Parents' tracking of developmental milestones can assist healthcare providers with early detection of developmental delays and appropriate referrals to early intervention. Crowdsourcing is one way to ...update the content and age data distribution of developmental checklists for parents and providers. This feasibility study examined which developmental milestones parents chose to track and what they added beyond traditional milestones, using the babyTRACKS crowd-based mobile app.
We analyzed the developmental diaries of 3,832 children, registered in the babyTRACKS app at an average age of 9.3 months. Their parents recorded a median of 5 milestones per diary, selecting from the accumulating lists of age-appropriate milestones or authoring new milestones. The final database included 645 types of milestones; 89.15% were developmental, of which 43.6% were comparable to the Centers for Disease Control (CDC) milestones while the rest were crowd-authored. Milestones were categorized into developmental domains: Gross Motor, Fine Motor, Oral Motor, Self-Care, Cognitive, Language Comprehension, Speech, Non-Verbal Communication, Social, Emotional, and Regulation.
On average, the milestone domains of Gross Motor, Fine Motor, Cognitive and Social were the most added to diaries (20%-30% of a diary). Within the Cognitive, Speech and Language Comprehension domains there were significantly more CDC comparable versus crowd-authored milestones (29% versus 21%, 22% versus 10%, 8% versus 4%). In contrast, within the Regulation and Oral Motor domains there were more crowd versus CDC milestones (17% versus 3%, 9% versus 3%). Crowd-authored Speech milestones were significantly older by 7 months than CDC milestones.
Tracking daily observations of child development provides a window into personally relevant milestones for the child and parent. The crowd of parents can independently track and add new milestones across main developmental domains. Regulation and Oral Motor development especially interest parents. Parents may be less aware of early progress in Language Comprehension and Speech; thus, these domains require more structured screening. Designing mobile early screening which is crowd-based engages parents as proactive partners in developmental tracking.
This meta-analysis updated evidence regarding sensory over-responsivity (SOR), under-responsivity (SUR) and seeking symptoms in individuals with autism spectrum disorders (ASDs) relative to typical ...controls and those with other conditions. Fifty-five questionnaire studies included 4606 individuals with ASD. Moderators tested were age, IQ, male ratio, matching group, and self-report. Compared to typical controls, effect size was large and significant for SOR, SUR, and Seeking but heterogeneous. For Seeking, age, IQ and self-report were significant moderators. Compared with developmental disorders (DDs) groups, effect size was significantly positive for SOR and Seeking; whereas compared with other clinical groups, only SOR was significant. These findings highlight the core nature of sensory symptoms in ASD and particularly SOR. Explanatory factors are yet to be revealed.
Background
Family‐centred care (FCC) is considered the best practice in paediatric care but it is not always implemented sufficiently. Effective training programmes that enhance health care ...providers' knowledge and self‐efficacy have the potential to improve FCC implementation in their daily practice. The goal of the study was to evaluate the sensitivity of the measure of processes of care (MPOC)‐service provider (MPOC‐SP) version and MPOC confidence (MPOC‐Con) in detecting changes following an FCC training.
Methods
The MPOC‐Con was developed for this study as a sequel to MPOC‐SP to measure self‐efficacy related to specific FCC practices. Twenty‐four health care providers (occupational and physical therapists, speech pathologist, and special education teacher) participated in a 6‐month FCC provider training. The training included 30 contact hours on FCC principles and techniques through experiential learning, reflective exercises, peer mentoring, and case‐study analyses. The MPOC‐SP and MPOC‐Con were administered preparticipation and postparticipation.
Results
Repeated multivariate analysis of variance and reliable change index (RCI) analyses indicated a significant group increase in performance and confidence following the training in two of the four MPOC‐SP factors and in all MPOC‐Con factors, F(1, 7) = 5.17, P = .003, η2 = .68; RCI > 1.96. Individual change patterns in FCC performance indicated patterns of increased, decreased, or stable performance, with the highest increased performances reported for treating people respectfully (79%) and communicating specific information (71%), mostly stable performance in providing general information (75%) and similar levels of increase and stability (41% and 39%, respectively) for interpersonal sensitivity. The Pearson's correlation between MPOC‐SP and MPOC‐Con were significant, moderate‐strong, and positive (r = .42–.69, P < .05).
