Effects of Developmental Care on Neurodevelopment of Preterm Infants

AbstractObjectivesThe aim of this study protocol is to systematically review the literature to examine the effects of developmental care on preterm infants’ neurodevelopment in the neonatal intensive care unit (NICU).Methods: We will retrieve the studies through searching the following databases: Web of Science, PubMed, EMBASE (Ovid), Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL (EBSCO), and Scopus.We will include randomized controlled trials (RCTs) with randomization at either an individual or cluster level. Our primary outcome will be the effect of developmental care in NICU neonates on their mental and motor development. The secondary outcome will be weight gain in NICU and hospital stay length. The assessment tool of development should be The Bayley Scales of Infant and Toddler Development, in any of the first, second and third edition.  This study will employ Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to identify relevant articles and report the screening process. The agreement between two experts in developmental neonatology will be reached in all selecting studies. Two reviewers will be achieved data extraction and then they will be compared. Any discrepancies between the extracted data will be discussed to reach a consensus. The extracted data will be imported to Review Manager 5.3 by one reviewer. Two reviewers will independently evaluate the risk of bias for all included studies using the Cochrane Collaborations’ tool for assessing risk of bias in randomized trials.We will conduct a meta-analysis for assessing the possible quantitative impact of developmental interventions on interested primary and secondary outcomes. We will use random effect if the I-square statistics is equal or more than 75%, and fixed effect otherwise. Publication bias will be assessed using Egger’s test and illustration with the funnel plot. We will estimate the Standardized Mean Difference (SMD) with 95% confidence interval through Metan command in STATA 14. The method provided by the Cochrane hand book, will be used in this statistical analysis. The significance level for assessing these analyses will be 0.05. Discussion: According to the findings of this systematic review, by abstracting the results and presenting the conclusions, improvements in interventional decisions can be improved, and results of this systematic review will highlight which clinical practice could possibly be optimized to improve outcome and specifically neurodevelopment in this vulnerable population

A Psychometric Study of the Bayley Scales of Infant and Toddler Development in Persian Language Children

