A guide for monitoring child development in low- and middle-income countries
A guide for monitoring child development in low- and middle-income countries
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DOI：
10.1542/peds.2007-1771
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发表时间：
2008-03-01
期刊：
影响因子：
8
通讯作者：
Cicchetti, Domenic V.
中科院分区：
文献类型：
--
作者：
Ertem, Ilgi O.;Dogan, Derya G.;Cicchetti, Domenic V.
OBJECTIVE.在低收入和中等收入国家，临床医生缺乏解决儿童早期语言、社会情感、认知、行为或神经运动发育困难的方法。为了填补这一空白，我们在土耳其设计了《儿童发展监测指南》，旨在帮助临床医生监测和支持儿童发展，并及早发现和管理发展困难。《儿童发展监测指南》的监测部分是一个实用的开放式访谈，促进临床医生和照顾者之间的沟通，并了解儿童的发展情况。我们报告的发展和心理测量学性能的监测儿童发展监测指南的监测组件为0至24个月的儿童。我们在一项对接受良好儿童护理的健康儿童的横断面研究（研究1）中检查了《儿童发展里程碑监测指南》的实现年龄和内部一致性。在2个临床样本中，我们研究了医学生和管理指南的儿童发育专家之间的评价者间可靠性（研究2），以及健康访问和全面发展评估期间管理的指南的并行有效性（研究3）。在研究1（N = 510）中，项目-总量表相关性范围为0.28至0.91。在所有里程碑中均发现了年龄依赖性成就模式。在研究2中（N = 92），医学生对之间和儿童发展专家和学生之间的评价者间的可靠性高（Kappa得分为0.83-0.88）。在研究3（N = 79）中，敏感性、特异性、阳性和阴性预测值分别为0.88、0.93、0.84和0.94。《儿童发育监测指南》是一种监测儿童发育的创新方法，专为低收入和中等收入国家的卫生保健提供者设计。在土耳其的研究提供了初步的证据，其可靠性和有效性。
OBJECTIVE. In low- and middle-income countries, methods for clinicians to address difficulties in language, social-emotional, cognitive, behavioral, or neuromotor development during early childhood are lacking. To fill this gap, we designed, in Turkey, the Guide for Monitoring Child Development, which aims to aid clinicians in monitoring and supporting child development and the early detection and management of developmental difficulties. The Guide for Monitoring Child Development monitoring component is a practical, open-ended interview that catalyzes communication between clinicians and caregivers and obtains a portrayal of the child's development. We report on the development and psychometric properties of the Guide for Monitoring Child Development monitoring component for children aged 0 to 24 months.METHODS. We examined the ages of attainment of Guide for Monitoring Child Development milestones and internal consistency in a cross-sectional study of healthy children receiving well-child care (study 1). In 2 clinical samples, we studied the interrater reliability between medical students and a child development specialist administering the guide (study 2), as well as the concurrent validity of the guide administered during a health visit and a comprehensive developmental assessment (study 3).RESULTS. In study 1 (N = 510), item-total scale correlations ranged from 0.28 to 0.91. An age-dependent attainment pattern was seen in all of the milestones. In study 2 (N = 92), interrater reliability between medical-student pairs and between the child development specialist and students was high (kappa scores were 0.83-0.88). In study 3 (N = 79), the sensitivity, specificity, and positive and negative predictive values were 0.88, 0.93, 0.84, and 0.94, respectively.CONCLUSIONS. The Guide for Monitoring Child Development is an innovative method for monitoring child development that is designed specifically for use by health care providers in low- and middle-income countries. Studies in Turkey provide preliminary evidence for its reliability and validity.