Utility of the World Health Organization Disability Assessment Schedule and the World Health Organization minimal generic set of domains of functioning and health in spinal cord injury

Objective: To compare easy-to-use International Classification of Functioning, Disability and Health (ICF)-based measures of functioning with the level and severity of spinal cord injury.Methods: Cross-sectional study. Patients (n = 142) and their significant others completed the 12-item World Health Organization Disability Assessment Schedule (WHODAS 2.0) questionnaire. A physician at the university hospital outpatient clinic assessed functioning with the 7-item World Health Organization (WHO) minimal generic set.Results: The patient and proxy WHODAS sum score was rated severe with decreasing severity in groups with complete and partial tetraplegia and paraplegia, respectively. Working ability was rated most severely impaired in the tetraplegic groups. Between-group differences were also found in mobility, household tasks, and self-care. Mobility was found to be associated with lesion severity; life activities, participation and friendships with lesion level; and self-care and WHODAS sum score with both lesion severity and level. Depending on the level and severity of spinal cord injury, a moderate to strong correlation was found between the sum scores of the 2 tools, and mostly very strong correlations between patient and proxy assessments of functioning.Conclusion: Both generic ICF-based tools, despite their briefness, seemed to be useful as they were able to differentiate various levels and severities of spinal cord injury. We recommend using the 12-item WHODAS 2.0 when planning individualized services for patients with spinal cord injury

Neonatal brainstem auditory function associates with early receptive language development in preterm children

Aim: To study whether auditory function measured with brainstem auditory evoked potential and brainstem audiometry recordings in the neonatal period associates with language development 1 year later in preterm infants.Methods: This retrospective study included 155 preterm infants (birthweight ≤1500 g and/or birth ≤32 gestational weeks) born between 2007 and 2012 at the Turku University Hospital. Auditory function was recorded in neonatal period. Information of language development was gathered at the mean corrected age of 1 year by using the Finnish version of the MacArthur Communicative Development Inventory.Results: Slower auditory processing (longer interpeak interval, IPI I-V) in the right ear in the neonatal brainstem auditory evoked potential recording associated with smaller receptive lexicon size at 1 year (P = .043). Infants with longer IPI I-V were more likely to have a deviant (≤17 words) receptive lexicon size (P = .033). The ab-sence of a contralateral response with right ear stimulation increased the risk for deviant lexicon size (P = .049).Conclusion: The results suggest that impaired auditory function in the neonatal pe-riod in preterm infants may lead to a poorer receptive language outcome 1 year later. Auditory pathway function assessment provides information for the identification of preterm children at risk for weak language development.Peer reviewe

Population-Based Screening for Language Delay: Let’s Talk STEPS Study

This study evaluates the reliability of two differently constructed screening instruments for language delay. Only few studies have addressed the question of early identification at population level. Data for this article were drawn from a Finnish cohort study, entitled the Steps to the Healthy Development and Well-Being of Children (the STEPS study, N = 9.936). The MacArthur Communicative Development Inventories (CDI-T), based on parent reported vocabulary, was used for screening at 24 months. At 36 months, child’s language skills were screened with the Fox Language Inventory (FLI) carried out by a clinical nurse. The Renfrew Word Finding Vocabulary Test and Reynell Developmental Language Scales III (language comprehension), served as outcome measures at 36 months. Receiver operating characteristic-analysis (ROC) was used to examine the cost and benefit of the two screening methods in decision making at 36 months. We found that expressive vocabulary at 24 months, can already foretell later language development. However, to reach even better predictivity, screening based on a structured language battery and age point of 36 months would be a valuable addition to clinical assessment. Further studies are needed to address to what extend early screening is able to predict atypical language during later preschool-years.</p

Communication skills predict social-emotional competencies

Introduction Studies have shown that many children with early language difficulties also have delays in social-emotional competencies as well as social-emotional and behavioral problems. It is unclear if these conditions are causally related, if they share a common underlying etiology, or if there are bidirectional effects. Studies investigating these associations have mostly involved children who are already using words to communicate, but it is important to know whether delays in preverbal communication and language development have any effects on these associations. The aim of the present study was to examine associations between preverbal communication and early verbal skills in infancy and subsequent social-emotional competencies and ensuing social-emotional and behavioral problems in early toddlerhood. The role of background factors known to influence early language development was also examined. Methods The sample consisted of 395 children (51.6% boys) from the Finnish Steps Study cohort. Language was assessed at age 13 months (+ 1 month) with the MacArthur Communicative Development Inventory for Infants (CDI-I), and the social-emotional domain was assessed at age < 17 months with the Brief Infant–Toddler Social and Emotional Assessment (BITSEA). Results Infants with lower preverbal gestural communication and receptive language skills had a higher risk of delays in social-emotional competencies in toddlerhood than children with better communication skills, but not of elevated social-emotional and behavioral problems. Conclusions The results indicate that lower early communication skills can predict delays in the development of social-emotional competencies, which has been found to be a risk factor for later development of social-emotional and behavioral problems. It is important to monitor early communication skills to provide guidance to parents in supporting early pragmatic communication and language development in infancy, if needed.Peer reviewe

