A Video-Based Classification System for Assessing Locomotor Skills in Children.

The Test of Gross Motor Development 2 (TGMD-2) is currently the standard approach for assessing fundamental movement skills (FMS), including locomotor and object control skills. However, its extensive application is restricted by its low efficiency and requirement of expert training for large-scale evaluations. This study evaluated the accuracy of a newly-developed video-based classification system (VCS) with a marker-less sensor to assess children's locomotor skills. A total of 203 typically-developing children aged three to eight years executed six locomotor skills, following the TGMD-2 guidelines. A Kinect v2 sensor was used to capture their activities, and videos were recorded for further evaluation by a trained rater. A series of computational-kinematic-based algorithms was developed for instant performance rating. The VCS exhibited moderate-to-very good levels of agreement with the rater, ranging from 66.1% to 87.5%, for each skill, and 72.4% for descriptive ratings. Paired t-test revealed that there were no significant differences, but significant positive correlation, between the standard scores determined by the two approaches. Tukey mean difference plot suggested there was no bias, with a mean difference (SD) of -0.16 (1.8) and respective 95% confidence interval of 3.5. The kappa agreement for the descriptive ratings between the two approaches was found to be moderate (k = 0.54, p < 0.01). Overall, the results suggest the VCS could potentially be an alternative to the conventional TGMD-2 assessment approach for assessing children's locomotor skills without the necessity of the presence of an experienced rater for the administration.

Identifying latent subgroups of children with developmental delay using Bayesian sequential updating and Dirichlet process mixture modelling.

Identifying children who are at-risk for developmental delay, so that these children can have access to interventions as early as possible, is an important and challenging problem in developmental research. This research aimed to identify latent subgroups of children with developmental delay, by modelling and clustering developmental milestones. The main objectives were to (a) create a developmental profile for each child by modelling milestone achievements, from birth to three years of age, across multiple domains of development, and (b) cluster the profiles to identify groups of children who show similar deviations from typical development. The ensemble methodology used in this research consisted of three components: (1) Bayesian sequential updating was used to model the achievement of milestones, which allows for updated predictions of development to be made in real time; (2) a measure was created that indicated how far away each child deviated from typical development for each functional domain, by calculating the area between each child's obtained sequence of posterior means and a sequence of posterior means representing typical development; and (3) Dirichlet process mixture modelling was used to cluster the obtained areas. The data used were 348 binary developmental milestone measurements, collected from birth to three years of age, from a small community sample of young children (N = 79). The model identified nine latent groups of children with similar features, ranging from no delays in all functional domains, to large delays in all domains. The performance of the Dirichlet process mixture model was validated with two simulation studies.

Componentes biosociales y enfermedades prevalentes de la infancia en menores de 5 años del Bañado Sur de Asunción / Biosocial components and prevalent childhood diseases in children under 5 years from the Bañado Sur of Asunción

Introducción: Las enfermedades prevalentes de la infancia en condiciones adversas como la pobreza pueden ser graves o mortales. La Atención Integrada a las Enfermedades Prevalentes de la Infancia (AIEPI) aborda los determinantes sociales de la salud. Objetivo: Conocer las enfermedades prevalentes y las condiciones ambientales de menores de 5 años del Bañado Sur aplicando AIEPI. Metodología: Estudio observacional, descriptivo, transversal, muestreo no probabilístico por cuotas en 4 barrios del Bañado Sur, mediante visitas semanales a 23 hogares (2016-2017). Se interpretó y clasificó la condición de salud según AIEPI (rojo grave, amarillo moderada, verde buena). La participación fue voluntaria, considerándose recomendaciones éticas para investigaciones en contextos vulnerables. La muestra seleccionada no es representativa de toda la población de niños bañadenses. Resultados: 42 menores de 5 años (26 niñas, 16 niños). 71% clasificó rojo y amarillo en simultáneo (por antecedentes y/o hallazgos). De 4 (<2 meses), 1 clasificó rojo y amarillo (diarrea con sangre); 1, amarillo (bajo peso, problemas de alimentación, infecciones, anemia); 2, verde. De 38 niños/as (>2 meses

