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Published on: August 25, 2014
Neurodevelopmental screening in toddlers and early preschoolers with sickle cell disease
Jeffrey Schatz1, Catherine B McClellan, Eve S Puffer
1Department of Psychology, University of South Carolina, Columbia, SC 29208, USA. schatz@sc.edu
Insights
The Denver II test can help identify young children with sickle cell disease (SCD) who may be at higher risk for neurodevelopmental complications. This screening tool aids in early detection and intervention for developmental delays in these children.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Hematology
Background:
- Sickle cell disease (SCD) presents a significant risk for early-onset neurologic complications.
- Early identification of at-risk children is crucial for timely intervention and improved outcomes.
- Developmental screening tools may offer a cost-effective approach to identify high-risk pediatric SCD cases.
Purpose of the Study:
- To evaluate the Denver II test's validity in detecting developmental attainment levels in young children with SCD.
- To assess the association between Denver II outcomes and neurologic risk factors in pediatric SCD.
- To determine if the Denver II can serve as a screening tool for neurodevelopmental risk in this population.
Main Methods:
- A cohort of 50 young children diagnosed with sickle cell disease was assessed.
- The Denver II developmental screening test was administered to all participants.
- Children's scores were analyzed in relation to hematocrit levels, transcranial Doppler (TCD) velocities, and birth history.
Main Results:
- Children with suspect Denver II outcomes exhibited lower functional communication skills.
- These children also had lower hematocrit percentages and higher mean TCD velocities.
- A higher likelihood of preterm birth was observed in children with suspect Denver II results.
Conclusions:
- The Denver II test demonstrated validity in assessing developmental levels, particularly in Language and Fine Motor domains for children with SCD.
- The findings suggest the Denver II is a potentially useful behavioral screening tool for identifying neurodevelopmental risk in young children with sickle cell disease.
- This screening can guide more frequent or intensive assessments for high-risk pediatric SCD patients.
Abstract:
Sickle cell disease is associated with an elevated risk for neurologic complications beginning in early childhood. Detecting higher-risk cases with developmental screening instruments may be a cost-effective method for identifying young children in need of more frequent or intensive assessment. We evaluated the validity of the Denver II test as a tool to detect lower levels of developmental attainment and their association with neurologic risk in 50 young children with sickle cell disease. Children with suspect Denver II outcomes showed lower scores for functional communication skills, had lower hematocrit percentage, higher mean velocities on transcranial Doppler ultrasound imaging, and were more likely to have had preterm birth. Validity of age equivalencies from specific Denver II areas was demonstrated for Language and Fine Motor scores, suggesting the instrument could be used to index children's developmental levels in these domains. The Denver II may be a useful behavioral screening tool for neurodevelopmental risk in sickle cell disease.