Comparing disability between traumatic brain injury and spinal cord injury using the 12-item WHODAS 2.0 and the WHO minimal generic data set covering functioning and health

Objective: To compare disability between two patient groups using short validated tools based on International Classification of Functioning, Disability and Health (ICF).Design: Cross-sectional study.Setting: University hospital specialist outpatient clinic.Subjects: A total of 94 patients with traumatic brain injury and 59 with spinal cord injury.Main measures: Disability evaluated using self-reported and proxy 12-item WHODAS 2.0 (World Health Organization Disability Assessment Schedule), and physician-rated WHO minimal generic data set covering functioning and health.Results: The two measures used showed severe but very different disabilities in these patient groups. Disability was assessed worse by physicians in the spinal cord injury population (sum 15.8 vs. 12.7, P = 0.0001), whereas disability assessed by the patients did not differ significantly between the two groups (sum 18.4 vs. 21.2). Further analysis revealed that in patients with “high disability” (the minimal generic data set score ⩾15), self-reported functioning was more severely impaired in the traumatic brain injury group compared to the spinal cord injury group (29.7 vs. 21.4, P Conclusion: Both generic measures were able to detect severe disability but also to detect differences between two patient populations with different underlying diagnoses.</p

Association of allergic diseases with children’s life satisfaction: population-based study in Finland

Objective To assess the impact of allergic diseases on the subjective well-being and life satisfaction of primary-school children.Design Population-based cohort.Setting Finnish sample of children ages 10 and 12 from the International Survey of Children’s Well-Being.Participants Nationally representative sample of 1947 school children.Main outcome measure Two different instruments to assess the child’s own perception of well-being, the short version of the Student Life Satisfaction Scale (SLSS) and the Brief Multidimensional Student Life Satisfaction Scale (BMSLSS).Results Altogether, 51.4% of children reported having at least one allergic condition (10.1% asthma, 23.8% eczema and 40.3% seasonal allergic rhinitis). A statistically significant distinction in life satisfaction emerged between non-allergic and allergic children (inferior in the latter). In particular, children with eczema were more likely to report a reduction in life satisfaction compared with non-allergic children (SLSS β=−128.220; BMSLSS β=−90.694; p<0.01). Apart from freedom from eczema, good life satisfaction was associated with a physically active lifestyle.Conclusions Active allergic disease reduces the child’s own perception of well-being. During clinical visits, more attention should be paid to the child’s psychosocial status and impairments, which may differ substantially from those of parents or medical authorities.</div

Continuous positive airway pressure treatment may negatively affect auditory maturation in preterm infants

Aim Nasal continuous positive airway pressure (CPAP) devices generate loud noise, which might harm auditory function and maturation. The function of auditory pathways can be examined by using brainstem auditory evoked potential (BAEP) and brainstem audiometry (BA) recordings. Our objective was to study whether CPAP treatment during the neonatal period is associated with abnormalities in BAEP and BA recordings. Methods Included in this retrospective study were preterm infants (birth weight <= 1500 g and/or gestational age <= 32 weeks) born between 2002 and 2006 with a comprehensive clinical background and follow-up data, including the duration of CPAP treatment (n = 162). BAEP and BA were recorded near the mean corrected age of one month. The following variables from BAEP and BA examinations were analysed: latencies of BAEP components I, III, V, interpeak intervals (IPI) I-V, I-III, III-V (ms), amplitude I and V (mu V), amplitude ratio I/V and BA thresholds. Results In the adjusted analysis, a longer CPAP treatment leads to longer latencies of BAEP component III (p = 0.01) and V (p = 0.02) in the right ear. Conclusion CPAP treatment may impair the auditory maturation and processing mediated via the dominant right ear. The hearing and neurodevelopment of the children who are treated with CPAP should be followed

Multi-center nationwide study on pediatric psychiatric inpatients 2000-2018: length of stay, recurrent hospitalization, functioning level, suicidality, violence and diagnostic profiles