Introduction: Prevalent childhood diseases in adverse conditions such as poverty can be serious or fatal. Integrated Management of Childhood Illness (IMCI) addresses the social determinants of health. Objective: Know the prevalent diseases and environmental conditions of children under 5 years old from Bañado Sur applying IMCI. Methodology: Observational, descriptive, cross-sectional study, non-probabilistic sampling by quotas in 4 neighborhoods of the Bañado Sur, through weekly visits to 23 households (2016-2017). The health condition was interpreted and classified according to IMCI (severe red, moderate yellow, good green). Participation was voluntary, considering ethical recommendations for research in vulnerable contexts. The selected sample is not representative of the entire population of children from the Bañado. Results: 42 children under 5 years (26 girls, 16 boys). 71% classified red and yellow simultaneously (by background and/or findings). From 4 (<2 months), one classified red and yellow (bloody diarrhea); other, yellow (low weight, nutrition problems, infections, anemia); two, green. Of 38 children (> 2 months <5 years) 55% classified red and yellow; 29% yellow; 16%, green. Of the red, 54% registered severe respiratory conditions; 21%, malnutrition and anemia; 10%, diarrhea with severe dehydration. Developmental surveillance: 1 classified red (hearing loss, language delay); 5, yellow per alert (absence of age skills); 36, yellow for normal development with risk factors such as low schooling of mothers, violence, polluted environment, overcrowding, and poverty. None of them classified green in all its dimensions. Protective factors: stable caregiver, breastfeeding in the first years. Conclusion: The prevalent childhood diseases in children of the Bañado Sur acquire a serious and repetitive character; its socio-environmental conditions are negative. Comprehensive and cross-sector public policies are urgently needed, such as Primary Health Care. IMCI is particularly recommended in its community component. Key Words: Integrated Care for Prevalent Diseases of Children, poverty, social determinants of health

Free-living Evaluation of Laboratory-based Activity Classifiers in Preschoolers.

Machine learning classification models for accelerometer data are potentially more accurate methods to measure physical activity in young children than traditional cut point methods. However, existing algorithms have been trained on laboratory-based activity trials, and their performance has not been investigated under free-living conditions. PURPOSE: This study aimed to evaluate the accuracy of laboratory-trained hip and wrist random forest and support vector machine classifiers for the automatic recognition of five activity classes: sedentary (SED), light-intensity activities and games (LIGHT_AG), walking (WALK), running (RUN), and moderate to vigorous activities and games (MV_AG) in preschool-age children under free-living conditions. METHODS: Thirty-one children (4.0 ± 0.9 yr) were video recorded during a 20-min free-living play session while wearing an ActiGraph GT3X+ on their right hip and nondominant wrist. Direct observation was used to continuously code ground truth activity class and specific activity types occurring within each class using a bespoke two-stage coding scheme. Performance was assessed by calculating overall classification accuracy and extended confusion matrices summarizing class-level accuracy and the frequency of specific activities observed within each class. RESULTS: Accuracy values for the hip and wrist random forest algorithms were 69.4% and 59.1%, respectively. Accuracy values for hip and wrist support vector machine algorithms were 66.4% and 59.3%, respectively. Compared with the laboratory cross validation, accuracy decreased by 11%-15% for the hip classifiers and 19%-21% for the wrist classifiers. Classification accuracy values were 72%-78% for SED, 58%-79% for LIGHT_AG, 71%-84% for MV_AG, 9%-15% for WALK, and 66%-75% for RUN. CONCLUSION: The accuracy of laboratory-based activity classifiers for preschool-age children was attenuated when tested on new data collected under free-living conditions. Future studies should train and test machine learning activity recognition algorithms using accelerometer data collected under free-living conditions.

Cross-Cultural Validity: Canadian Norm Values of the Alberta Infant Motor Scale Evaluated for Dutch Infants.

PURPOSE: To examine whether the Canadian normative values of the Alberta Infant Motor Scale (AIMS) are appropriate for Dutch infants. METHOD: In a cross-sectional study, 499 infants developing typically (0.5-19 months) were assessed using the AIMS home video method. The scaling method was used for calculating item locations of the Dutch sample, and Welch test to compare Canadian and Dutch raw scores. RESULTS: THE: AIMS items (45 of 58) met the criterion for stable regression to calculate item locations of the Dutch data set and compare these with the Canadian data set. Dutch infants passed 42 of 45 items at an older age. Most monthly age groups of Dutch infants had lower mean AIMS scores. CONCLUSION: The Canadian norms are not appropriate for the Dutch study sample. Dutch infants appear to develop in a similar sequence but at a slower rate. This has implications regarding the clinical use of the AIMS in the Netherlands.

