Training Health Professionals Engaging in 18-Month Checkup for Early Detection and Early Intervention of Autism Spectrum Disorder

Early detection and early intervention of Autism Spectrum Disorder (ASD) are among the most important issues in public health systems. In Japan, 18-month check-up held by each municipality provides a chance to survey ASD and other neurodevelopmental problems, which is why we developed training seminars for health professionals engaging in the check-ups. The training materials consisted of a booklet, DVD, and video clips. These materials focused on understanding neurotypical social communication development from age one to two years. Questionnaires were provided before and after the training. Overall subjective evaluation was positive. An additional finding was that public health nurses working for municipalities have lesser self-confidence in the issue before the seminars, despite the fact that they are on the front line of the check-up. Providing chances to learn about typical child development and early signs of ASD will contribute to better early detection and early interventions

Monitoring Compassion Fatigue and Compassion Satisfaction of Mental Health Professionals in a Prefectural Mental Health Care Team for Eastern Japan Earthquake Disaster: Prospective Longitudinal Cohort Questionnaire Assessment

The purpose of this study is to conduct the assessment of Compassion Fatigue and Satisfaction before going to the disaster zone, while in the disaster zone, and after the activities at the disster zone. We used the Compassion Fatigue and Satisfaction Self-Test for helpers to assess the mental state of care or support givers.This study is a prospective longitudinal cohort questionnaire assessment. The study subjects were mental health professionals who have joined a prefectural Mental Health Care Team for Eastern Japan Earthquake Disaster, and worked in seriously tsunami-suffered areas from April to August in 2011.23 members of the prefectural Mental Health Care Team for Eastern Japan Earthquake Disaster were divided into two types: Compassion Fatigue Decrease Type and Compassion Fatigue Increase Type. We discussed the chracteristics of these two types

ESSENCE-Q – used as a screening tool for neurodevelopmental problems in public health checkups for young children in south Japan

Background: Screening for developmental disorders is an important task for Child Health Care. The concept of ESSENCE (early symptomatic syndromes eliciting neurodevelopmental clinical examinations) was created to cover all types of early developmental disorders and the ESSENCE-Questionnaire (ESSENCE-Q containing 12 questions with possible total scores ranging from 0 to 22) was developed as a tool for early detection of these disorders. The aim of this study was to perform a validation study in a public health situation in Japan. Methods: The psychometric properties of the ESSENCE-Q, completed by mothers, public health nurses (PHNs), and psychologists at 18-month (n=143 children) and 36-month (n=149 children) checkups were evaluated in a small city of Japan. Results were validated against clinical ESSENCE diagnoses. Receiver operating characteristic curves were generated and compared by using the area under the curve (AUC). Optimal cutoff values were explored. Results: At the 18-month checkup, AUC by mothers was 0.72, by PHNs 0.86, and by psychologists 0.82. An optimal cutoff was 3 with a high negative predictive value (NPV). At the 36-month checkup, AUC by mothers was 0.57, by PHNs 0.82, and by psychologists 0.87. Optimal cutoff was 2 with high NPV. Conclusion: The ESSENCE-Q completed by PHNs and psychologists had good diagnostic validity. The results suggested that almost all children scoring under cutoff would not have any ESSENCE problems/diagnoses

ESSENCE-Q- used as a screening tool for neurodevelopmental problems in public health checkups for young children in south Japan

Background: Screening for developmental disorders is an important task for Child Health Care. The concept of ESSENCE (early symptomatic syndromes eliciting neurodevelopmental clinical examinations) was created to cover all types of early developmental disorders and the ESSENCE-Questionnaire (ESSENCE-Q containing 12 questions with possible total scores ranging from 0 to 22) was developed as a tool for early detection of these disorders. The aim of this study was to perform a validation study in a public health situation in Japan. Methods: The psychometric properties of the ESSENCE-Q, completed by mothers, public health nurses (PHNs), and psychologists at 18-month (n=143 children) and 36-month (n=149 children) checkups were evaluated in a small city of Japan. Results were validated against clinical ESSENCE diagnoses. Receiver operating characteristic curves were generated and compared by using the area under the curve (AUC). Optimal cutoff values were explored. Results: At the 18-month checkup, AUC by mothers was 0.72, by PHNs 0.86, and by psychologists 0.82. An optimal cutoff was 3 with a high negative predictive value (NPV). At the 36-month checkup, AUC by mothers was 0.57, by PHNs 0.82, and by psychologists 0.87. Optimal cutoff was 2 with high NPV. Conclusion: The ESSENCE-Q completed by PHNs and psychologists had good diagnostic validity. The results suggested that almost all children scoring under cutoff would not have any ESSENCE problems/diagnoses

