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      Utilization of physical therapy, speech therapy and occupational therapy by children and adolescents in Germany.
      Results of the cross-sectional KiGGS Wave 2 study and trends

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          Abstract

          Allied health services such as physical therapy, speech therapy and occupational therapy contribute to the early treatment of health disorders in children and adolescents and promote a healthy development. This article describes the utilization of these allied health services by children and adolescents in Germany and analyses its association with demographic and social factors. The analyses are based on the second wave of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2, 2014-2017) including 15,023 participants. Trends are calculated in comparison with the KiGGS baseline study (2003-2006). Within one year, 9.6% of children and adolescents in Germany use physical therapy, 6.1% speech therapy and 4.0% occupational therapy. Speech therapy and occupational therapy are used more frequently by boys than by girls. The utilization of speech therapy is highest among 3- to 6-year-olds with 15.0%. Occupational therapy (8.3%) is most frequently used by 7- to 10-year-olds and physical therapy (16.9%) by 14- to 17-year-olds. Social differences are evident mainly in the higher utilization of occupational therapy and speech therapy and a lower utilization of physical therapy by socially disadvantaged children and adolescents. Over the last ten years, the utilization of speech therapy and physical therapy in children and adolescents has increased significantly.

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          Normative data and scale properties of the German parent SDQ.

          The Strengths and Difficulties Questionnaire (SDQ) is a short assessment instrument which addresses positive and negative behavioural attributes of children and adolescents and generates scores for clinically relevant aspects. Although this brief questionnaire has been widely used in Germany to gather information from parents, teachers, and older children themselves, normative results obtained with the German version have not yet been reported to the international scientific community. To allow comparisons with SDQ findings in other countries, normative data for the German parent-rated form as well as a community-based evaluation of scale properties are summarised and complemented by results obtained in a number of clinical samples. Parent ratings were collected for a community-based sample of 930 children and adolescents aged between 6 and 16 years, in which both genders and all age levels were equally represented. Statistical evaluation of psychometric properties included a factor analysis verifying the proposed scale structure, assessment of scale homogeneities, and determination of age, gender and social class effects. Based on the distributions of SDQ scores observed in this normative sample, recommended bandings identifying normal, borderline, and clinical ranges were defined for each scale. Exact replication of the original scale structure, satisfactory internal reliabilities, and observation of the expected associations with age and gender confirmed the equivalence of the German SDQ parent questionnaire with the English original. Differences between community-based results and clinical groups provided descriptive evidence of a dramatic impact of clinically defined psychiatric status on SDQ scores. After evaluating parent ratings obtained in a community-based sample, the German SDQ was shown to possess favourable psychometric properties. Thus, the German translation of this popular and versatile instrument seems to be a similarly reliable and useful assessment tool as the original English questionnaire.
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            Standard Definitions. Final Dispositions of Case Codes and Outcome Rates for Surveys

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              KiGGS Wave 2 cross-sectional study - participant acquisition, response rates and representativeness.

              For the third time, wave 2 of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), which is conducted in the context of health monitoring at the Robert Koch Institute, now provides representative cross-sectional data for Germany. Completed in 2017, data for the cross-sectional component of KiGGS Wave 2 was collected in the form of an interview and examination survey. Interview survey data was collected from 15,023 participants, meaning that the required number of participants has been reached. A randomly selected subgroup of 3,567 participants was also examined. The overall response rate was 40.1%. Differences in response rates were registered regarding certain sociodemographic characteristics. Weighting was applied to compensate for differences in willingness to participate related to age, gender, geographic region, nationality and education factors. Weighting ensures that assessments of the health of children and adolescents in Germany are representative for the population. The data serves to estimate prevalence rates and, through comparison with the results from previous survey waves, to analyse trends. A set of measures were taken to recruit a sufficiently large group of participants and ensure that the net sample reflects the composition of the overall population to the highest degree. For future surveys, further measures ought to be taken in order to improve the integration of hard-to-reach subgroups.
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                Author and article information

                Journal
                J Health Monit
                J Health Monit
                JoHM
                Journal of Health Monitoring
                Robert Koch Institute (Nordufer 20 13353 Berlin, Germany )
                2511-2708
                12 December 2018
                December 2018
                : 3
                : 4
                : 20-34
                Affiliations
                Robert Koch Institute , Berlin, Department of Epidemiology and Health Monitoring
                Author notes
                Corresponding author Dr Alexander Rommel, Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 62–66, D-12101 Berlin, Germany, E-mail: RommelA@ 123456rki.de
                Article
                10.17886/RKI-GBE-2018-097
                8852792
                35586141
                21063839-087f-44ce-b4ea-5f4ae1821002
                © Robert Koch Institute. All rights reserved unless explicitly granted.

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 28 August 2018
                : 17 October 2018
                Page count
                Figures: 2, Tables: 3, Equations: 0, References: 29, Pages: 15
                Funding
                Funded by: Federal Ministry of Health
                Award Recipient : KiGGS
                Funded by: Robert Koch Institute
                Award Recipient : KiGGS
                KiGGS is funded by the Federal Ministry of Health and the Robert Koch Institute.
                Categories
                Focus

                physical therapy,speech therapy,occupational therapy,health monitoring,kiggs

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