Conclusions
The MPOC‐SP and the MPOC‐Con are sensitive measures suitable for evaluating individual and group changes following training. When designing professional development programmes, managers and educators should consider the interrelation between self‐efficacy and implementing acquired knowledge and skills in FCC.
Family accommodation refers to the attempt of family members (most often parents) to prevent their child's distress related to psychopathology. Family accommodation can limit meaningful participation ...in personal and social routines and activities. Accommodation has been studied extensively in the context of childhood anxiety and has been linked to greater impairment, and poor intervention outcomes. Like anxiety, sensory over-responsivity (SOR) symptoms are associated with heightened distress and thus, may also be accommodated by family members. The current study describes the validation of a new pediatric family accommodation scale for SOR. Parents of 301 children ages 3-13 years completed an online survey, of which 48 had medical or developmental conditions. The survey included the Child Sensory Profile 2 and the newly developed family accommodation scale for sensory over-responsivity (FASENS). Three Sensory Profile 2 scores were analyzed: SOR, sensory under-responsivity and sensory seeking. The FASENS consists of 18 items; 12 describing the frequency of accommodation behaviors and 6 describing the impact of the accommodation on the wellbeing of the family and the child. Results indicated that the FASENS has high internal consistency (α = 0.94) as well as a significant 3-factor confirmatory model fit: (1) accommodations (i.e., avoidance and changes), (2) family impact, and (3) child impact. FASENS scores significantly correlated with SOR symptoms (
= 0.52-0.60,
< 0.001). However, they also correlated with under-responsivity and seeking (
= 0.33-0.42,
< 0.001). Parents of children with health conditions reported significantly higher FASENS scores (
< 0.002), which corresponded with their child's significantly higher sensory scores (
< 0.001). Family accommodations for SOR occur to some extent in the general population, but their prevalence and impact are significantly greater when the child has a health condition, in addition to SOR. Additional research is needed to explore whether these accommodations are adaptive and whether families and children would benefit from learning to reduce them, as with anxiety.
Objective: To establish the diagnostic validity of sensory overresponsivity (SOR), there is a need to document rates of SOR and the co-occurrence of SOR with other psychiatric disorders. Although ...this was not a diagnostic study of SOR, this study was designed to investigate rates of elevated SOR symptoms and associations between elevated SOR symptoms, psychiatric disorder status, and family impairment. Method: From a larger birth cohort followed from infancy to school age, 338 children aged 7 to 10 years (51% boys, 49% girls) and their parents participated in an intensive assessment. Parents were interviewed with the Diagnostic Interview Schedule for Children (DISC) and completed the SensOR inventory and the Family Life Impairment Scale. Results: Approximately one-fifth (21.2%) of children had elevated SOR symptoms. One-fourth (24.3%) of those with an elevated SOR score met criteria for a "DSM-IV" diagnosis, and 25.4% of children with a "DSM-IV" diagnosis had an elevated SOR score. Parents of children with elevated SOR alone reported a similar number of restrictions in family life as parents of those with an internalizing and/or externalizing diagnosis. SOR predicted concurrent family impairment above and beyond DSM diagnostic status and socio-demographic risk. Conclusions: Elevated SOR occurs in the absence of other psychiatric conditions and is associated with impairment in family life. Services for children with comorbid elevated SOR and an externalizing disorder are needed to address the extremely high level of family impairment reported. (Contains 2 figures and 3 tables.)
Some individuals who suffer from obsessive-compulsive (OC) disorder (OCD), report disturbing sensory preoccupations. The inability to stop obsessing over stimuli resonates with a difficulty in ...sensory habituation. Impaired sensory habituation, to a degree that clearly dysregulates response to sensory stimuli, and impairs participation in everyday activities, can be part of a disorder known as sensory over-responsivity (SOR). Although previous studies indicated a correlation between OCD and SOR, physiological experiments show that individuals with OCD are not more sensitive to sensory stimuli than controls. In the current study, we (1) validated a sensory habituation psycho-physiological protocol and (2) tested whether a "slow to habituate" mechanism can explain the occurrence of elevated SOR and OC symptoms.
