Assessing the cognitive and behavioral development of 3-year-old children born from fathers with severe male infertility.

BACKGROUND: Despite the large number of babies born worldwide following intracytoplasmic sperm injection, concerns about the procedure's safety still exist owing to the use of suboptimal spermatozoa. Thus, follow-up of children conceived via intracytoplasmic sperm injection is highly recommended. We propose the use of parent-administered questionnaires to monitor the development of offspring conceived via intracytoplasmic sperm injection. OBJECTIVE: This study aimed to determine whether male infertility treatment affects offspring development. STUDY DESIGN: We compared obstetrical and neonatal outcomes and physical and psychological development of toddlers conceived via in vitro fertilization and intracytoplasmic sperm injection. Once newborns reached 3 years of age, participating patients were sent a set of parent-administered questionnaires, including the Ages and Stages Questionnaires; Prescreening Developmental Questionnaire 2; Peabody Developmental Motor Scales, Second Edition; Social Skills Rating System; Parenting Stress Index, Third Edition; and Child Behavior Checklist for Ages 2-3. Child development was measured by the Ages and Stages Questionnaires; Prescreening Developmental Questionnaire 2; and Peabody Developmental Motor Scales, Second Edition, questionnaires, whereas Social Skills Rating System; Parenting Stress Index, Third Edition; and Child Behavior Checklist for Ages 2-3 questionnaires were used to measure child behavior. The child's developmental or behavioral outcome was considered "abnormal" when he or she scored below average in ≥2 questionnaires from the respective category. We also conducted subanalyses to assess the effects of male genomic integrity, DNA fragmentation, chemical exposure, utilization of surgically retrieved spermatozoa, and extended embryo culture to determine the development of a child conceived via intracytoplasmic sperm injection. RESULTS: A total of 12,306 couples met the inclusion criteria for this study; 1914 of 7433 patients (25.8%) who underwent intracytoplasmic sperm injection and 451 of 4873 patients (9.3%) who underwent in vitro fertilization returned the questionnaires. Our comparison of obstetrical outcomes between the 2 groups did not reveal any significant differences in the mode of delivery distribution, with most mothers having uncomplicated vaginal deliveries. Furthermore, gender distribution, gestational ages, and birthweights were also comparable between children conceived via intracytoplasmic sperm injection and in vitro fertilization. However, children conceived via in vitro fertilization displayed impaired developmental characteristics compared with the intracytoplasmic sperm injection-conceived cohort (adjusted odds ratio, 0.72; 95% confidence interval, 0.5-0.9; P=.0004). There was no difference in child behavior. Furthermore, 3 cases of autism were reported, 1 case from the in vitro fertilization group and 2 from the intracytoplasmic sperm injection group, all conceived from couples with an older male partner. Ages and Stages Questionnaires outcomes were also compared for the offspring conceived via in vitro fertilization and intracytoplasmic sperm injection by gender; however, no significant differences were observed. In addition, 5 separate subanalyses were then conducted exclusively for the intracytoplasmic sperm injection-conceived group. Levels of spermatogenic failure, DNA fragmentation, and chemical exposure did not significantly affect offspring development. Interestingly, although the length of embryo culture did not seem to influence child development, the abnormal behavior rate was significantly higher in children from the day 3 embryo transfer cohort (adjusted odds ratio, 0.4; 95% confidence interval, 0.05-0.34; P=.04). Children conceived via intracytoplasmic sperm injection from ejaculated spermatozoa displayed impaired developmental and behavioral characteristics compared with toddlers conceived from surgically retrieved specimens (adjusted odds ratio, 4.9; 95% confidence interval, 1.2-20.7; P=.05). CONCLUSION: Most children conceived via intracytoplasmic sperm injection and in vitro fertilization are developing well without significant delays. Although the development of a child conceived via intracytoplasmic sperm injection was not affected by most of the variables assessed, those conceived from surgically retrieved spermatozoa were at a considerably lower risk of abnormal developmental and abnormal behavioral characteristics than offspring conceived from ejaculated specimens. However, given the small numbers of respondents available for many subgroups of interest, further studies of outcomes of children born from fathers with severe male factor infertility are warranted.

