Verhaltensstörungen im Kindergartenalter

Social developmental delays among 3 to 6 year old children in preschools in German social hotspots: results of a dynamic prospective cohort study

BACKGROUND

Social skills are valid predictors for school readiness and subsequent school success. The federal state law for child day-care and preschools in Mecklenburg-Western Pomerania, a federal state in Germany, provides additional funds for the targeted and individualized promotion of social developmental delays for children in preschools in social hotspots. The law grants additional funds to eligible preschools, provided that each child's development is documented with a standardized, objective and valid screening instrument.

METHODS

To monitor the development and to detect social developmental delays, the preschools involved use the "Dortmund Developmental Screening for Preschools" (DESK 3-6). For the prevalence and risk factors, data of 5595 children aged 3 to 6 years from these preschools were analyzed.

RESULTS

9.6% of the children show reasonable findings in their social development; for a further 6.1% the results were inconclusive. Sex, presence of chronic diseases or disabilities and reasonable findings in the domains motor development and language and cognition were risk factors in terms of social development across all age groups.

CONCLUSIONS

The federal state law is a good example for the implementation of a standardized monitoring of the development of children. With the help of this screening instrument, prevention activities to reduce the prevalence of developmental delays can be conducted in early childhood. Early preventive activities should take into account the reported risk factors for the social development.

TRIAL REGISTRATION

German Clinical Trials Register, ID: DRKS00015134, Registered on 29 October 2018, retrospectively registered.

Verhaltensauffälligkeiten bei Kindern mit Entwicklungsdefiziten im Vorschulalter

Zusammenfassung. Es wurde der Zusammenhang zwischen Verhaltens- und Entwicklungsauffälligkeiten untersucht. An der Studie nahmen 201 Kinder im Alter zwischen 36 und 72 Monaten teil. Pädagogische Fachkräfte beurteilten grundlegende Fertigkeiten mit Hilfe der Entwicklungsbeobachtung und -dokumentation (EBD) und das Problemverhalten mit dem Strengths and Difficulties Questionnaire (SDQ). Mittels binär logistischer Regressionen wurde analysiert, ob das Ausmaß an Entwicklungsdefiziten eines Kindes das Risiko für Verhaltensauffälligkeiten erhöht und welche konkreten Entwicklungsdefizite das Vorliegen von Verhaltensauffälligkeiten vorhersagen. 41 von 96 Kindern mit Entwicklungsdefiziten in mindestens einem oder mehreren EBD-Bereichen wiesen nach dem Urteil der pädagogischen Fachkräfte auch ein erhöhtes Risiko für Verhaltensauffälligkeiten auf. Als bedeutsame Prädiktoren haben sich das Alter und das Ausmaß an Entwicklungsdefiziten erwiesen, wobei insbesondere Defizite in den sozialen und emotionalen Fertigkeiten mit einem erhöhten Risiko für Verhaltensauffälligkeiten assoziiert waren. Die Befunde verdeutlichen, dass der Entwicklungsdiagnostik und –förderung ein hoher Stellenwert in der Prävention von Verhaltensauffälligkeiten zukommt.

[Cognitive, linguistic, motoric, and social deficits in schoolstarters with behavioral disorders]

Studies show that ADHD, conduct disorders, and anxiety disorders are clinical disorders mostly diagnosed in schoolstarters. The preschool medical examination in Bremen was therefore extended by behavioral screenings. Based on their screening results from the SEU (health examination for school entry) 2011 in Bremen, 67 preschoolers were tested for behavioral disorders. Subsequently, children with behavioral or emotional symptoms (N = 56) were compared to symptomfree controls (N = 52) for their cognitive, motoric, linguistic, and social-emotional development. Psychosocial health was obtained through external assessment by the parents and kindergarten teachers. Results of the WPPSI-III, M-ABC-2, and ET 6-6 were included in the analysis. 32 children met the criteria for behavioral disorders. Children with behavioral or emotional symptoms showed significant lower scores on tests measuring cognitive, motoric, linguistic and emotional development compared to controls. Results suggest that there is necessity to screen all preschoolers for behavioral disorders before entering school. Because children with clinical or subclinical behavioral disorders showed major developmental deficits compared to children without behavioral symptoms, it is essential to conduct a multiple assessment on children with suspected behavioral disorders to ensure early developmental support and adequate interventional programs.

Screening in child health: studies of the efficacy and relevance of preventive care practices

BACKGROUND

Pediatric screening enables the prevention or early detection of diseases and developmental disturbances in infancy and childhood. Screening is a standard component of pediatric practice in many countries, but its scientific basis is not well known.

METHODS

The scientific justification for pediatric screening beyond the neonatal period is presented on the basis of a selective review of the literature on some aspects of pediatric screening.

RESULTS

The level of evidence varies highly among pediatric screening interventions and can be difficult to determine because of confounding variables. Parent counseling is associated with improvements in child-raising competence, accident prevention, and reading behavior. The early detection of abnormalities in a child's motor, linguistic, mental, or social development is possible and often leads to effective early interventions. Cyanotic congenital heart defects can be detected with 63% sensitivity and 99.8% specificity; cerebral palsy can be diagnosed with 33% to 100% sensitivity and 52.3% to 100% specificity (different figures from multiple studies). Physical therapy seems to improve some manifestations of cerebral palsy. Motor development at 90 days is correlated with motor development at 57 months (72% sensitivity, 91% specificity). A developmental quotient above 85 in a two-year-old child is correlated with an intelligence quotient above 85 when the child is 7 years old.

CONCLUSION

There is an increasing amount of scientific evidence in favor of pediatric screening. Nonetheless, further epidemiological studies are needed.

Frühe Kindheit

Die bei jungen Kindern bestehende starke Abhängigkeit des Erlebens und Verhaltens von den primären Bezugspersonen erschwert die Diagnostik psychischer Störungen. Es wird die Klassifikation psychischer Störungen bei Kindern zwischen null und sechs Jahren diskutiert. Dazu wird die Klassifikation DC: 0 – 3R der Arbeitsgruppe Zero To Three vorgestellt; auf die Forschungskriterien für Null- bis Fünfjährige (RDC-PA) der Task Force on Research Diagnostic Criteria wird eingegangen. Des Weiteren werden aus aktuellen Studien epidemiologische Daten präsentiert.