We designed a protocol to test auditory sensory habituation through electrodermal activity (EDA) recording. The protocol included two randomly ordered aversive and neutral sound conditions; each set of six everyday life sounds was presented as a continuous stimulus. During the presentation of sounds, EDA was measured and participants could press a button to shorten the stimuli. Participants also completed sensory and OC symptom questionnaires. Participants included 100 typically developing adults that were divided into high versus low OC symptom groups. Mixed models analysis was used throughout to meet the need for capturing the temporal nature of habituation.
Distinct physiological indices were computed to measure sensitivity versus habituation. Habituation was slower in the aversive versus neutral condition. Sensitivity was higher for the aversive stimuli. Self-report of sensory habituation and sensitivity partially correlated with the physiological habituation indices. A comparison of the physiological pattern between those with high versus low OC symptoms revealed significant differences in the habituation and sensitivity indices, across conditions.
The interplay between SOR and OC symptoms can be explained by a "slow to habituate" mechanism. Identifying behavioral and physiological markers of sensory problems in OCD is important for assessment, intervention and the discovery of underlying mechanisms.
Many clients engage in an intense search for evidence related to the diagnosis, prognosis and intervention options of their (or their dependent's) health condition. A client‐based search for evidence ...poses challenges from a client and clinician perspective and evolves the client‐clinician relationship. This paper describes the meaning of searching for health evidence by health‐care clients such as parents of hospitalised children through a personal story. I discuss the subjective search for evidence‐based health information, interpretation and transfer of information as well as its impact on providers. In order to implement client‐centred care and evidence‐based practice health care organisations and providers need to take an active role in guiding clients in effective health information‐seeking behaviour and to develop mechanisms for processing evidence presented by clients.
Objective: This study aimed to characterize clusters of children based on ADHD and sensory over-responsivity (SOR) symptoms, and to compare their markers. Method: Parents of 922 infants completed the ...Infant–Toddler Social and Emotional Assessment (ITSEA) Sensory Sensitivity, Attention, and Activity/Impulsivity scales at three time points during early childhood and the Child Behavior Checklist (CBCL) and SensOR inventory during elementary school age. Results: Four school-age clusters emerged from the CBCL ADHD and SensOR scores: (a) elevated SOR symptoms only (n = 35); (b) elevated ADHD symptoms only (n = 38); (c) elevated ADHD and SOR symptoms (ADHD + S, n = 35); and (d) low ADHD and SOR symptoms (n = 814). The SOR and ADHD + S clusters had higher early Sensitivity scores than the ADHD and Low clusters. The ADHD and ADHD + S clusters differed from the SOR and Low clusters in their early Attention and Activity/Impulsivity scores. Conclusion: SOR and ADHD symptoms occur independently and consistently over time.
Early detection of autism spectrum disorder (ASD) is crucial for timely intervention, yet diagnosis typically occurs after age three. This study aimed to develop a machine learning model to predict ...ASD diagnosis using infants' electronic health records obtained through a national screening program and evaluate its accuracy. A retrospective cohort study analyzed health records of 780,610 children, including 1163 with ASD diagnoses. Data encompassed birth parameters, growth metrics, developmental milestones, and familial and post-natal variables from routine wellness visits within the first two years. Using a gradient boosting model with 3-fold cross-validation, 100 parameters predicted ASD diagnosis with an average area under the ROC curve of 0.86 (SD < 0.002). Feature importance was quantified using the Shapley Additive explanation tool. The model identified a high-risk group with a 4.3-fold higher ASD incidence (0.006) compared to the cohort (0.001). Key predictors included failing six milestones in language, social, and fine motor domains during the second year, male gender, parental developmental concerns, non-nursing, older maternal age, lower gestational age, and atypical growth percentiles. Machine learning algorithms capitalizing on preventative care electronic health records can facilitate ASD screening considering complex relations between familial and birth factors, post-natal growth, developmental parameters, and parent concern.
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