Confirmatory analysis and normative tables for the Brazilian Ages and Stages Questionnaires: Social-Emotional.

BACKGROUND: In Brazil, large-scale governmental programmes have been implemented to evaluate the development of all children who are enrolled in public daycare centres and preschools using the Brazilian Ages and Stages Questionnaires: Social-Emotional (ASQ:SE) as a screening tool. However, in the Brazilian context, there is a lack of studies that have investigated the clinical utility of the ASQ:SE, and only a few studies have partially investigated the psychometric properties of the Brazilian version of this scale. OBJECTIVES: The present study had two aims: (a) to develop reference norms for the ASQ:SE to help professionals screen child development and because the psychometric properties of the ASQ:SE have only been partially examined, (b) to confirm its factorial structure within a multidimensional item response theory framework. METHODS: The sample size was 54,570 children (53% males, 1-5 years old) who were enrolled in Brazilian public daycare centres and preschools and assessed in 2011. The results allowed the development of reference norms for all age intervals by considering raw scores at the 95th percentile as "monitoring zone" and scores at the 99th percentile as "refer child for further evaluation." Samejima's graded response model was employed, and its fit was checked by the root mean squared error of approximation. RESULTS: The results were ≤0.08, indicating sufficient fit for the two-factor structure. The raw results were 70 and 99.75 (12 months), 75 and 100 (18 months), 70 and 100 (24 months), 85 and 120 (30 months), 90 and 130 (36 months), 95 and 135 (48 months), and 110 and 150 (60 months) for monitoring zone and to refer the child for further evaluation. DISCUSSION: Early identification is the initial stage in this early identification process, thus allowing for referral or intervention. This study may help identify children with developmental delays.

ADAPTING A PARENT-COMPLETED, SOCIOEMOTIONAL QUESTIONNAIRE IN CHINA: THE AGES & STAGES QUESTIONNAIRES: SOCIAL-EMOTIONAL.

The Ages & Stages Questionnaire: Social-Emotional (ASQ:SE; Squires, Bricker, & Twombly, 2002a), developed in the United States, was translated and adapted for use in China. Lack of valid and reliable instruments for identifying social and emotional delays in young children is a worldwide issue. Professionals in China have recently focused efforts on developing methods for early identification of social, emotional, and behavioral issues in the birth-to-5 population. Following the guidelines of the International Test Commission, the ASQ:SE was translated into Simplified Chinese (ASQ:SE-C) to collect a normative sample of 2,528 children across China. Data were analyzed to evaluate the psychometric properties of the ASQ:SE-C, using both classical test theory and item response theory, including generating cutoff points appropriate for the Chinese sample. A panel of Chinese experts was surveyed to assess face validity and estimated utility of the newly adapted tool. Discussions of research findings and implications for future studies are provided.

Adaptation of the Ages and Stages Questionnaire for Remote Aboriginal Australia.

A key challenge to providing quality developmental care in remote Aboriginal primary health care (PHC) centers has been the absence of culturally appropriate developmental screening instruments. This study focused on the cross-cultural adaptation of the Ages and Stages Questionnaires, 3rd edition (ASQ-3), with careful attention to language and culture. We aimed to adapt the ASQ-3 for use with remote dwelling Australian Aboriginal children, and to investigate the cultural appropriateness and feasibility of the adapted ASQ-3 for use in this context. We undertook a qualitative study in two remote Australian Aboriginal communities, using a six-step collaborative adaptation process. Aboriginal Health Workers (AHWs) were trained to use the adapted ASQ-3, and follow-up interviews examined participants' views of the cultural acceptability and usefulness of the adapted instrument. The adapted ASQ-3 was found to have high face validity and to be culturally acceptable and relevant to parents, AHWs, and early childhood development experts.

Developmental screening in a Canadian First Nation (Mohawk): psychometric properties and adaptations of ages & stages questionnaires (2nd edition).

