Concept of Health Care Counseling for Pediatricians.

Health care counseling (HCC) is a relatively new concept that amalgamates human biology, human psychology and medical sociology principles, and applies the same in real-time clinical situations. In India, there is a real paucity of trained mental health personnel, and hence counseling services are restricted to few departments. HCC is especially important for the child population, as the pediatricians need to partner the parenting responsibilities in different illness care settings covering the period from newborn to adolescence. This paper proposes steps for further development of the concept, expertise and systematic training program for health personnel, as an activity of Centre for Health Care Counseling Studies under Kerala University of Health Sciences. Once the process is documented, we hope that the same would be made available to other states in India.

Development and validation of language evaluation scale Trivandrum for children aged 0-3 years--LEST (0-3).

OBJECTIVE: To develop and validate a simple screening tool which can be used in the Community to identify delay in language development among children of 0-3 years of age. METHODS: The normal range for the 33 items of Language Evaluation Scale Trivandrum for 0-3years LEST(0-3) were carefully selected from various existing language development charts and scales, by experts keeping in mind the face validity and content validity. The criterion validity was assessed using a community sample of 643 children of 0 to 3 years of age, including 340 (52.9%) boys. LEST (0-3) was validated against Receptive Expressive Energent Language Scale, for screening delay in language development among children of 0-3 years. RESULTS: When one item delay was taken as LEST delay (test positive), the sensitivity and specificity of LEST(0-3), was found to be 95.85% and 77.5%, respectively with a negative predictive value of 99.8% and LR (negative) of 0.05.When two item delay was taken as LEST delay(test positive), the sensitivity and specificity of LEST(0-3), was found to be 66.7% and 94.8% respectively with a negative predictive value of 98.7% and LR (negative) of 0.35. The test-retest and inter-rater reliability were good and acceptable (Inter-class correlation of 0.69 for test-retest and 0.94 for inter-rater). CONCLUSIONS: LEST (0-3) is a simple, reliable and valid screening tool for use in the community to identify children between 0-3 years with delay in language development, enabling early intervention practices.