A study on detection of risk factors of a toddler’s fall injuries using visual dynamic motion cues

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.The research in this thesis is intended to aid caregivers’ supervision of toddlers to prevent accidental injuries, especially injuries due to falls in the home environment. There have been very few attempts to develop an automatic system to tackle young children’s accidents despite the fact that they are particularly vulnerable to home accidents and a caregiver cannot give continuous supervision. Vision-based analysis methods have been developed to recognise toddlers’ fall risk factors related to changes in their behaviour or environment. First of all, suggestions to prevent fall events of young children at home were collected from well-known organisations for child safety. A large number of fall records of toddlers who had sought treatment at a hospital were analysed to identify a toddler’s fall risk factors. The factors include clutter being a tripping or slipping hazard on the floor and a toddler moving around or climbing furniture or room structures. The major technical problem in detecting the risk factors is to classify foreground objects into human and non-human, and novel approaches have been proposed for the classification. Unlike most existing studies, which focus on human appearance such as skin colour for human detection, the approaches addressed in this thesis use cues related to dynamic motions. The first cue is based on the fact that there is relative motion between human body parts while typical indoor clutter does not have such parts with diverse motions. In addition, other motion cues are employed to differentiate a human from a pet since a pet also moves its parts diversely. They are angle changes of ellipse fitted to each object and history of its actual heights to capture the various posture changes and different body size of pets. The methods work well as long as foreground regions are correctly segmented

A smart vision sensor for detecting risk factors of a toddler's fall in a home environment

This paper presents a smart vision sensor for detecting risk factors of a toddler's fall in an indoor home environment assisting parents' supervision to prevent fall injuries. We identified the risk factors by analyzing real fall injury stories and referring to a related organization's suggestions to prevent falls. In order to detect the risk factors using computer vision, two major image processing methods, clutter detection and toddler tracking, were studied with using only one commercial web-camera. For practical purposes, there is no need for a toddler to wear any sensors or markers. The algorithms for detection have been developed, implemented and tested

Vision-based toddler tracking at home

This paper presents a vision-based toddler tracking system for detecting risk factors of a toddler's fall within the home environment. The risk factors have environmental and behavioral aspects and the research in this paper focuses on the behavioral aspects. Apart from common image processing tasks such as background subtraction, the vision-based toddler tracking involves human classification, acquisition of motion and position information, and handling of regional merges and splits. The human classification is based on dynamic motion vectors of the human body. The center of mass of each contour is detected and connected with the closest center of mass in the next frame to obtain position, speed, and directional information. This tracking system is further enhanced by dealing with regional merges and splits due to multiple object occlusions. In order to identify the merges and splits, two directional detections of closest region centers are conducted between every two successive frames. Merges and splits of a single object due to errors in the background subtraction are also handled. The tracking algorithms have been developed, implemented and tested

A study on detection of risk factors of a toddler's fall injuries using visual dynamic motion cues

The research in this thesis is intended to aid caregivers’ supervision of toddlers to prevent accidental injuries, especially injuries due to falls in the home environment. There have been very few attempts to develop an automatic system to tackle young children’s accidents despite the fact that they are particularly vulnerable to home accidents and a caregiver cannot give continuous supervision. Vision-based analysis methods have been developed to recognise toddlers’ fall risk factors related to changes in their behaviour or environment. First of all, suggestions to prevent fall events of young children at home were collected from well-known organisations for child safety. A large number of fall records of toddlers who had sought treatment at a hospital were analysed to identify a toddler’s fall risk factors. The factors include clutter being a tripping or slipping hazard on the floor and a toddler moving around or climbing furniture or room structures. The major technical problem in detecting the risk factors is to classify foreground objects into human and non-human, and novel approaches have been proposed for the classification. Unlike most existing studies, which focus on human appearance such as skin colour for human detection, the approaches addressed in this thesis use cues related to dynamic motions. The first cue is based on the fact that there is relative motion between human body parts while typical indoor clutter does not have such parts with diverse motions. In addition, other motion cues are employed to differentiate a human from a pet since a pet also moves its parts diversely. They are angle changes of ellipse fitted to each object and history of its actual heights to capture the various posture changes and different body size of pets. The methods work well as long as foreground regions are correctly segmented.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Early detection of communication delays with the PEDS tools in at-risk South African infants

