Validation of Rapid Neurodevelopmental Assessment for 2- to 5-Year-Old Children in Bangladesh

OBJECTIVE: Validate a tool to determine neurodevelopmental impairments (NDIs) in >2- to 5-year-old children in a country with limited child development expertise. METHODS: Rapid Neurodevelopmental Assessment (RNDA) is a tool designed to detect functional status and NDIs across multiple neurodevelopmental domains. Validity was determined in 77 children enrolled by door-to-door sampling in Dhaka and who were administered the RNDA by 1 of 6 testers (4 developmental therapists, 2 special education teachers) and simultaneously administered a test of adaptive behavior (AB; Independent Behavior Assessment Scale) and intelligence quotient (IQ) tests (Bayley Scales of Infant Development II, Stanford Binet Intelligence Scale, Wechsler Preschool and Primary Scales of Intelligence) by psychologists. RESULTS: Interrater reliability ranged from good to excellent. There were significant differences in AB in mean percentile scores on the Independent Behavior Assessment Scale for motor (P = .0001), socialization (P = .001), communication (P = .001), and full-scale (P = .001) scores in children with ≥1 NDI (“any NDI”) versus no NDI. Significant differences in those with versus those without “any NDI” were found on IQ scores. Sensitivity and specificity for “significant difficulties” (defined as AB z-scores < −2 SDs and/or IQ <70) and “mild difficulties included” (AB z-scores < −1SD and/or IQ <85) were 90% and 60% and 80% and 76%, respectively. CONCLUSIONS: The RNDA validity results are promising for use by child care professionals in field and clinical settings, but the tool needs further replication and refinement for assessment of specific impairments of vision, hearing, and seizures.

[1]  R. Goodman,et al.  The extended version of the Strengths and Difficulties Questionnaire as a guide to child psychiatric caseness and consequent burden. , 1999, Journal of child psychology and psychiatry, and allied disciplines.

[2]  N. Gordon.  Treatment of Cerebral Palsy and Motor Delay (2nd ed) , 1983 .

[3]  J. Squires,et al.  Revision of a parent-completed development screening tool: Ages and Stages Questionnaires. , 1997, Journal of pediatric psychology.

[4]  M. Durkin,et al.  Validity of the 'Ten Questions' for screening serious childhood disability: results from urban Bangladesh. , 1990, International journal of epidemiology.

[5]  L. Mullany,et al.  Association between Nutritional Status and Positive Childhood Disability Screening Using the Ten Questions Plus Tool in Sarlahi, Nepal , 2010, Journal of health, population, and nutrition.

[6]  M. Pang,et al.  Determinants of activity and participation in preschoolers with developmental delay. , 2011, Research in developmental disabilities.

[7]  P E Shrout,et al.  Design of two-phase prevalence surveys of rare disorders. , 1989, Biometrics.

[8]  Konstantinos Papadopoulos,et al.  Adaptive behavior of children and adolescents with visual impairments. , 2011, Research in developmental disabilities.

[9]  Delay Are Listed.  Treatment of cerebral palsy and motor delay. , 1983, Archives of disease in childhood.

[10]  W. Grove.  Statistical Methods for Rates and Proportions, 2nd ed , 1981 .

[11]  M. Durkin,et al.  Screening methods for childhood hearing impairment in rural Bangladesh. , 2006, International journal of pediatric otorhinolaryngology.

[12]  H. McConachie,et al.  Development of an Independent Behaviour Assessment Scale for Bangladesh , 1999 .

[13]  S. Castle,et al.  Child development: vulnerability and resilience. , 1996, Social science & medicine.

[14]  P. Glewwe,et al.  Developmental potential in the first 5 years for children in developing countries , 2007, The Lancet.

[15]  Steven G. LoBello,et al.  A Table for Determining Probability of Obtaining Verbal and Performance Scale Discrepancies on the Wechsler Preschool and Primary Scale of Intelligence-Revised. , 1991 .

[16]  A. Paolitto,et al.  Stanford-Binet Intelligence Scale. , 2000 .

[17]  D. Egan.  Developmental Examination of Infants and Preschool Children , 1990 .

[18]  Mary D. Sheridan.  Spontaneous play in early childhood from birth to six years , 1977 .

[19]  A. Boonen,et al.  The international classification for functioning, disability and health , 2007, Clinical Rheumatology.

[20]  P. Shrout,et al.  Validity of the Ten Questions Screen for Childhood Disability: Results from Population‐Based Studies in Bangladesh, Jamaica, and Pakistan , 1994, Epidemiology.

[21]  T. Dishion,et al.  Collateral benefits of the Family Check-Up on early childhood school readiness: indirect effects of parents' positive behavior support. , 2008, Developmental psychology.

