Agreement Between Parental Report and Clinician Observation of Infant Developmental Skills

Characterization of early skill profiles for infants across varying genetic likelihoods for neurodevelopmental disorders

Several infant behaviors spanning multiple developmental domains have been identified as promising markers of early neurodivergence, such as ADHD or ASD. Some of these early markers include social-communication differences, atypical attention, and motor deficits. Research involving early predictors of ADHD features in infants is scarcer than research involving early predictors of ASD. However, studies among school-age children have observed comparable profiles of language, attention, and motor skills between children with ASD and children with ADHD. Given that assessing early features of ASD and ADHD is fundamental to increasing earlier diagnoses, this study examined parent-reported social-communication, attention, and motor profiles across 12-month-old infants at elevated genetic likelihoods for ASD (EL-ASD) and ADHD (EL-ADHD), and low genetic likelihood for either disorder (LL). Parent responses on the CSBS-CG, FYI, and EMQ were compared across the three groups. Results showed EL-ASD participants as scoring lower than both LL and EL-ADHD participants on parent-reported social skills and attention constructs (Responding to and Initiating Social Attention). Although FYI constructs are meant to measure attention, the Responding to and Initiating Social Attention subscales also include aspects of social communication. Differences between EL-ADHD and LL infants on measures of social-communication, motor, and attention skills were not observed, suggesting that parent-reported differences between EL-ADHD and LL infants' behavior may not be as detectable during infancy as those associated with ASD. Future research is required to further the understanding of developmental differences of infants with features of ADHD.

Measuring Intentional Communication in Infants at Elevated Likelihood of Autism: Validity, Reliability, and Responsiveness of a Novel Coding Scale

PURPOSE

Intentional communication acts, or purposefully directed vocalizations and gestures, are particularly difficult for infants at elevated likelihood for eventual diagnosis of autism. The ability to measure and track intentional communication in infancy thus has the potential to aid early identification and intervention efforts. This study assesses the validity of a novel measure of intentional communication intended for use within semistructured caregiver-infant interactions.

METHOD

The Intentional Communication Coding Scale (IC Coding Scale) captures infants' Vocalizations, Gestures, and Combined (vocalizations paired with gestures) acts. Using data from 36 infants at elevated likelihood for autism, we tested the convergent and discriminant validity of the IC Coding Scale with established language measures using Spearman's rho. We tested interrater reliability using intraclass correlation coefficient (ICC) calculations. Finally, we tested responsiveness (i.e., sensitivity to change) using Wilcoxon signed-ranks tests and Spearman's rho.

RESULTS

Our initial psychometric tests suggested adequate levels of convergent and discriminant validity. ICCs ranged from .77 to .92, while confidence intervals were wide, suggesting that Gestures and Combined acts were coded more variably than Vocalizations were among raters. Tests of the scale's responsiveness suggested adequate sensitivity to change across a 12-week period.

CONCLUSIONS

This study is an important first step toward validating the IC Coding Scale for use in measuring and tracking intentional communication behaviors in infants at elevated likelihood for autism within more naturalistic, semistructured activities. Additional studies are needed to disentangle the effects of intervention from maturation and to examine types of intentional communication acts in more detail.

The contributions of motor skill proficiency to cognitive and social development in early childhood

With limited evidence from intervention studies, causal relationships between motor competence and cognitive and social development have yet to be clearly established. In this research, we investigated whether a targeted training programme to improve fundamental movement skills (i.e., object control, locomotor) in young children would also lead to improvements in the cognitive (i.e., executive function) and social (i.e., socioemotional competence) domains. Using a two-arm group randomised intervention design, 185 children aged 36 to 60 months (mean 47.51, SD 8.11 months) were allocated to a motor skill intervention group or an active control group. The intervention was implemented over one school year, and outcomes were monitored across five time points. Longitudinal analysis was performed using hierarchical linear mixed-effects and latent growth curve models. Participation in the motor skill intervention led to higher rates of development of object control skills (p < 0.001) and executive function (p < 0.001). A dose‒response relationship was found in which those children who displayed greater development of object control skills over time also displayed greater development of executive function (p = 0.001). We found no significant effects of the intervention on locomotor skills, social behaviours, or socioemotional competence. These findings provide evidence of a causal relationship between motor and cognitive development.