Avaliação de crianças com Síndrome de Down através da CIF-CJ: comparação da visão dos pais e das terapeutas / Evaluation of children with Down's Syndrome through ICF-CJ: comparison of parents 'and therapists' vision / Evaluación de niños con Síndrome de Down a través de la CIF-CJ: comparación de la visión de los padres y de los terapeutas

Introdução: A chegada de um filho com deficiência traz muitos desafios aos familiares podendo impactar na funcionalidade da criança. A visão que a família possui da criança nem sempre condiz tanto com suas potencialidades quanto com déficits. Por isso, interessa comparar a visão dos pais e terapeutas da criança. Objetivo: Comparar a visão dos pais e dos terapeutas em relação à funcionalidade de crianças com Síndrome de Down (SD). Métodos: Trata-se de um estudo qualitativo, de amostra por conveniência, com três crianças com SD, seus pais e terapeutas. A coleta de dados se deu por meio da aplicação da CIF-CJ com um dos responsáveis da criança e com a terapeuta estagiária responsável por cada caso, todos atendidos em clínica-escola de Fonoaudiologia. Resultados: Após análise dos três casos observou-se que a diferença nas respostas entre familiares e terapeutas esteve concentrada na percepção da linguagem das crianças, sobretudo em relação à fala. Também se observou que os terapeutas percebem a relação dos familiares com os profissionais de saúde mais frágeis do que os pais. Os resultados reforçam a importância sobre um olhar sobre a funcionalidade na clínica da infância. Conclusão: Na comparação da funcionalidade na percepção de pais e terapeutas, destacou-se a diferença na percepção da produção linguística das crianças.

Introduction: The arrival of a disabled child brings many challenges to the family members and can impact on the child's functionality. The family's view of the child does not always match both their potentialities and deficits. It is therefore important to compare the views of the child's parents and therapists. Objective: To compare the views of parents and therapists regarding the functionality of children with Down Syndrome (DS). Methods: This is a qualitative, sample-for-convenience study with three children with DS, their parents and therapists. Data collection was done through the application of the CIF-CJ with one of the responsible of the child and with the trainee therapist responsible for each case, all of whom were attended at university speech-language pathology clinic. Results: After analyzing the three cases, it was observed that the difference in the responses of the family and the therapists was concentrated in the children language, especially in relation to speech. It has also been observed that therapists perceive the relationship of family members with health professionals who are more fragile than their parents. The results reinforce the importance of looking at functionality in childhood clinic. Conclusion: In the comparison of functionality in the perception of parents and therapists, the difference in perception of the children's linguistic production was highlighted.

Introducción: La llegada de un hijo con discapacidad trae muchos desafíos a los familiares que pueden impactar en la funcionalidad del niño. La visión que la familia posee del niño no siempre condice tanto con sus potencialidades como con déficits. Por eso, interesa comparar la visión de los padres y terapeutas del niño. Objetivo: comparar la visión de los padres y de los terapeutas en relación a la funcionalidad de niños con Síndrome de Down (SD). Metodos: Se trata de un estudio cualitativo, de muestra por conveniencia, con tres niños con SD, sus padres y terapeutas. La recolección de datos se dio por medio de la aplicación de la CIF-CJ con uno de los responsables del niño y con la terapeuta pasante responsable de cada caso, todos atendidos en clínica-escuela de Fonoaudiología. Resultados: Después del análisis de los tres casos se observó que la diferencia en la respuesta de los familiares y de los terapeutas estuvo concentrada en la percepción del lenguaje de los niños, sobre todo en relación al habla. También se observó que los terapeutas perciben la relación de los familiares con los profesionales de salud más frágiles que los padres. Los resultados refuerzan la importancia sobre una mirada sobre la funcionalidad en la clínica de la niñez. Conclusión: En la comparación de la funcionalidad en la percepción de padres y terapeutas, se destacó la diferencia en la percepción de la producción lingüística de los niños.

Functional independence of Taiwanese patients with mucopolysaccharidoses.