How to Cite This Article: Azari. N, Soleimani F, Vameghi R, Sajedi F, Shahshahani S, Karimi H, Kraskian A, Shahrokhi A, Teymouri R, Gharib M. A Psychometric Study of the Bayley Scales of Infant and Toddler Development in Persian Language Children. Iran J Child Neurol. Winter 2017; 11(1):50-56.AbstractObjectiveBayley Scales of infant & toddler development is a well-known diagnostic developmental assessment tool for children aged 1–42 months. Our aim was investigating the validity & reliability of this scale in Persian speaking children.Materials & MethodsThe method was descriptive-analytic. Translation- back translation and cultural adaptation was done. Content & face validity of translated scale was determined by experts’ opinions. Overall, 403 children aged 1 to 42 months were recruited from health centers of Tehran, Iran during years of 2013- 2014 for developmental assessment in cognitive, communicative (receptive & expressive) and motor (fine & gross) domains. Reliability of scale was calculated through three methods; internal consistency using Cronbach’s alpha coefficient, test-retest and interrater methods. Construct validity was calculated using factor analysis and comparison of the mean scores methods.ResultsCultural and linguistic changes were made in items of all domains especially on communication subscale. Content and face validity of the test were approved by experts’ opinions. Cronbach’s alpha coefficient was above 0.74 in all domains.Pearson correlation coefficient in various domains, were ≥ 0.982 in test retest method, and ≥0.993 in inter-rater method. Construct validity of the test was approved by factor analysis. Moreover, the mean scores for the different age groups were compared and statistically significant differences were observed between mean scores of different age groups, that confirms validity of the test.ConclusionThe Bayley Scales of Infant and Toddler Development is a valid and reliable tool for child developmental assessment in Persian language children.References1. Boyle CA, Boulet S, Schieve LA, Cohen RA, Blumberg SJ, Yeargin-Allsopp M, et al. Trends in the prevalence of developmental disabilities in US children, 1997–2008. Pediatrics 2011:peds. 2010-989.2. Sajedi F, Doulabi MA, Vameghi R, Baghban AA, Mazaheri MA, Mahmodi Z, et al. Development of Children in Iran: A Systematic Review and Meta-Analysis. Glob J Health Sci 2015 Dec 18;8(8):51251.3. Soleimani F, Vameghi R, Biglarian A, Rahgozar M. Prevalence of motor developmental disorders in children in Alborz Province, Iran in 2010. Iran Red Crescent Med J 2014 Dec 25;16(12):e16711.4. Soleimani F, Vameghi R, Biglarian A. 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First experiences with early intervention: a national perspective. Pediatrics 2004 Apr;113(4):887-96.10. Raju TN, Higgins RD, Stark AR, Leveno KJ. Optimizing care and outcome for late-preterm (near-term) infants: a summary of the workshop sponsored by the National Institute of Child Health and Human Development. Pediatrics 2006;118(3):1207-14.11. First LR, Palfrey JS. The infant or young child with developmental delay. N Engl J Med 1994 Feb 17;330(7):478-83.12. Dobrez D, Sasso AL, Holl J, Shalowitz M, Leon S, Budetti P. Estimating the cost of developmental and behavioral screening of preschool children in general pediatric practice. Pediatric 2001;108(4):913-22.13. Torras-Mana M, Guillamon-Valenzuela M, Ramirez-Mallafre A, Brun-Gasca C, Fornieles-Deu A. Usefulness of the Bayley scales of infant and toddler development, third edition, in the early diagnosis of language disorder. Psicothema 2014;26(3):349-56.14. Gladstone M, Lancaster GA, Jones A, Maleta K, Mtitimila E, Ashorn P, et al. 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Monitoring psychomotor development in a resourcelimited setting: an evaluation of the Kilifi Developmental Inventory. Ann Trop Paediatr 2008 Sep;28(3):217-26.20. Harris SR, Megens AM, Backman CL, Hayes VE. Stability of the Bayley II Scales of Infant Development in a sample of low-risk and high-risk infants. Dev Med Child Neurol 2005 Dec;47(12):820-3.21. Albers CA, Grieve AJ. Review of Bayley Scales of Infant and Toddler Development. J Psychoeduc Assess 2007 Jun;25(2):180-190. DOI: 10.1177/0734282906297199. 22. Godamunne P, Liyanage C, Wimaladharmasooriya N, Pathmeswaran A, Wickremasinghe AR, Patterson C, et al. Comparison of performance of Sri Lankan and US children on cognitive and motor scales of the Bayley scales of infant development. BMC Res Notes 2014 May 16;7:300.23. Deroma L, Bin M, Tognin V, Rosolen V, Valent F, Barbone F, et al. [Interrater reliability of the Bayley III test in the Italian Northern-Adriatic Cohort II]. Epidemiol Prev 2013 Jul-Oct;37(4-5):297-302.24. Zakaria S, Seok CB, Sombuling A, Ahmad MS, Hashmi SI. Reliability and Validity for Malay Version of Bayley Scales of Infant and Toddler Development-(Bayley- III): Preliminary Study. International Proceedings of Economics Development & Research 2012;40. 25. Yu YT, Hsieh WS, Hsu CH, Chen LC, Lee WT, Chiu NC, et al. A psychometric study of the Bayley Scales of Infant and Toddler Development - 3rd Edition for term and preterm Taiwanese infants. Res Dev Disabil 2013 Nov;34(11):3875-83.26. Acton BV, Biggs WS, Creighton DE, Penner KA, Switzer HN, Thomas JHP, et al. Overestimating neurodevelopment using the Bayley-III after early complex cardiac surgery. Pediatrics 2011 Oct;128(4):e794-800.27. Anderson PJ, De Luca CR, Hutchinson E, Roberts G, Doyle LW. Underestimation of developmental delay by the new Bayley-III Scale. Arch Pediatr Adolesc Med 2010 Apr;164(4):352-6.28. Campbell SK, Zawacki L, Rankin KM, Yoder JC, Shapiro N, Li Z, et al. Concurrent validity of the TIMP and the Bayley III scales at 6 weeks corrected age. Pediatr Phys Ther 2013 Winter;25(4):395-401.29. Visser L, Ruiter SAJ, Van der Meulen BF, Ruijssenaars WAJJM, Timmerman ME. Validity and suitability of the Bayley-III Low Motor/Vision version: A comparative study among young children with and without motor and/or visual impairments. Res Dev Disabil 2013 Nov;34(11):3736-45.30. Soleimani F, Azari N, Vameghi R, Sajedi F, Shahshahani S, Karimi H, Kraskian A, Shahrokhi A, Teymouri R, Gharib M. Is the Bayley Scales of Infant and Toddler Developmental Screening Test, valid and reliable for Persian speaking children? Iran J Pediatr 2016 October; 26(5):83-90

