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Developmental screenings in rural settings: a comparison of the child development review and the Denver II Developmental Screening Test.

Screening results for the Child Development Review (CDR) and the Denver II Developmental Screening Test (Denver II) were compared in two locations: the Cheyenne River Reservation in South Dakota and Sioux Falls, S.D. Seventy-three white, Native American and other minority children, half originating from the reservation and half from Sioux Falls, were randomly assigned to take one developmental screening test. A chi-square analysis indicated a significant difference in results across tests. Specifically, more CDR than Denver II subjects passed the screening and more Denver II than CDR subjects failed the screening. This pattern held for subjects living on, but not off, the reservation. Thus, for Native American, white and other minority children living on the Cheyenne River Reservation, the CDR may be undersensitive and/or the Denver II oversensitive to suspect presentations. Medical practitioners are advised to use these instruments with caution in rural settings.

Chi-Square Distribution↗

Grandmother co-residence, parenting, and child development among low income, urban teen mothers.

PURPOSE: To examine the relationships among grandmother co-residence, parenting, and early child development among low income, urban families with teen mothers whose children vary in growth (adequate versus failure to thrive [FTT]). METHODS: Seventy-nine adolescent mothers of infants and toddlers (42 with adequate growth and 37 with FTT) recruited from a primary care clinic. Data collected during a laboratory evaluation included a videotaped session of mother and child during feeding, developmental assessment (Bayley Scales), and questionnaires on family support, perceived parenting stress, and maternal perception of child's temperament. ANALYSIS: Multivariate analyses of covariance. Independent variables were growth (adequate/FTT) and grandmother co-residence (present/absent). Dependent variables were maternal warmth during feeding, maternal perception of child's temperament, child's mealtime behavior, and child's cognitive and motor development. Covariates were child's age, maternal age, maternal education, parity, family support, and perceived stress. RESULTS: Teen mothers living with grandmothers were younger (mean age = 17.4 versus 18.6, p = .03) and had fewer children (mean parity = 1.2 versus 1.7, p = .001). Mothers displayed more warmth when not living with grandmothers (p = .01). Among adequately growing children, grandmother co-residence was associated with better motor skills (106 versus 98, p = .039). In contrast, among children with FTT, grandmother co-residence was associated with lower motor skills (90 versus 100, p = .017). CONCLUSIONS: Although multigenerational families may be protective for some teen parents and their young children, grandmother co-residence was not associated with maternal warmth. With the added stress of a poorly growing child, grandmother co-residence was associated with less optimal motor development.

Adolescent↗

Evaluation of a child development centre in a rural area.

In this article we discuss the setting up of a child development centre for children with a developmental delay in a rural market town away from a tertiary centre. The process was evaluated by a variety of methods including analysis of centre activity, preliminary questionnaires to parents at the end of their child's assessment, reflections by the centre team and in the final year of the project, a survey of all parents who had used the service, professionals who worked in it and other agencies in the centre town and a comparison town. Parents and staff reported high levels of satisfaction in relation to multidisciplinary working, venue, communication, and a child/family friendly approach. Further work is needed in developing links with social services and the voluntary sector.

Child↗

Child development and marital relations.

This article examines aspects of the marital relationship and its assessment relevant to scholars of child development. The case for attending to marriage in child research is outlined before reviewing what is known about the construct of marital quality, behavior, emotional responding, and cognition in marriage. Practical recommendations are made for assessing each of these areas before arguing that the child's perspective of the marriage is critical for understanding children's behavior. Several limitations and promises of marital research for understanding children are also discussed.

Child↗

Child development: risk factors for adverse outcomes in developing countries.

Poverty and associated health, nutrition, and social factors prevent at least 200 million children in developing countries from attaining their developmental potential. We review the evidence linking compromised development with modifiable biological and psychosocial risks encountered by children from birth to 5 years of age. We identify four key risk factors where the need for intervention is urgent: stunting, inadequate cognitive stimulation, iodine deficiency, and iron deficiency anaemia. The evidence is also sufficient to warrant interventions for malaria, intrauterine growth restriction, maternal depression, exposure to violence, and exposure to heavy metals. We discuss the research needed to clarify the effect of other potential risk factors on child development. The prevalence of the risk factors and their effect on development and human potential are substantial. Furthermore, risks often occur together or cumulatively, with concomitant increased adverse effects on the development of the world's poorest children.