BACKGROUND: Information on functional strengths and weaknesses of mucopolysaccharidosis (MPS) patients is important for early intervention programs and enzyme replacement therapy (ERT). METHODS: We used the Functional Independence Measure for Children (WeeFIM) questionnaire to assess the functional skills of 63 Taiwanese MPS patients (median age, 13 years 3 months; range, 3-20 years) from January 2012 to December 2018. RESULTS: Mean total WeeFIM score was 75.4 of a potential score of 126. Mean total WeeFIM scores of each type (MPS I, MPS II, MPS IIIB, MPS IVA, and MPS VI) were 103.8, 76.2, 41.6, 92.2, and 113.6, respectively. Mean scores for self-care, mobility, and cognition domains were 30 (maximum 56), 23 (maximum 35), and 22 (maximum 35), respectively. MPS type IIIB patients had the lowest scores in self-care, mobility, cognition, and total domains compared to other types of MPS. All patients with ERT in MPS I, II, and IVA had higher scores in self-care and mobility domains than patients without ERT. Most patients required assistance for self-care skills, especially in grooming and bathing. CONCLUSION: MPS patients require support and supervision in self-care tasks. For cognition tasks, MPS IIIB patients also require help. This questionnaire is useful to identify the strengths and limitations of MPS patients.

Developmental Trajectories of Anxiety and Depression Symptoms from Early to Middle Childhood: a Population-Based Cohort Study in the Netherlands.

Developmental patterns of anxiety and depression symptoms in early childhood have previously been related to anxiety and mood disorders in middle childhood. In the current study, trajectories of anxiety and depression symptoms (1.5-10 years) were related to children's broader psychosocial and school-related functioning at 10 years. We included a population-based sample of 7499 children, for whom primary caregivers reported anxiety and depression symptoms on the Child Behavior Checklist, at children's ages of 1.5, 3, 6, and 10. Growth Mixture Modeling identified four distinct, gender-invariant, trajectories of anxiety and depression symptoms: low (82.4%), increasing (7.4%), decreasing (6.0%), and increasing symptoms up to age 6 followed by a decrease to age 10 (preschool-limited, 4.2%). Children with a non-Dutch ethnicity had lower odds to be in the increasing trajectory and higher odds to be in the decreasing and pre-school limited trajectory. Also, low maternal education predicted the decreasing and pre-school limited trajectory. Higher levels of psychopathology during pregnancy for both mothers and fathers predicted the increasing, decreasing, and preschool-limited trajectory, compared to the low trajectory. At age 10, children in the increasing and preschool-limited trajectory had diminished psychosocial outcomes (friendship-quality and self-esteem) and worse school-related outcomes (school performance and school problems). This study adds to current knowledge by demonstrating that developmental patterns of anxiety and depression symptoms in early childhood are related to broader negative outcomes in middle childhood. Child and family factors could guide monitoring of anxiety and depression symptoms in the general population and provide targets for prevention programs.

Developmental Trajectories for the Early Clinical Assessment of Balance by Gross Motor Function Classification System Level for Children With Cerebral Palsy.

Background: Children with cerebral palsy (CP) characteristically present with impairments in balance. Currently, the pattern and timing of the development of balance ability have not been described for children with CP of varying Gross Motor Function Classification System (GMFCS) levels. Objective: The purpose of this study was to document longitudinal developmental trajectories in a measure of balance, the Early Clinical Assessment of Balance (ECAB) scores, along with age-specific reference percentiles and the amount of change typical over a 1-year period for children within different GMFCS levels. Design: The design was a longitudinal cohort study. Methods: Participants included 708 children with CP, aged 18 months through their 12th birthday, and their families. Children participated in 2 to 5 assessments using the GMFCS and ECAB. Results: Longitudinal trajectories describing the average change in the ECAB score with respect to age were created by fitting separate nonlinear mixed-effect models for children in each GMFCS level. Reference percentiles were constructed using quantile regression of ECAB data from the first visit (baseline) and 12-month and 24-month visits. Using these reference points, the amount of change in percentiles was calculated for all children by subtracting the baseline percentile score from the 12-month percentile score. Children whose percentile changes are within the 80% limits can usually be described as "developing as expected" for their age and GMFCS levels. Limitations: Limitations of this study included use of a convenience sample, a ceiling effect of the ECAB for some children in GMFCS levels I and II, and the use of both a 12-month and 24-month study protocol that impacted the number of children available for each assessment session. Conclusions: When used appropriately to monitor development and change over time for children with CP, the ECAB longitudinal trajectories, reference percentiles, and the associated change scores presented here should assist therapists and families in collaborative interaction to proactively plan services and interventions relative to balance ability.