BACKGROUND: The need for early intervention tools adapted to the First Nation culture is well documented. However, standards derived from First Nation communities are absent from the literature. This study examines the psychometric properties of an adaptation of a caregiver-completed screening tool, the Ages & Stages Questionnaires (ASQ), for the Mohawk population. METHODS: Participants who completed the questionnaires include 17 teachers, along with the parents of 282 children (130 girls and 152 boys) between the ages of 9 and 66 months who attend the Child and Family Center Mohawk Territory, Quebec. RESULTS: For the internal consistency of the four questionnaires (36-, 42-, 48- and 54-month intervals), Cronbach's alphas varied between .61 and .84. Five results were below 0.60: "gross motor" (Q36 and Q42), "problem solving" (Q36) and "personal-social" (Q36 and Q42). A comparison of the results shows that parents and teachers agreed in 85% of the cases concerning the referral of the child for further evaluation. Moreover, the group discussion with the parents revealed that the use of the questionnaire was appreciated and was deemed appropriate for use within the community. CONCLUSION: The results show that the ASQ is a screening test that may be appropriate for use with children from communities that are seemingly very different in terms of geographic, climatic and cultural backgrounds. This preliminary study with the Child and Family Center appears to support further study and the use of the ASQ with the Mohawk population.

Socio-cultural Adaptation and Validation of Ages and Stages Questionnaire (ASQ 3) in Indian Children Aged 2 to 24 Months.

OBJECTIVE: To socio-culturally adapt and validate a Hindi language version of ASQ-3 in Indian children aged 2-24 months. METHODS: This cross-sectional study was conducted at a tertiary-care center between March, 2017 and April, 2019. Children "at-risk" for developmental delay of either gender aged 2-24 months. Socio-cultural adaptation was done through interaction among 37 subject experts followed by validation. After piloting in 20 children, modified ASQ-3 was validated in 568 at-risk children (4 age-groups: 2-7, 7-13, 13-19 and 19-24 months). Validation was done against Development assessment scale for Indian infants (DASII). RESULTS: Results: After screening 654 children, 568 were enrolled. Among these, 420 had developmental delay on DASII while 18 failed to be identified on ASQ (4.3%). Overall sensitivity and specificity of Hindi language Indian-adaptation of ASQ-3 in detecting developmental delay were 95.9% (95%CI: 93.6%-97.5%) and 81.7% (95%CI: 74%-87.9%), respectively with a positive predictive value (PPV) of 94.6% (95%CI: 92%-96.5%) and negative predictive value (NPV) of 85.6% (95%CI: 78.2%-92.2%). The sensitivity and specificity for motor delay were 96.1% (93.8%-97.7%) and 92.4% (86.4%-96.3%) [PPV: 97.7% (95.8%-98.9%); NPV: 87.7% (81%-92.7%)]. Sensitivity and specificity for mental delay were 95.5% (93.1%-97.2%)and 95.3% (90.1%-98.3%) [PPV: 98.6% (97%-99.5%); NPV: 85.9% (79.1%-91.2%)]. CONCLUSION: The Hindi language Indian-adaptation of ASQ-3 had good psychometric properties with high sensitivity for developmental delay (95.9%), mental delay (95.5%), and motor delay (96.1%), suggesting it to be a good screening tool for neurodevelopmental delay.

Lack of voluntary interest and difficulty making eye contact are the most discriminative behaviors of the ASQ:SE and might suggest delays: Results from a large-scale assessment.

BACKGROUND: Every child is unique, but development tends to occur in predictable steps and stages. The early identification of infants who face developmental delays is critical, boosting the use of screening tools to determine risks for delays. The city of Rio de Janeiro conducted a large-scale assessment of children who were enrolled in educational facilities using the Ages & Stages Questionnaires: Social-Emotional (ASQ:SE). OBJECTIVES: We examined the internal structure of the ASQ:SE and its most discriminative items of risks of delays in development among 12- to 60-month-old children. The trajectory of the discrimination parameter of eight anchor items was used to check how well they inform the risk of social-emotional competence delays throughout development. METHODS: Data from 79,332 children (1-5 years) were analyzed via Samejima Graded Response model of Item Response Theory (IRT). The discrimination (a) and threshold (b) parameters were computed, and errors were achieved via maximum likelihood. Data/codes are available at https://osf.io/by6sf/. RESULTS: (a) Item Response Theory analyses supported the unidimensionality of data via the root mean square error of approximation and standardized root mean square residual results (RMSEA). (b) The lack of voluntary interest was the most discriminative risk behavior in the first 5 years. (c) Lack of interest was the most persistent risk behavior. (d) Difficulty making eye contact was nearly as informative as lack of interest. CONCLUSION: Lack of voluntary interest in things should be considered a critical risk-related behavior, and making eye contact is a vital aspect of typical development. Both behaviors may be predictors of children's delays.MAIN OUTCOMESThe ASQ:SE is a valid and reliable tool to measure child development.The internal structure of the ASQ:SE is well-fitted with a unidimensional solution.A child's age is a vital aspect of the discrimination parameter of the IRT model.Lack of interest in things and difficulty making eye contact are critical risk-related behaviors.

