gave initial training in the basic behavioral technique to address the three autism symptom clusters at home. Follow-up support was given either on a weekly, fortnightly or monthly basis. Most of the children were also placed in play-schools. Data was analyzed using appropriate bivariate and multivariate techniques.
Results
There was statistical and clinical amelioration in the severity of autism, with acquisition of social skills and language skills (all
P
= 0.001) after intervention in children with mild to severe autism. Gender showed a trend in becoming a significant predictor for intervention response.
Conclusions
Low-intensity, home-based EI can be effectively used in situations where there is paucity of disability resources in countries like India, especially in primary-care and community settings.
CDC Kerala – The Untold Story Nair, M. K. C.; Leela, Leena Mundapalliyil; George, Babu ...
Indian journal of pediatrics,
05/2016, Letnik:
83, Številka:
5
Journal Article
Recenzirano
This article is our life time experience in conceptualizing and systematically developing Child Development Centre (CDC) Kerala in the last 25 years, from a research project to a national training ...centre in child and adolescent development and premarital counseling. CDC Kerala’s major contribution was in creating a ‘conceptual framework’ of a valid link between childhood disability, low birth weight, adolescent girls’ nutrition and fetal onset adult lifestyle diseases. It all started with a randomized controlled trial (RCT) proving beyond doubt that early stimulation is effective in improving the neurodevelopmental status of high risk babies at one and two years and the same cohort was followed-up in detail at 5, 13, 16, 19 and 24 completed years. The process of establishing CDC Kerala is being presented under (i) clinical child development, (ii) adolescent care counseling, (iii) young adults and premarital counseling and (iv) institution building.
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