Merging Policy Initiatives and Developmental Perspectives in Early Intervention

Predictive value of the Ages and Stages Questionnaire® for school performance and school intervention in late preterm- and term-born children

BACKGROUND

The new health supervision guidelines emphasize the importance of surveillance or a formal developmental screening test at 4 years, one of the most used tests is Ages & Stages Questionnaire. Nevertheless, there is still not enough evidence whether these tools will be useful to predict future school performance (SP).

OBJECTIVES

The objectives of this study were to evaluate the Ages & Stages Questionnaire 3rd edition 48-month interval (ASQ3-48) translated to Spanish for predicting the need for school intervention (SI) and poor SP at 8-9 years of age, in late preterm infants (LPIs) and term-born infants (Terms) and to compare the prevalence of SI and poor SP in the two groups.

METHODS

Data were collected from a cohort of 75 LPIs and 58 Terms assessed with ASQ3-48 and with a further assessment of academic results at 8-9 years, through a standardized school test of the Education Department of Catalonia. SI data were obtained through a parent report. Area under the curve (AUC), sensitivity, specificity and predictive values were calculated, and logistic regression analysis was used.

RESULTS

The prevalence of poor SP was 12.8%, without statistically significant differences between LPIs and Terms. LPIs had higher SI than Terms (29.3% vs. 10.3%, P = 0.001). AUC for poor SP was 0.73 and for receiving SI was 0.56 without differences between the two groups. The sensitivity of the ASQ3-48 for poor SP was 41%, for specificity 92%, and for receiving SI 14% and 89%, respectively. Poor SP was related to having positive screening in the ASQ3-48 (OR 6.5 [95% CI, 1.9-22.2]) while having received SI was related to late prematurity (OR 3.6 [95% CI, 1.3-9.6]).

CONCLUSIONS

The ASQ3-48 shows acceptable predictive properties for poor SP but not for receiving SI. No differences were found in SP between LPI and Term cohorts, but LPIs are likelier to require SI.

SYSTEMATIC LITERATURE REVIEW ON MODELS AND PRACTICES OF EARLY CHILDHOOD INTERVENTION IN BRAZIL

Objective:

To identify which Early Childhood Intervention practices and models are described in the Brazilian literature.

Data sources:

A systematic integrative review of the literature indexed in databases from Virtual Health Library, Bielefeld Academic Search Engine, Education Resources Information Center and Portal of Periodicals of the Coordination of Improvement of Higher Education Personnel was carried out, considering the period between 2005 and 2015. The following articles were analyzed: those published in English or Portuguese, fully available online, with the terms “Early Intervention”, “Early Stimulation” or “Essential Stimulation” in the title, abstract or keywords; studies that enrolled children aged from 0 to 6 years, their caregivers or professionals in Early Intervention services; manuscripts published in journals classified as ≥ B2 (WebQualis; Qualis 2014) in the fields of Education or Physical Education; and studies that described Early Intervention practices.

Data synthesis:

Early Intervention seems to be developed exclusively related to the health sector, with prevalence of practices aimed at stimulating skills through the use of clinical approaches, whose focus is centered on the child and structured in the model of rehabilitative care.

Conclusions:

The adoption of Early Intervention practices and models are far from those recommended and recognized by the international literature as good practices. In this sense, the need of continuous education of professionals involved in this area is shown, as well the need for investments in research on this subject.