An Exploratory Analysis of the Internal Structure of Test Through a Multimethods Exploratory Approach of the ASQ:SE in Brazil.

Background A wide range of exploratory methods is available in psychometrics as means of gathering insight on existing data and on the process of establishing the number and nature of an internal structure factor of a test. Exploratory factor analysis (EFA) and principal component analysis (PCA) remain well-established techniques despite their different theoretical perspectives. Network analysis (NA) has recently gained popularity together with such algorithms as the Next Eigenvalue Sufficiency Test. These analyses link statistics and psychology, but their results tend to vary, leading to an open methodological debate on statistical assumptions of psychometric analyses and the extent to which results that are generated with these analyses align with the theoretical basis that underlies an instrument. The current study uses a previously published data set from the Ages & Stages Questionnaires: Social-Emotional to explore, show, and discuss several exploratory analyses of its internal structure. To a lesser degree, this study furthers the ongoing debate on the interface between theoretical and methodological perspectives in psychometrics. Methods From a sample of 22,331 sixty-month-old children, 500 participants were randomly selected. Pearson and polychoric correlation matrices were compared and used as inputs in the psychometric analyses. The number of factors was determined via well-known rules of thumb, including the parallel analysis and the Hull method. Multidimensional solutions were rotated via oblique methods. R and Factor software were used, the codes for which are publicly available at https://luisfca.shinyapps.io/psychometrics_asq_se/ . Results Solutions from one to eight dimensions were suggested. Polychoric correlation overcame Pearson correlation, but nonconvergence issues were detected. The Hull method achieved a unidimensional structure. PCA and EFA achieved similar results. Conversely, six clusters were suggested via NA. Conclusion The statistical outcomes for determining the factor structure of an assessment diverged, varying from one to eight domains, which allowed for different interpretations of the results. Methodological implications are further discussed.

Evidence-Informed Milestones for Developmental Surveillance Tools.

The Centers for Disease Control and Prevention's (CDC) Learn the Signs. Act Early. program, funded the American Academy of Pediatrics (AAP) to convene an expert working group to revise its developmental surveillance checklists. The goals of the group were to identify evidence-informed milestones to include in CDC checklists, clarify when most children can be expected to reach a milestone (to discourage a wait-and-see approach), and support clinical judgment regarding screening between recommended ages. Subject matter experts identified by the AAP established 11 criteria for CDC milestone checklists, including using milestones most children (≥75%) would be expected to achieve by specific health supervision visit ages and those that are easily observed in natural settings. A database of normative data for individual milestones, common screening and evaluation tools, and published clinical opinion was created to inform revisions. Application of the criteria established by the AAP working group and adding milestones for the 15- and 30-month health supervision visits resulted in a 26.4% reduction and 40.9% replacement of previous CDC milestones. One third of the retained milestones were transferred to different ages; 67.7% of those transferred were moved to older ages. Approximately 80% of the final milestones had normative data from ≥1 sources. Social-emotional and cognitive milestones had the least normative data. These criteria and revised checklists can be used to support developmental surveillance, clinical judgment regarding additional developmental screening, and research in developmental surveillance processes. Gaps in developmental data were identified particularly for social-emotional and cognitive milestones.

Infant mental health in Malaysia.

The Infant Mental Health system in Malaysia is described, beginning with cultural and religious practices that influence mental health practices. Second, a description of the Malaysian mental health system, including historical influences, is given. Third, policy and services for young children with mental health problems are described. Finally, recommendations for future steps for developing an effective infant mental health system are presented, including the development of infant mental health policies by the government, increased personnel training, increased community mental health resources, integration of culture into the mental health system, and finally, development of appropriate screening and assessment instruments and systems.

