To validate a rapid neurodevelopmental assessment tool for use by child care professionals to determine neurodevelopmental impairments (NDIs) in children ages 5-9 years (61-108 months) in Bangladesh.
In a convenience sample of community children (n = 18), interrater reliability was determined between 6 testers. Validity was determined in 121 children by simultaneous administration of a test of adaptive behavior (AB) (ie, the Independent Behavior Assessment Scale, or Gold Standard I) and IQ tests (Wechsler Preschool and Primary Scales of Intelligence or the Wechsler Intelligence Scales for Children, or Gold Standard II) by child psychologists.
Interrater reliability was excellent (kappa = 1.00). Significantly lower scores were obtained on AB and IQ tests in those identified with “any (≥1) NDI” and most specific NDIs. Sensitivity and specificity for “any NDI” with (a) “significant difficulties” (defined as AB z-scores < −2 SD and/or IQ < 70) or (b) “mild difficulties included” (AB z scores < −1 SD and/or IQ < 85) were 84% and 57%; and 83% and 70%, respectively.
The rapid neurodevelopmental assessment tool shows promise as a tool for use by a range of professionals for identifying NDIs in children of primary school age. Further refinement for identifying specific impairments is needed.
[Show abstract][Hide abstract] ABSTRACT: The paper describes the stages in development of an assessment of the adaptive behaviour skills of children in Bangladesh. Item selection and reduction are described, based on an ecological analysis of behaviours expected of children aged between two and nine years of age, living in both urban and rural settings. The IBAS has four major subscales: motor skills, socialisation, communication and daily living skills. Norms have been constructed based on testing a nationally representative sample of 1404 children. Content, construct and discriminant validity are established, and the reliability of the total scale and subscales is high, both between testers and over time. The IBAS can provide a baseline indication of level of skills in a child with intellectual disability, and aid in planning an appropriate curriculum-based programme in discussion with the child's family.
Journal of Applied Research in Intellectual Disabilities 03/2010; 12(3):241 - 252. DOI:10.1111/j.1468-3148.1999.tb00080.x · 1.38 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Infant and child physical vulnerability is demonstrated by the extremely high mortality levels in these age groups in the pre-modern West and parts of the contemporary Third World. Some children, such as females or later additions to the family, are subject to disproportionately high mortality risk. In spite of the age-old vulnerability of young children, disproportionate gains have been made in reducing their mortality in modern times. This has been a product of social and individual change, government intervention and biomedical research. These advances exhibit during crises greater resilience to reversal than might be anticipated. Rarely do infant and child mortality levels return more than a fraction of the way to the original levels. The explanation is irreversible changes to individuals and society and the persistence of health knowledge even when health facilities are paralysed.
Social Science & Medicine 10/1996; 43(5):609-19. DOI:10.1016/0277-9536(96)00109-8 · 2.89 Impact Factor
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