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      Instability of revised Korean Developmental Screening Test classification in first year of life

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          Abstract

          Background

          Early development is characterized by considerable variability.

          Purpose

          This study aimed to examine the stability of developmental classifications using the revised Korean Developmental Screening Test (K-DST) in healthy term infants aged 4–6 and 10–12 months.

          Methods

          Data were obtained from the Korean Children’s Environmental Health Study, a nationwide prospective birth cohort. Sixty-nine healthy term infants (26 boys, 43 girls) underwent serial K-DST assessments at 4–6 and 10–12 months of age, between August 2017 and December 2019

          Results

          At 4–5 months, over 50% of infants were categorized in the ≥-1 standard deviation (SD) group, with the lowest prevalence in the gross motor domain (52.7%). Seven infants (10.1%) scored below -2 SD in at least one domain, most commonly in gross and fine motor domains (7.3%). At 10–12 months, over 70% of infants scored in the ≥-1 SD group, except in the language domain. Six infants (9.5%) scored below -2 SD in at least one domain, (cognition 4.8%, language 3.2%, gross motor 3.2%). Serial follow-up showed significant improvement, with many infants moving to the ≥-1 SD group, particularly in the gross motor domain (33.3%). Of the seven infants scoring below -2 SD at 4–5 months, only two remained in this category at 10–12 months.

          Conclusion

          Infants scoring below -2 SD on the revised K-DST 4–5 months questionnaire, especially in the gross motor domain, should undergo close monitoring and repeated evaluations in the absence of neurological abnormalities or developmental red flags.

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          Most cited references24

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          Developmental disabilities among children younger than 5 years in 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

          Summary Background The Sustainable Development Goals (SDGs) mandate systematic monitoring of the health and wellbeing of all children to achieve optimal early childhood development. However, global epidemiological data on children with developmental disabilities are scarce. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 provides a comprehensive assessment of prevalence and years lived with disability (YLDs) for development disabilities among children younger than 5 years in 195 countries and territories from 1990 to 2016. Methods We estimated prevalence and YLDs for epilepsy, intellectual disability, hearing loss, vision loss, autism spectrum disorder, and attention deficit hyperactivity disorder. YLDs were estimated as the product of the prevalence estimate and the disability weight for each mutually exclusive disorder, corrected for comorbidity. We used DisMod-MR 2.1, a Bayesian meta-regression tool, on a pool of primary data derived from systematic reviews of the literature, health surveys, hospital and claims databases, cohort studies, and disease-specific registries. Findings Globally, 52·9 million (95% uncertainty interval [UI] 48·7–57·3; or 8·4% [7·7–9·1]) children younger than 5 years (54% males) had developmental disabilities in 2016 compared with 53·0 million (49·0–57·1; or 8·9% [8·2–9·5]) in 1990. About 95% of these children lived in low-income and middle-income countries. YLDs among these children increased from 3·8 million (95% UI 2·8–4·9) in 1990 to 3·9 million (2·9–5·2) in 2016. These disabilities accounted for 13·3% of the 29·3 million YLDs for all health conditions among children younger than 5 years in 2016. Vision loss was the most prevalent disability, followed by hearing loss, intellectual disability, and autism spectrum disorder. However, intellectual disability was the largest contributor to YLDs in both 1990 and 2016. Although the prevalence of developmental disabilities among children younger than 5 years decreased in all countries (except for North America) between 1990 and 2016, the number of children with developmental disabilities increased significantly in sub-Saharan Africa (71·3%) and in North Africa and the Middle East (7·6%). South Asia had the highest prevalence of children with developmental disabilities in 2016 and North America had the lowest. Interpretation The global burden of developmental disabilities has not significantly improved since 1990, suggesting inadequate global attention on the developmental potential of children who survived childhood as a result of child survival programmes, particularly in sub-Saharan Africa and south Asia. The SDGs provide a framework for policy and action to address the needs of children with or at risk of developmental disabilities, particularly in resource-poor countries. Funding The Bill & Melinda Gates Foundation.
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            A unified theory of development: a dialectic integration of nature and nurture.

            The understanding of nature and nurture within developmental science has evolved with alternating ascendance of one or the other as primary explanations for individual differences in life course trajectories of success or failure. A dialectical perspective emphasizing the interconnectedness of individual and context is suggested to interpret the evolution of developmental science in similar terms to those necessary to explain the development of individual children. A unified theory of development is proposed to integrate personal change, context, regulation, and representational models of development.
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              Prevalence of developmental delays and participation in early intervention services for young children.

              The objective of this study was to use a nationally representative longitudinal sample of children born in the United States in 2001 to estimate rates of eligibility for Part C early intervention, to estimate rates of access to services for developmental delays, and to examine factors that are associated with access to services. Data for this study were collected as part of the Early Childhood Longitudinal Study, Birth Cohort, which obtained data from participants when children were 9 and 24 months of age. Descriptive analyses were used to generate national estimates of the prevalence of developmental delays that would make children eligible for Part C services and rates of participation in early intervention services. Logistic regression analyses were conducted to examine whether child developmental delay, race, insurance availability, and poverty status were associated with the probability of receiving services. Results indicated that approximately 13% of children in the sample had developmental delays that would make them eligible for Part C early intervention. At 24 months, only 10% of children with delays received services. Children with developmental delays were more likely to receive services than those who do not have delays; black children were less likely to receive services than children from other ethnic and racial groups. The prevalence of developmental delays that make children eligible for Part C services is much higher than previously thought. Moreover, the majority of children who are eligible for Part C services are not receiving services for their developmental problems. Strategies need to be developed to monitor patterns of enrollment in early intervention services and reach out to more minority children, particularly black children.
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                Author and article information

                Journal
                Clin Exp Pediatr
                Clin Exp Pediatr
                CEP
                Clinical and Experimental Pediatrics
                Korean Pediatric Society
                2713-4148
                January 2025
                11 November 2024
                : 68
                : 1
                : 97-103
                Affiliations
                [1 ]Department of Pediatrics, Daegu Catholic University Medical Center, Daegu Catholic University School of Medicine, Daegu, Korea
                [2 ]Child Developmental & Psychological Test Laboratory, Department of Pediatrics, Daegu Catholic University Medical Center, Daegu, Korea
                [3 ]Department of Preventive Medicine, Daegu Catholic University Medical Center, Daegu Catholic University School of Medicine, Daegu, Korea
                Author notes
                Corresponding author: Jin Kyung Kim, MD, PhD. Department of Pediatrics, Daegu Catholic University Medical Center, Daegu Catholic University School of Medicine, 33 Duryugongwon-ro 17 gil, Nam-gu, Daegu 42472, Korea Email: kimjk@ 123456cu.ac.kr
                Author information
                http://orcid.org/0000-0002-3036-6818
                http://orcid.org/0009-0007-6237-7582
                http://orcid.org/0000-0003-0603-1791
                http://orcid.org/0009-0000-5787-7151
                http://orcid.org/0000-0002-5809-5394
                http://orcid.org/0000-0003-0018-851X
                Article
                cep-2024-00619
                10.3345/cep.2024.00619
                11725617
                39533733
                c72ec4bd-5075-45a0-94fc-60ffec21dc06
                Copyright © 2025 by The Korean Pediatric Society

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 7 April 2024
                : 22 July 2024
                : 22 July 2024
                Categories
                Original Article
                Neurology

                infant development,revised-korean developmental screening test,developmental delay

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