A Comparison Study of the Tehran Norms to the Reference Norms on Children Performance of the Bayley III

Objectives The Bayley Scales of Infant and Toddler Development (Bayley III) assess cognitive, language, and motor development of children aged 1–42 months, and have been widely used globally. It is unclear whether or not the reference norms of the Bayley III are acceptable for use in other populations or lead to over or under-estimating development. The purpose of this study was to estimate the distribution of the Bayley scores by age in Persian speaking children and to compare the norms between Persian and reference norms. Materials & Methods We constructed Bayley III norms for cognitive, language, and motor scales using 1,674 typically developing children by consecutive sampling from health care centers. First cut-off point was determined, and then the scaled scores, based on Persian speaking and reference norms, were compared. The proportions of children with low scores (scoring less than -1SD and -2 SD) based on the two norms were compared, to identify over or under-referral for developmental delay resulting from reference norms. Results Scaled scores based on Persian norms varied across values based on reference norms on all subtests. The mean differences were significant across all five sub-tests (p < .05), with large effect sizes for receptive and expressive communication, fine and gross motor sub-tests of .20, .23, .14, and .25 respectively, and with small effect size for cognition sub-test of .02. Large effect sizes for all age groups were found for cognition, expressive communication, and fine motor sub-tests. For the receptive communication sub-test, effect sizes were generally large, with the exception of four age groups. For the gross motor sub-test, effect sizes were generally large, with the exception of six age groups. More children scored below 1 and 2 SD using the Persian norms and resulted in under-referral regarding cognitive, receptive and expressive communication, fine and gross motor skills. Conclusion The Persian norms differ from the reference norms for all sub-tests and these differences are clinically significant. The use of the reference norms leads to fewer referrals in all sub-scales and leads to fewer diagnoses of children with developmental delay. Population specific norms are required to identify children with low scores for referral and intervention

Validity and Reliability Determination of Denver Developmental Screening Test-II in 0-6 Year-Olds in Tehran

Objective: This research was designed to identify the validity and reliability of the Persian version of Denver Developmental Screening Test II (DDST-II) in Iranian children, in order to provide an appropriate developmental screening tool for Iranian child health workers. Methods: At first a precise translation of test was done by three specialists in English literature and then it was revised by three pediatricians familiar with developmental domains. Then, DDST-II was performed on 221 children ranging from 0 to 6 years, in four Child Health Clinics, in north, south, east and west regions of Tehran city. In order to determine the agreement coefficient, these children were also evaluated by Ages and Stages Questionnaires (ASQ) test. Because ASQ is designed to use for 4-60 month- old children, children who were out of this rang were evaluated by developmental pediatricians. Available sampling was used. Obtained data was analyzed by SPSS software. Findings: Developmental disorders were observed in 34% of children who were examined by DDST-II, and in 12% of children who were examined by ASQ test. The estimated consistency coefficient between DDST-II and ASQ was 0.21, which is weak, and between DDST-II and the physicians'examination was 0.44. The content validity of DDST-II was verified by reviewing books and journals, and by specialists'opinions. All of the questions in DDST-II had appropriate content validity, and there was no need to change them. Test-retest and Inter-rater methods were used in order to determine reliability of the test, by Cronbach's a and Kauder-Richardson coefficients. Kauder-Richardson coefficient for different developmental domains was between 61% and 74%, which is good. Cronbach's a coefficient and Kappa measure of agreement for test-retest were 92% and 87% and for Inter-rater 90% and 76%, respectively. Conclusion: Persian version of DDST-II has a good validity and reliability, and can be used as a screening tool for developmental screening of children in Tehran city

Developmental screening of 4–60 Months Children in Tehran City using Denver Developmental Screening Test II and Ages and Stages Questionnaires