Adapting the Ages and Stages Questionnaire to Identify and Quantify Development Among Children With Evidence of Zika Infection.

This article describes novel methods of applying the Ages and Stages Questionnaire-3rd edition (ASQ-3) to assess and quantify developmental delay among children following the 2015-2016 Zika virus outbreak in Brazil. Many of the children with Zika virus infection were expected to have severe developmental delay. However, administering the ASQ-3 to caregivers of these children according to standard protocol would have screened for the overall presence of delay but not the severity of delay. We adopted an amended protocol for administration of the ASQ-3 to quantify the developmental functioning of children severely affected by Zika virus infection in this investigation. Protocols for administering the ASQ-3 among this population were drafted in consultation with developmental measurement experts and are presented here. Specific developmental estimates are discussed, including developmental age equivalents, developmental quotients, and developmental quotient z scores. The calculations of these estimates are presented with examples in the context of the 2015-2016 Zika virus outbreak and associated microcephaly among prenatally infected children from 2 states in northeastern Brazil. Potential applications of these methods for estimating developmental ability among similar pediatric populations are discussed.

Modifying a general social-emotional measure for early autism screening.

Objective: Broadband social-emotional screening tools are designed to evaluate a child's social development and interactions. Such tools are expected to have reasonable sensitivity for identifying children at risk for autism spectrum disorder (ASD) but would also likely over-estimate risk for ASD since other conditions can also affect social development. In this study, a subset of ASD items from one general social-emotional screening measure, the Ages & Stages Questionnaires: Social Emotional, 2nd edition, was analyzed to determine if use of an ASD subscale might improve prediction of ASD risk for young children. Methods: The ASD subscale was used with 60 families who had a child referred for an ASD evaluation. Social-emotional screening and ASD screening results were compared with the subsequent results from gold-standard diagnostic testing for ASD at a regional autism center, using contingency matrices. Results: As expected, the social-emotional screening tool identified nearly all of the children in the high-risk clinical sample. Use of the ASD subscale increased specificity for ASD (from 4% to 52%) and demonstrated correct prediction of ASD diagnosis in 70% of ASD cases. Conclusions: These preliminary results suggest that using a subset of ASD-specific items on a social-emotional screening tool can increase the tool's specificity for ASD, by isolating ASD-specific concerns.

Play to Teach: Coaching Paraeducators to Facilitate Communication in the Preschool Classroom.

Paraeducators are ideal candidates for delivering communication interventions to children with developmental disabilities and delays (DD) because they spend a significant amount of time with these children. However, professional development is often inadequate and limited research supports best practices. Additionally, paraeducators work with multiple children with varying skill levels. Little research has been conducted on the use of existing strategies with multiple children. This single-case study examines the effect of a training package on paraeducators' fidelity of intervention implementation with a child dyad and subsequent child outcomes. Results suggest that formal coaching contributed to improved fidelity of intervention implementation. Furthermore, paraeducators were able to use intervention strategies with children with varying communication skills and goals. Variable increases in child communication were also detected.

State Variability in Diagnosed Conditions for IDEA Part C Eligibility.

An infant or toddler can begin the process of receiving Part C early intervention services by having a diagnosed condition with a high probability of developmental delay (Individuals with Disabilities Education Improvement Act, 2004). How states define those diagnosed conditions that begin the initiation process varies widely. Lists of diagnosed conditions were collected from state Part C websites and Part C coordinators for a descriptive analysis. Across 49 states, the District of Columbia, and 4 territories, a final list of 620 unique conditions was compiled. No single condition was listed by all jurisdictions. Hearing impairment was the condition listed by the most states (n = 38), followed by fetal alcohol syndrome (n = 34). Of the 620 conditions, 168 (27%) were listed by only 1 state, 554 (89%) were listed by fewer than 10 states, and 66 (11%) were listed by 10 or more states. Of these 66 conditions, 47 (71%) were listed by fewer than 20 states. Most of these 66 conditions (n = 48; 72.7%) had a prevalence of "very rare or rare," 8 (12%) were "common," 6 (9%) were "very common," and 4 (6.1%) were "unknown." The wide heterogeneity in the number and type of diagnostic conditions listed across states should be further investigated as it may represent imbalances in children with diagnosed conditions gaining access to Part C evaluations and individualized family service plans and potentially the services themselves across states. In addition, providing ready access to lists of diagnosed conditions is a simple step that could help states and Part C programs facilitate access to services.