ESSENCE-Q - dash; a first clinical validation study of a new screening questionnaire for young children with suspected neurodevelopmental problems in south Japan

Background: Early identification of autism spectrum disorder, intellectual developmental disorder, attention-deficit/hyperactivity disorder, and other neurodevelopmental disorders/problems is crucial, yet diagnosis is often delayed for years under the often misguided “wait-and-see” paradigm. The early symptomatic syndromes eliciting neurodevelopmental clinical examinations-questionnaire (ESSENCE-Q) is a brief (12-item) screening questionnaire developed specifically for the purpose of speeding up the identification process of a wide variety of neurodevelopmental problems. The aims were to 1) estimate the reliability of the ESSENCE-Q, 2) evaluate the clinical cutoff levels suggested by the author of the ESSENCE-Q, and 3) propose optimal cutoff levels based on receiver operating characteristic analysis. Methods: The ESSENCE-Q was used for 1 year by a psychiatrist in Kochi, Japan, assessing children under the age of 6 years referred for developmental problems. The children were also clinically assessed with regard to whether or not they met criteria for a developmental disorder (diagnosis positive and diagnosis negative groups). We contrasted the results of the ESSENCE-Q and those of clinical diagnostic assessments in 130 cases. Results: Cronbach’s alpha was 0.82, sensitivity was 0.94 (95% confidence interval [CI]: [0.88, 0.98]), and specificity 0.53 (95% CI: [0.28, 0.77]), which are reasonable psychometrics for a first-step screening tool. Based on receiver operating characteristic analysis, we recommended an optimal cutoff level of yes ≥2 or maybe/a little ≥3 on the ESSENCE-Q (0.87 (95% CI: [0.79, 0.92]) sensitivity and 0.77 (95% CI: [0.50, 0.93]) specificity). Conclusion and implication: The ESSENCE-Q can be a good instrument for use as a screening tool for aiding in the process of early identification of neurodevelopmental disorders in clinical settings. To establish the broader validity and reliability of the ESSENCE-Q, case–control studies and general population studies of children in different age groups are needed

ESSENCE-Q – a first clinical validation study of a new screening questionnaire for young children with suspected neurodevelopmental problems in south Japan

BACKGROUND: Early identification of autism spectrum disorder, intellectual developmental disorder, attention-deficit/hyperactivity disorder, and other neurodevelopmental disorders/problems is crucial, yet diagnosis is often delayed for years under the often misguided “wait-and-see” paradigm. The early symptomatic syndromes eliciting neurodevelopmental clinical examinations-questionnaire (ESSENCE-Q) is a brief (12-item) screening questionnaire developed specifically for the purpose of speeding up the identification process of a wide variety of neurodevelopmental problems. The aims were to 1) estimate the reliability of the ESSENCE-Q, 2) evaluate the clinical cutoff levels suggested by the author of the ESSENCE-Q, and 3) propose optimal cutoff levels based on receiver operating characteristic analysis. METHODS: The ESSENCE-Q was used for 1 year by a psychiatrist in Kochi, Japan, assessing children under the age of 6 years referred for developmental problems. The children were also clinically assessed with regard to whether or not they met criteria for a developmental disorder (diagnosis positive and diagnosis negative groups). We contrasted the results of the ESSENCE-Q and those of clinical diagnostic assessments in 130 cases. RESULTS: Cronbach’s alpha was 0.82, sensitivity was 0.94 (95% confidence interval [CI]: [0.88, 0.98]), and specificity 0.53 (95% CI: [0.28, 0.77]), which are reasonable psychometrics for a first-step screening tool. Based on receiver operating characteristic analysis, we recommended an optimal cutoff level of yes ≥2 or maybe/a little ≥3 on the ESSENCE-Q (0.87 (95% CI: [0.79, 0.92]) sensitivity and 0.77 (95% CI: [0.50, 0.93]) specificity). CONCLUSION AND IMPLICATION: The ESSENCE-Q can be a good instrument for use as a screening tool for aiding in the process of early identification of neurodevelopmental disorders in clinical settings. To establish the broader validity and reliability of the ESSENCE-Q, case–control studies and general population studies of children in different age groups are needed