Objective: This research was designed to evaluate the developmental status of children aged 4–60 months in Tehran city by two developmental screening tests, Denver Developmental Screening Test II (DDST II) and Ages and Stages Questionnaires (ASQ) and also to determine the consistency coefficient between these two tests. Materials & Methods: In this cross–sectional study, DDST II and ASQ were performed on 197 children (104 boys, 93 girls), aged 4–60 months (Mean=23.5 months), at four health centers in Tehran city. Evaluation of 15% of children was repeated by Developmental Pediatricians who were blinded to the screening results.  Results: Developmental disorders were observed in 37% and 18% of children who were examined by DDST II and ASQ tests, respectively. Considering those children who were healthy but their parents were concerned about their developmental status, these figures changed to 38% and 43%, respectively. The estimated consistency coefficient between DDST II and ASQ was 0.21 which is weak (P=0.002) (for gross motor 0.24, language 0.18, personal-social 0.06 and fine motor 0.05). The consistency coefficient between the physicians’ examination with DDST II and ASQ were 0.17 (P=0.099) and 0.47 (P=0.003), respectively. Conclusion: A weak consistency coefficient was found between DDST II and ASQ tests. Therefore, the results of these two screening tools should be compared with a developmental diagnostic test in order to choose an appropriate screening tool

Personal-Social Developmental Screening of 0- 60 Months Old Children by Using DDST-II and ASQ

Objective: This research was made to personal- social developmental screening of 4-60 months old children in Tehran city by DDST-II and ASQ and determining the agreement coefficient of two tests. Materials & Methods: In this study, the personal-social developmental status of 197 children 4-60 months old were screened by using ASQ and PDQ (93 girls and 104 boys). Convenient sampling was used. Data was analyzed by SPSS software. Results: By using DDST-II and ASQ personal- social developmental delay detected in 11% and 1.5% of children respectively. The estimated consistency coefficient between DDST-II and ASQ for Personal- social domain was 0.06. Conclusion: In this study personal- social developmental screening of children showed different results and kappa measure agreement of two tests was weak. For selecting a suitable tool we must consider the psychometric characteristics (sensitivity, specificity, positive and negative predicting power) of the tool. This study showed that the results of developmental screening of 4-60 months old children in Tehran by using ASQ and PDQ lead to different results. This finding emphasizes the need to comparing the results of screening tests with a diagnostic gold standard test

Evaluating the Validity and Reliability of PDQ-II and Comparison with DDST-II for Two Step Developmental Screening

Objective: This research was designed to identify the validity and reliability of the Prescreening Developmental Questionnaire 2 (PDQ-II) in Tehran in comparison with the Denver Developmental Screening Test-II (DDST-II). Methods: After translation and back translation, the final Persian version of test was verified by three pediatricians and also by reviewing relevant literature for content validity. The test was performed on 237 children ranging from 0 to 6 years old, recruited by convenient sampling, from four health care clinics in Tehran city. They were also evaluated by DDST II simultaneously. Interrater methods and Cronbach's a were used to determine reliability of the test. The Kappa agreement coefficient between PDQ and DDST II was determined. The data was analyzed by SPSS software. Findings: All of the questions in PDQ had satisfactory content validity. The total Cronbach's α coefficient of 0-9 months, 9-24 months, 2-4 years and 4-6 years questionnaires were 0.951, 0.926, 0.950 and 0.876, respectively. The Kappa measure of agreement for interrater tests was 0.89. The estimated agreement coefficient between PDQ and DDST II was 0.383. Based on two different categorizing possibilities for questionable scores, that is, "Delayed" or "Normal", sensitivity and specificity of PDQ was determined to be 35.7-63% and 75.8-92.2%, respectively. Conclusion: PDQ has a good content validity and reliability and moderate sensitivity and specificity in comparison with the DDST-II, but by considering their relatively weak agreement coefficient, using it along with DDST-II for a two-stage developmental screening process, remains doubtful

Developing of the Persian Version of Bayley Scales of Infant and Toddlers Development Screening Test and Determine its Validity and Reliability