Multiple Trajectories in Anxious Solitary Youths: the Middle School Transition as a Turning Point in Development.

This study aimed to identify divergent patterns of individual continuity and change in anxious solitude (AS) in the last half of elementary school (3rd - 5th grade) and the first two years of middle school (6th - 7th grade), and test predictors and outcomes of these pathways. Participants were 688 youths (girls n = 354, 51.5%; M age at outset = 8.66 years, SD = 0.50). Latent class growth analyses identified two AS trajectory classes in elementary school (moderate-decreasing, high-increasing) and three in middle school (low-stable, low-increasing, high-decreasing). The elementary school moderate-decreasing class was two-and-a-half times more likely than others to end in the middle school low-stable class. In contrast, the elementary school high-increasing class was twice as likely as others to end in the middle school low-increasing class, and four times as likely to end in the middle school high-decreasing class. Peer exclusion predicted membership in increasing AS trajectory classes in both elementary and middle school, whereas the middle school high-decreasing AS trajectory class demonstrated decreasing peer exclusion during middle school. Likewise, inability to defend oneself predicted membership in increasing AS trajectory classes in both elementary and middle school, whereas membership in the middle school high-decreasing AS trajectory class was predicted by inability to defend oneself in elementary but not middle school. High-decreasing AS youths' improved ability to defend themselves in middle school appeared to be related to a cascade of improvements in related domains. In contrast, membership in increasing AS classes in elementary and middle school predicted symptoms of social anxiety and depression.

Developmental Trajectories of Shyness-Sensitivity from Middle Childhood to Early Adolescence in China: Contributions of Peer Preference and Mutual Friendship.

This study examined trajectories of shyness-sensitivity and the contributions of peer relationships to these trajectories in Chinese children. Participants were 1061 school-age children (537 boys), initially in fifth grade (Mage = 11 years), in China. Longitudinal data on shyness-sensitivity were collected from peer assessments once a year for four years. In addition, peer nomination data on peer acceptance-rejection and mutual friendship were collected in the initial study. Four distinct shyness-sensitivity trajectories were identified: Low-Stable, Low-Increasing, Moderate-Decreasing, and High-Stable. Children with high peer acceptance scores were more likely to be in the High-Stable and Moderate-Decreasing trajectories than in the Low-Stable and Low-Increasing trajectories. The analysis of predictors of the within-trajectory growth rate indicated that children who were more liked by peers increased their shyness-sensitivity more slowly within the Low-Increasing trajectory and that children with mutual friendship involvement decreased their shyness-sensitivity more slowly within the Moderate-Decreasing trajectory. The results suggested that positive relationships might serve to attenuate developmental changes of shyness-sensitivity within these trajectories. The results were discussed in the Chinese context.

Development of Aggression Subtypes from Childhood to Adolescence: a Group-Based Multi-Trajectory Modelling Perspective.

The persistence of elevated subtypes of aggression beginning in childhood have been associated with long-term maladaptive outcomes. Yet it remains unclear to what extent there are clusters of individuals following similar developmental trajectories across forms (i.e., physical and indirect) and functions (i.e., proactive and reactive) of aggression. We aimed to identify groups of children with distinct profiles of the joint development of forms and functions of aggression and to identify risk factors for group membership. A sample of 787 children was followed from birth to adolescence. Parent and teacher reports, and standardised assessments were used to measure two forms and two functions of aggressive behaviour, between six and 13 years of age along with preceding child, maternal, and family-level risk-factors. Analyses were conducted using a group-based multi-trajectory modelling approach. Five trajectory groups emerged: non-aggressors, low-stable, moderate-engagers, high-desisting, and high-chronic. Coercive parenting increased membership risk in the moderate-engagers and high-chronic groups. Lower maternal IQ increased membership risk in both high-desisting and high-chronic groups, whereas maternal depression increased membership risk in the high-desisting group only. Never being breastfed increased membership risk in the moderate-engagers group. Boys were at greater risk for belonging to groups displaying elevated aggression. Individuals with chronic aggression problems use all subtypes of aggression. Risk factors suggest that prevention programs should start early in life and target mothers with lower IQ. Strategies to deal with maternal depression and enhance positive parenting while replacing coercive parenting tactics should be highlighted in programming efforts.