Development of a new screening tool for neuromotor development in children aged two – the neuromotor 5 min exam 2-year-old version (N5E2)

Acknowledgement This study is a part of the project related to the Japan Environment and Children’s Study (JECS) that is conducted and funded by the Ministry of Environment of Japan.Peer reviewedPostprin

Early detection of ESSENCE in Japanese 0-4-year-olds. Studies of neurodevelopmental problems in the community and in clinics

BACKGROUND: Early identification of children with neurodevelopmental problems/ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations) is a critical issue both in the community and in clinical settings. AIMS: Approach early identification of ESSENCE from three different angles; training for health professionals, early concern regarding motor development, and the development and preliminary validation of a new one-page screening questionnaire, the ESSENCE-Q. METHODS: (Study I) Evaluate the effect of seminars and materials developed for the training of health professionals engaging in child 18-month check-ups, using a before-and-after questionnaire. (Study II) Explore whether concern about early motor development may be an indication of ESSENCE, using a prospective clinical cohort of children under age two years. (Study III) Develop and examine the ESSENCE-Q as a parent screening questionnaire in a clinical setting, in the context of an explorative study of the ESSENCE-Q used for one year in a neurodevelopmental clinic. (Study IV) Validate the ESSENCE-Q in a community setting targeting mothers, public health nurses, and psychologists in routine child-health check-ups. RESULTS: (Study I) Overall subjective evaluation was positive, and self-confidence of public health nurses improved after the seminar. (Study II) The majority of children with concern about early motor delay had ESSENCE. (Study III) The ESSENCE-Q appeared to have good psychometric properties as a parent questionnaire in a clinical setting. (Study IV) The ESSENCE-Q when used by public health nurses and psychologists appeared to have good psychometric properties in a public health setting. CONCLUSION: Neurodevelopmental disorders/problems can often be identified in very early childhood. Careful observation of motor development would seem to be crucial, and the ESSENCE-Q would be a useful tool in screening for ESSENCE both in clinics and in the general preschool population of children. Public health nurses may be the most appropriate professionals in the screening process, and providing training for them in the field of ESSENCE is critical

ESSENCE‐Q obtained in routine Japanese public child health check‐ups may be a valuable tool in neurodevelopmental screening

Aim: Our aim was to extend the validity of a questionnaire developed for screening and identifying early symptomatic syndromes eliciting neurodevelopmental clinical examinations‐questionnaire (ESSENCE‐Q) in young children. Methods: Early symptomatic syndromes eliciting neurodevelopmental clinical examinations‐questionnaire data for 207 children, living in Aki City, Japan, in 2014‐2015, were obtained from mothers, public health nurses and psychologists at 20‐ and 40‐month routine check‐ups at child healthcare centres. These were checked against subsequent ESSENCE diagnoses made by physicians. Receiver operating characteristic curves were constructed, and the area under the curves was compared. Sensitivity, specificity, positive predictive values (PPVs) and negative predictive values were calculated at optimal cut‐off values. The clinical utility index was also calculated. Results: When the ESSENCE‐Q was used by public health nurses, it demonstrated good validity, in terms of high sensitivity and high NPVs, at the 20‐month check‐up, but not at 40 months. Psychologists demonstrated good validity at both ages, but mothers did not. Good negative utility indexes, indicating screening accuracy, were obtained from the psychologists at both check‐ups and from nurses at 20 months. Conclusion: The ESSENCE‐Q results used by nurses and psychologists showed good validity. Future studies should confirm the effectiveness of this tool to identify children in need of clinical detailed neurodevelopmental assessment