Careers: child development.
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The Christchurch Child Development Study is a longitudinal study of a birth cohort of 1265 New Zealand children who have been studied over an 11-year period using data from multiple sources including parental interview, medical records, teacher questionnaires and direct testing of children. The article provides a review of the major lines of epidemiological research examined in the Study. These include: breast feeding and child health; parental smoking and child health; the effects of low level lead exposure; childhood asthma; nocturnal bladder control; the effects of early hospital admission; the distribution of child health services; and the consequences of private medical insurance. In addition a number of general topics (sample attrition, measurement error, individual differences and causal inference) relating to longitudinal designs are discussed briefly. It is concluded that the longitudinal design is a powerful and cost-effective method of gathering data for general paediatric epidemiological purposes but that research in this area would benefit from an increased use of emerging methods of statistical modelling.
The Tokyo Child Development Schedule (TCDS) consisting of 140 items divided into seven areas--gross motor, fine motor, self-help, play, socialization, speech and comprehension-cognition--was developed. Each item is checked by a caretaker of a child with a three-point scale: pass, sometimes pass and fail. All of the seven areas and the entire portion of the TCDS exhibited a high grade of test-retest reliability. All but two of the items showed good agreement between the results of the two-time ratings. In 53 children with or without autistic features, the total scores on the TCDS and mental ages on the Japanese version of the Stanford-Binet Intelligence Scale demonstrated the value of correlation coefficient (r) of 0.779.
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The concurrent validity and reliability of the Minnesota Child Development Inventory (MCDI) was assessed by comparing the MCDI general development index score, and each of the seven subscale scores, with the mental and psychomotor age equivalents achieved on the Bayley Scales of Infant Development. In addition, the co-positivity, co-negativity, positive and negative predictive values of the MCDI in identifying infants with a mental development index (MDI), or psychomotor development index (PDI) of greater than 2 SD below the mean were assessed. Subjects were 101 infants (8 to 19 months old) who were seen at a neonatal developmental follow-up clinic after discharge from the neonatal intensive care unit. Correlations were obtained for the entire sample as well as for the two chronological age groups (i.e., 8 to 10 months and 17 to 19 months) within the sample. A strong correlation between the MCDI scales and the Bayley Mental and Psychomotor Scales was documented for the entire population as well as for the individual age groups. The overall validity of the MCDI in identifying infants with a MDI or PDI of greater than 2 SD below the mean was limited due to relatively poor co-positivity and positive predictive value. Although the MCDI may yield consistent information about the development of an infant's skills, this research suggests the MCDI has limited capacity to discern infants having delayed development.
Past studies relating smoking during pregnancy (and afterwards) and later child development are critically reviewed. There are consistent deficits among offspring of smokers in stature, cognitive development and educational achievement, as well as more frequent problems of temperament, adjustment, and behavior, particularly abnormally high levels of activity and inattention. The meaning of these relationships remains obscure, since it cannot be assumed that these abnormalities of child development are caused by parental cigarette smoking. In most studies there has been relatively little attention paid to the potential confounding by social, demographic, and psychological differences between smokers and nonsmokers. It is thus essential to carefully balance the comparative impact of social and environmental influences that may be different between families of smokers and nonsmokers, versus the toxic effects of tobacco.
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Fourteen asthmatic children between 11 and 14 years of age participated in weekly group discussion sessions for nine months. The purposes were to allow open discussion about asthma, to mutually educate the children and staff about the medical and social implications of their disease and to give the patients a chance to deal with adults without fear of reprimand or betrayal of trust. Anger, envy, fear, sadness and guilt were the emotions predominant in the sessions. Group sessions may offer a further modality in the total care of the asthmatic child.
The role of cognition in child development is reviewed with respect to the role of cognitive processing and cognitive deficits. Cognitive processing is discussed with respect to the self-system; the effects of psychosocial experiences; risk, vulnerability and protective mechanisms; vulnerability to depression; aetiology and treatment of depression. Cognitive deficits are discussed with respect to the socio-emotional consequences of language delay and reading difficulties; hyperkinetic/attentional deficit syndromes; schizophrenia; and autism. It is concluded that the ways in which we appraise our life circumstances and the ways in which we react to experiences of all kinds are greatly influenced by how we think about ourselves and our environment. Biases and distortions in such cognitive processing may be associated with social and emotional malfunction. These biases may derive from earlier experiences, from intensive temperamental styles, or from deficits in the ability to process incoming information. The further study of cognitive processing and cognitive deficits is likely to be rewarding and helpful for clinical practice.
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Nutritional services were integrated in a comprehensive child development program for sixty-eight disadvantaged urban families in an attempt to promote maximum cognitive and psychosocial functioning in their children. Child development trainers made weekly home visits beginning in pregnancy, which combined data gathering, direct nutritional counseling, and early sensory excercises for infants. This paper describes the prenatal home visit program, the training of the home visitors, how the 24-hr. food recall method was adapted for their use, the nature of the home visits, and the complex role of the home visitor. The group whose families participated in the prenatal home visits and were also followed for six months after the infants' birth scored higher on six-month Cattell Scales than did a control group who entered the program at six months of age. There were no stillbirths or neonatal deaths. The incidence of low-birth-weight infants was lower than the national averages. Participation in the program was high.
A study was conducted to determine the knowledge and attitude about breast feeding (BF) amongst child development project officers (CDPOs) working in Integrated Child Development Services Scheme. A semi structured pretested questionnaire was administered. It was found that majority of respondent had correct knowledge about feeding of colostrum, age of initiation of breast feeding and introduction of semi-solid foods. Majority of CDPOs had the knowledge that consumption of dry fruits, milk and desi ghee would increase that breast milk secretion. The percentage of subjects who were aware that BF should be discontinued if mother is suffering from illness like breast cancer (48%) tuberculosis (57%), malaria (67%) and Diarrhoea (84%). There is need of continuing education of CDPOs for updating their knowledge.
A study of 1037 representative Dunedin children delivered by a variety of modes was described. The results showed that there were no significant differences in maternal general mental ability, training in child development, or background of child experiences among the five delivery groups studied. Also, there were no significant differences between children who were spontaneous deliveries or any of the other groups in age at which the developmental milestones were achieved, nor in any of the developmental characteristics assessed.