Predictors of childhood trajectories of overt and indirect aggression: An interdisciplinary approach.

The aim of this study was to advance our understanding of the development of aggression in boys and girls by testing a model combining insights from both evolutionary theory and developmental psychology. A sample of 744 children (348 girls) between six and 13 years old was recruited in schools with high deprivation indices. Half of the sample (N = 372; 40.1% girls) had received special educational services for behavioral and/or socio-emotional problems. Two trajectories for overt aggression and two trajectories for indirect aggression were identified and binomial logistic regressions were used to identify environmental predictors and sex-specific patterns of these trajectories. Results indicated that peer rejection predicted overt aggression and indirect aggression and that extraversion and male sex predicted overt aggression. The results also showed that interaction between parental practices and some child temperament traits predicted overt aggression (coercion and lack of supervision associated with extraversion or low effortful control) or indirect aggression (coercion and neglect associated with negative affect or low effortful control), and the absence of a father figure predicted high indirect aggression in girls.

Eight-Year Latent Class Trajectories of Academic and Social Functioning in Children with Attention-Deficit/Hyperactivity Disorder.

We examined trajectories of academic and social functioning in children with attention-deficit/hyperactivity disorder (ADHD) to identify those who might be at risk for especially severe levels of academic and social impairment over time. We estimated a series of growth mixture models using data from two subsamples of children participating in the NIMH Collaborative Multisite Multimodal Treatment Study of Children with ADHD (MTA) including those with at least baseline and 96-month data for reading and mathematics achievement (n = 392; 77.3% male; M age = 7.7; SD = 0.8) or social skills ratings from teachers (n = 259; 74.9% male; M age = 7.6; SD = 0.8). We compared latent trajectories for children with ADHD to mean observed trajectories obtained from a local normative (i.e., non-ADHD) comparison group (n = 289; 80.6% male; M age = 9.9; SD = 1.1). Results indicated six latent trajectory classes for reading and mathematics and four classes for teacher social skills ratings. There was not only a relationship between trajectories of inattention symptoms and academic impairment, but also a similarly strong association between trajectory classes of hyperactive-impulsive symptoms and achievement. Trajectory class membership correlated with socio-demographic and diagnostic characteristics, inattention and hyperactive-impulsive symptom trajectories, externalizing behavior in school, and treatment receipt and dosage. Although children with ADHD display substantial heterogeneity in their reading, math, and social skills growth trajectories, those with behavioral and socio-demographic disadvantages are especially likely to display severe levels of academic and social impairment over time. Evidence-based early screening and intervention that directly address academic and social impairments in elementary school-aged children with ADHD are warranted. The ClinicalTrials.gov identifier is NCT00000388.

The value of Gesell score in predicting the outcome of cochlear implantation in children.

The purpose is to determine the value of preoperative evaluation on developmental levels using Gesell score in predicting the postoperative outcome in pediatric cochlear implantation (CI) recipients. 78 children who underwent CI were included in our study. Age at the time of CI ranged from 6 to 67 months. The Gesell score including adaptability, fine motor, gross motor, language, and social skill was used for evaluating the patients' developmental levels before the CI, and a developmental quotient (DQ) was calculated by the following formula: (developmental age/actual age) × 100. The auditory perception and speech production abilities were evaluated using the categories of auditory performance (CAP) and speech intelligibility rating (SIR) before CI and at 1 year after CI. The associations between the preoperative Gesell score/DQ and the improvement of postoperative CAP/SIR outcomes were analyzed. Preoperative developmental evaluation of CI candidates suggested that the developmental delay was common in children with profound hearing loss. The mean of language DQ (46.72 ± 17.59) was significantly decreased than the mean of others' ability DQ in the enrolled children. The older the pediatric CI candidates were, the lower the DQ were. Age/adaptability DQ and improvement of postoperative CAP/SIR 1 year after CI were related. Age was negative correlation with the CI outcome and adaptability DQ was positive correlation with the CI outcome. The mean of CAP 1 year after CI was 4.16, and the mean of SIR 1 year after CI was 2.03. The first logistics regression equation was Y1 = exp (-18.123 + 0.199 × adaptability DQ - 0.163 × age), and Y1 was the possibility which CAP was lower than 5 1 year after CI. The sensitivity of first regression equation was 84.2% and specificity was 70.8%. The second logistics regression equation was Y2 = exp (-23.347 + 0.268 × adaptability DQ - 0.164 × age), and Y2 was the possibility which SIR was lower than 3 1 year after CI. The sensitivity of second regression equation was 85.7% and specificity was 72.7%. Preoperative Gesell score may be value in predicting the postoperative outcome in pediatric CI recipients. The older children are more serious developmental delay occur, so the CI operation should be finished as early as possible. Adaptability DQ combined with age has predictive effect on the postoperative outcome of cochlear implantation in children.