Genetic and epigenetic characteristics of ICSI children.

The outcome of pregnancy and the developmental wellbeing of children conceived from 12,866 consecutive intracytoplasmic sperm injection (ICSI) cycles was assessed. A total of 3277 couples delivered 5891 neonates. There was a higher than normal incidence of de-novo chromosomal abnormalities in a small sample of ICSI offspring. Controlling for maternal age showed that the incidence of low birth weight and gestational length were comparable with the naturally conceived counterpart. Rates of malformation in ICSI offspring ranged from 3.5 to 6.2%. At 3 years of age (n = 811), the proportion of children at risk for developmental delays was 10.4% in ICSI and 10.7% in IVF singletons. However, high order gestations were characterized by 19.4% of the children having compromised development. Epigenetic analysis of assisted reproductive technique conceptuses found minor imprinted gene expression imbalances. ICSI offspring presented with genetic defects that were inherited or arose de novo. Obstetric and neonatal outcomes of singleton pregnancies appeared to be dependent upon maternal age. ICSI and IVF appeared to exert a negative effect on the wellbeing of offspring mainly because of the association with multiple gestations. All assisted reproduction procedures should be monitored for the eventual effect of environmental aggressors on offspring epigenesis.

Preliminary Results of the Macedonian-Adapted Version of Ages and Stages Developmental Questionnaires.

CONTEXT: Early detection of developmental problems is critical, and interventions are more effective when they are carried out early in a child's life. In Macedonia, there are only four centers providing early intervention services. AIMS: In this research, we determined the reliability of the translation and adaptation of Ages and Stages Questionnaires 3rd edition (ASQ-3-M) for assessment of children aged 3-5 years old in Macedonia, and reported preliminary results of the gender differences in the development. MATERIALS AND METHODS: ASQ-3-M was completed by 165 parents and 40 educators in seven kindergarten classrooms. Children were 3-5 years old. STATISTICAL ANALYSIS USED: Cronbach's alpha, Intraclass Correlation coefficient (ICC), and interrater reliability (IRR) were used to assess ASQ-3-M psychometric properties. The Bayesian t-test was performed to estimate the difference in means between males and females. RESULTS: The Cronbach's alpha ranged from 0.65 to 0.87. The overall ICC was 0.89 (ranged from 0.8 to 0.95), which indicates a strong to almost perfect strength of agreement between test-retest. IRR correlation revealed an average of 0.88 (ranged from 0.74 to 0.95), suggesting that ASQ-3-M is reliable and stable. CONCLUSIONS: The results from the comparison between males and females on all dimensions of ASQ-3-M were not statistically significant (BF10 <3), indicating no significant gender difference. That said, the ASQ-3 is recommended for routine use in screening children aged 3-5 years old.

ASQ-3: Validation of the Ages and Stages Questionnaire for the detection of neurodevelopmental disorders in Argentine children. / ASQ-3: validación del Cuestionario de Edades y Etapas para la detección de trastornos del neurodesarrollo en niños argentinos.

INTRODUCTION: The systematic assessment of child development in the first years of life is an essential component of pediatric health checkups. The Ages and Stages Questionnaire, third edition (ASQ-3) is the most validated scale, and has been recommended by the UNICEF to verify if children have a normal neurological development. It is a monitoring instrument to assess the main developmental areas, including communication, gross motor, fine motor, personal-social, and problem solving skills, and to compare the local population to the international development standards. OBJECTIVE: To validate the ASQ-3 in a pediatric population group. METHODS: Children aged 1-66 months were assessed at a public hospital by pediatricians, psychologists, and educational psychologists. The SSPS software package was used to determine population scales. RESULTS: In 630 children, who had a homogeneous sex distribution, an 88% sensibility and a 94% specificity were determined, with a positive predictive value of 88% and a negative predictive value of 96%, compared to the National Screening Test (Prueba Nacional de Pesquisa, PRUNAPE) and the cut-off scores for each age group. CONCLUSION: The ASQ-3 established that 19.5% of children were at risk of experiencing neurodevelopmental disorders. The ASQ-3 met psychometric properties compared to the PRUNAPE, which is the gold standard for the targeted and systematic assessment of developmental milestones during health checkups in a rapid, simple and cost-effective manner, so it was considered useful to monitor child neurological development.