Inpatient treatment is an important part of child and adolescent psychiatric (CAP) care. This nationwide study explores the changes in length of stay, recurrent hospitalization, functioning level, suicidality, violence and diagnoses of CAP inpatients in Finland in 2000, 2011 and 2018. We obtained comprehensive questionnaire data on each study year from 93 to 95% of all CAP wards in Finland. We split the 1276 inpatients into two age groups in each study year: under 13 and 13-18. The median length of stay in inpatient treatment decreased from 82.0 days in 2000 to 20.5 days in 2018 (p </p

Suicidality among child and adolescent psychiatric inpatients: time trend study comparing 2000 and 2011

Child and adolescent inpatient treatment has faced major changes since the year 2000, including shorter inpatient stays and a greater use of psychotropic drugs. This study explored changes and correlates of suicidal threats and suicide acts among inpatients, by comparing Finnish cross-sectional surveys from 2000 to 2011. A questionnaire that explored the background, diagnosis and treatment characteristics of inpatients was sent to all child and psychiatric wards in Finland. The data collection was carried out on specified days in 2000 and 2011. We received comprehensive data on 504 patients from 64/69 (93%) wards in 2000 and on 412 patients from 75/79 (95%) wards in 2011. The Spectrum of Suicidal Behaviour Scale was used to explore suicidality. The prevalence of suicidality did not change in this nationwide study: suicidal threat rates were 38% in 2000 and 37% in 2011, and suicide attempts in both years were 11%. The prevalence of suicidal acts was higher among girls and teenagers, while low general functioning, defined as Children’s Global Assessment Scale scores of under 30, was associated with both suicidal threats and acts. Violent acts were associated with both suicidal threats and acts in 2000, but not in 2011. Despite changes in treatment practices and shorter inpatient stays, the prevalence of suicidality in child and adolescent inpatient treatment remained unchanged in Finland in 2000 and 2011.</p

Nuoret luupin alla – koulukysely: 6.- ja 9.-luokkalaisten hyvinvointi, osallisuus ja vaikutusmahdollisuudet Varsinais-Suomessa

Käsillä oleva raportti on vuonna 2008 toteutetun 6.- ja 9.-luokkalaisten varsinaissuomalaisten lasten ja nuorten valtaa, vaikutusvaltaa, hyvinvointia ja osallisuutta laajasti selvittäneen tutkimushankkeen loppuraportti. Hanketta on rahoittanut Länsi-Suomen lääninhallitus ja sen on toteuttanut kokonaisuudessaan Turun yliopiston alaisuudessa toimiva Turun lapsi- ja nuorisotutkimuskeskus. Hankkeen vastuuhenkilönä toimi tutkimuskoordinaattori Leena Haanpää ja käytännön toteutuksesta hänen lisäkseen vastasivat tutkija Mervi Tiensuu-Tsiopoulos, amanuenssi Camilla Ehrs sekä tutkimusjohtaja Hanna Lagström.Tutkimusaineiston tilastollisesta käsittelystä vastasi statistikko Anne Kaljonen. Tutkimustietoa lasten ja nuorten elämästä tarvitaan niin päätöksenteon, lasten ja nuorten kanssa työtään tekevien toiminnan tueksi kuin lasten ja nuorten oman äänen esiin saamiseksi. On tärkeää saada tietoa siitä, miten nuoret kokevat siirtymävaiheet esimerkiksi alakoulusta yläkouluun tai yläkoulusta toisen asteen koulutukseen. Mitä muutoksia nuoressa ja hänen suhteissaan vanhempiin, ikätovereihin ja yhteiskuntaan tapahtuu nuoren edetessä koulutaipaleella? Onko muutos samanlaista tytöillä ja pojilla tai suomen- ja ruotsinkielisillä? Panostukset lasten ja nuorten elämään tässä hetkessä kantavat hedelmää tulevaisuuden aikuisten hyvinvoinnille. Perusta elämälle luodaan lapsuudessa ja nuoruudessa, sillä elämäntavat, koulutuspäätökset ja sitä kautta aikuisuuden elämänura rakennetaan nuorena. Tämä Turun lapsi- ja nuorisotutkimuskeskuksen raportti nostaa esille lasten ja nuorten oma äänen monilta elämänalueilta. Toistaiseksi suomalaisten nuorten aikuisten elämää laajasti kartoittavaa tutkimusta on tehty vielä vähän. Siksi Nuoret luupin alla -tutkimushanketta on tarkoitus jatkaa laajentamalla sitä toisen asteen oppilaitoksissa toteutettavaksi, sillä aikuisuuden kynnyksellä olevien nuorten äänen kuuleminen on myös tarpeen.Siirretty Doriast