Automated classification of neonatal sleep states using EEG.

OBJECTIVE: To develop a method for automated neonatal sleep state classification based on EEG that can be applied over a wide range of age. METHODS: We collected 231 EEG recordings from 67 infants between 24 and 45weeks of postmenstrual age. Ten minute epochs of 8 channel polysomnography (N=323) from active and quiet sleep were used as a training dataset. We extracted a set of 57 EEG features from the time, frequency, and spatial domains. A greedy algorithm was used to define a reduced feature set to be used in a support vector machine classifier. RESULTS: Performance tests showed that our algorithm was able to classify quiet and active sleep epochs with 85% accuracy, 83% sensitivity, and 87% specificity. The performance was not substantially lowered by reducing the epoch length or EEG channel number. The classifier output was used to construct a novel trend, the sleep state probability index, that improves the visualisation of brain state fluctuations. CONCLUSIONS: A robust EEG-based sleep state classifier was developed. It performs consistently well across a large span of postmenstrual ages. SIGNIFICANCE: This method enables the visualisation of sleep state in preterm infants which can assist clinical management in the neonatal intensive care unit.

Developmental milestones for productivity occupations in children and youth: An integrative review.

BACKGROUND: Limited research exists on developmental milestones for productivity occupations throughout the paediatric lifespan, and negative connotations of work for children and youth may have contributed to a paucity of literature on the topic. OBJECTIVE: To ascertain what is currently known about the timing and types of engagement in productivity occupations in children and youth aged 4-19. METHODS: Literature referencing productive occupations in children and youth aged 4-19 was searched for this integrative review. Search terms were established based on paediatric age and occupational therapy descriptors, and terminology associated with productivity. Sixty-seven peer-reviewed articles were analyzed according to the constant comparative method. RESULTS: Six core productive occupations emerged as avenues for productive engagement: paid work, school-related activities, caring for self and others, household chores, volunteering, and agricultural chores. A timeline was constructed to display common milestones for engagement in these occupations throughout the paediatric lifespan. Paediatric engagement was found to be influenced by personal (age, gender, child and youth perceptions, and safety considerations), and environmental (familial factors, parental perceptions, societal influences, and safety considerations) factors. CONCLUSIONS: Approaches to paediatric practice must account for the full spectrum of productive occupations children and youth engage in beyond the school context.

Language Evaluation Scale Trivandrum (LEST 3-6 years) Development and Validation.

Language Evaluation Scale Trivandrum (LEST:3-6 years) with 31-items, was validated against extended REELS with a community sample-606 children (3-6yrs). One item and two item delay as LEST delay showed a sensitivity of (81%, 47%); specificity (68%, 94%), PPV (12%, 31%); NPV (98%, 97%) and accuracy (68.5%, 92%), respectively. LEST (3-6years) is a simple, valid, community screening tool.

Language profiles and literacy outcomes of children with resolving, emerging, or persisting language impairments.

