Supporting & Related Research

Objective: We examined the parental perception and accuracy of Mandarin translated Parents’ Evaluation of Developmental Status, a screening questionnaire for parents’ concerns on their child’s various developmental skills.

Methods: The questionnaire was translated into Mandarin. Upon enrollment, caregivers completed the Mandarin PEDS and answered four questions about its acceptability and usefulness, and its ease of understanding and completing. The Mandarin PEDS were independently evaluated by a pediatrician and a community nurse, and classified as ‘high’ risk (> 2 predictive concerns), ‘medium’ risk (1 predictive concern), ‘low’ risk (any non-predictive concerns) or ‘no’ risk (if no concern) for developmental delays. The caregivers repeated Mandarin PEDS at a 2-week interval for test-retest reliability, while their children underwent testing for accuracy using a developmental assessment test.

Results: The majority (> 85%) of the 73 caregivers recruited perceived the Mandarin PEDS as acceptable and useful, as well as easy to understand and complete. Fifteen (20.5%) and 24 (33.9%) responses were classified as high and moderate risks respectively. The test-retest and inter-rater reliabilities were excellent, with intra-class correlation coefficients of 0.812 (95% CI: 0.701, 0.881, p < 0.001) and a kappa value of 0.870 (p < 0.001) respectively. Mandarin PEDS was 80.0% sensitive and 83.8% specific for those in high risk category (adjusted OR = 64.68; 95% CI 1.33, 3139.72; p = 0.035).

Conclusions: The Mandarin PEDS was well received by the caregivers, and it was reliable and accurate in detecting developmental delays among the Mandarin-speaking population. We recommend it for early detection of children with developmental and behavioral problems. This article is protected by copyright. All rights reserved.

The Supplemental Nutrition Assistance Program (SNAP) helps working families meet their nutritional needs. Families whose earned income increases in a given month may have their SNAP benefits abruptly reduced or cut off in the following month. Using sentinel sample data from 2007–15 for families with children younger than age four, we investigated how SNAP benefit reductions or cutoffs resulting from increased income were related to economic hardships (food and energy insecurity, unstable housing, forgone health and/or dental care, and health cost sacrifices) and to caregiver and child health. PEDS was used to measure developmental-behavioral status. After we controlled for covariates, we found that the groups whose SNAP benefits were reduced or cut off had significantly increased odds of household and child food insecurity, compared to a group with consistent participation in SNAP. Reduced benefits were associated with 1.43 and 1.22 times greater odds of fair or poor caregiver and child health/development, respectively. Policy modifications to smooth changes in benefit levels as work incomes improve may protect working families with young children from increased food insecurity, poor health, and forgone care.

The main goal of this research was to describe the type and level of parents’ concerns about child development and behaviour according to the PEDS test (Parents’ Evaluation of Developmental Status). The sample included 289 parents of children from three to seven years of age, from two preschool institutions in Serbia. A significantly high correlation was determined between parents’ general concerns and expressed concerns with regard to behaviour (χ2 = 17.86, df = 2, p < .001) and getting along with others (χ2 = 22.57, df = 2, p < .000). A marginally significant correlation was determined between parents’ general concerns and manifested concerns with regard to fine motor skills (χ2 = 5.90, df = 2, p = .052), as well as expressive language (χ² = 5.858, df = 2, p = .053). According to the criteria of PEDS test, this research identified 56.4% of children whose development needed to be monitored, 27.7% of children who needed to be referred for detailed diagnostic procedures, and 1.7% who needed to be included in treatment or special education support.

Methods:

• Cognitive stimulation during the first five years of life is critical for proper childhood development.
• Prior community evaluations in rural Ghana have demonstrated that children in the Bibiani-AnhwiasoBekwai (BAB) district receive inadequate cognitive simulation.

Objectives:

• To characterize baseline child development in the BAB district.
• To obtain formative data for developing a mentorship program for first-time mothers and their children.