[22]  Carol Bellamy,et al.  'The state of the world's children'. , 1985, People Count.

[23]  Duncan Cramer,et al.  Quantitative data analysis for social scientists , 1990 .

[24]  Nelson Cowan,et al.  The development of memory in childhood , 1997 .

[25]  P. Piot,et al.  AIDS: an international perspective. , 1988, Science.

[26]  P. Sonksen.  A developmental approach to sensory disabilities in early childhood. , 1985, International rehabilitation medicine.

[27]  J. Volpe,et al.  Neurological Examination: Normal and Abnormal Features , 2008 .

[28]  T. Kurashige,et al.  Proposal for Revised Classification of Epilepsies and Epileptic Syndromes , 1989, No to hattatsu = Brain and development.

[29]  A. Petrie,et al.  Promotion of Visual Development of Severely Visually Impaired Babies: Evaluation of A Developmentally Based Programme , 1991, Developmental medicine and child neurology.

[30]  P. Maulik,et al.  Childhood Disability in Low- and Middle-Income Countries: Overview of Screening, Prevention, Services, Legislation, and Epidemiology , 2007, Pediatrics.

[31]  K. Olness,et al.  'The state of the world's children'. , 1985, Archives of disease in childhood.

[32]  J. Berry,et al.  Health and Cross-Cultural Psychology: Toward Applications , 1988 .

[33]  B. Everitt,et al.  Statistical methods for rates and proportions , 1973 .

[34]  R. Goodman.  The Strengths and Difficulties Questionnaire: a research note. , 1997, Journal of child psychology and psychiatry, and allied disciplines.

[35]  Nicholas J. Baldwin,et al.  Great Ormond Street Hospital for children , 2013 .

[36]  D. Murphey.  Discriminant Validity of a Community-Level Measure of Children's Readiness for School. , 2003 .

[37]  P. Caldwell.  Child survival: physical vulnerability and resilience in adversity in the European past and the contemporary Third World. , 1996, Social science & medicine.

[38]  J. Katz,et al.  The association of preterm birth and small birthweight for gestational age on childhood disability screening using the Ten Questions Plus tool in rural Sarlahi district, southern Nepal. , 2012, Child: care, health and development.

[39]  G. Baird,et al.  Early identification of autism by the CHecklist for Autism in Toddlers (CHAT) , 2000, Journal of the Royal Society of Medicine.

[40]  M. A. Merrill,et al.  Stanford-Binet Intelligence Scale , 1972 .

[41]  H. Kohli.  Early child development. , 2008, The National medical journal of India.

[42]  P. Maulik,et al.  Community-based interventions to optimize early childhood development in low resource settings , 2009, Journal of Perinatology.

[43]  A. Berg,et al.  Distribution of Epilepsy Syndromes in a Cohort of Children Prospectively Monitored from the Time of Their First Unprovoked Seizure , 1999, Epilepsia.

[44]  H. McConachie,et al.  A randomized controlled trial of alternative modes of service provision to young children with cerebral palsy in Bangladesh. , 2000, The Journal of pediatrics.

[45]  H. McConachie,et al.  Behaviour problems in young children in rural Bangladesh. , 2009, Journal of tropical pediatrics.

[46]  E. Peile,et al.  The Normal Child , 2006 .

[47]  M. Durkin,et al.  Socioeconomic status and the prevalence of mental retardation in Bangladesh. , 1993, Mental retardation.

[48]  N. Bayley.  Bayley Scales of Infant Development , 1999 .

[49]  K. Baba.  The Normal Child , 1969, Shikai tenbo = Dental outlook.

[50]  Dilara Begum,et al.  Validation of Rapid Neurodevelopmental Assessment Instrument for Under-Two-Year-Old Children in Bangladesh , 2010, Pediatrics.

[51]  S. Whaley,et al.  Literacy Promotion for Families Participating in the Women, Infants and Children Program , 2011, Pediatrics.

[52]  J. Farver,et al.  Cultural differences in Korean- and Anglo-American preschoolers' social interaction and play behaviors. , 1995, Child development.

[53]  Hugh Jolly,et al.  Clinics in Developmental Medicine , 1965 .

[54]  G. Chard.  International Classification of Functioning, Disability and Health , 2004 .

[55]  J Devlin.  Child Development, Diagnosis and Assessment. , 1991 .

[56]  G. Darmstadt,et al.  Neurodevelopmental Outcomes of Preterm Infants in Bangladesh , 2006, Pediatrics.

[57]  P. Biondich,et al.  Identifying Infants and Young Children With Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening , 2006, Pediatrics.

[58]  H. McConachie,et al.  Validation of a home-based neurodevelopmental screening tool for under 2-year-old children in Bangladesh. , 2013, Child: care, health and development.