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Risk factor assessment to anticipate performance in the National Developmental Screening Test in children from a
Alejandro Montes1, Gustavo Pazos2,3
1Servicio de Pediatría, Hospital Provincial "Dr. Andrés Isola", Puerto Madryn, Chubut, 9120, Argentina. alejandroenriquemontes@gmail.com.
Insights
This study identified key risk factors for inapparent developmental disorders (IDDs) in young children. A combined pre-screening method showed high sensitivity and specificity, aiding resource allocation in disadvantaged areas.
Area of Science:
- Pediatric developmental screening
- Public health in disadvantaged communities
Background:
- Early identification of inapparent developmental disorders (IDDs) is crucial for resource optimization.
- The National Developmental Screening Test is a key tool, but identifying at-risk children efficiently is challenging.
Purpose of the Study:
- To estimate the prevalence of children suspected of having IDDs.
- To identify associated risk factors (RFs).
- To develop and assess a pre-screening procedure using identified RFs.
Main Methods:
- Administered the National Developmental Screening Test to 60 children (2-4 years) in a disadvantaged area.
- Assessed 24 biological and socioenvironmental factors to identify RFs via bivariate and multivariate analyses.
- Developed and combined three methods to estimate the likelihood of failing the screening test.
Main Results:
- Prevalence of suspected IDDs was 55.0%, significantly higher than national standards.
- Six initial RFs were identified; three (maternal education, health checkups, growth Z-scores, maternal age) were significant in a logistic model.
- The combined pre-screening method demonstrated high sensitivity (85%) and specificity (79%).
Conclusions:
- The prevalence of suspected IDDs in this population is notably high.
- Combining risk factor accumulation with a multivariate model offers a robust approach for pre-screening.
- A practical, sensitive, and specific pre-screening procedure can be developed for socioeconomically disadvantaged areas.
Introduction:
Identifying children at risk of failing the National Developmental Screening Test by combining prevalences of children suspected of having inapparent developmental disorders (IDDs) and associated risk factors (RFs) would allow to save resources.
Objectives:
1. To estimate the prevalence of children suspected of having IDDs. 2. To identify associated RFs. 3. To assess three methods developed based on observed RFs and propose a pre-screening procedure.
Materials And Methods:
The National Developmental Screening Test was administered to 60 randomly selected children aged between 2 and 4 years old from a socioeconomically disadvantaged area from Puerto Madryn. Twenty-four biological and socioenvironmental outcome measures were assessed in order to identify potential RFs using bivariate and multivariate analyses. The likelihood of failing the screening test was estimated as follows: 1. a multivariate logistic regression model was developed; 2. a relationship was established between the number of RFs present in each child and the percentage of children who failed the test; 3. these two methods were combined.
Results:
The prevalence of children suspected of having IDDs was 55.0% (95% confidence interval: 42.4%-67.6%). Six RFs were initially identified using the bivariate approach. Three of them (maternal education, number of health checkups and Z scores for height-for-age, and maternal age) were included in the logistic regression model, which has a greater explanatory power. The third method included in the assessment showed greater sensitivity and specificity (85% and 79%, respectively).
Conclusions:
The estimated prevalence of children suspected of having IDDs was four times higher than the national standards. Seven RFs were identified. Combining the analysis of risk factor accumulation and a multivariate model provides a firm basis for developing a sensitive, specific and practical pre-screening procedure for socioeconomically disadvantaged areas.
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