BACKGROUND: Children with language impairment (LI) show heterogeneity in development. We tracked children from pre-school to middle childhood to characterize three developmental trajectories: resolving, persisting and emerging LI. METHODS: We analyzed data from children identified as having preschool LI, or being at family risk of dyslexia, together with typically developing controls at three time points: t1 (age 3;09), t3 (5;08) and t5 (8;01). Language measures are reported at t1, t3 and t5, and literacy abilities at t3 and t5. A research diagnosis of LI (irrespective of recruitment group) was validated at t1 by a composite language score derived from measures of receptive and expressive grammar and vocabulary; a score falling 1SD below the mean of the typical language group on comparable measures at t3 and t5 was used to determine whether a child had LI at later time points and then to classify LIs as resolving, persisting or emerging. RESULTS: Persisting preschool LIs were more severe and pervasive than resolving LIs. Language and literacy outcomes were relatively poor for those with persisting LI, and relatively good for those with resolving LI. A significant proportion of children with average language abilities in preschool had LIs that emerged in middle childhood - a high proportion of these children were at family risk of dyslexia. There were more boys in the persisting and resolving LI groups. Children with early LIs which resolved by the start of formal literacy instruction tended to have good literacy outcomes; children with late-emerging difficulties that persisted developed reading difficulties. CONCLUSIONS: Children with late-emerging LI are relatively common and are hard to detect in the preschool years. Our findings show that children whose LIs persist to the point of formal literacy instruction frequently experience reading difficulties.

Concordancia interobservador en la evaluación de la escala de desarrollo infantil Bayley II / Matching interobserver assessment scale of child development Bayley II

Un elemento importante en la realización de proyectos de investigación en niños es disminuir el sesgo interobservador al realizar mediciones del desarrollo. Cuando se asegura la validez de un instrumento de evaluación, la magnitud del error se puede determinar a través de estudios de concordancia, que tienen como propósito estimar hasta qué punto dos observadores coinciden en su evaluación. La Escala de Desarrollo Infantil Bayley II (BSID-II) evalúa el desarrollo de los niños de 1 a 42 meses de edad, la prueba consta de tres subescalas diferenciadas: cognoscitiva, psicomotora y de comportamiento. El objetivo del presente estudio fue determinar la concordancia interobservador en la evaluación de la Escala de Desarrollo Infantil Bayley II en niños de 1 a 42 meses de edad. Se realizó un estudio descriptivo de corte transversal con 30 niños nacidos a término sin diagnóstico de enfermedad neurológica, genética o metabólica que acudieron a consulta externa al Laboratorio de Psicobiología durante el periodo comprendido de agosto de 2013 a mayo de 2014. Se documentó la historia clínica y se evaluó con la escala BSID-II a cada participante. Se evaluó la concordancia mediante el test de Kappa media de Cohen con el software Epi dat 4. La prevalencia de retraso global en el desarrollo de los niños fue de 67%, a partir de ello se observó concordancia tanto en las comparaciones del Índice de desarrollo mental k=0.9528, como en el Índice de desarrollo psicomotor k=.9023. El análisis demostró concordancia entre dos profesionistas, lo cual implica que de acuerdo a las categorías no hubo sesgo en el diagnóstico. Este dato es un indicador positivo respecto al nivel de coordinación y la coincidencia en el diagnóstico, además facilita la implementación de tratamientos adecuados para cada uno de los casos evaluados.

An important element when conducting research projects in children is decreasing interobserver bias when making measurements. When the validity of an instrument of evaluation is ensured, the magnitude of error can be determined through studies of concordance, whose purpose is to estimate how much two observers agree in their assessment. The Scale of Infant Development Bayley II evaluates the development of children 1-42 months of age. The test consists of three distinct subscales: cognitive, motor and behavioural. The aim of the present study was to determine interobserver agreement on the implementation of the Bayley Scale of Infant Development (BSID-II, 1993) in children 1-42 months of age. A descriptive cross-sectional study was conducted with 30 children born at term without a diagnosis of neurological, genetic or metabolic diseases that attended external consultation in the lab of Psychobiology during the period august 2013 to May 2014. A clinical history was documented, and the BSDI-II scale was applied, the agreement was assessed by Cohen´s Kappa test mean with Epi dat 4 software. The prevalence of developmental delay in children was 67% concordance was observed in the mental development index k = 0.9528 as well as in the psychomotor development index k = 0.9023. The analysis demonstrated concordance between the two professionals, which means that according to the categories no bias in occurred. This data is a positive indicator with respect to the level of coordination and the agreement in the diagnosis and also facilitates the implementation of an appropriate treatment for each of the cases evaluated.