Background: Prevalence of communication delays or disorders is increasing, possibly because of various environmental risk factors. Selection and implementation of effective screening tools are important to detect at-risk infants as early as possible. This study aimed to evaluate the accuracy of the Parents' Evaluation of Developmental Status (PEDS), PEDS-Developmental Milestones and PEDS tools to detect communication delays in infants (6-12 months) in a South African primary healthcare context. Method: A comparative study design evaluated the accuracy of the PEDS tools to detect communication delays, using an internationally accepted diagnostic assessment tool, the Rossetti Infant-Toddler Language Scale (RITLS). A convenience sample of 201 infants was selected at primary healthcare clinics. Results: Expressive and receptive language sensitivity scores were low across all three screens (ranging between 14% and 44%). The PEDS tools had high sensitivity (71%) and specificity (73%) ratings for the receptive and expressive language and socio-emotional domain in combination. Conclusion: In the sample population, the PEDS tools did not accurately detect receptive and expressive language delays; however, communication delays in general were identified. Future research determining accuracy of the PEDS, PEDS-Developmental Milestones and PEDS tools for children aged 2-5 years in detecting communication delays should be prioritised

Comparative Network Analysis of Preterm vs. Full-Term Infant-Mother Interactions

Several studies have reported that interactions of mothers with preterm infants show differential characteristics compared to that of mothers with full-term infants. Interaction of preterm dyads is often reported as less harmonious. However, observations and explanations concerning the underlying mechanisms are inconsistent. In this work 30 preterm and 42 full-term mother-infant dyads were observed at one year of age. Free play interactions were videotaped and coded using a micro-analytic coding system. The video records were coded at one second resolution and studied by a novel approach using network analysis tools. The advantage of our approach is that it reveals the patterns of behavioral transitions in the interactions. We found that the most frequent behavioral transitions are the same in the two groups. However, we have identified several high and lower frequency transitions which occur significantly more often in the preterm or full-term group. Our analysis also suggests that the variability of behavioral transitions is significantly higher in the preterm group. This higher variability is mostly resulted from the diversity of transitions involving non-harmonious behaviors. We have identified a maladaptive pattern in the maternal behavior in the preterm group, involving intrusiveness and disengagement. Application of the approach reported in this paper to longitudinal data could elucidate whether these maladaptive maternal behavioral changes place the infant at risk for later emotional, cognitive and behavioral disturbance

Early Screening Tool For Autism Spectrum Disorder For Visual Impairments

The aim of the present study was to evaluate developed screening tools on autism students’ to detect early signs especially on visual for ASD children. Early intervention in autism spectrum disorder (ASD) improves outcomes, but treatment access depends on early identification. Method of collecting data was using tool, observation and interview. Design stage produces flowchart and storyboard and development stage produces learning media with conceptual characteristics presented through materials equipped with visualization in the form of videos, pictures, sound and text. The results of this research illustrate that there is a positive score and feedback from children with autism. Besides that, children with autism are easy to focus using this tool. Recommendation of a screening for autism disorders in practice when concerns from parents or family are not raised, challenge the quality of the instrument and the overall screening procedure. The benefits of early ASD screening and detection must be weighed against the risk for false positive test results causingparents unnecessary worry

DO IT Trial: vitamin D Outcomes and Interventions in Toddlers - a TARGet Kids! randomized controlled trial.

BackgroundVitamin D levels are alarmingly low (<75 nmol/L) in 65-70% of North American children older than 1 year. An increased risk of viral upper respiratory tract infections (URTI), asthma-related hospitalizations and use of anti-inflammatory medication have all been linked with low vitamin D. No study has determined whether wintertime vitamin D supplementation can reduce the risk of URTI and asthma exacerbations, two of the most common and costly illnesses of early childhood. The objectives of this study are: 1) to compare the effect of 'high dose' (2000 IU/day) vs. 'standard dose' (400 IU/day) vitamin D supplementation in achieving reductions in laboratory confirmed URTI and asthma exacerbations during the winter in preschool-aged Canadian children; and 2) to assess the effect of 'high dose' vitamin D supplementation on vitamin D serum levels and specific viruses that cause URTI.Methods/designThis study is a pragmatic randomized controlled trial. Over 4 successive winters we will recruit 750 healthy children 1-5 years of age. Participating physicians are part of a primary healthcare research network called TARGet Kids!. Children will be randomized to the 'standard dose' or 'high dose' oral supplemental vitamin D for a minimum of 4 months (200 children per group). Parents will obtain a nasal swab from their child with each URTI, report the number of asthma exacerbations and complete symptom checklists. Unscheduled physician visits for URTIs and asthma exacerbations will be recorded. By May, a blood sample will be drawn to determine vitamin D serum levels. The primary analysis will be a comparison of URTI rate between study groups using a Poisson regression model. Secondary analyses will compare vitamin D serum levels, asthma exacerbations and the frequency of specific viral agents between groups.DiscussionIdentifying whether vitamin D supplementation of preschoolers can reduce wintertime viral URTIs and asthma exacerbations and what dose is optimal may reduce population wide morbidity and associated health care and societal costs. This information will assist in determining practice and health policy recommendations related to vitamin D supplementation in healthy Canadian preschoolers