Objective: The aim of the study was to develop a valid and reliable Persian version of the Bayley Scales of Infant and Toddlers Development Screening Test. Materials & Methods: Forward and backward translation, face and content validity determination, and cultural and linguistic adaptations of the questionnaires were performed, consecutively. Clarity of items of the translated version of the scale were examined by a study that carried out on 45 Persian 1- to 42-month-old children, recruited by sampling in Tehran, during the year 2012 . In order to determine the reliability internal consistency, inter-rater and test-retest, 34 tests carried out. For determining the psychometric properties of the tests, later a representative sample of 260, 1- to 42-months-old children recruited through consecutive sampling from health -care centers in five main districts in Tehran.  Results: Performing cultural and lingual adaptations, our expert team made some inevitable changes to the test items. Almost in all age groups, cultural or linguistic changes were made in items in communication domains. The Cronbach alpha in cognitive, communication (receptive and expressive), fine and gross motor subtests were 0.96, 0.95. 0.95 and 0.94 respectively. The construct validity of the tests by factor analysis and comparison of mean scores in age groups was confirmed. Conclusion: The Persian version of the Bayley Scales of Infant and Toddlers Development Screening test is a valid and reliable tool

Validity and reliability of the Persian version of greenspan social-emotional growth chart

Background: The estimated prevalence of mental health disorders in children and adolescents is between 10% and 20%. Furthermore, a quarter of very premature infants exhibit socioemotional delays in infancy and childhood. The objective of this study was to determine the validity and reliability of Greenspan social-emotional growth chart (GSEGC) in Persian children aged 1–42 months. Materials and Methods: After translation procedures, the face validity, content validity, construct validity, test–retest reliability, and internal consistency of the GSEGC questionnaire were evaluated. The quality of translating items was obtained using the suggestions of the research group. The face validity of the GSEGC was performed by interviewing with 10 mothers in the target group. To evaluate content validity quantitatively, content validity ratio (CVR) and content validity index (CVI) were used after reviewing the face and content validity and pilot study, 264 parents of children aged 1–42 months completed the GSEGC questionnaire to assess the construct validity and internal consistency. In order to determine the test-retest reliability, after 2 weeks, 18 parents completed the questionnaire again. Results: Eleven questions were changed according to the interviews (questions 1–6, 9–11, and 15–16). The lowest CVR was related to items 30 and 20 (0.636), and other items had an acceptable CVR. The lowest CVI value was related to item 1 of clarity and simplicity (0.818), and other items had an acceptable CVI. Intra-class correlation coefficient was 0.988 for all items of questionnaire. Furthermore, Cronbach's alpha coefficient was 0.952 for all items. In factor analysis, two factors were extracted from the items in questionnaire. Conclusion: The Persian version of GSEGC questionnaire has acceptable face, content and, constructs validity, test-retest reliability and high internal consistency in the target population. Therefore, the Persian version of the GSEGC can be used as a tool to assess 1–42 months sensory processing and socio-emotional development

Interaction of Escherichia coli heat-labile enterotoxin B-pentamer with exopolysaccharides from Leuconostoc mesenteroides P35: Insights from surface plasmon resonance and molecular docking studies

International audienceIn this study, the interaction of exopolysaccharides from Leuconostoc mesenteroides P35 (EPS-LM) with Escherichia coli heat-labile enterotoxin B-pentamer (LTB) was investigated at different concentrations and temperatures by using surface plasmon resonance (SPR) and molecular docking approaches. FT-IR spectral analysis together with HPTLC analysis revealing that glucose is the only constitutive monosaccharide of EPS-LM suggests that its structure is composed of dextran with α-D (1 → 6) glycosidic linkages. SPR analysis revealed the high affinity of EPS-LM for immobilized LTB toxin (KA=(2.05 ± 0.04) × 106 mol.L−1 at 37°C). The binding process was spontaneous (ΔG0), and entropy-driven (ΔS>0) with an increase of KA with temperature. This suggests that EPS-LM - LTB interaction is dominated by hydrophobic forces. The binding affinity of EPS-LM to LTB had negligible dependence on enthalpy (ΔH = 0.084 kJ mol−1). Further, molecular docking results suggested the presence of some binding sites of EPS-LM on the LTB through hydrophobic forces (Lys, Asp, Arg, Glu) and also hydrogen bonding (Glu) in the hydrophobic core of LTB. Besides autodock studies, Schiffer-Edmundson helical wheel diagrams of LTB in α-helix domain suggested that LTB hydrophobic core is a highly effective region, which was able to form favorable non-polar interactions of the protein's binding surface (with amino acids residues such as Tyr, Leu, Ile) with EPS-LM. This study provided thus further insights into the interactions between EPS-LM and LTB, suggesting that EPS produced by some LAB, such as EPS produced by Ln. mesenteroides P35 strain are good candidates to inhibit E. coli toxin activity