Child Development↗

Unrealistic expectations of parents who maltreat their children: an educational deficit that pertains to child development.

Forty-one parents estimated when their own child and an "average" child would attain a number of different developmental milestones. These milestones and the accompanying normative data were derived from the Vineland Social Maturity Scale (Doll, 1965). Parents were divided into three groups on the basis of a prior history of child abuse, child neglect, or no previous background of abuse or neglect. Results indicate that both the abuse and neglect groups differed from the comparison group when absolute difference scores from the normative data were analyzed. When directionality of scores were analyzed (i.e., too high or too low expectations for the child), no differences were found among the groups. Implications of an education deficit model of unrealistic parental expectations were discussed.

Adult↗

Multidisciplinary assessment at a child development centre: do we conform to recommended standards?

BACKGROUND: A proposed standard for the multidisciplinary assessment (MDA) of children with autism has been recently published by the National Autistic Society. This prompted a review of current practice at the child development centre in our local centre, to judge whether we were able to conform to the proposed national standard. The recommendation is that a child should complete a three-stage assessment process from referral to completion of assessment within 30 weeks, with set times for completion of each stage (6, 7 and 17 weeks respectively). We applied this assessment model to children with a range of neurodevelopment problems, as the process of MDA is the same, irrespective of diagnosis. METHODS: A retrospective analysis of medical and therapy records of all MDAs was carried out between April 2001 and March 2002. RESULTS: In the 12-month period studied, 52 MDAs were performed. Delays occurred, as judged by the standard, at all three stages of the assessment process. A total of 42% of children were seen within 6 weeks of initial referral, 37% within a further 7 weeks for specialist assessment, and 37% within a further 17 weeks for completion of MDA. As delays occurred at all stages, the cumulative total showed that only 19% of children completed all three stages within the recommended 30-week standard. Barriers encountered included waiting times to see professionals, parental non-attendance and prolonged assessment of complex problems. Some of these factors are outside our control, and on removing these factors the data were re-analysed. This resulted in a slight improvement to 45%, 48% and 49% for completion of stages 1, 2 and 3 respectively. The major reason for delay remained the service capacity. CONCLUSION: In our experience the standards proposed by the National Autistic Society are not practical within present resources. We suggest that a reasonable expectation is to complete all assessments, from first concern to completed MDA, should be carried out within 52 weeks with present levels of resources. Any further improvement will require additional resources to reduce waiting times and increase the capacity.

Autistic Disorder↗

A model for teaching early child development.

A model of teaching psychological aspects of infant growth and development to medical students in a pediatric clinical rotation is described. Small groups of 8 to 10 medical students observe an infant developmental-assessment-parent-interview conducted by a child development specialist. Emphasis is placed upon demonstrating infant temperament, age-appropriate competencies, and the dynamic interplay between parent and child. Evaluation of this training program suggests its effectiveness as a method of instruction and its usefulness as an approach to the evaluation of the young child.

Child Development↗

Welfare reform, family support, and child development: perspectives from policy analysis and developmental psychopathology.

This article explores the implications of recent welfare-related policy change for the well-being of children in low-income families, and for research investigating child development processes and outcomes. It provides an overview of current welfare-related policies and explores the implications for developmental researchers. The article also synthesizes early findings from research, highlighting both overall impacts and the more nuanced evidence that while families are transitioning off welfare, only a small number are transitioning out of poverty, and a subgroup of families at risk are not faring well. It then examines, from a theoretical and methodological framework, what developmental psychopathology might bring to the study of welfare-related impacts on children in the context of this complex and changing policy landscape, and what welfare researchers might bring to the field of developmental psychopathology. The article concludes with broad recommendations for both research and policy.

Adaptation, Psychological↗

The Charing Cross Hospital Child Development Centre: a description of its work ad an evaluation of its first 385 patients.

Charing Cross Hospital provides facilities for the study of handicapped children in a normal nursery which forms part of its Child Development Centre. The period of assessment varies from one day to three weeks; the advantages of prolonged assessment are discussed. Parental involvement and support, and the teaching of medical students are emphasized. A study of the Centre's first 385 patients is presented.

Child Day Care Centers↗