World-wide it is important to recognize Indigenous children’s speech and language competence and their language learning environments. Indigenous Australian children participated in the child cohort of Footprints in Time: Longitudinal Study of Indigenous Children, a national study supported by Indigenous Australians and the Australian Government collected annually (in waves). There were 692 3–5-year-old children in wave 1, and two years later, 570 5–7-year-old children were in wave 3 (77.0% of children in wave 1 were also in wave 3). Data were obtained via parent interviews and direct assessment. The children spoke between one and eight languages including: English (wave 1: 91.2%, wave 3: 99.6%), Indigenous languages (wave 1: 24.4%, wave 3: 26.8%), creoles (wave 1: 11.5%, wave 3: 13.7%), foreign languages (non-Indigenous languages other than English) (wave 1: 2.0%, wave 3: 5.1%), and sign languages (wave 1: 0.6%, wave 3: 0.4%). Children who spoke an Indigenous language were more likely to live in moderate to extreme isolation than their English-speaking counterparts. Parental concern about speech and language skills was similar to data for non-Indigenous children with approximately one quarter of parents expressing concern (wave 1: yes = 13.9%, a little = 10.4%). Children’s language environments were rich, with many family members and friends telling oral stories, reading books, and listening to the children read. Almost a third of families wanted to pass on their cultural language, and many indicated that they would like their child to learn an Indigenous language at school. Overall, Indigenous Australian children have rich cultural and linguistic traditions and their speech and language competence is promoted through family, community, and educational experiences.

Objective: This study determined the feasibility and validity of a Chinese-translated Parents’ Evaluation of Developmental Status (PEDS), a questionnaire for parents to report concerns involving language, motor skills, learning, behavior, and social skills of children.

Method: The PEDS questionnaire was translated to Chinese and underwent testing for reliability and validity (sensitivity and specificity) against a diagnostic reference-standard developmental assessment test, Griffiths Mental Development Scales – Extended Revised. Parents / caregivers completed the questionnaire twice within a two-week interval. The scores were assessed separately by a pediatrician and a community nurse. Respondents also answered four study-designed questions about PEDS on acceptability and usefulness as screening tool, and ease of understanding and completing.

Results: Sixty-eight (84.0%) respondents thought the Chinese PEDS was acceptable to screen for children with developmental and behavioral concerns. They rated it as very easy or easy to understand (n = 79, 97.5%) and very easy or easy to complete (n = 79, 97.5%). There was a 71.6% agreement [intra-rater (test-retest) reliability of 0.615 (p < 0.001)] between the first and second PEDS for two predictive concerns, one predictive concern, non-predictive concern or no concern. There was an 88.9% agreement [inter-rater reliability with kappa value 0.849 (p < 0.001)] for the score assessment between pediatrician and community nurse. PEDS had 75.0% sensitivity and 86.2% specificity for two or more predictive caregivers concerns (with adjusted OR 14.53; 95% CI 2.00, 105.83; p = 0.008).

Conclusions: PEDS can be used for early detection of children with developmental problems in the Chinese speaking population.

This meta-analysis of 37 PEDS studies included a total of 210,242 children/parents. The studies were conducted in the US, Canada, Australia, Thailand, The Philippines, Indonesia, Spain, India and Tanzania. Dr. Woolfenden and colleagues found that parental concerns indicating high developmental risk were associated with multiple risk factors: male gender, low birth weight, poor/fair child health rating, poor maternal mental health, lower socioeconomic status (SES), minority ethnicity, not being read to, a lack of access to health care and not having health insurance. Thus PEDS ensures both developmental-behavioral screening plus psychosocial risk assessment, i.e., surveillance. The authors conclude, “given [that] the prevalence of parental concerns increased with biological and psychosocial adversity, the service response needs to be one of proportionate universalism where the greater the disadvantage, the more services available.”

Introduction: PEDS is a 10 questions tool used to elicit parental developmental concerns across a number of domains and hence to identify high risk children.

Objective: Testing the validity and reliability of translated PEDS and its use in Malaysia as a developmental screening tool.

Method: PEDS was translated into Malay and Mandarin by linguistics and medical professionals, followed by focussed group discussion. A cross sectional study involving 120 children between 1 and 6 years of age was conducted between 15 February and 31 May 2012 in Sibu. Caregivers completed the translated PEDS and answered questions regarding the acceptability and usefulness. PEDS was repeated 2 weeks later while the children underwent Griffiths Mental Development Scales.