INTRODUCCIÓN: La evaluación sistemática del desarrollo infantil durante los primeros años de vida es un componente esencial en el control de salud pediátrico. El Cuestionario de Edades y Etapas, tercera edición (Ages and Stages Questionnarie; ASQ-3, por sus siglas en inglés), es la escala con más estudios de validación y recomendada por el Fondo de las Naciones Unidas para la Infancia (UNICEF) para verificar que el neurodesarrollo de los niños sea normal. Es una herramienta de monitoreo que evalúa las principales áreas de desarrollo, como comunicación, motricidad gruesa, fina, socioindividual y de resolución de problemas, que permite la comparación de la población local con los estándares internacionales de desarrollo. OBJETIVO: Realizar la validación del ASQ-3 en un grupo de población infantil. MÉTODOS: Se evaluaron niños en un hospital público de 1 a 66 meses de edad, por profesionales de la salud pediatras, psicólogos y psicopedagogas. Se utilizó el paquete SSPS para la determinación de los baremos de la población. RESULTADOS: En la muestra de 630 niños, con una distribución homogénea por sexos, se establecieron una sensibilidad del 88%, especificidad del 94%, como valores predictivos positivos del 88% y negativos del 96%, comparados con la Prueba Nacional de Pesquisa (PRUNAPE) y los puntajes de corte para cada edad. CONCLUSIÓN: El ASQ-3 pudo discriminar que el 19,5% de los niños estaban en riesgo de sufrir trastornos del neurodesarrollo. Cumplió con las propiedades psicométricas comparado con el estándar de oro PRUNAPE para la evaluación dirigida y sistemática de hitos madurativos en el control de salud, de manera rápida, sencilla y económica, por lo que resultó una herramienta útil en el monitoreo del neurodesarrollo infantil.

The explication of a mentor model, videotaping, and reflective consultation in support of infant mental health.

Infant mental health, as concept and intervention, is poorly understood by most practitioners in education settings. Direct-service personnel often lack appropriate knowledge, training, skills, and confidence in recognizing and addressing infant mental health problems. While programs and policymakers increasingly acknowledge the need to offer infant mental health services in order to prevent or mediate poor developmental outcomes among young children, effective methods of realizing an infant mental health initiative remain elusive. This qualitative study of five early education programs examines the use of mentors trained in clinical psychology or social work to support educators in delivering infant mental health services. The perspectives of administrators, direct-service providers, and mentors help us understand what constitutes successful infant mental health mentoring in general, and videotaping in combination with reflective consultation in particular.

Risk for maternal depression and child aggression in Early Head Start families: A test of ecological models.

Current literature indicates that risk for maternal depression is substantial in low-income families. A large body of research also indicates that when mothers are depressed, children are at risk for a number of developmental difficulties. While mutual influence between child and parental difficulties has been noted, few studies examine risk factors for both depression and child aggression within ecological models. The present cross-site study examined the unique and additive contributions of contextual factors, including SES and family functioning, on maternal depression and child aggression in Early Head Start families. A multiethnic sample of parents and their children, between the ages of 12 and 43 months, participated in this study. Families came from five Early Head Start programs across the United States, representing both urban and rural areas. Structural equation models (SEM) demonstrate mutual links between depression and aggression, mediated at least in part by ecological factors. SEM indicated that 36.4% of the variance in child aggression is accounted for in a model linking aggressive behavior to parent depression, stress, and couple-level functioning, as well as other family interaction variables. A second model focusing on maternal depression revealed that 44.5% of the variance in maternal depression was accounted for through family factors, including couple-related support and satisfaction and parenting stress. In this second model, child aggression was indirectly linked to maternal depression. These data have important implications for programs serving at-risk families.