A National School Health Campaign in Lebanon on Children Aged between 3 and 12 Years Old: Concordance Level between Parents' Reports and Medical Visit Findings about Physical and Mental Health

A school's commitment to promoting health extends beyond students' efforts to encompass parental involvement and must recognize the critical role of parents in enhancing overall student well-being. This study, conducted in 27 schools across Lebanon, assessed parents' awareness of their children's physical and mental health. A school health campaign involved direct medical interventions on 7184 students, followed by phone interviews with 3880 parents to compare their responses with the medical findings. Discordances ranged from extreme mismatches (≥50%) to mild mismatches (<15%), with notable disparities in incomplete vaccination (67.8%), BMI (59%), and mental health indicators (expressions of sadness (69.1%), loneliness (61.0%), and anxiety (53.4%)). Factors such as school type, child's age, governorate, family income, parents' occupation, education level, and marital status significantly influenced discordance rates. Notably, mental health aspects exhibited higher disparities, emphasizing the need for improved communication between parents, physicians, and children. Bridging these gaps could empower parents with better knowledge, fostering environments conducive to lifelong healthy behaviors in children. The study underscores the urgency for enhanced communication strategies to bridge discrepancies and ensure a more comprehensive understanding of children's physical and mental well-being.

Effect of Neonatal Abstinence Syndrome Treatment Status and Maternal Depressive Symptomatology on Maternal Reports of Infant Behaviors

OBJECTIVE

The objective of this study is to investigate the effects of maternal perinatal depression symptoms and infant treatment status for neonatal abstinence syndrome (NAS) on maternal perceptions of infant regulatory behavior at 6 weeks of age.

METHODS

Mothers and their infants (N = 106; 53 dyads) were recruited from a rural, White cohort in Northeast Maine. Mothers in medication-assisted treatment (methadone) and their infants (n = 35 dyads) were divided based on the infant's NAS pharmacological treatment (n = 20, NAS+ group; n = 15, NAS- group) and compared with a demographically similar, nonexposed comparison group (n = 18 dyads; COMP group). At 6 weeks postpartum, mothers reported their depression symptoms Beck Depression Inventory-2nd Edition) and infant regulatory behaviors [Mother and Baby Scales (MABS)]. Infant neurobehavior was assessed during the same visit using the Neonatal Network Neurobehavioral Scale (NNNS).

RESULTS

Mothers in the NAS+ group showed significantly higher depression scores than the COMP group (p < .05) while the NAS- group did not. Across the sample, mothers with higher depression scores reported higher infant "unsettled-irregularity" MABS scores, regardless of group status. Agreement between maternal reports of infant regulatory behaviors and observer-assessed NNNS summary scares was poor in both the NAS+ and COMP groups.

CONCLUSIONS

Postpartum women in opioid recovery with infants requiring pharmacological intervention for NAS are more at risk for depression which may adversely influence their perceptions of their infants' regulatory profiles. Unique, targeted attachment interventions may be needed for this population.

Agreement of Clinician‐Administered and Modified Parent‐Administered House‐Brackmann Scales in Children with Bell's Palsy

Objective

Currently there is no parent administered scale for facial nerve function in children. We set out to assess the agreement between a newly developed parent-administered modified version of the House-Brackmann (HB) scale and the standard clinician-administered HB scale in children with Bell's palsy.

Study Design

Secondary analysis of a triple-blind, randomized, placebo-controlled trial of corticosteroids to treat idiopathic facial paralysis (Bell's palsy) in children (6 months to <18 years).

Setting

Multicenter study at pediatric hospitals with recruitment in emergency departments.

Methods

Children were recruited within 72 hours of symptom onset and assessed using the clinician-administered and the parent-administered modified HB scales at baseline, and at 1, 3, and 6 months until recovered. Agreement between the 2 scales was assessed using intraclass coefficient (ICC) and a Bland-Altman plot.

Results

Data were available for 174 of the 187 children randomized from at least 1 study time point. The mean ICC between clinician and parent HB scores across all time points was 0.88 (95% confidence interval, CI: 0.86, 0.90). The ICC for the data collected at baseline was 0.53 (95% CI: 0.43, 0.64), at 1 month was 0.88 (95% CI: 0.84, 0.91), at 3 months was 0.80 (95% CI: 0.71, 0.87) and at 6 months was 0.73 (95% CI: 0.47, 0.89). A Bland-Altman plot indicated a mean difference between the 2 scores (clinician-reported minus parent-reported) of only -0.07 (95% limits of agreement -1.37 to 1.23).

Conclusion

There was good agreement between the modified parent-administered and the clinician-administered HB scales.