Result: Till 3 May 2012, a total of 86 caregivers were recruited (46 used Malay PEDS, 40 for Mandarin). Preliminary data showed 26% of caregivers reporting 2 or more significant concerns and 17% have no concern. Preliminary analysis showed significant correlation between PEDS and global developmental disabilities and/or language disorder as assessed by the gold standard test (p <0.001), with sensitivity 73.5% and positive predictive value of 67.9%. Agreement test showed high correlation of the intra-raters reliability. Almost all (97.7%) caregivers rated the PEDS as very easy or easy to understand and complete; 90.7% found it acceptable as a developmental screening tool, and 62.1% believe it is very useful for Malaysian health professional.

Conclusions: Final result will be presented and relevant recommendation made to help improving the early detection of children at risk in Malaysia.

Methods: 133 Newborn infants admitted longer than 3 days to private-sector neonatal intensive care units were enrolled. 113 of these parents were contacted when their infants were 6-months corrected-age. They completed the ASQ (n=60) and the PEDS COMBINED (n=65) questionnaires at home. Returned questionnaires were compared using an in-subject design. Concordance between the questionnaires was determined with the kappa coefficient (κ) and Test of Symmetry.

Results: Concordance between the ASQ and PEDS COMBINED was 90.7% (κ = 0.82, ρ = 0.05).

The ASQ and PEDS COMBINED identified 40% and 42% of the cohort with developmental concerns. The ASQ and PEDS COMBINED showed excellent interrater agreement, identifying the same infants requiring further developmental assessment. When there was discordance, it was non-significant in the direction of the ASQ being more likely to identify an infant as delayed overall and statistically significant in the direction of the PEDS COMBINED being more likely to identify communication delays (ρ = 0.01)

Conclusions: The ASQ and PEDS COMBINED identify the same infants with developmental concerns. The PEDS COMBINED is more sensitive to communication delays.

Objective: This study explored the potential roles and utility of the Parents Evaluation of Developmental Status (PEDS) to screen children for developmental delays in a Southeast Asian clinical sample of preschool children. The PEDS is a 10-item questionnaire instrument used in pediatric settings for reporting parents’ concerns for their children’s development, learning, and behavior. Clinicians use it to make decisions about clinical pathways for high-, moderate-, and low-risk categories of concerns, but its utility in cross-cultural contexts has not been well documented.

Methods: Participants in this study were 1806 parents, teachers, and child care workers of preschool children in Singapore. Of these, 47.2% were English speaking, 21.2% were Mandarin Chinese speaking, and 31.6% were Malay speaking. PEDS was translated into Chinese and Malay for parents using these languages predominantly.

Results: Only parent results were analyzed. The reporting of significant parental concern was considerably higher than US norms and Australian pilot figures when western cutoff scores were applied. When cutoff scores were adjusted, similar patterns of reporting of high, medium, and low risk for disability could be captured.

Conclusions: Parents’ interpretation of the concept of “concern” varies across language and culture. Findings highlight the importance of evaluating a screening tool’s use in local contexts before its widespread implementation to yield clinically meaningful results.

Comment from Frances Page Glascoe: Culture does matter. Quality translations do too. We’ve been working with Dr. Kiing and colleagues since she sent us the above data in 2001, where we mutually concluded that the Mandarin translation was problematic. It isn’t enough to translate and back-translate. Wording has to be tested by providers and parents to make sure it works as intended. In 2005, after much machinating and vetting, we generated a new translation using an alternative Chinese terms for “Do you have concerns…” that was not synonymous with “Do you care…?”. Back-translated, the phrasing for the Chinese translation is “Are you worried….?” Although we know this doesn’t work in English (only about 2% of English speaking parents will respond and we know that rates of problems are much higher than that), the new translation works well with Chinese speaking parents and ensures their rates of “worries” are commensurate with parents speaking other languages. We thank Dr. Kiing, her colleagues and especially Dr. Teck-Hock Toh for working with us on this issue. We’ve also shared the revised translation with researchers using Survey PEDS within National Survey of Early Childhood Health (NSECH) who found similar problems with their original translation.

Ideally, journal editors/reviewers should ask about the time frame for data collection and if old, should also ask what is known and has been done since then. If such had occurred, this paper would surely not have been published.

So, please also read the subsequent study using better translations of Mandarin by Lim Boon Chuan and colleagues.