Using Informatics to Improve Autism Screening in a Pediatric Primary Care Practice

Background: According to the most recent report from the CDC (2018), autism spectrum disorder (ASD) affects approximately one in 59 children in the United States (U.S.). In 2007, the American Academy of Pediatrics (AAP) issued a strong recommendation for all primary care providers to screen children for autism, using a validated tool, at the 18 and 24-month well-child visits, in order to begin the referral process for more formal testing, and intervention, promptly. Despite the strong stance of the AAP and evidence supporting the importance of early intervention for children with ASD, not all primary care providers are screening for ASD or developmental delay. Purpose: To improve the percentage of eligible children, presenting for 18 and 24 month wellchild visits in a pediatric primary care office, who are screened for ASD, by integrating the Modified Checklist for Autism in Toddlers (M-CHAT) screening tool into the electronic medical record with tablets. The specific aims were to increase the percentage of children screened and improve the documentation of the screens performed. Methods: This quality improvement project utilized a before-after quantitative design to support the improvement. Reports were obtained for three months prior to the implementation of the tablets and process change, and again for three months following the implementation. Manual chart reviews were also performed to verify the data from the reports. The definition used for complete screening for this project included 1) presence of the completed screen in the medical record, 2) provider documentation of the result, interpretation, and plan if indicated, and 3) CPT code entry for charge capture completed in the electronic medical record. Results: The results of the project revealed improvements in overall percentages of eligible children screened for autism at D-H Nashua Pediatrics. The percentage of complete screening increased from 64.7% to 73.9% following the implementation of the project, a change which is statistically significant (t=31.6105, df=16,p=0.05). Each individual element was also tracked and those results showed that 1) the completeness of provider documentation related to the screening increased from 93.6% to 96% (t=41.3321, df=16, p=0.05) and 2) the M-CHAT screen was present in the electronic health record (EHR) 98.9% of the time, which was an increase from 84.6% (t=295.4084, df=16, p=0.05). The charge capture completion rate remained statistically unchanged at 76.5% (t=0.4664, df=16, p=0.05). Additionally, only one screening was noted to be missed altogether, out of 280 eligible children. Prior to the project, there were four missed screenings (out of 156 eligible children) captured by the chart reviews conducted over three months prior to the implementation of the project. Overall, the results show that the project resulted in an increase the percentage of M-CHAT screening, an increase in the presence of source documentation in the electronic health record (EHR), and more complete provider documentation related to the screening

Analysis of Detection of Growth and Development In Gross Motor Toddlers (Case Study of Babies Aged 6 Months Cannot Pronning, Roll and Crooked)

The analytical method of detecting growth and development carried out on children is not solely without reasons and benefits, apart from detecting whether there is a disturbance in their growth and development or not, as well as early prevention in children so that parents are able to minimize the occurrence of problems and obstacles to the growth and development of the baby. The number of respondents used is one, because this research is in the form of a field case study of toddlers aged 6 months who were conducted at AMC Metro Hospital with sources from the child development polyclinic doctor, and the baby's parents. Data obtained through direct observation, interviews and documentation. Data analysis was carried out to limit matters outside the subject matter of the study so that it focuses on the main topic. The results of the research showed that toddlers experienced gross motoric problems, namely not being able to lie on their stomach, rolling over (turning over and then lying on their backs), and tilting caused by several factors including the birth process by cesarean section, breastfeeding was replaced with formula milk, and lack of stimulus from other people. old. The solution that can be given is to carry out routine checks on child growth and development polyclinics and independent stimulation at home using the KIA, KPSP, DDTK/SDIDTK guide books, as a reference in an effort to overcome problems that occur in these babies